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OralDosageFormsThatShouldNotBeCrushed2015

DrugProduct
Absorica
Accutane
AcipHex
Acticlate

ActiveIngredient(s)
(isotretinoin)
(isotretinoin)
(rabeprazole)
(doxycycline)

DosageForm(s)
Capsule
Capsule
Tablet
Tablet

Actiq

(fentaNYL)

Lozenge

Actonel

(risedronate)

Tablet

AdalatCC
AdderallXR
AeroHistPlus
AfeditabCR
Afinitor
Aggrenox
AlavertAllergy(Sinus12hour)
AllegraD
Alophen
ALPRAZolamER
Altoprev
AmbienCR
AmibidDM
Amitiza
Ampyra
Amrix
Aplenzin
Apriso
Aptivus
AquatabC
AquatabD
Aricept23mg

(NIFEdipine)
(amphetaminesalts)
(combination)
(NIFEdipine)
(everolimus)
(combination)
(combination)
(combination)
(bisacodyl)
(ALPRAZolam)
(lovastatin)
(zolpidem)
(combination)
(lubiprostone)
(dalfampridine)
(cyclobenzaprine)
(buPROPion)
(mesalamine)
(tipranavir)
(combination)
(combination)
(donepezil)

Tablet
Capsule
Tablet
Tablet
Tablet
Capsule
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Capsule
Tablet
Capsule
Tablet
Capsule
Capsule
Tablet
Tablet
Tablet

Reasons/Comments
Mucousmembraneirritant
Mucousmembraneirritant
Slowrelease
Filmcoated(h)(Note:tabletscoredinthirdsrather
thanhalf)
Slowrelease(Note:thislollipopdeliverysystem
requiresthepatienttoslowlyallowdissolution)
Irritant(Note:chewed,crushed,orsuckedtabletsmay
causeoropharyngealirritation)
Slowrelease
Slowrelease(a)
Slowrelease(h)
Slowrelease
Mucousmembraneirritant
Slowrelease
Slowrelease
Slowrelease
Entericcoated
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease(Note:formerlyfampridineSR)
Slowrelease
Slowrelease
Slowrelease(a)(Note:maintainpHat<6.0)
Note:oilemulsionwithinspheres;taste
Slowrelease(h)
Slowrelease(h)
Note:crushingthe23mgtabletmaysignificantly
increasetherateofabsorption;the5mgand10mg
tabletsarenotaffected

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Page1of15

OralDosageFormsThatShouldNotBeCrushed2015
Arthrotec
Asacol
Aspirinentericcoated
Atelvia

(diclofenac)
(mesalamine)
(aspirin)
(risedronate)

Tablet
Tablet
Tablet,Caplet
Tablet

Entericcoated
Slowrelease
Slowrelease;Entericcoated
Slowrelease(Note:tabletcoatingisanimportantpart
oftheslowrelease;chewed,cut,orcrushedtablets
maycauseoropharyngealirritation)

AugmentinXR
AVINza
Avodart

(combination)
(morphine)
(dutasteride)

Tablet
Capsule
Capsule

Slowrelease(b,h)
Slowrelease(a;notpudding)
Note:drugmaycausefetalabnormalities;women
whoare,ormaybecome,pregnant,shouldnothandle
capsules;allwomenshouldusecautioninhandling
capsules,especiallyleakingcapsules

AzulfidineENTabs
BayerEC
BayerRegular
Belsomra

(sulfaSALAzine)
(aspirin)
(aspirin)
(suvorexant)

Tablet
Caplet
Caplet
Tablet

Slowrelease(b)
Entericcoated
Entericcoated
Note:notscored;nostudiesavailablefromcompany

BiaxinXL
BidexA
BidhistD
Biltricide
BiohistLA
BisacEvac
Bisacodyl
BisaLax
Boniva

(clarithromycin)
(combination)
(combination)
(praziquantel)
(combination)
(bisacodyl)
(combination)
(combination)
(ibandronate)

Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet

BromfedPD
BudeprionSR
Bunavail

(combination)
(buPROPion)
(combination)

Capsule
Tablet
Buccalfilm

CalanSR

(verapamil)

