Recommendations

Oral Dosage Forms That Should Not Be Crushed

The List of Oral Dosage Forms That Should Not Be Crushedcommonly referred to as the "Do Not Crush" list, contains medications that should not be crushed because of their special pharmaceutical formulations or characteristics, such as oral dosage forms that are sustained-release in nature.

 

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Drug Product

Active Ingredient(s)

Dosage Form(s)

Reasons/Comments

Absorica

(ISOtretinoin)

Capsule

Mucous membrane irritant

Abstral

(fentaNYL)

Tablet

Note: Sublingual tablet; do not suck, chew, or swallow whole.

AcipHex

(rabeprazole)

Tablet

Slow-release

AcipHex Spinkle

(rabeprazole)

Capsule

Slow-release; Note: contents are intended to be sprinkled on food or liquid but should not be chewed or crushed.

Acticlate

(doxycycline hyclate)

Capsule; Tablet

Film-coated; tablet is scored and may be split; Note: 150 mg tablets can be broken into two-thirds or one-third to provide a 100 mg and 50 mg strength, respectively

Actiq

(fentaNYL)

Lozenge

Slow-release; Note: this lollipop delivery system requires the patient to slowly allow dissolution. If chewed and swallowed, may result in a lower peak concentration and bioavailability.

Actonel

(risedronate)

Tablet

Irritant; Note: chewed, crushed, or sucked tablets may cause oropharyngeal ulceration.

Actoplus Met Xr

(combination)

Tablet

Slow-release

Adalat CC

(NIFEdipine)

Tablet

Slow-release

Adderall XR

(amphetamine salts)

Capsule

Slow-release (a)

Adzenys XR-ODT

(amphetamine)

Tablet

Slow-release; Sublingual form (g)

Afeditab CR

(NIFEdipine)

Tablet

Slow-release

Afinitor

(everolimus)

Tablet

Mucous membrane irritant

Aggrenox

(combination)

Capsule

Slow-release

Alecensa

(alectinib)

Capsule

Antineoplastic

Alophen

(bisacodyl)

Tablet

Enteric-coated

Altoprev

(lovastatin)

Tablet

Slow-release

Alunbrig

(brigantinib)

Tablet

Antineoplastic

Ambien CR

(zolpidem)

Tablet

Slow-release

Amitiza

(lubiprostone)

Capsule

-

Amnesteem

(ISOtretinoin)

Capsule

Mucous membrane irritant

Ampyra

(dalfampridine)

Tablet

Slow-release; Note: formerly fampridine-SR

Amrix

(cyclobenzaprine)

Capsule

Slow-release (a)

Aplenzin

(buPROPion)

Tablet

Slow-release

Aptensio XR

(methylphenidate)

Capsule

Slow-release (a)

Aptivus

(tipranavir)

Capsule

Note: oil emulsion within spheres; taste

Aricept 23 mg

(donepezil)

Tablet

Note: crushing the 23 mg tablet may significantly increase the rate of absorption; the 5 mg and 10 mg tablets are not affected

Arthrotec

(combination)

Tablet

Enteric-coated

Arymo ER

(morphine)

Tablet

Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose.

Asacol HD

(mesalamine)

Tablet

Slow-release

Aspirin enteric-coated

(aspirin)

Caplet; Tablet

Slow-release; Enteric-coated

Astagraf XL

(tacrolimus)

Capsule

Slow-release

Atelvia

(risedronate)

Tablet

Slow-release; Note: chewed, cut, or crushed tablets may cause oropharyngeal irritation

Augmentin XR

(combination)

Tablet

Slow-release (b,h)

Austedo

(deutetrabenazine)

Tablet

-

Avodart

(dutasteride)

Capsule

Mucous membrane irritation; Note: drug may cause fetal abnormalities; women who are, or may become, pregnant, should not handle capsules; all women should use caution in handling capsules, especially leaking capsules

Azulfidine EN-Tabs

(sulfaSALAzine)

Tablet

Slow-release (b)

Bayer EC, Bayer Regular

(aspirin)

Caplet

Enteric-coated

Belbuca

(buprenorphine)

Film, buccal

Sublingual form (g); Note: chewing or swallowing may result in lower bioavailability.

