Meds That Should Not Be Crushed (2024)

Acamprosate

Campral

Tablet

  • Modified-release

Acetaminophen

Tylenol Arthritis Pain

Extended-Release (US)

Tablet

  • Modified-release

Albuterol

VoSpire ER (US)

Tablet

  • Modified-release

Alendronate

Fosamax

Tablet

  • Irritant (oropharyngeal)

Alfuzosin

Uroxatral (US),
Xatral (Canada)

Tablet

  • Modified-release

Alprazolam

Xanax XR (US)

Tablet

  • Modified-release

Ambrisentan

Letairis (US),

Volibris (Canada)

Tablet

  • Teratogenic

Amoxicillin/Clavulanate

Augmentin XR (US)

Tablet

  • Modified-release
  • Scored tablets can be split

Apremilast

Otezla (US)

Tablet

  • Antineoplastic

Aprepitant

Emend (US)

Capsule

  • Nanocrystal

Aspirin

Ecotrin

Tablet

  • Modified-release
  • Irritant (gastric)

Aspirin/Dipyridamole

Aggrenox

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Atomoxetine

Strattera

Capsule

  • Irritant (ocular)

Axitinib

Inlyta

Tablet

  • Antineoplastic

Belladonna Alkaloids

Donnatal Extentabs (US)

Tablet

  • Modified-release

Benzonatate

Tessalon Perles (US)

Capsule

  • Local anesthetic effect could increase the risk of choking

Bisacodyl

Dulcolax

Capsule

Tablet

  • Modified-release
  • Irritant (gastric)

Bosutinib

Bosulif

Tablet

  • Antineoplastic

Budesonide

Entocort EC (US),

Entocort (Canada)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Budesonide

Uceris (US)

Tablet

  • Modified-release

Buprenorphine

Belbuca(US)

Film

  • Sublingual dosage form

Bupropion

Aplenzin (US),

Budeprion SR (US), Wellbutrin SR, XL,

Zyban

Tablet

  • Modified-release

Cabozantinib

Cabometyx, Cometriq (US)

Capsule, Tablet

  • Antineoplastic

Carbamazepine

Carbatrol (US),

Equetro (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Carbamazepine

Tegretol XR (US),

Tegretol CR (Canada)

Tablet

  • Modified-release

Carvedilol

Coreg CR (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Cefuroxime

Ceftin

Tablet

  • Bad taste

Chlorpheniramine Maleate

Chlor-Trimeton Allergy

12 Hour (US)

Tablet

  • Modified-release

Ciprofloxacin

Cipro

Tablet

  • Bad taste

Ciprofloxacin

Cipro XR (US),

Cipro XL (Canada)

Tablet

  • Modified-release

Clarithromycin

Biaxin XL

Tablet

  • Modified-release

Clonidine

Kapvay (US)

Tablet

  • Modified-release

Colestipol

Colestid

Tablet

  • Modified-release

Cyclobenzaprine

Amrix (US)

Capsule

  • Modified-release

Cyclophosphamide

generics

Capsule

Tablet

  • Antineoplastic

Dabigatran

Pradaxa

Capsule

  • Intact product must be taken to avoid increased exposure

Dalfampridine

Ampyra (US)

Tablet

  • Modified-release

Darifenacin

Enablex

Tablet

  • Modified-release

Dasatinib

Sprycel

Tablet

  • Antineoplastic
  • Teratogenic

Deferasirox

Exjade

Tablet

  • Tablet is for oral suspension

Desvenlafaxine

Pristiq

Tablet

  • Modified-release

Dexlansoprazole

Dexilant

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Dexmethylphenidate

Focalin XR (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Dextroamphetamine

Dexedrine

Capsule

  • Modified-release

Dextroamphetamine/

Amphetamine

Adderall XR

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Diclofenac

Voltaren XR (US),

Voltaren SR (Canada)

Tablet

  • Modified-release

Diclofenac/Misoprostol

Arthrotec

Tablet

  • Modified-release
  • Irritant (gastric)
  • Teratogenic

Didanosine

Videx EC

Capsule

  • Modified-release

Diflunisal

Generics

Tablet

  • Irritant (gastric)