Tablet

Slowrelease
Slowrelease
Slowrelease
Taste(h)
Slowrelease(h)
Entericcoated(c)
Entericcoated(c)
Entericcoated(c)
Note:chewed,crushed,orsuckedtabletsmaycause
oropharyngealirritation
Slowrelease
Slowrelease
Note:chewingorswallowingmayresultinlowerpeak
concentrationsandbioavailability
Slowrelease(h)

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Page2of15

OralDosageFormsThatShouldNotBeCrushed2015
Carbatrol
CardeneSR
Cardizem

(carBAMazepine)
(niCARdipine)
(diltiazem)

Capsule
Capsule
Tablet

CardizemCD
CardizemLA
CarduraXL
CartiaXT
CefaclorER
Ceftin
Cefuroxime
CellCept
Cerdelga
CharcoalPlus
ChlorTrimeton12H
CiproXR
ClaritinD12Hour
ClaritinD24Hour
Colace
Colestid
Commit

(diltiazem)
(diltiazem)
(doxazosin)
(diltiazem)

(cefuroxime)

(mycophenolate)
(eliglustat)

(combination)
(ciprofloxacin)
(combination)
(combination)
(docusate)
(colestipol)
(nicotine)

Capsule
Tablet
Tablet
Capsule
Tablet
Tablet
Tablet
Capsule,Tablet
Capsule
Tablet
Tablet
Tablet
Tablet
Tablet
Capsule
Tablet
Lozenge

Concerta
Contrave

(methylphenidate)
(combination)

Tablet
Tablet

CoregCR

(carvedilol)

Capsule

CotazymS
CoveraHS
Creon5,10,20
Crixivan

(pancrelipase)
(verapamil)
(pancrelipase)
(indinavir)

Capsule
Tablet
Capsule
Capsule

Slowrelease(a)
Slowrelease
Note:althoughnotinthepackageinsert,thedrughas
acoatingthatisintendedtoreleasethedrugover
approximately3hours
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease(b)
Taste(b)(Note:usesuspensionforchildren)
Taste(b)(Note:usesuspensionforchildren)
Teratogenicpotential(i)
Preferablytakenwithwater
Entericcoated
Slowrelease(b)
Slowrelease(b)
Slowrelease
Slowrelease
Taste(e)
Slowrelease
Note:integritycompromisedbychewingorcrushing
Slowrelease
Slowrelease(Note:chewing,dividing,orcrushing
tabletsmayalterreleaserate)
Slowrelease(a)(Note:mayaddcontentsofcapsule
tochilled,notwarm,applesauceandconsume
immediately)
Entericcoated(a)
Slowrelease
Slowrelease(a)
Taste(Note:capsulemaybeopenedandmixedwith
fruitpuree[e.g.,banana])

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Page3of15

OralDosageFormsThatShouldNotBeCrushed2015
Cymbalta

(DULoxetine)

Capsule

Slowrelease(a)(Note:mayaddcontentsofcapsule
toapplejuiceorapplesaucebutNOTchocolate)

Cytovene
Cytoxan

(ganciclovir)
(cyclophosphamide)

Capsule
Tablet

Depakene
Depakote
DepakoteER
DetrolLA
Dexilant
Diclegis
DilacorXR
DilatrateSR
DiltCD
DiltiaXT
DitropanXL
DivalproexER
Doxidan
Drisdol
Droxia

(divalproex)
(divalproex)
(divalproex)
(tolterodine)
(dexlansoprazole)
(combination)
(diltiazem)
(isosorbide)
(diltiazem)
(diltiazem)
(oxybutynin)
(divalproex)
(bisacodyl)
(ergocalciferol)
(hydroxyurea)

Capsule
Tablet
Tablet
Capsule
Capsule
Tablet
Capsule
Capsule
Capsule
Capsule
Tablet
Tablet
Tablet
Capsule
Capsule

Dulcolax
DynaCircCR
E.E.S.400
Easprin
ECNaprosyn
EcotrinAdultLowStrength
EcotrinMaximumStrength
EcotrinRegularStrength
EfferK
EffervescentPotassium
EffexorXR

