If You Do This Common Thing With Your Pills, Have Your Liver Checked Now

There are so many reasons this can be hazardous to your health.

Americans are no stranger to prescription medication—the good, the bad, and the ugly. At any given time, roughly half the U.S. population reports taking at least one prescription drug during the previous month, while a quarter is prescribed three drugs over that same timeframe, according to the Centers for Disease Control and Prevention (CDC).

Any way you slice it, that's a lot of medication—and a lot of opportunities for things to go wrong. That's why health authorities are warning consumers about one common practice with prescription meds that could be putting you in harm's way. They say that doing this one thing to your pills may harm your liver, and you should never do it without consulting your doctor first.

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Splitting your pills in half could be dangerous, says the FDA.

Split prescription pill
Shutterstock

According to a recent report sponsored by UnitedHealth Group, over half of Americans say they would consider splitting their pills at home as a means of saving money on their medication. But the U.S. Food and Drug Administration (FDA) calls this a "risky practice," pointing to health problems associated with pill-splitting.

"At some point your healthcare or managed care company may have recommended tablet splitting for reasons such as to adjust the dosing of your medication or to reduce costs. In such cases, it is your healthcare professional's responsibility to monitor the impact of risks associated with the practice of tablet splitting," the FDA shares via its website. "FDA does not encourage the practice of tablet splitting unless it's specified in the drug's professional prescribing information," Mansoor Khan, PhD, a representative of the FDA's Office of Pharmaceutical Science, added while speaking with Pharmacy Times.

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Dosing errors can cause liver problems—and they're surprisingly common.

prescription pills spilling onto table
Shutterstock/mwesselsphotography

Dosing errors are known to cause acute liver failure, even in over-the-counter medications like acetaminophen. Harsher prescription medications can have a profound effect on the liver when mishandled by consumers.

As it turns out, dosing errors are very prevalent when consumers split their own prescription pills at home. A study published in the Journal of Advanced Nursing found that roughly one-third of cut pills are split unevenly with the doses altered by 15 percent or more. Another 14 percent of patient-cut pills are off by 25 percent or more. Taken in greater-than-prescribed quantities, some medications can become toxic rather than therapeutic.

Never split pills with these labels.

doctor pointing at pill bottle counseling patient
Shutterstock/wutzkohphoto

Besides the prevalence of dosing errors caused by pill-splitting, there's another problem with cutting your pills at home: some medications have coatings that are designed to release your medication more slowly. "When you cut a long-acting pill, you can end up making the dose come out much higher and faster, which can be dangerous," Maria Torroella Carney, MD, chief of the division of geriatric and palliative medicine and Northwell Health, tells medical site Single Care. Look for markings on the label that indicate time-released medication (often marked "XR") or "enteric-coated tablets." These are designed to protect the stomach by dissolving only after reaching the intestines, so cutting them in half can cause dangerous side effects as the medicine is released earlier than intended.

"Most sustained, controlled, or timed release medications are not meant for splitting. In those rare instances where splitting is recommended for this type of medication, such information will be printed in the 'HOW SUPPLIED' section of the professional label insert and in the patient package insert," says the FDA.

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However, it may be safe to split pills under some circumstances.

Elderly woman pouring pills from bottle on hand, closeup view
iStock

Tablets that are scored down the middle may be safe to split at home. This is true for two reasons. First, the scoring suggests that the manufacturers have anticipated consumers splitting the pills, and second, you should be able to split your pills into more accurate doses using the scoring as a guide. If you do choose to portion out your pills at home, invest in a pill-splitting device for a safe and even split, and split one pill at a time as needed.

"However, some tablets may not be suitable for this method because of their unique shape and size—even if they appear to be scored. It is important to discuss this issue with your healthcare professional to determine what is best for you," says the FDA.

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Lauren Gray
Lauren Gray is a New York-based writer, editor, and consultant. Read more
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