Belviq XR

(lorcaserin hydrochloride)

Tablet

Slow-release

Biaxin-XL

(clarithromycin)

Tablet

Slow-release

Biltricide

(praziquantel)

Tablet

Taste (h)

Binosto

(alendronate)

Tablet

Effervescent tablet (f)

Bisac-Evac

(bisacodyl)

Tablet

Enteric-coated (c)

Bisacodyl

(combination)

Tablet

Enteric-coated (c)

Bisa-Lax

(combination)

Tablet

Enteric-coated (c)

Boniva

(ibandronate)

Tablet

Note: chewed, crushed, or sucked tablets may cause oropharyngeal irritation

Bonjesta

(combination)

Tablet

Slow-release

Bosulif

(bosutinib)

Tablet

Antineoplastic; Note: crushed or broken tablets should not be handled

Briviact

(brivaracetam)

Tablet

Film-coated (b)

Budeprion SR

(buPROPion)

Tablet

Slow-release

Bunavail

(combination)

Buccal film

Note: chewing or swallowing may result in lower peak concentrations and bioavailability

Butrans

(buprenorphine)

Film

Slow-release; Note: may expose to potentially fatal overdose

Cabometyx

(cabozantinib)

Tablet

Film-coated

Caprelsa

(vandetanib)

Tablet

Irritant

Carbaglu

(carglumic acid)

Tablet

Note: tablets should be dispersed completely in water

Carbatrol

(carBAMazepine)

Capsule

Slow-release (a)

Cardene SR

(niCARdipine)

Capsule

Slow-release

Cardizem

(dilTIAZem)

Tablet

Note: although not in the package insert, the drug has a coating that is intended to release the drug over approximately 3 hours

Cardizem CD

(dilTIAZem)

Capsule

Slow-release

Cardizem LA

(dilTIAZem)

Tablet

Slow-release

Cardura XL

(doxazosin)

Tablet

Slow-release

Cartia XT

(dilTIAZem)

Capsule

Slow-release

Cefaclor ER

------

Tablet

Slow-release (b)

Ceftin

(cefuroxime)

Tablet

Taste (b) (Note: use suspension for children)

CellCept

(mycophenolate)

Capsule; Tablet

Teratogenic potential (i)

Cerdelga

(eliglustat)

Capsule

Preferably taken with water

Cholbam

(cholic acid)

Capsule

Note: capsules may be opened and the contents mixed with food/drink

Cipro XR

(ciprofloxacin)

Tablet

Slow-release (b)

Claravis

(ISOtretinoin)

Capsulte

Mucous membrane irritant

Colace

(docusate)

Capsule

Taste (e)

Colestid

(colestipol)

Tablet

Slow-release

Cometriq

(cabozantinib)

Capsule

Antineoplastic

Concerta

(methylphenidate)

Tablet

Slow-release

Contrave

(combination)

Tablet

Slow-release

Conzip

(traMADol)

Capsule

Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose.

Coreg CR

(carvedilol)

Capsule

Slow-release (a) (Note: may add contents of capsule to chilled, not warm, applesauce and consume immediately)

Cotempla XR-ODT

(methylphenidate)

Tablet

Slow-release; oral disintegrating tablet designed to disintegrate on the tongue.

Creon 5, 10, 20

(pancrelipase)

Capsule

Slow-release (a)

Cresemba

(isavuconazium)

Capsule

-

Crixivan

(indinavir)

Capsule

Taste; Note: capsule may be opened and mixed with fruit puree (e.g., banana)

Cymbalta

(DULoxetine)

Capsule

Slow-release

Cytoxan

(cyclophosphamide)

Tablet

Note: drug may be crushed but company recommends using injection

Delzicol

(mesalamine)

Capsule

Slow-release (a)

Depakene

(valproic acid)

Capsule

Slow-release; mucus membrane irritant (b)

Depakote, Depakote ER

(divalproex)

Tablet

Slow-release

Detrol LA

(tolterodine)

Capsule

Slow-release

Dexilant

(dexlansoprazole)