(bisacodyl)
(isradipine)
(erythromycin)
(aspirin)
(combination)
(aspirin)
(aspirin)
(aspirin)
(potassiumbicarbonate)

(venlafaxine)

Tablet;Capsule
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Capsule

Skinirritant
Note:drugmaybecrushedbutcompanyrecommends
usinginjection
Slowrelease;mucusmembraneirritant(b)
Slowrelease
Slowrelease
Slowrelease
Slowrelease(a)
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Entericcoated(c)
Liquidfilled(d)
Note:exposuretothepowdermaycauseseriousskin
toxicities;healthcareworkersshouldwearglovesto
administer
Entericcoated(c);Liquidfilled
Slowrelease
Entericcoated(b)
Entericcoated
Entericcoated
Entericcoated
Entericcoated
Entericcoated
Effervescenttablet(f)
Effervescenttablet(f)
Slowrelease

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Page4of15

OralDosageFormsThatShouldNotBeCrushed2015
Embeda
EMycin
Enablex
EntocortEC
Epanova

(morphinesulfate)
(erythromycin)
(darifenacin)
(budesonide)
(omega3carboxylicacids)

Capsule
Tablet
Tablet
Capsule
Capsule

Slowrelease(a)
Entericcoated
Slowrelease
Entericcoated(a)
Note:contentsofcapsulemayerodewallsof
Styrofoamorplasticmaterials
Slowrelease(a)
Sublingualform(g)
Note:packageinsertindicatespotentialteratogenic
effects;materialsafetydatasheetwarnsagainstskin
contact;healthcareworkersshouldtakeappropriate
precautions
Entericcoated
Entericcoated
Entericcoatedpellets(a)
Entericcoated
Taste;teratogenicpotential(i)
Slowrelease(Note:crushing,chewing,ordissolving
tabletscancauserapidreleaseandabsorptionofa
potentiallyfataldose)
Note:donotgiveaswholetablet,tabletsaremeant
tobegivenasoralsuspension;seecompanyinsert

Equetro
Ergomar
Erivedge

(carBAMazepine)
(ergotamine)
(vismodegib)

Capsule
Tablet
Capsule

EryTab
ErythromycinBase
ErythromycinDelayedRelease
ErythromycinStearate
Evista
Exalgo

(erythromycin)

(raloxifene)
(HYDROmorphone)

Tablet
Tablet
Capsule
Tablet
Tablet
Tablet

Exjade

(deferasirox)

Tablet

ExtendrylJR
ExtendrylSR
Feenamint
Feldene
FentaNYL

(combination)
(combination)
(bisacodyl)
(piroxicam)

Capsule
Capsule
Tablet
Capsule
Lozenge

Slowrelease
Slowrelease(b)
Entericcoated(c)
Mucousmembraneirritant
Slowrelease(Note:thislollipopdeliverysystem
requiresthepatienttoslowlydissolveinmouth)

Fentora
Feosol
Feratab
Fergon

(fentaNYL)
(ferroussulfate)
(ferroussulfate)
(ferrousgluconate)

Tablet
Tablet
Tablet
Tablet

Note:buccaltablet;swallowwhole
Entericcoated(b)
Entericcoated(b)
Entericcoated

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Page5of15

OralDosageFormsThatShouldNotBeCrushed2015
FeroGrad500mg
FerroSequels
FlagylER
FleetLaxative
Flomax
FocalinXR
Fortamet
Fosamax
Gleevec

(combination)
(combination)
(metroNIDAZOLE)
(bisacodyl)
(tamsulosin)
(dexmethylphenidate)
(metFORMIN)
(alendronate)
(imatinib)

Tablet
Tablet
Tablet
Tablet
Capsule
Capsule
Tablet
Tablet
Tablet

GlipiZIDEXR
GlucophageXR
GlucotrolXL
Glumetza
Gralise
Guaifed
GuaifedPD
GuaifenexDM
GuaifenexGP
GuaifenexPSE
GuaifFENesin/Pseudoephedrine
GuaiMAXD
Halfprin81
Hetlioz

