Oral Dosage Forms That Should Not Be Crushed 2016

1 oral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 1 of 16 Drug ProductActive Ingredient(s) Dosage form (s)Reasons/CommentsAbsorica(isotreti noin)CapsuleMucous membrane irritantAccutane(isotretinoin)CapsuleMuc ous membrane irritantAcipHex(rabeprazole)TabletSlow-r eleaseActiclate(doxycycline)Capsule; TabletFilm-coated (h) (Note: tablet scored in thirds rather than half)Actiq(fentaNYL)LozengeSlow-release (Note: this lollipop delivery system requires the patient to slowly allow dissolution)Actonel(risedronate)TabletIr ritant (Note: chewed, Crushed , or sucked tablets may cause oropharyngeal irritation)Adalat CC(NIFE dipine)TabletSlow-releaseAdderall XR(amphetamine salts)CapsuleSlow-release (a)AeroHist Plus(combination)TabletSlow-release (h)Afeditab CR(NIFE dipine)TabletSlow-releaseAfinitor(everol imus)TabletMucous membrane irritantAggrenox(combination)CapsuleSlow -releaseAlavert Allergy (Sinus 12 hour)(combination)TabletSlow-releaseAlle gra-D(combination)TabletSlow-releaseAlop hen(bisacodyl)TabletEnteric-coatedALPRAZ olam ER(ALPRAZ olam)TabletSlow-releaseAltoprev(lovastat in)TabletSlow-releaseAmbien CR(zolpidem)TabletSlow-releaseAmibid DM(combination)TabletSlow-releaseAmitiza (lubiprostone)CapsuleSlow-releaseAmpyra( dalfampridine)TabletSlow-release (Note: formerly fampridine-SR)Amrix(cyclobenzaprine)Caps uleSlow-releaseAplenzin(buPROPion)Tablet Slow-releaseApriso(mesalamine)CapsuleSlo w-release (a) (Note.)

2 Maintain pH at < )Aptensio XR(methylphenidate) CapsuleSlow-release (a)Aptivus(tipranavir)CapsuleNote: oil emulsion within spheres; tasteAquatab C(combination)TabletSlow-release (h)Aquatab D(combination)TabletSlow-release (h) oral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 2 of 16 Aricept 23 mg(donepezil)TabletNote: crushing the 23 mg tablet may significantly increase the rate of absorption; the 5 mg and 10 mg tablets are not affectedArthrotec(diclofenac)TabletEnter ic-coatedAsacol(mesalamine)TabletSlow-re leaseAspirin enteric-coated(aspirin)Caplet; Tablet Slow-release; Enteric-coatedAtelvia(risedronate)Tablet Slow-release (Note: tablet coating is an important part of the slow-release; chewed, cut, or Crushed tablets may cause oropharyngeal irritation)Augmentin XR(combination)TabletSlow-release (b,h)AVINza(morphine)CapsuleSlow-release (a; not pudding)Avodart(dutasteride)CapsuleNote: drug may cause fetal abnormalities; women who are, or may become, pregnant, Should not handle capsules; all women Should use caution in handling capsules, especially leaking capsulesAzulfidine EN-Tabs(sulfaSALA zine)TabletSlow-release (b)Bayer EC(aspirin)CapletEnteric-coatedBayer Regular(aspirin)CapletEnteric-coatedBels omra(suvorexant)TabletNote: not scored.

3 No studies available from companyBelviq XR(lorcaserin) TabletSlow-releaseBiaxin-XL(clarithromyc in)TabletSlow-releaseBidex A(combination)TabletSlow-releaseBidhist- D(combination)TabletSlow-releaseBiltrici de(praziquantel)TabletTaste (h)Biohist LA(combination)TabletSlow-release (h)Bisac-Evac(bisacodyl)TabletEnteric-co ated (c) Bisacodyl(combination)TabletEnteric-coat ed (c) Bisa-Lax(combination)TabletEnteric-coate d (c) Boniva(ibandronate)TabletNote: chewed, Crushed , or sucked tablets may cause oropharyngeal irritationBriviact(brivaracetam)TabletFi lm-coated (b) oral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 3 of 16 Bromfed PD(combination)CapsuleSlow-releaseBudepr ion SR (buPROPion)TabletSlow-releaseBunavail(co mbination)Buccal filmNote: chewing or swallowing may result in lower peak concentrations and bioavailabilityCabometyx(cabozantinib)Ta bletFilm-coatedCalan SR(verapamil)TabletSlow-release (h)Carbatrol(carBAMazepine)CapsuleSlow-r elease (a)Cardene SR(niCARdipine)CapsuleSlow-releaseCardiz em(diltiazem)TabletNote: although not in the package insert, the drug has a coating that is intended to release the drug over approximately 3 hoursCardizem CD(diltiazem)CapsuleSlow-releaseCardizem LA(diltiazem)TabletSlow-releaseCardura XL(doxazosin)TabletSlow-releaseCartia XT(diltiazem)CapsuleSlow-releaseCefaclor ER------TabletSlow-release (b)Ceftin(cefuroxime)TabletTaste (b) (Note: use suspension for children)Cefuroxime------TabletTaste (b) (Note: use suspension for children)CellCept(mycophenolate)Capsule.