Capsule

Slow-release (a)

Dexilant Solutab

(dexlansoprazole)

Tablet

Tablets are designed to disintegrate on the tongue; may also be swallowed with water

Diclegis

(combination)

Tablet

Slow-release

Dilatrate-SR

(isosorbide dinitrate)

Capsule

Slow-release

Diltia XT

(dilTIAZem)

Capsule

Slow-release

Ditropan XL

(oxybutynin)

Tablet

Slow-release

Doryx, Doryx MPC

(doxycycline hyclate)

Tablet

Slow-release

Drisdol

(ergocalciferol)

Capsule

Liquid filled (d)

Droxia

(hydroxyurea)

Capsule

Note: exposure to the powder may cause serious skin toxicities; health care workers should wear gloves to administer

Duavee

(combination)

Tablet

Antineoplastic

Duexis

(combination)

Tablet

-

Dulcolax

(bisacodyl)

Capsule; Tablet

Enteric-coated (c); Liquid-filled

Durlaza

(aspirin)

Capsule

Slow-release

Easprin

(aspirin)

Tablet

Enteric-coated

EC-Naprosyn

(naproxen)

Tablet

Enteric-coated (b)

Ecotrin Adult Low Strength

(aspirin)

Tablet

Enteric-coated

Ecotrin Maximum Strength

(aspirin)

Tablet

Enteric-coated

Ecotrin Regular Strength

(aspirin)

Tablet

Enteric-coated

Edluar

(zolpidem)

Tablet

Sublingual form (g)

Effer-K

(potassium bicarbonate)

Tablet

Effervescent tablet (f)

Effervescent Potassium

------

Tablet

Effervescent tablet (f)

Effexor XR

(venlafaxine)

Capsule

Slow-release (a)

Embeda

(combination)

Capsule

Slow-release (a); Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose

Enablex

(darifenacin)

Tablet

Slow-release

Entocort EC

(budesonide)

Capsule

Enteric-coated (a)

Envarsus XR

(tacrolimus)

Tablet

Slow-release

Epanova

(omega-3-carboxylic acids)

Capsule

Note: contents of capsule may be erosive

Equetro

(carBAMazepine)

Capsule

Slow-release (a)

Ergomar

(ergotamine)

Tablet

Sublingual form (g)

Erivedge

(vismodegib)

Capsule

Note: package insert indicates potential teratogenic effects; material safety data sheet warns against skin contact; health care workers should take appropriate precautions

Ery-Tab

(erythromycin)

Tablet

Enteric-coated

Eryc

(erythromycin)

Capsule

Enteric-coated pellets (a)

Erythromycin Base

-----

Tablet

Enteric-coated

Erythromycin Stearate

------

Tablet

Enteric-coated

Erythromycin ethylsuccinate

------

Tablet

Taste (b)

Evista

(raloxifene)

Tablet

Taste; teratogenic potential (i)

Exalgo

(HYDROmorphone)

Tablet

Slow-release (Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose)

Exjade

(deferasirox)

Tablet

Note: do not give as whole tablet, tablets are meant to be given as oral suspension; see company insert

Farydak

(panobinostat)

Capsule

Irritant

Feldene

(piroxicam)

Capsule

Mucous membrane irritant

Felodipine

------

Tablet

Slow-release

Fentora

(fentaNYL)

Tablet

Note: buccal tablet; do not swallow whole

Fetzima

(levomilnacipran)

Capsule

Slow-release

Fibricor

(fenofibric acid)

Tablet

------

Flagyl ER

(metroNIDAZOLE)

Tablet

Slow-release

Fleet Laxative

(bisacodyl)

Tablet

Enteric-coated (c)

Flomax

(tamsulosin)

Capsule

Slow-release

FluvoxaMINE ER

------

Capsule

Slow-release

Focalin XR

(dexmethylphenidate)

Capsule

Slow-release (a)

Forfivo XL

(buPROPion)

Tablet

Slow-release

Fortamet

(metFORMIN)

Tablet

Slow-release

Fosamax

(alendronate)

Tablet

Mucous membrane irritant

Fosamax Plus D

(combination)