Diltiazem

Cardizem CD,

Cartia XT (US),

Dilacor XR (US),

Dilt-XR (US),

Taztia XT (US),

Tiazac

Capsule

  • Modified-release
  • Can be opened for administration of intact granules (Taztia XT and Tiazac)

Diltiazem

Cardizem

Cardizem LA (US),

Tiazac XC (Canada)

Tablet

  • Modified-release

Dimethyl Fumarate

Tecfidera

Capsule

  • Modified-release

Disopyramide

Norpace CR (US)

Capsule

  • Modified-release

Divalproex

Depakote Sprinkle (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Divalproex

Depakote (US),

Depakote ER (US),

Epival ECT (Canada)

Tablet

  • Modified-release

Docusate Sodium

Colace

Capsule

  • Bad taste

Donepezil

Aricept

(23 mg strength only)

Tablet

  • Intact product must be taken to avoid increased rate of absorption

Doxazosin

Cardura XL (US)

Tablet

  • Modified-release

Doxycycline

Doryx (US),

Apprilon (Canada)

Capsule, Tablet

  • Modified-release
  • Scored tablets can be split

Duloxetine

Cymbalta

Capsule

  • Modified-release

Dutasteride

Avodart,

Jalyn

Capsule

  • Teratogenic
  • Irritant (mucous membrane)

Elbasvir/Grazoprevir

Zepatier (US)

Tablet

  • Amorphous solid dispersion

Elexacaftor/Tezacaftor/

Ivacaftor

Trikafta

Tablet

  • Amorphous solid dispersion

Enzalutamide

Xtandi

Capsule

  • Antineoplastic

Ergotamine

Ergomar (US)

Tablet

  • For sublingual administration

Erythromycin

Erythromycin

delayed-release

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Erythromycin

E.E.S.

Tablet

  • Bad taste

Erythromycin

Ery-Tab (US),

PCE

Tablet

  • Modified-release

Esomeprazole

Nexium

Capsule (US),

Tablet (Canada)

  • Modified-release
  • Capsule can be opened for administration of intact granules

Eszopiclone

Lunesta (US)

Tablet

  • Bad taste

Etravirine

Intelence

Tablet

  • Amorphous solid dispersion
  • Tablet may be dispersed in water
  • Scored tablets can be split

Everolimus

Afinitor

Zortress (US)

Tablet

  • Amorphous solid dispersion
  • Irritant (mucous membrane)
  • Teratogenic

Felodipine

Plendil

Tablet

  • Modified-release

Fenofibrate

TriCor (US)

Tablet

  • Nanocrystal

Fentanyl

Abstral

Tablet

  • Sublingual dosage form

Fentanyl

Actiq (US)

Lozenge

  • Lozenge should be sucked, not chewed

Fentanyl

Fentora

Tablet

  • Buccal dosage form

Ferrous Gluconate

Fergon (US)

Tablet

  • Modified-release
  • Irritant (gastric)

Ferrous Sulfate

Feosol (US),

Feratab (US)

Tablet

  • Modified-release
  • Irritant (gastric)

Fesoterodine

Toviaz

Tablet

  • Modified-release

Fexofenadine/

Pseudoephedrine

Allegra-D

Tablet

  • Modified-release

Finasteride

Propecia,

Proscar

Tablet

  • Teratogenic

Fluoxetine

Prozac Weekly (US)

Capsule

  • Modified-release

Fluvastatin

Lescol,

Lescol XL

Capsule, Tablet

  • Modified-release (Lescol XL)

Fluvoxamine

Luvox CR (US)

Capsule

  • Modified-release

Gabapentin

Gralise (US),

Horizant (US)

Tablet

  • Modified-release

Galantamine

Razadyne ER (US),

Reminyl ER (Canada)

Capsule

  • Modified-release

Glecaprevir/Pibrentasvir

Mavyret (US)

Tablet

  • Amorphous solid dispersion

Glipizide

Glucotrol XL (US)