4 TabletTeratogenic potential (i)Cerdelga(eliglustat)CapsulePreferably taken with waterCharcoal Plus------TabletEnteric-coatedChlor-Trim eton 12-H(combination)TabletSlow-release (b)Cholbam(cholic acid) CapsuleNote: capsules may be opened and the contents mixed with food/drinkCipro XR(ciprofloxacin)TabletSlow-release (b)Claritin-D 12 Hour(combination)TabletSlow-releaseClari tin-D 24 Hour(combination)TabletSlow-releaseColac e(docusate)CapsuleTaste (e) Colestid(colestipol)TabletSlow-releaseCo mmit(nicotine)LozengeNote: integrity compromised by chewing or crushingConcerta(methylphenidate)TabletS low-releaseContrave(combination)TabletSl ow-release (Note: chewing, dividing, or crushing tablets may alter release rate) oral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 4 of 16 Coreg CR(carvedilol)CapsuleSlow-release (a) (Note: may add contents of capsule to chilled, not warm, applesauce and consume immediately)Cotazym-S(pancrelipase)Capsu leEnteric-coated (a)Covera-HS(verapamil)TabletSlow-releas eCreon 5, 10, 20(pancrelipase)CapsuleSlow-release (a)Crixivan(indinavir)CapsuleTaste (Note: capsule may be opened and mixed with fruit puree [ , banana])Cymbalta(DULoxetine)CapsuleSlow- release (a) (Note: may add contents of capsule to apple juice or applesauce but NOT chocolate)Cytovene(ganciclovir)CapsuleSk in irritantCytoxan(cyclophosphamide)TabletN ote: drug may be Crushed but company recommends using injectionDepakene(divalproex)CapsuleSlow -release.

5 Mucus membrane irritant (b)Depakote(divalproex)TabletSlow-releas eDepakote ER(divalproex)TabletSlow-releaseDetrol LA(tolterodine)CapsuleSlow-releaseDexila nt(dexlansoprazole)CapsuleSlow-release (a)Diclegis(combination)TabletSlow-relea seDilacor XR(diltiazem)CapsuleSlow-releaseDilatrat e-SR(isosorbide)CapsuleSlow-releaseDilt- CD(diltiazem)CapsuleSlow-releaseDiltia XT(diltiazem)CapsuleSlow-releaseDitropan XL(oxybutynin)TabletSlow-releaseDivalpro ex ER(divalproex)TabletSlow-releaseDoxidan( bisacodyl)TabletEnteric-coated (c) Drisdol(ergocalciferol)CapsuleLiquid filled (d)Droxia(hydroxyurea)CapsuleNote: exposure to the powder may cause serious skin toxicities; health care workers Should wear gloves to administerDulcolax(bisacodyl)Capsule; TabletEnteric-coated (c); Liquid-filledDurlaza(aspirin) CapsuleSlow-releaseDynaCirc CR(isradipine)TabletSlow-releaseOral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 5 of 400(erythromycin)TabletEnteric-coated (b)Easprin(aspirin)TabletEnteric-coatedE C-Naprosyn(combination)TabletEnteric-coa tedEcotrin Adult Low Strength(aspirin)TabletEnteric-coatedEco trin Maximum Strength(aspirin)TabletEnteric-coatedEco trin Regular Strength(aspirin)TabletEnteric-coatedEff er-K(potassium bicarbonate)TabletEffervescent tablet (f)Effervescent Potassium------TabletEffervescent tablet (f)Effexor XR(venlafaxine)CapsuleSlow-releaseEmbeda (morphine sulfate)CapsuleSlow-release (a)E-Mycin(erythromycin)TabletEnteric-co atedEnablex(darifenacin)TabletSlow-relea seEntocort EC(budesonide)CapsuleEnteric-coated (a)Envarsus XR(tacrolimus) TabletSlow-releaseEpanova(omega-3-carbox ylic acids)CapsuleNote.