Tablet

Mucous membrane irritant

Fulyzaq

(crofelemer)

Tablet

Slow-release

Gleevec

(imatinib)

Tablet

Mucous membrane irritant; Note: may be dissolved in water or apple juice

Glucophage XR

(metFORMIN)

Tablet

Slow-release

Glucotrol XL

(glipiZIDE)

Tablet

Slow-release

Glumetza

(metFORMIN)

Tablet

Slow-release

Gralise

(gabapentin)

Tablet

Slow-release (b)

Guaifed, Guaifed-PD

(combination)

Capsule

Slow-release

Guaifenex DM

(combination)

Tablet

Slow-release (h)

Guaifenex GP

(combination)

Tablet

Slow-release

Guaifenex PSE

(combination)

Tablet

Slow-release (h)

GuaifFENesin/Pseudoephedrine

------

Tablet

Slow-release

GuaiMAX-D

(combination)

Tablet

Slow-release

Halfprin 81

(aspirin)

Tablet

Enteric-coated

Hetlioz

(tasimelteon)

Capsule

Note: not scored; no studies available from company

Horizant

(gabapentin)

Tablet

Slow-release (b)

Hydrea

(hydroxyurea)

Capsule

Note: exposure to the powder may cause serious skin toxicities; health care workers should wear gloves to administer

Hysingla ER

(HYDROcodone)

Tablet

Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose

Ibrance

(palbociclib)

Capsule

Antineoplastic

Iclusig

(PONATinib)

Tablet

Antineoplastic

Idhifa

(enasidenib)

Tablet

Antineoplastic

Imbruvica

(ibrutinib)

Capsule

Antineoplastic; Note: not scored; no studies available from company

Imdur

(isosorbide mononitrate)

Tablet

Slow-release (h); Note: 30mg tablet may not be split

Impavido

(miltefosine)

Capsule

Note: not scored; no studies available from company

Inderal LA

(propranolol)

Capsule

Slow-release

Indocin SR

(indomethacin)

Capsule

Slow-release (a,b)

Inlyta

(axitinib)

Tablet

Antineoplastic

InnoPran XL

(propranolol)

Capsule

Slow-release

Intelence

(etravirine)

Tablet

Note: tablet should be swallowed whole and not crushed; tablet may be dispersed in water

Intermezzo

(zolpidem)

Tablet

Sublingual form (g)

Intuniv

(guanFACINE)

Tablet

Slow-release

Invega

(paliperidone)

Tablet

Slow-release

Invokamet XR

(combination)

Tablet

Slow-release

Iressa

(gefitinib)

Tablet

Note: tablet may be dissolved in 4-8 ounces of water

Isradipine

------

Tablet

Slow-release

Isosorbide SR

(isosorbide mononitrate)

Tablet

Slow-release

Jakafi

(ruxolitinib)

Tablet

Note: see prescribing information for making a suspension

Jalyn

(combination)

Capsule

Mucous membrane irritant; Note: women who are, or may become, pregnant, should not handle crushed or broken tablets (l)

Janumet, Janumet XR

(combination)

Tablet

Slow-release

Jentadueto XR

(combination)

Tablet

Slow-release

Juxtapid

(lomitapide)

Capsule

------

Kadian

(morphine)

Capsule

Slow-release (a) (Note: do not give via NG tubes; crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose)

Kaletra

(combination)

Tablet

Film-coated (b)

Kapvay

(cloNIDine)

Tablet

Slow-release

Kazano

(combination)

Tablet

Note: not scored; no studies available from company

K-Dur

(potassium chloride)

Tablet

Slow-release (b)

Keppra

(levETIRAcetam)

Tablet

Taste (b) (Note: some extemporaneous formulas are pharmacy prepared)

Keppra XR

(levETIRAcetam)

Tablet

Slow-release (b)

Khedezla

(desvenlafaxine)

Tablet

Slow-release

Kisqali

(ribociclib succinate)

Tablet

Antineoplastic

Kisqali Femara Co-Pack

(combination)

Tablet

Antineoplastic

Klor-Con

(potassium chloride)