(glipiZIDE)
(metFORMIN)
(glipiZIDE)
(metFORMIN)
(gabapentin)
(combination)
(combination)
(combination)
(combination)
(combination)

(combination)
(aspirin)
(tasimelteon)

Tablet
Tablet
Tablet
Tablet
Tablet
Capsule
Capsule
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Capsule

HistaVentDA
Horizant
Hydrea

(combination)
(gabapentin)
(hydroxyurea)

Tablet
Tablet
Capsule

HysinglaER

(HYDROcodone)

Tablet

Slowrelease
Slowrelease
Slowrelease
Entericcoated(c)
Slowrelease
Slowrelease(a)
Slowrelease
Mucousmembraneirritant
Taste(h)(Note:maybedissolvedinwaterorapple
juice)
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease(h)
Slowrelease
Slowrelease(h)
Slowrelease
Slowrelease
Entericcoated
Note:notscored;nostudiesavailablefromcompany
Slowrelease(h)
Slowrelease
Note:exposuretothepowdermaycauseseriousskin
toxicities;healthcareworkersshouldwearglovesto
administer
Slowrelease(Note:crushing,chewing,ordissolving
tabletscancauserapidreleaseandabsorptionofa
potentiallyfataldoseofhydrocodone)

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Page6of15

OralDosageFormsThatShouldNotBeCrushed2015
Imbruvica

(ibrutinib)

Capsule

Note:notscored;nostudiesavailablefromcompany

Imdur
Impavido

(isosorbide)
(miltefosine)

Tablet
Capsule

Slowrelease(h)
Note:notscored;nostudiesavailablefromcompany

InderalLA
IndocinSR
InnoPranXL
Intelence

(propranolol)
(indomethacin)
(propranolol)
(etravirine)

Capsule
Capsule
Capsule
Tablet

Intermezzo
Intuniv
Invega
IsoptinSR
IsordilSublingual
IsosorbideDinitrateSublingual
IsosorbideSR
Jakafi

(zolpidem)
(guanFACINE)
(paliperidone)
(verapamil)
(isosorbide)
(isosorbide)
(isosorbide)
(ruxolitinib)

Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet

Jalyn

(combination)

Capsule

JanumetXR
Kadian

(combination)
(morphine)

Tablet
Capsule

Slowrelease
Slowrelease(a,b)
Slowrelease
Note:tabletshouldbeswallowedwholeandnot
crushed;tabletmaybedispersedinwater
Sublingualform(g)
Slowrelease
Slowrelease
Slowrelease(h)
Sublingualform(g)
Sublingualform(g)
Slowrelease
Note:seeprescribinginformationformakinga
suspension
Mucousmembraneirritant(Note:womenwhoare,or
maybecome,pregnant,shouldnothandlecrushedor
brokentablets[l])
Slowrelease
Slowrelease(a)(Note:donotgiveviaNGtubes)

Kaletra
KaonCL10
Kapidex

(combination)
(potassium)
(dexlansoprazole)

Tablet
Tablet
Capsule

Filmcoated
Slowrelease(b)
Slowrelease(a)(Note:namechangedtoDexilant)

Kapvay
Kazano

(cloNIDine)
(combination)

Tablet
Tablet

Slowrelease
Note:notscored;nostudiesavailablefromcompany

KDur

(potassium)

Tablet

Slowrelease

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Page7of15

OralDosageFormsThatShouldNotBeCrushed2015
Keppra

(levETIRAcetam)

Tablet

KeppraXR
Ketek
Khedezla
KlorCon
KlorConM
Klotrix
KLyte
KLyteCL
KLyteDS
KombiglyzeXR

(levETIRAcetam)
(telithromycin)
(desvenlafaxine)
(potassium)
(potassium)
(potassium)
(potassium)
(potassium)
(potassium)
(combination)

Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet

KTab
LaMICtalXR
LescolXL
Letairis
Levbid
LevsinexTimecaps
Lialda
LiquibidPD
Lithobid
Lodrane24
Lodrane24D
LoHist12Hour
Lovaza

(potassium)
(lamoTRIgine)
(fluvastatin)
(ambrisentan)
(hyoscyamine)
(hyoscyamine)
(mesalamine)
(combination)
(lithium)
(brompheniramine)
(combination)
(brompheniramine)
(combination)