Tablet

  • Modified-release

Guaifenesin

Mucinex (US)

Tablet

  • Modified-release

Guaifenesin/

Dextromethorphan

Mucinex DM (US)

Tablet

  • Modified-release

Guaifenesin/

Pseudoephedrine

Mucinex D (US)

Tablet

  • Modified-release
  • Scored tablets can be split

Guanfacine

Intuniv (US),

Intuniv XR (Canada)

Tablet

  • Modified-release

Hydromorphone

Exalgo (US),

Jurnista (Canada)

Tablet

  • Modified-release

Hydroxyurea

Droxia (US),

Hydrea

Capsule

  • Irritant (cytotoxic)

Hyoscyamine

Levbid (US)

Capsule

Tablet

  • Modified-release
  • Scored tablets can be split

Ibandronate

Boniva (US)

Tablet

  • Irritant (oropharyngeal)

Ibuprofen

Advil,

Motrin

Tablet

  • Bad taste

Imatinib

Gleevec

Tablet

  • Antineoplastic
  • Irritant (mucous membrane)
  • Scored tablets can be split

Indinavir

Crixivan

Capsule

  • Bad taste
  • Can be opened for administration of intact granules

Indomethacin

Indocin SR (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Isavuconazonium Sulfate

Cresemba

Capsule

  • High risk of instability or reduced absorption

Isosorbide Dinitrate

Dilatrate-SR (US)

Capsule

  • Modified-release

Isosorbide Dinitrate

Isordil Sublingual (US)

Tablet

  • Sublingual dosage form

Isosorbide Mononitrate

Imdur

Tablet

  • Modified-release
  • Scored tablets can be split

Isotretinoin

Absorica (US),

Accutane (Canada),

Amnesteem (US),

Clarus (Canada),

Epuris (Canada)

Capsule

  • Irritant (esophageal)
  • Teratogenic

Itraconazole

Sporanox

Capsule

  • Amorphous solid dispersion

Ivacaftor

Kalydeco

Tablet

  • Amorphous solid dispersion

Ivosidenib

Tibsovo (US)

Tablet

  • Amorphous solid dispersion

Lamotrigine

Lamictal XR (US)

Tablet

  • Modified-release

Lansoprazole

Prevacid

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Lansoprazole

Prevacid SoluTab (US),

Prevacid FasTab (Canada)

Tablet

  • Should be dissolved in the mouth, not chewed

Lenalidomide

Revlimid

Capsule

  • Teratogenic

Levetiracetam

Keppra

Tablet

  • Bad taste

Levetiracetam

Keppra XR (US)

Tablet

  • Modified-release

Levodopa/Carbidopa

Sinemet CR

Tablet

  • Modified-release
  • Scored tablets can be split

Levomilnacipran

Fetzima

Capsule

  • Modified-release

Lithium Carbonate

Lithobid (US),

Lithmax (Canada)

Tablet

  • Modified-release

Lopinavir/Ritonavir

Kaletra

Tablet

  • Amorphous solid dispersion
  • Reduced bioavailability with crushing8

Loratadine/

Pseudoephedrine

Claritin-D (US),

Claritin Allergy and Sinus (Canada)

Tablet

  • Modified-release

Lovastatin

Altoprev (US)

Tablet

  • Modified-release

Lubiprostone

Amitiza (US)

Capsule

  • Stability is compromised

Lumacaftor/Ivacaftor

Orkambi

Tablet

  • Amorphous solid dispersion

Memantine

Namenda XR

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Mesalamine

Asacol,

Lialda (US)

Pentasa

Capsule (US),

Tablet (Canada)

  • Modified-release
  • Capsules can be opened for administration of intact granules (Delzicol, Pentasa [US])

Mesalamine

Asacol,

Lialda (US)

Tablet

  • Modified-release

Metformin

Fortamet (US),

Glucophage XR (US), Glumetza

Tablet

  • Modified-release

Methylphenidate

Metadate CD (US),

Ritalin LA (US),

Biphentin (Canada)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Methylphenidate