Tablet

Slow-release (b)

Klor-Con M

(potassium chloride)

Tablet

Slow-release (b,h)

K-Lyte, K-Lyte CL, K-Lyte DS

(potassium)

Tablet

Effervescent tablet (f)

Kombiglyze XR

(combination)

Tablet

Slow-release (Note: tablet matrix may remain in stool)

Korlym

(mifepristone)

Tablet

------

K-Tab

(potassium chloride)

Tablet

Slow-release (b)

LaMICtal XR

(lamoTRIgine)

Tablet

Slow-release

Lenvima

(lenvatinib)

Capsule

Note: may be dissolved in a small glass of liquid

Lescol XL

(fluvastatin)

Tablet

Slow-release

Letairis

(ambrisentan)

Tablet

------

Levbid

(hyoscyamine)

Tablet

Slow-release (h)

Levsinex Timecaps

(hyoscyamine)

Capsule

Slow-release

Lialda

(mesalamine)

Tablet

Slow-release

Linzess

(linaclotide)

Capsule

(a)

Lithobid

(lithium)

Tablet

Slow-release

Lovaza

(combination)

Capsule

Note: contents of capsule may be erosive

Lynparza

(olaparib)

Capsule

Antineoplastic

Maxifed DM, Maxifed DMX

(combination)

Tablet

Slow-release (h)

Maxiphen DM

(combination)

Tablet

Slow-release (h)

Medent-DM

(combination)

Tablet

Slow-release

Mestinon ER

(pyridostigmine)

Tablet

Slow-release (b)

Metadate CD

(methylphenidate)

Capsule

Slow-release (a)

Metadate ER

(methylphenidate)

Tablet

Slow-release

Methylin ER

(methylphenidate)

Tablet

Slow-release

Metoprolol ER

------

Tablet

Slow-release

Micro K Extencaps

(potassium chloride)

Capsule

Slow-release (a,b)

Minocin

(minocycline)

Capsule

Mucous membrane irritant

Minolira

(minocycline)

Tablet

Slow-release (h)

Miraplex ER

(pramipexole)

Tablet

Slow-release

Miraphen PSE

(combination)

Tablet

Slow-release

Morphabond

(morphine)

Tablet

Slow-release (b); Note: crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose

Motrin

(ibuprofen)

Tablet

Taste (b,e)

Moxatag

(amoxicillin)

Tablet

Slow-release (h)

MS Contin

(morphine)

Tablet

Slow-release (b); Note: crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose

Mucinex

(guaiFENesin)

Tablet

Slow-release

Mucinex DM

(combination)

Tablet

Slow-release

Mydayis

(combination)

Capsule

Slow-release (a)

Myfortic

(mycophenolic acid)

Tablet

Slow-release; Enteric-coated

Myrbetriq

(mirabegron)

Tablet

Slow-release

Myorisan

(ISOtretinoin)

Capsule

Mucous membrane irritant

Namenda XR

(memantine)

Capsule

Slow-release (a,b)

Namzaric

(combination)

Capsule

Slow-release (a)

Naprelan

(naproxen)

Tablet

Slow-release

Nerlynx

(neratinib maleate)

Tablet

Antineoplastic

Neurontin

(gabapentin)

Capsule; Tablet

(b,h)

NexIUM

(esomeprazole)

Capsule

Slow-release (a)

Niaspan

(niacin)

Tablet

Slow-release

Nifediac CC

(NIFEdipine)

Tablet

Slow-release

Nifedical XL

(NIFEdipine)

Tablet

Slow-release

Ninlaro

(ixazomib)

Capsule

Antineoplastic

Nitrostat

(nitroglycerin)

Tablet

Sublingual form (g)

Norflex ER

(orphenadrine)

Tablet

Slow-release

Norpace CR

(disopyramide)

Capsule

Slow-release form within a special capsule

Northera

(droxidopa)

Capsule

Note: no studies available from company

Norvir

(ritonavir)

Capsule; Tablet

Note: crushing tablets has resulted in decreased bioavailability of drug (b)

Noxafil

(posaconazole)

Tablet

Slow-release (b)