Tablet
Tablet
Tablet
Tablet
Tablet
Capsule
Tablet
Tablet
Tablet
Capsule
Capsule
Tablet
Capsule

LuvoxCR
MaxifedDM
MaxifedDMX
MaxiphenDM
MedentDM
MestinonER
MetadateCD

(fluvoxaMINE)
(combination)
(combination)
(combination)
(combination)
(pyridostigmine)
(methylphenidate)

Capsule
Tablet
Tablet
Tablet
Tablet
Tablet
Capsule

Taste(b)(Note:someextemporaneousformulasare
pharmacyprepared)
Slowrelease(b)
Slowrelease(b)
Slowrelease
Slowrelease(b)
Slowrelease(b,h)
Slowrelease
Effervescenttablet(f)
Effervescenttablet(f)
Effervescenttablet(f)
Slowrelease(Note:tabletmatrixmayremaininstool)
Slowrelease(b)
Slowrelease
Slowrelease
Slowrelease
Slowrelease(h)
Slowrelease
Slowrelease
Slowrelease(h)
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Note:contentsofcapsulemayerodewallsof
Styrofoamorplasticmaterials
Slowrelease
Slowrelease(h)
Slowrelease(h)
Slowrelease(h)
Slowrelease
Slowrelease(b)
Slowrelease(a)

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Page8of15

OralDosageFormsThatShouldNotBeCrushed2015
MetadateER
MethylinER
MetoprololER
MicroKExtencaps
MiraphenPSE
Morphinesulfateextendedrelease
Motrin
Movantik
Moxatag
MSContin
Mucinex
MucinexDM
Myfortic
Myrbetriq
NamendaXR
Naprelan
NexIUM
Niaspan
NicotinicAcid
NifediacCC
NifedicalXL
Nitrostat
NorflexER
Northera
NorpaceCR
Norvir

(methylphenidate)
(methylphenidate)

(potassiumchloride)
(combination)

(ibuprofen)
(naloxegol)
(amoxicillin)
(morphine)
(guaiFENesin)
(combination)
(mycophenolate)
(mirabegron)
(memantine)
(naproxen)
(esomeprazole)
(nicotinicacid)

(NIFEdipine)
(NIFEdipine)
(nitroglycerin)
(orphenadrine)
(droxidopa)
(disopyramide)
(ritonavir)

Tablet
Tablet
Tablet
Capsule
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet
Capsule
Tablet
Capsule
Tablet
Capsule;Tablet
Tablet
Tablet
Tablet
Tablet
Capsule
Capsule
Tablet

Noxafil
NucyntaER

(posaconazole)
(tapentadole)

Tablet
Tablet

OFEV
Oleptro

(nintedanib)
(traZODone)

Capsule
Tablet

Slowrelease
Slowrelease
Slowrelease
Slowrelease(a,b)
Slowrelease
Slowrelease
Taste(b,e)
Filmcoated
Slowrelease
Slowrelease(b)
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Slowrelease(a)
Slowrelease
Slowrelease(a)
Slowrelease
Slowrelease(h)
Slowrelease
Slowrelease
Sublingualform(g)
Slowrelease
Note:nostudiesavailablefromcompany
Slowreleaseformwithinaspecialcapsule
Note:crushingtabletshasresultedindecreased
bioavailabilityofdrug(b)
Slowrelease(b)
Slowrelease(Note:crushing,chewing,ordissolving
tabletsmayresultinoverdoseordeath)
Taste
Slowrelease(h)

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Page9of15

OralDosageFormsThatShouldNotBeCrushed2015
Omtryg

(omega3acidethylestersA)

Capsule

Note:contentsofcapsulemayerodewallsof
Styrofoamorplasticmaterials
Slowrelease(Note:crushing,chewing,ordissolving
tabletsmayresultinoverdoseordeath)

OpanaER

(oxymorphone)

Tablets

Oracea
OramorphSR
Otezla
OxyCONTIN

(doxycycline)
(morphine)
(apremilast)
(oxyCODONE)

