Tablet splitting inaccurate and dangerous, study suggests

Splitting tablets into smaller doses may be inaccurate with potentially toxic effects, according to Belgian research.

Medical researchers warned the inaccuracy of tablet splitting could affect treatment dosage and have serious effects on patients’ health. It comes after a study found average fragments could deviate from recommended doses by up to 25%.

Experts called on manufacturers to produce more dose options and liquid alternatives to make the practice redundant.

Study lead Charlotte Verrue from Ghent University said tablet splitting was widespread in healthcare: ‘It is done for a number of reasons: to increase dose flexibility, to make tablets easier to swallow and to save money for both patients and healthcare providers.

‘However, the split tablets are often unequal sizes and a substantial amount of the tablet can be lost during splitting.’

In the study, published in the Journal of Advanced Nursing, researchers asked five volunteers to split tablets using techniques commonly employed in nursing homes.

Eight different-sized tablets for conditions such as Parkinson’s, congestive heart failure and arthritis were split into 3,600 separate halves and quarters.

Researchers found 31% of the tablet fragments deviated from their theoretical weight by more than 15%. In addition, 14% deviated by more than 25%. Even the most accurate method produced error margins of 8%.

Ms Verrue said: ‘Tablet splitting is daily practice in nursing homes. However, not all formulations are suitable for splitting and, even when they are, large dose deviations or weight losses can occur.

‘This could have serious clinical consequences for drugs where there is a small difference between therapeutic and toxic doses.’

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