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Is it okay to cut UNscored tablets?

Posted
kyegirl kyegirl (New) New

I was taught NO, but my work is telling me to do it.just curious on your thoughts, however I will be calling a pharmacist for reference. Thanks!

P.S. This specific drug was Aricept.

Depends on what it is. Always check with pharmacy, and if they ok it, make sure you have an order to back it up (med can be scored).

sharpeimom

Specializes in ortho, hospice volunteer, psych,. Has 20 years experience.

i was taught no as a student but two of the places i worked, expected me to split pills using a pill cutter. some of the other nurses just snapped the scored pills in half using their fingernails and that scared me. i kept my very own pill splitter and used it, then took it home with me. i bought a bunch and left them at work, but they quickly vanished.

my rule was that if the pill didn't split absolutely right down the middle, i wasted it and used another one.

GaJordyLPN

Specializes in LTC. Has 3 years experience.

No, no, no. If a tablet is not scored, pharmacudically the components in the tablet are not evenly distributed, so half of the medication is not in half of the tablet. If administered, a med error would occur. I would tell the supervisor who told you to do this to an unscored tablet to get an order clarrification to use half the unscored tablet. Doubt the doctor would agree to that. But if the supervisor has a problem with that, tell them its not their license that would be in jeopardy for doing this, its yours. And you dont feel comfortable doing that. Its easy to call the pharmacy and getting the medication called in to backup or rewrite the order to begin the next day after the tote with the medicine comes in for the next day. Tell them to rewite the order for the next day or have the correct dosage called in to backup. Hope this helps!

Thanks everyone! GaJordylpn, those were my thoughts exactly!!!! It was an order for 5mg Aricept, and they wanted me to cut a 10mg in half. So my reply was, "So you mean to tell me, if the order was for 2.5mg, you'd want me to cut it into 4's". I wasn't mean about it, but seriously. It doesn't make any sense. Just wanted to make sure I wasn't crazy.....

Lexi McDonough

Specializes in CCRN, CMSRN, ACLS, Tele, Code TeamLeader. Has 3 years experience.

Although not being scored does not necessarily mean the tablet cannot safely be cut into equal pieces with equal amounts of medication, it depends on the how that specific pill was manufactured. Also, unscored tablets are physically harder to cut into equal pieces.

Any scored tablet is guaranteed by the manufacturer to contain equal amounts of medication in each half and is designed so that if it looks like the two halves are equal, its safe to assume they are.

Unscored tablets do not have that guarantee. MOST of the time, pills are just mixtures of medication and binders/fillers that are pressed into pill molds and maybe coated so they are easier to swallow. Those medications are essentially scored tablets without the score mark, and they can be safely cut in half if you are physically able to get two equally sized halves, but many other pills cannot be cut because it will interfere with the mechanism of delivery or because the medication is not evenly distributed in the pill.

Bottom line: Scored tablets are safe to cut and administer in halves (as long as you successfully break it into equal pieces, use a pill cutter). Unscored tablets may or may not be safe to cut in half, and its the responsibility of the RN to administer all medications safely, to the best of their ability.

Edited by Lexi McDonough
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Lexi McDonough

Specializes in CCRN, CMSRN, ACLS, Tele, Code TeamLeader. Has 3 years experience.

Good call on calling the pharmacist by the way, other than the researchers who designed the drug they are the ones who know the most about medications.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

No, no, no. If a tablet is not scored, pharmacudically the components in the tablet are not evenly distributed, so half of the medication is not in half of the tablet. If administered, a med error would occur. I would tell the supervisor who told you to do this to an unscored tablet to get an order clarrification to use half the unscored tablet. Doubt the doctor would agree to that. But if the supervisor has a problem with that, tell them its not their license that would be in jeopardy for doing this, its yours. And you dont feel comfortable doing that. Its easy to call the pharmacy and getting the medication called in to backup or rewrite the order to begin the next day after the tote with the medicine comes in for the next day. Tell them to rewite the order for the next day or have the correct dosage called in to backup. Hope this helps!

That's definitely one of the more ridiculous nursing myths I've ever heard of. All tablets are manufactured in the same basic process and the active components exist throughout the tablet. Whether or not it's pressed with a score mark has nothing to do with whether or not the medication is spread out through tablet. It's not unusual for non-generics in particular to not have score marks, this is because the manufacturer prefers patients buy the tablets in the dosage they will be using. Either way, score marks are not the preferred way to cut pills since they don't always split evenly through midline as consistently as a pill does with an actual pill splitter.