Nucynta ER

(tapentadole)

Tablet

Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose

OFEV

(nintedanib)

Capsule

Taste

Olysio

(simeprevir)

Capsule

------

Omtryg

(omega-3-acid ethyl esters A)

Capsule

Note: contents of capsule may be erosive

Opana ER

(oxyMORphone)

Tablet

Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose

Opsumit

(macitentan)

Tablet

------

Oravig

(miconazole)

Tablet, buccal

Buccal form

Orenitram

(treprostinil)

Tablet

Slow-release

Oseni

(combination)

Tablet

------

Otezla

(apremilast)

Tablet

Film-coated

Oxaydo

(oxyCODONE)

Tablet

Note: not amenable to crushing; may obstruct feeding tubes (b)

Oxtellar XR

(OXcarbazepine)

Tablet

Slow-release

OxyCONTIN

(oxyCODONE)

Tablet

Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose

Pancreaze

(pancrelipase)

Capsule

Slow-release; Enteric-coated (a)

Paxil 

(PARoxetine)

Tablet

Film-coated (b)

Paxil CR

(PARoxetine)

Tablet

Slow-release

PCE

(erythromycin)

Tablet

Enteric-coated (b)

Pentasa

(mesalamine)

Capsule

Slow-release (a)

Pertyze

(pancrelipase)

Capsule

Slow-release (a)

Pexeva

(PARoxetine)

Tablet

Film-coated (b)

Pomalyst

(pomalidomide)

Capsule

Antineoplastic

Potiga

(ezogabine)

Tablet

------

Pradaxa

(dabigatran)

Capsule

Note: breaking, chewing, or emptying contents of the capsule can result in increased exposure

Prevacid

(lansoprazole)

Capsule

Slow-release (a)

Prevacid SoluTab

(lansoprazole)

Tablet

Note: see package insert for administration instructions via an oral syringe of NG tube

Prevpac

(combination)

Capsule; Tablet

Slow-release

PriLOSEC

(omeprazole)

Capsule

Slow-release (a,b)

Pristiq

(desvenlafaxine)

Tablet

Slow-release

Procardia 

(NIFEdipine)

Capsule

Note: pharmacokinetics may be altered if not taken whole

Procardia XL

(NIFEdipine)

Tablet

Slow-release

Procysbi

(cysteamine)

Capsule

Slow-release (a)

Propecia

(finasteride)

Tablet

Note: women who are, or may become, pregnant, should not handle crushed or broken tablets

Proscar

(finasteride)

Tablet

Note: women who are, or may become, pregnant, should not handle crushed or broken tablets

Protonix

(pantoprazole)

Tablet

Slow-release (b)

PROzac Weekly

(FLUoxetine)

Tablet

Enteric-coated

Pylera

(combination)

Capsule

Mucous membrane irritant

Qtern

(combination)

Tablet

------

Qudexy XR

(topiramate)

Capsule

Slow-release (a)

Ranexa

(ranolazine)

Tablet

Slow-release

Rapamune

(sirolimus)

Tablet

Note: pharmacokinetic parameters may be affected (b)

Rayaldee

(calcifediol)

Capsule

Slow-release

Rayos

(predniSONE)

Tablet

Slow-release; Note: delayed release is dependent on an intact coating (b)

Razadyne ER

(galantamine)

Capsule

Slow-release

Requip XL

(rOPINIRole)

Tablet

Slow-release

Revlimid

(lenalidomide)

Capsule

Note: Teratogenic potential; health care workers should avoid contact with capsule contents/body fluids

Reyataz

(atazanavir)

Capsule

Note: an oral powder is available, see prescribing information for administration instructions

Ritalin LA

(methylphenidate)

Capsule

Slow-release (a)

Ritalin SR

(methylphenidate)

Tablet

Slow-release

Roweepra

(levETIRAcetam)

Tablet

Taste (b)

Roweepra ER

(levETIRAcetam)

Tablet

Slow-release (b)

Rydapt

(midostaurin)

Capsule

Antineoplastic

Rytary

(combination)

Capsule

Slow-release (a)

Rythmol SR

(propafenone)