6 Contents of capsule may erode walls of Styrofoam or plastic materialsEquetro(carBAMazepine)CapsuleSl ow-release (a)Ergomar(ergotamine)TabletSublingual form (g)Erivedge(vismodegib)CapsuleNote: package insert indicates potential teratogenic effects; material safety data sheet warns against skin contact; health care workers Should take appropriate precautionsEry-Tab(erythromycin)TabletEn teric-coatedErythromycin Base-----TabletEnteric-coatedErythromyci n Delayed-Release------CapsuleEnteric-coat ed pellets (a)Erythromycin Stearate------TabletEnteric-coatedEvista (raloxifene)TabletTaste; teratogenic potential (i)Exalgo(HYDRO morphone)TabletSlow-release (Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose)Exjade(deferasirox)TabletNote: do not give as whole tablet, tablets are meant to be given as oral suspension; see company insertExtendryl JR(combination)CapsuleSlow-releaseOral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 6 of 16 Extendryl SR(combination)CapsuleSlow-release (b)Farydak(panobinostat) CapsuleIrritantFeen-a-mint(bisacodyl)Tab letEnteric-coated (c) Feldene(piroxicam)CapsuleMucous membrane irritantFentaNYL------LozengeSlow-releas e (Note: this lollipop delivery system requires the patient to slowly dissolve in mouth)Fentora(fentaNYL)TabletNote: buccal tablet.

7 Swallow wholeFeosol(ferrous sulfate)TabletEnteric-coated (b)Feratab(ferrous sulfate)TabletEnteric-coated (b)Fergon(ferrous gluconate)TabletEnteric-coatedFero-Grad 500 mg(combination)TabletSlow-releaseFerro-S equels(combination)TabletSlow-releaseFla gyl ER(metroNIDAZOLE)TabletSlow-releaseFleet Laxative(bisacodyl)TabletEnteric-coated (c) Flomax(tamsulosin)CapsuleSlow-releaseFoc alin XR(dexmethylphenidate)CapsuleSlow-releas e (a)Fortamet(metFORMIN)TabletSlow-release Fosamax(alendronate)TabletMucous membrane irritantGleevec(imatinib)TabletTaste (h) (Note: may be dissolved in water or apple juice)GlipiZIDE XR(glipiZIDE)TabletSlow-releaseGlucophag e XR(metFORMIN)TabletSlow-releaseGlucotrol XL(glipiZIDE)TabletSlow-releaseGlumetza( metFORMIN)TabletSlow-releaseGralise(gaba pentin)TabletSlow-releaseGuaifed(combina tion)CapsuleSlow-releaseGuaifed-PD(combi nation)CapsuleSlow-releaseGuaifenex DM(combination)TabletSlow-release (h)Guaifenex GP(combination)TabletSlow-releaseGuaifen ex PSE(combination)TabletSlow-release (h)GuaifFENesin/Pseudoephedrine------Tab letSlow-releaseGuaiMAX-D(combination)Tab letSlow-releaseHalfprin 81(aspirin)TabletEnteric-coatedOral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 7 of 16 Hetlioz(tasimelteon)CapsuleNote: not scored; no studies available from companyHista-Vent DA(combination)TabletSlow-release (h)Horizant(gabapentin)TabletSlow-releas eHydrea(hydroxyurea)CapsuleNote: exposure to the powder may cause serious skin toxicities.