Capsule
Tablet
Tablet
Tablet

Slowrelease
Slowrelease(b)
Filmcoated
Slowrelease(Note:tabletdisruptionmaycausea
potentiallyfataloverdoseofoxyCODONE)

Pancreaze
Pancrecarb
Pancrelipase
PaxilCR
Pentasa
Pertyze
Plendil
Pradaxa

(pancrelipase)
(pancrelipase)

(PARoxetine)
(mesalamine)
(pancrelipase)
(felodipine)
(dabigatran)

Capsule
Capsule
Capsule
Tablet
Capsule
Capsule
Tablet
Capsule

PreHistD
Prevacid
PrevacidSoluTab

(combination)
(lansoprazole)
(lansoprazole)

Tablet
Capsule
Tablet

Entericcoated(a)
Entericcoated(a)
Entericcoated(a)
Slowrelease
Slowrelease
Slowrelease(a)
Slowrelease
Note:breaking,chewing,oremptyingcontentsofthe
capsulecanresultinincreasedexposure
Slowrelease(h)
Slowrelease
Note:orallydisintegratingdonotswallow;dissolvein
wateronlyanddispenseviadosingsyringeofNGtube

PrevacidSuspension

(lansoprazole)

Suspension

PriLOSEC
PriLOSECOTC
Pristiq
ProcardiaXL
Propecia

(omeprazole)
(omeprazole)
(desvenlafaxine)
(NIFEdipine)
(finasteride)

Capsule
Tablet
Tablet
Tablet
Tablet

Slowrelease(Note:containsentericcoatedgranules;
mixwithwateronly;notforNGuse)
Slowrelease
Slowrelease
Slowrelease
Slowrelease
Note:womenwhoare,ormaybecome,pregnant,
shouldnothandlecrushedorbrokentablets

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Page10of15

OralDosageFormsThatShouldNotBeCrushed2015
ProquinXR
Proscar

(ciprofloxacin)
(finasteride)

Tablet
Tablet

Slowrelease
Note:womenwhoare,ormaybecome,pregnant,
shouldnothandlecrushedorbrokentablets

Protonix
PROzacWeekly
QDALL
QDALLAR
QudexyXR
Ranexa
Rapamune

(pantoprazole)
(FLUoxetine)
(combination)
(combination)
(topiramate)
(ranolazine)
(sirolimus)

Tablet
Tablet
Capsule
Capsule
Capsule
Tablet
Tablet

Rayos

(predniSONE)

Tablet

RazadyneER
Renagel

(galantamine)
(sevelamer)

Capsule
Tablet

Slowrelease
Entericcoated
Slowrelease
Slowrelease
Slowrelease(a)
Slowrelease
Note:pharmacokineticparametersmaybeaffected
(b)
Slowrelease(Note:delayedreleaseisdependenton
anintactcoating)
Slowrelease
Note:tabletsexpandinliquidifbrokenorcrushed

Renvela

(sevelamercarbonate)

Tablet

Note:tabletsexpandinliquidifbrokenorcrushed(b)

RequipXL
Rescon
ResconJR
ResconMX
Respahist
RespaireSR
Revlimid

(ropinirole)
(combination)
(combination)
(combination)
(combination)
(combination)
(lenalidomide)

Tablet
Tablet
Tablet
Tablet
Capsule
Capsule
Capsule

Reyataz

(atazanavir)

Capsule

Slowrelease
Slowrelease(h)
Slowrelease(h)
Slowrelease(h)
Slowrelease(a)
Slowrelease
Note:Teratogenicpotential;healthcareworkers
shouldavoidcontactwithcapsulecontents/body
fluids
Note:anoralpowderisavailable,seeprescribing
informationforadministrationinstructions

RitalinLA
RitalinSR
RTanna

(methylphenidate)
(methylphenidate)
(combination)

Capsule
Tablet
Tablet

Slowrelease(a)
Slowrelease
Slowrelease

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Page11of15

OralDosageFormsThatShouldNotBeCrushed2015
RythmolSR
Ryzolt

(propafenone)
(traMADol)

Capsule
Tablet

Slowrelease
Slowrelease(Note:crushingmaycauseoverdose)