Capsule

Slow-release

Sensipar

(cinacalcet)

Tablet

Note: tablets are not scored and cutting may cause variable dosage accuracy

SEROquel XR

(QUEtiapine)

Tablet

Slow-release

Sinemet CR

(levodopa/carbidopa)

Tablet

Slow-release (h)

SINUvent PE

(combination)

Tablet

Slow-release (h)

Sirturo

(bedaquiline)

Tablet

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Sitavig

(acyclovir)

Tablet

Buccal form

Solodyn

(minocycline)

Tablet

Slow-release

Somnote

(chloral hydrate)

Capsule

Liquid filled

Sprycel

(dasatinib)

Tablet

Film-coated (Note: active ingredients are surrounded by wax matrix to prevent healthcare exposure; women who are, or may become, pregnant should not handle crushed or broken tablet)

Stalevo

(combination)

Tablet

Note: combining multiple tablets or portions of tablets may lead to an overdose of entacapone

Staxyn

(verdenafil)

Tablet

Sublingual form (g)

Stivarga

(regorafenib)

Tablet

Antineoplastic

Strattera

(atomoxetine)

Capsule

Note: capsule contents can cause ocular irritation

Suboxone

(combination)

Film, buccal

Sublingual form (g)

Sular

(nisoldipine)

Tablet

Slow-release

Symax Duotab, Symax SR

(hyoscyamine)

Tablet

Slow-release

Synjardy XR

(combination)

Tablet

Slow-release

Tafinlar

(dabrafenib)

Capsule

Antineoplastic

Tagrisso

(osimertinib)

Tablet

Note: tablet may be dissolved in 2 ounces of water

Targiniq ER

(combination)

Tablet

Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose of oxyCODONE

Tasigna

(nilotinib)

Capsule

Note: disruption of capsule may yield high blood levels causing enhanced toxicity (a)

Taztia XT

(dilTIAZem)

Capsule

Slow-release (a)

Tecfidera

(dimethyl fumarate)

Capsule

Slow-release

Tegretol-XR

(carBAMazepine)

Tablet

Slow-release

Temodar

(temozolomide)

Capsule

Mucous membrane irritant; Note: accidentally opened or damaged capsules require rigorous precautions to avoid inhalation or contact with the skin or mucous membranes (i)

Tessalon Perles

(benzonatate)

Capsule

Note: swallow whole; local anesthesia of the oral mucosa; choking could occur

Theo-24

(theophylline)

Capsule

Slow-release; Note: contains beads that dissolve throughout the GI tract

Theochron

(theophylline)

Tablet

Slow-release

Tiazac

(dilTIAZem)

Capsule

Slow-release (a)

Topamax

(topiramate)

Capsule; Tablet

Taste; Taste (a)

Topamax Sprinkle

(topiramate)

Capsule

Taste (a)

Toprol XL

(metoprolol succinate)

Tablet

Slow-release (h)

Touro CC-LD

(combination)

Tablet

Slow-release (h)

Touro LA-LD

(combination)

Tablet

Slow-release (h)

Toviaz

(fesoterodine)

Tablet

Slow-release

Tracleer

(bosentan)

Tablet

Note: women who are, or may become, pregnant, should not handle crushed or broken tablets

Trental

(pentoxifylline)

Tablet

Slow-release

Treximet

(combination)

Tablet

Note: unique drug matrix enhances rapid drug absorption

Trilipix

(fenofibric acid)

Capsule

Slow-release

Trokendi XR

(topiramate)

Capsule

Slow-release

Troxyca ER

(combination)

Tablet

Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose

Trulance

(plecanatide)

Tablet

Note: see package insert for instructions on crushing administration

Uceris

(budesonide)

Tablet

Slow-release; Note: film coating is designed to break down at or above pH of 7.0

Ultresa

(pancrelipase)

Capsule

Slow-release (a)

Uniphyl

(theophylline)

Tablet

Slow-release (h)

Uptravi

(selexipag)

Tablet

Film-coated

Urocit-K

(potassium citrate)

Tablet

Slow-release; Wax-coated; prevents upper GI release

Uroxatral

(alfuzosin)

