In the midst of splitting/cutting my mum’s prescription pills, I became aware of how efficient my pill cutter was.

All I had to do was place the pills or tablets centrally under its sharp blade. Whack and there were two equal halves. Each time I used it, I couldn’t help but be reminded of a guillotine. A much less deadly mini version.

This small implement has indeed made my life so much easier in the pill splitting/cutting sphere. That said, I still manage to produce crumbles, which probably is more my fault than the gadget’s. It’s not always easy to find the scored or the indented line in the middle of pills, particularly if they are tiny and white. It’s also a little awkward to manoeuvre some pills, due to their unusual shape, to the chopping block.

Hence, I Googled pill splitters/cutters. In the hope of learning how to better use the one I already have and/or find a newer model. I learnt immediately that I, who normally asks more than a few questions and research most things, should have done both but didn’t. I was remiss. Making up for the oversight, I discovered some insightful information about pill splitting/cutting.

Splitting or cutting is obtaining a smaller amount of the whole pill. It basically allows for a smaller dose to actually be taken. I have been splitting/cutting my mum’s pills as per her cardiologist and palliative care doctor’s prescriptions for a while now. The pills prescribed were double the daily needed dosage. One is a 40mg diuretic. The other is a 5mg beta blocker and the third is a 0.5mg fast acting tranquiliser. All 3 pills have to be halved.

I didn’t consider and/or realise that one of the more common reasons for pill splitting was cost savings. Duh. Naturally, it’ll work out cheaper if the quantity of a larger and smaller dosage drug is sold at almost similar prices.

I learnt.  “The generic sertraline 100mg is an antidepressant with a line down the middle. Generic pricing for 30 tablets of 100mg averages is about $11.50. Generic pricing for 30 tablets of 50mg averages is about $10.00. By cutting the 100mg dose in half, you would save close to half of the cost[1].

The other reason for pill splitting is when the required doses are not available in the market. I checked my mum’s 3 prescription pills. I couldn’t find them in smaller doses, at least not online. Hence, the pill splitting/cutting to meet the required dosage.

Long before I got my almost precise cutter, I used a kitchen knife to split pills. I now know that’s not what knives are for. Anyways, the scored or defined line was where I placed the blade and pressed down firmly. Mostly, I managed even cuts. At times, some halves were bigger than others. This concerned me. At times, there were crumbles. This also concerned me. Was I giving my mum the correct dosage – too much or too little?

I learnt. “When a pill is split, there may be different amounts in each half of the pill. Since the active ingredient in each pill is not usually evenly distributed throughout the pill, this may lead to one half containing more of the active ingredient than the other, giving it more potency[2].” Hmm. Worrying.

I learnt. “Physical limitations: If a medical condition has made your hands weak or unsteady, or if your vision is impaired, it will be tough to split pills cleanly by yourself. Miscommunication: Your doctor may write “1/2 pill” and your pharmacist may see “1 — 2 pills.” Confusion: If you forget to split pills before taking them, you’ll take twice as much as your doctor intended[3].”

Or a combination of miscommunication, confusion and a lack of clear instructions. This happened when there was a change in the diuretic brand that my mum was already on. As before, it was 40mg to be halved and taken, but it was not clearly communicated. Gratefully, my mum was not given twice the dosage.  

I also learnt that not all pills are suitable for splitting even if they are scored. Best to avoid are pills with a hard outer coat as splitting a coated pill can make it harder to swallow and may change the way the body absorbs the medicine. Extended-release pills that are formulated to give medication slowly throughout the day. They may lose this capability if split in half.  Capsules because they contain powder or gel. Capsules must be taken whole. There are many more medicines on the not-to-be split list.

And, my biggest learning is to ask questions, clarify instructions, and ask again if unclear of the doctors, nurses and pharmacists whom I liaise with. Particularly when it comes to medicines and/or procedures that impact health and life. Or, at least, Google.