Sensipar

(cinacalcet)

Tablet

SEROquelXR
SinemetCR
SINUventPE
SloNiacin
Solodyn
Somnote
Sprycel

(QUEtiapine)
(levo/carbidopa)
(combination)
(nicotinicacid)
(minocycline)
(chloralhydrate)
(dasatinib)

Tablet
Tablet
Tablet
Tablet
Tablet
Capsule
Tablet

Note:tabletsarenotscoredandcuttingmaycause
variabledosageaccuracy
Slowrelease
Slowrelease(h)
Slowrelease(h)
Slowrelease(h)
Slowrelease
Liquidfilled
Filmcoated(Note:activeingredientsaresurrounded
bywaxmatrixtopreventhealthcareexposure;
womenwhoare,ormaybecome,pregnant,should
nothandlecrushedorbrokentablet)

Strattera

(atomoxetine)

Capsule

Note:capsulecontentscancauseocularirritation

Sudafed12hour
Sudafed24hour
Sular
SymaxDuotab
SymaxSR
TarginiqER

(combination)
(combination)
(nisoldipine)
(hyoscyamine)
(hyoscyamine)
(combination)

Capsule
Capsule
Tablet
Tablet
Tablet
Tablet

Slowrelease(b)
Slowrelease(b)
Slowrelease
Slowrelease
Slowrelease
Slowrelease(Note:crushing,chewing,ordissolving
tabletscancauserapidreleaseandabsorptionofa
potentiallyfataldoseofoxycodone)

Tasigna

(nilotinib)

Capsule

TaztiaXT
Tecfidera
TEGretolXR

(diltiazem)
(dimethylfumarate)
(carBAMazepine)

Capsule
Capsule
Tablet

Note:disruptionofcapsulemayyieldhighbloodlevels
causingenhancedtoxicity
Slowrelease(a)
Slowrelease
Slowrelease

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Page12of15

OralDosageFormsThatShouldNotBeCrushed2015
Temodar

(temozolomide)

Capsule

TessalonPerles

(benzonatate)

Capsule

Theo24

(theophylline)

Capsule

Theochron
Tiazac
Topamax
ToprolXL
TouroCCLD
TouroLALD
Toviaz
Tracleer

(theophylline)
(diltiazem)
(topiramate)
(metoprolol)
(combination)
(combination)
(fesoterodine)
(bosentan)

Tablet
Capsule
Tablet;Capsule
Tablet
Tablet
Tablet
Tablet
Tablet

TRENtal
Treximet

(pentoxifylline)
(combination)

Tablet
Tablet

Trilipix
TylenolArthritis
Uceris

(fenofibricacid)
(acetaminophen)
(budesonide)

Capsule
Tablet
Tablet

UltramER

(traMADol)

Tablet

Ultrase
Ultresa
Uniphyl
UrocitK
Uroxatral
Valcyte
VerapamilSR

(pancrelipase)
(pancrelipase)
(theophylline)
(potassiumcitrate)
(alfuzosin)
(valGANCiclovir)

Capsule
Capsule
Tablet
Tablet
Tablet
Tablet
Tablet

Slowrelease(Note:accidentallyopenedordamaged
capsulesrequirerigorousprecautionstoavoid
inhalationorcontactwiththeskinormucous
membranes[i])
Note:swallowwhole;localanesthesiaoftheoral
mucosa;chokingcouldoccur
Slowrelease(Note:containsbeadsthatdissolve
throughouttheGItract)
Slowrelease
Slowrelease(a)
Taste;Taste(a)
Slowrelease(h)
Slowrelease(h)
Slowrelease(h)
Slowrelease
Note:womenwhoare,ormaybecome,pregnant,
shouldnothandlecrushedorbrokentablets
Slowrelease
Note:uniquedrugmatrixenhancesrapiddrug
absorption
Slowrelease
Slowrelease
Slowrelease(Note:filmcoatingisdesignedtobreak
downatorabovepHof7.0)
Slowrelease(Note:tabletdisruptionmaycausea
potentiallyfataloverdoseofdrug)
Entericcoated
Slowrelease(a)
Slowrelease
Waxcoated;preventsupperGIrelease
Slowrelease
Teratogenicandirritantpotential(i,b)
Slowrelease(h)