Tablet

Slow-release

Valcyte

(valGANCiclovir)

Tablet

Teratogenic and irritant potential (b, i)

Vantrela ER

(HYDROcodone)

Tablet

Slow-release

Vascepa

(icosapent ethyl)

Capsule

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Venclexta

(venetoclax)

Tablet

Film-coated, Antineoplastic

Verelan, Verelan PM

(verapamil)

Capsule

Slow-release (a)

VESIcare

(solifenacin)

Tablet

Taste

Videx EC

(didanosine)

Capsule

Slow-release; Enteric-coated

Viekira XR

(combination)

Tablet

Slow-release

Vimovo

(combination)

Tablet

Slow-release

Viokace

(pancrelipase)

Tablet

Mucous membrane irritant

Viramune XR

(nevirapine)

Tablet

Slow-release (b)

Voltaren XR

(diclofenac)

Tablet

Slow-release

VoSpire ER

(albuterol)

Tablet

Slow-release

Votrient

(PAZOPanib)

Tablet

Note: crushing significantly increases the AUC and Tmax

Wellbutrin

(buPROPion)

Tablet

------

Wellbutrin SR, Wellbutrin XL

(buPROPion)

Tablet

Slow-release

Xalkori

(crizotinib)

Capsule

Antineoplastic

Xanax XR

(ALPRAZolam)

Tablet

Slow-release (b)

Xartemis XR

(combination)

Tablet

Slow-release (Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose)

Xeljanz XR

(tofacitinib)

Tablet

Slow-release

Ximino

(minocycline)

Capsule

Slow-release

Xigduo XR

(combination)

Tablet

Slow-release

Xtampza ER

(oxyCODONE)

Capsule

Slow-release (a, b)

Xtandi

(enzalutamide)

Capsule

Antineoplastic

Yosprala

(combination)

Tablet

Slow-release

Zegerid

(combination)

Capsule

Slow-release (b)

Zejula

(niraparib tosylate)

Capsule

Antineoplastic

Zelboraf

(vemurafenib)

Tablet

Antineoplastic

Zenatane

(ISOtretinoin)

Capsule

Mucous membrane irritant

Zenpep

(pancrelipase)

Capsule

Slow-release (a)

Zohydro ER

(HYDROcodone)

Capsule

Slow-release; Note: crushing, chewing, or dissolving capsules can cause rapid release and absorption of a potentially fatal dose

Zolinza

(vorinostat)

Capsule

Note: irritant; avoid contact with skin or mucous membranes; avoid contact with crushed or broken tablets

Zortress

(everolimus)

Tablet

Note: crushed powder may cause mucous membrane irritation

Zubsolv

(combination)

Tablet

Sublingual form (g)

Zuplenz

(ondansetron)

Film, oral

Sublingual form (g)

Zyban

(buPROPion)

Tablet

Slow-release

Zydelig

(idelalisib)

Tablet

Antineoplastic; Note: not scored; film-coated

Zylinga

(abiraterone)

Tablet

Antineoplastic

Zyflo CR

(zileuton)

Tablet

Slow-release

a: Capsule may be opened and the contents taken without chewing or crushing; soft food such as applesauce  or pudding may facilitate administration; contents may generally be administered via NG tube using an appropriate fluid provided entire contents are washed down the tube.

b: Liquid dosage forms of the product are available; however, dose, frequency of administration, and manufacturers may differ from that of the solid dosage form.

c: Antacids and/or milk may prematurely dissolve the coating of the tablet.

d: Capsule may be opened and the liquid contents removed for administration.

e: The taste of this product in a liquid form would likely be unacceptable to the patient; administration via NG tube should be acceptable.

f: Effervescent tablets must be dissolved in the amount of diluent recommended by the manufacturer.

g: Tablets are made to disintegrate under the tongue.

h: Tablet is scored and may be broken in half without affecting release characteristics.

i: Skin contact may enhance tumor production; avoid direct contact.

More Recommendations

This list includes look-alike and sound-alike name pairs. Use this list to determine which medications require special safeguards to reduce the risk of errors and minimize harm.