Concerta,

Metadate ER (US), Methylin ER (US),

Ritalin SR

Tablet

  • Modified-release

Metoprolol Succinate

Toprol-XL (US)

Tablet

  • Modified-release
  • Scored tablets can be split

Metoprolol Tartrate

Lopressor SR (Canada)

Tablet

  • Modified-release

Metronidazole

Flagyl ER (US)

Tablet

  • Modified-release

Minocycline

Solodyn (US)

Tablet

  • Modified-release

Mirabegron

Myrbetriq

Tablet

  • Modified-release

Morphine Sulfate

Kadian

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Morphine Sulfate

MS Contin

Tablet

  • Modified-release

Mycophenolate

CellCept

Capsule, Tablet

  • Teratogenic

Mycophenolic Acid

Myfortic

Tablet

  • Modified-release
  • Teratogenic

Naproxen

EC Naprosyn (US), Naprelan

Tablet

  • Modified-release

Nevirapine

Viramune XR

Tablet

  • Modified-release

Niacin

Niaspan,

Niaspan FCT (Canada)

Tablet

  • Modified-release

Nicardipine

Cardene SR (US)

Capsule

  • Modified-release

Nicotine

Nicorette (US)

Lozenge

  • Should be dissolved in the mouth, not chewed

Nifedipine

Adalat CC (US),

Procardia XL (US),

Adalat XL (Canada)

Tablet

  • Modified-release

Nilotinib

Tasigna

Capsule

  • Antineoplastic
  • Modified-release
  • Can be opened for administration of intact granules

Nisoldipine

Sular (US)

Tablet

  • Modified-release

Nitroglycerin

Nitrostat

Tablet

  • Sublingual dosage form

Olaparib

Lynparza

Tablet

  • Amorphous solid dispersion

Omeprazole

Prilosec (US),

Prilosec OTC (US),

Losec (Canada)

Capsule, Tablet

  • Modified-release
  • Capsule can be opened for administration of intact granules (Prilosec)

Orphenadrine

Norflex ER (US)

Tablet

  • Modified-release

Oxybutynin

Ditropan XL

Tablet

  • Modified-release

Oxycodone

OxyContin (US),

Oxy Neo (Canada),

Xtampza ER (US)

Capsule, Tablet

  • Modified-release

Oxymorphone

Opana ER (US)

Tablet

  • Modified-release

Paliperidone

Invega

Tablet

  • Modified-release

Pancreatic Enzymes

Creon,

Pancreaze (US),

Pertzye (US),

Zenpep (US)

Capsule

  • Modified-release
  • Irritant (oral mucosal)
  • Can be opened for administration of intact granules

Pantoprazole

Protonix (US),

Pantoloc (Canada)

Tablet

  • Modified-release

Paroxetine

Paxil CR

Tablet

  • Modified-release

Pazopanib

Votrient

Tablet

  • Antineoplastic

Pentoxifylline

Trental (US)

Tablet

  • Modified-release

Piroxicam

Feldene (US)

Capsule

  • Irritant (oropharyngeal)

Pomalidomide

Pomalyst

Capsule

  • Antineoplastic
  • Teratogenic

Posaconazole

Noxafil DR (US)

Posanol (Canada)

Tablet

  • Amorphous oral dispersion
  • Modified-release

Potassium Chloride

Micro-K (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Potassium Chloride

Klor-Con (US)

Tablet

  • Modified-release

Praziquantel

Biltricide

Tablet

  • Bad taste
  • Scored tablets can be split

Propafenone

Rythmol SR (US)

Capsule

  • Modified-release

Propranolol

Inderal LA,

InnoPran XL (US)

Capsule

  • Modified-release

Pseudoephedrine

Sudafed 12 Hour, 24 Hour (US)

Tablet

  • Modified-release

Pseudoephedrine/

Brompheniramine

LoHist 12D (US)

Tablet

  • Modified-release

Pseudoephedrine/

Desloratadine

Clarinex D (US)

