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Tablet Crushing Issues

Many people struggle at times taking their medicine because of swallowing difficulties and may resort to crushing tablets or opening capsules. A preliminary survey reported in an article[1] that almost 60% patients experienced difficulties swallowing tablets or capsules. Subsequently, 68% of these patients needed to open a capsule or crush a tablet.

What are the consequences of tablet crushing or opening capsules?

Advice from the NHS is not to crush pills, open capsules or alter your medicine without getting medical advice as this could stop the medicine working properly.[2]

Tablets and capsules are very complex and specifically developed to treat the patient’s condition. Some are designed to be released over several hours[3], others have special coatings to protect your stomach or to protect the active ingredient from the stomach acid.

Crushed tablets may also taste unpleasant without their special coating.[3]

If a tablet is crushed or a capsule opened, it could mean that the medicine is released into your body all at once, when it should be released slowly over many hours. This means you are more likely to receive a very high dose and experience side effects. It could also make your medicine less effective because you do not receive the correct dose.[3]

When is it ok to crush tablets or open capsules?

Before a prescription is written, it’s important that patients are asked whether they have any difficulty swallowing tablets or capsules. Whenever a swallowing difficulty is identified, the doctor will look to investigate and identify the cause of the issue and treat this appropriately.[4]

There are many different formats of medication which give options to a patient with difficulties swallowing. Your doctor should discuss these with you to find the most appropriate and acceptable one for you. Formats may include liquid, dispersible, buccal, sublingual, rectal, transdermal, intranasal or via injection.[4] Most commonly available medications are now available in a liquid form. Liquids may be the most appropriate solution for someone suffering from swallowing difficulties.[4]

Crushing tablets or opening capsules should only be advised as a last resort and only by a doctor or pharmacist[1]. If a healthcare professional does advise the manipulation of your medication, it is important that you are told how to do this safely and appropriately.

Also, it’s important to remember, your circumstances may change over time. A prescription your doctor has written for you in the past may no longer be the most appropriate way for you to take your medication. It’s important that if you are having problems swallowing your medicines, you inform a healthcare professional such as your doctor, nurse or pharmacist.

There is a solution

Your pharmacist will be best able to advise you if your medicine is available in a liquid form.

If you can swallow liquids safely, a liquid medication will make the medicine easier for you to swallow and will help to ensure that your treatment is working as effectively as it should be.[3]


ROS000057-001 Aug 2023


  1. Strachan, I & Greener, M. (2005) Medication-related swallowing difficulties may be more common than we realise. Pharmacy in Practice. Volume 15; issue 9; p411–414.
  2. https://www.nhs.uk/common-health-questions/medicines/can-i-crush-medicines-before-taking-them/ (accessed 29th Aug 2023)
  3. Medicines Management and Older People- a guide for healthcare professionals. Edited by R Greenwall. August 2016.
  4. Guideline on the medication management of adults with swallowing difficulties. David Wright, Nigel Chapman, Mathias Foundling-Miah, Ralph Greenwall, Richard Griffith, Anne Guyon, Honor Merriman