8 Health care workers Should wear gloves to administerHysingla ER(HYDRO codone)TabletSlow-release (Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose of HYDRO codone)Imbruvica(ibrutinib)CapsuleNote: not scored; no studies available from companyImdur(isosorbide)TabletSlow-relea se (h)Impavido(miltefosine)CapsuleNote: not scored; no studies available from companyInderal LA(propranolol)CapsuleSlow-releaseIndoci n SR(indomethacin)CapsuleSlow-release (a,b)InnoPran XL(propranolol)CapsuleSlow-releaseIntele nce(etravirine)TabletNote: tablet Should be swallowed whole and not Crushed ; tablet may be dispersed in waterIntermezzo(zolpidem)TabletSublingua l form (g)Intuniv(guanFACINE)TabletSlow-release Invega(paliperidone)TabletSlow-releaseIr essa(gefitinib)TabletNote: tablet may be dissolved in 4-8 ounces of waterIsoptin SR(verapamil)TabletSlow-release (h)Isordil Sublingual(isosorbide)TabletSublingual form (g)Isosorbide Dinitrate Sublingual(isosorbide)TabletSublingual form (g)Isosorbide SR(isosorbide)TabletSlow-releaseJakafi(r uxolitinib)TabletNote: see prescribing information for making a suspensionOral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 8 of 16 Jalyn(combination)CapsuleMucous membrane irritant (Note: women who are, or may become, pregnant, Should not handle Crushed or broken tablets [l])Janumet XR(combination)TabletSlow-releaseJentadu eto XR (combination) TabletSlow-releaseKadian(morphine)Capsul eSlow-release (a) (Note.)

9 Do not give via NG tubes)Kaletra(combination)TabletFilm-coa tedKaon-CL-10(potassium)TabletSlow-relea se (b)Kapidex(dexlansoprazole)CapsuleSlow-r elease (a) (Note: name changed to Dexilant)Kapvay(cloNIDine)TabletSlow-rel easeKazano(combination)TabletNote: not scored; no studies available from companyK-Dur(potassium)TabletSlow-releas eKeppra(levETIRA cetam)TabletTaste (b) (Note: some extemporaneous formulas are pharmacy prepared)Keppra XR(levETIRA cetam)TabletSlow-release (b)Ketek(telithromycin)TabletSlow-releas e (b)Khedezla(desvenlafaxine)TabletSlow-re leaseKlor-Con (potassium)TabletSlow-release (b)Klor-Con M(potassium)TabletSlow-release (b,h)Klotrix(potassium)TabletSlow-releas eK-Lyte(potassium)TabletEffervescent tablet (f)K-Lyte CL(potassium)TabletEffervescent tablet (f)K-Lyte DS(potassium)TabletEffervescent tablet (f)Kombiglyze XR(combination)TabletSlow-release (Note: tablet matrix may remain in stool)K-Tab(potassium)TabletSlow-release (b)LaMICtal XR(lamoTRIgine)TabletSlow-releaseLenvima (lenvatinib)CapsuleNote.

10 May be dissolved in a small glass of liquidLescol XL(fluvastatin)TabletSlow-releaseLetairi s(ambrisentan)TabletSlow-releaseLevbid(h yoscyamine)TabletSlow-release (h)Levsinex Timecaps(hyoscyamine)CapsuleSlow-release oral Dosage Forms that Should Not Be Crushed 2016 You may purchase a wall chart version of this list at: 9 of 16 Lialda(mesalamine)TabletSlow-releaseLiqu ibid-PD(combination)TabletSlow-release (h)Lithobid(lithium)TabletSlow-releaseLo drane 24(brompheniramine)CapsuleSlow-releaseLo drane 24D(combination)CapsuleSlow-releaseLoHis t 12 Hour(brompheniramine)TabletSlow-releaseL ovaza(combination)CapsuleNote: contents of capsule may erode walls of Styrofoam or plastic materialsLuvox CR(fluvoxaMINE)CapsuleSlow-releaseMaxife d DM(combination)TabletSlow-release (h)Maxifed DMX(combination)TabletSlow-release (h)Maxiphen DM(combination)TabletSlow-release (h)Medent-DM(combination)TabletSlow-rele aseMestinon ER(pyridostigmine)TabletSlow-release (b)Metadate CD(methylphenidate)CapsuleSlow-release (a)Metadate ER(methylphenidate)TabletSlow-releaseMet hylin ER(methylphenidate)TabletSlow-releaseMet oprolol ER------TabletSlow-releaseMicro K Extencaps(potassium chloride)CapsuleSlow-release (a,b)Miraphen PSE(combination)TabletSlow-releaseMorpha bond(morphine)TabletSlow-release (b)Morphine sulfate extended-release------TabletSlow-release Motrin(ibuprofen)TabletTaste (b,e) Movantik()