Tablet

  • Modified-release

Pseudoephedrine/

Fexofenadine

Allegra D

Tablet

  • Modified-release

Pyridostigmine

Mestinon Timespan (US),

Mestinon SR (Canada)

Tablet

  • Modified-release

Quetiapine

Seroquel XR

Tablet

  • Modified-release

Rabeprazole

Aciphex (US),

Aciphex Sprinkle (US),

Pariet (Canada)

Capsule, Tablet

  • Modified-release

Raloxifene

Evista

Tablet

  • Bad taste
  • Teratogenic

Ranolazine

Ranexa (US)

Tablet

  • Modified-release

Regorafenib

Stivarga

Tablet

  • Amorphous solid dispersion
  • Antineoplastic

Risedronate

Actonel

Tablet

  • Irritant (oropharyngeal)

Risedronate

Atelvia (US),

Actonel DR (Canada)

Tablet

  • Modified-release
  • Irritant (oropharyngeal)

Risperidone

Risperdal M

Tablet

  • Must be allowed to dissolve on the tongue

Ritonavir

Norvir

Tablet

  • Amorphous solid dispersion

Ropinirole

Requip XL (US)

Tablet

  • Modified-release

Sirolimus

Rapamune

Tablet

  • Nanocrystal

Solifenacin

Vesicare

Tablet

  • Bad taste

Sulfasalazine

Azulfidine EN-Tabs (US),

Salazopyrin EN (Canada)

Tablet

  • Modified-release

Suvorexant

Belsomra (US)

Tablet

  • Amorphous solid dispersion

Tacrolimus

Astagraf XL (US)

Prograf

Capsule

  • Amorphous solid dispersion

Tamsulosin

Flomax (US),

Flomax CR (Canada)

Capsule, Tablet

  • Modified-release

Tapentadol

Nucynta ER

Tablet

  • Modified-release

Temozolomide

Temodar (US),

Temodal (Canada)

Capsule

  • Irritant (cytotoxic)

Tezacaftor/Ivacaftor

Symdeko

Tablet

  • Amorphous solid dispersion

Theophylline

Theo-24 (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Theophylline

Generics

Tablet

  • Modified-release

Tipranavir

Aptivus

Capsule

  • Bad taste

Tolterodine

Detrol LA

Capsule

  • Modified-release

Topiramate

Topamax

Capsule, Tablet

  • Bad taste
  • Capsules can be opened for administration of intact granules

Topiramate

Qudexy XR (US),

Trokendi XR (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules (Qudexy XR)

Tramadol

ConZip (US),

Ryzolt (US),

Ultram ER (US),

Zytram XL (Canada)

Capsule, Tablet

  • Modified-release

Trazodone

Generics

Tablet

  • Bad taste
  • Scored tablets can be split

Trazodone

Oleptro

Tablet

  • Modified-release
  • Scored tablets can be split

Valganciclovir

Valcyte

Tablet

  • Irritant
  • Teratogenic, carcinogenic

Valproic Acid

Depakene

Capsule

  • Irritant (oropharyngeal)

Vandetanib

Caprelsa

Tablet

  • Antineoplastic
  • Irritant

Vemurafenib

Zelboraf

Tablet

  • Amorphous solid dispersion

Venetoclax

Venclexta

Tablet

  • Amorphous solid dispersion

Venlafaxine

Effexor XR

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Verapamil

Verelan,

Verelan PM (US)

Capsule

  • Modified-release
  • Can be opened for administration of intact granules

Verapamil

Calan SR (US),

Covera-HS (US),

Isoptin SR

Tablet

  • Modified-release
  • Scored tablets can be split

Vismodegib

Erivedge

Capsule

  • Teratogenic

Vorinostat

Zolinza

Capsule

  • Irritant (skin and mucous membrane)

Zileuton

Zyflo CR (US)

Tablet

  • Modified-release

Zolpidem

Ambien CR (US)

Tablet

  • Modified-release

Zolpidem

Intermezzo (US)

Tablet

  • Sublingual dosage form
Meds That Should Not Be Crushed (2024)
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