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Page13of15

OralDosageFormsThatShouldNotBeCrushed2015
Verelan
VerelanPM
VESIcare
VidexEC
Vimovo
Viokace
ViramuneXR
VoltarenXR
VoSpireER
Votrient

(verapamil)
(verapamil)
(solifenacin)
(didanosine)
(combination)
(pancrelipase)
(nevirapine)
(diclofenac)
(albuterol)
(pazopanib)

Capsule
Capsule
Tablet
Capsule
Tablet
Tablet
Tablet
Tablet
Tablet
Tablet

WellbutrinSR,XL
XanaxXR
Xarelto

(buPROPion)
(ALPRAZolam)
(rivaroxaban)

Tablet
Tablet
Tablet

XartemisXR

(combination)

Tablet

XigduoXR
Zegerid
Zenpep
ZohydroER

(combination)
(combination)
(pancrelipase)
(HYDROcodone)

Tablet
Capsule
Capsule
Capsule

Zolinza

(vorinostat)

Capsule

Zortress

(everolimus)

Tablet

Zyban
Zydelig
ZyfloCR

(buPROPion)
(idelalisib)
(zileuton)

Tablet
Tablet
Tablet

Slowrelease(a)
Slowrelease(a)
Entericcoated
Slowrelease
Slowrelease
Mucousmembraneirritant
Slowrelease(b)
Slowrelease
Slowrelease
Note:crushingsignificantlyincreasestheAUCand
Tmax
Slowrelease
Slowrelease
Note:crushedtabletmustbegivenwithin4hours
Slowrelease(Note:crushing,chewing,ordissolving
tabletscancauserapidreleaseandabsorptionofa
potentiallyfataldose)
Slowrelease
Slowrelease(b)
Slowrelease(b)
Slowrelease(Note:crushing,chewing,ordissolving
capsulesmayresultinoverdoseordeath)
Note:irritant;avoidcontactwithskinormucous
membranes;avoidcontactwithcrushedorbroken
tablets
Note:crushedpowdermaycausemucousmembrane
irritation
Slowrelease
Note:notscored;filmcoated
Slowrelease

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Page14of15

OralDosageFormsThatShouldNotBeCrushed2015
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)

Capsulemaybeopenedandthecontentstakenwithoutcrushingorchewing;softfoodsuchasapplesauceorpuddingmayfacilitateadministration;contents
Liquiddosageformsoftheproductareavailable;however,dose,frequencyofadministrationandmanufacturersmaydifferfromthatofthesoliddosageform.
Antacidsand/ormilkmayprematurelydissolvethecoatingofthetablet.
Capsulemaybeopenedandtheliquidcontentsremovedforadministration.
Thetasteofthisproductformwouldlikelybeunacceptabletothepatient;administrationvianasogastrictubeshouldbeacceptable.
Effervescenttabletsmustbedissolvedintheamountofdiluentrecommendedbythemanufacturer.
Tabletsaremadetodisintegrateunderthetongue.
Tabletisscoredandmaybebrokeninhalfwithoutaffectingreleasecharacteristics.
Skincontactmayenhancetumorproduction;avoiddirectcontact.

Disclaimer:Thislistisnotmeanttorepresentallproducts,eitherbygenericortradename.Whileeveryefforthasbeenmadetoensuretheaccurcayandcompleteness
oftheinformationpresentedinthischart,thereaderisadvisedthattheauthors,editor,orpublishercannotberesponsiblefortehcurrencyoftehinformation,forany
errorsoromissions,orforanyconsequencesthatmayarrise.
TwoofficialUSPtermsareusedtodesignatespecialreleasemedicationforms:"extendedrelease"and"delayedrelease".Others(e.g.,sustainedrelease,controlled
release)arecommonlyusedonpackagelabeling.Theterm"Slowrelease"isbeingusedheretosignifyallsuchdrugswithaspecialreleasemechanism.

ISMP2015.Permissionisgrantedtoreporducematerialforinternalusewithinhealthcareorganizations.

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Page15of15

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