1st edition

King Abdul Aziz University Hospital

Pharmaceutical Services Department

Crushing Guide for

Oral Medication
Do NOT Rush To Crush

2021
 1st edition
King Abdul Aziz University Hospital
Pharmaceutical Services Department

Crushing Guide for

Oral Medication
Done by:
RPh. Mawhiba Alqurbi , R1 Ph. Practice Resident
Rph. Samiah Alsohimi , R1 Ph. Practice Resident
Rph. Aisha Alharbi, R1 Ph. Practice Resident

Edited and Reviewed by:

RPh. Nada Asali , Inpatient Pharmacy Supervisor
Rph. Suha Alhebshi, Acting Supervisor (Inpatient pharmacy)

Attested by:
Dr. Hussain Bakhsh, Pharmacy Director
 PREFACE

The pharmaceutical services department in King Abdul-Aziz University

Hospital is proud to develop the first edition of the Crushing Guide for Oral
Medication for nurses and other health care professionals who need a practical
resource for preparing oral medications for patients who have problems
swallowing or those who are fed via feeding tubes and cannot use tablets or
capsules in their whole solid form. In actual fact, If the medications are given via
the feeding tubes without the correct advice, drug bioavailability may be altered,
tubes may become occluded, or drugs may bind to the feeding tube.

We hope this guide will be a reliable, reputable, and quick reference for nursing
staff and other health care professionals in our hospital. In order to achieve the
mission of our hospital. We hope that practitioners utilize this guide in their daily
practice and will find it to be a great tool towards achieving the goal of safe
patient care.

However, we welcome any comments and suggestions. Please feel free to call
the Pharmacy department on extension: 17151, 17308

RPh. Nada S. Asali

Supervisor, Inpatient pharmacy Services
King Abdulaziz University Hospital - Jeddah

RPh. Suha Alhebshi

Acting Supervisor, Inpatient pharmacy Services
King Abdulaziz University Hospital – Jeddah
 Symbols and Abbreviations

DO NOT CRUCH
DO NOT open the capsule
Scored tablet
Hazard
Irritant

Caution
Dispersed the tablet
Open and dispersed the capsule
Highlighted medication with green color indicates that it's
safe to crush
Highlighted medication with yellow color indicates that this
item can be crushed with caution or no data is available
Highlighted medication with light red color indicates that this
item can NOT be crushed
 Don’t rush to crush!
There are multiple reasons for crushing tablets or capsule contents before
administering medications, but there are numerous medications that should not be
crushed. These medications should not be chewed, either, usually due to their specific
formulations and their pharmacokinetic properties also crushing can increase the risk
of drug toxicity.

Generally, medications that should not be crushed fall into one of these categories:

Sustained-release tablets: which can be composed of multiple layers for different

drug release times, as can beads within capsules. Some of the more common
prefixes or suffixes for sustained-release, controlled-release, or controlled-
delivery products include: 12-hour, 24-hour, CC, CD, CR, ER, LA, Retard, SA, Slo-,
SR, XL, XR, or XT.
Enteric-coated tablets: which are formulated because certain drugs can be
irritating to the stomach or are degraded by stomach acid. By enteric-coating
tablets or capsule beads, the drug’s release can be delayed until it reaches the
small intestine. Prefixes include EN- and EC-.

This guideline includes many of these types of formulations, along with their do’s and
don’ts. If there is ever any doubt about the best way to administer a particular product
or whether it can be halved or crushed, even if any brand names are not included in
this guide, kindly contact the pharmacy.
If your patient has difficulty swallowing or has an enteral
feeding tube in place, ask your pharmacist:

• Can I crush it?

• Can I dissolve or disperse it?

• Can I open the capsule to crush contents?

• Can I use a liquid formula alternative?

• Can I give injection contents orally?

A TO Z LIST
Alphabetical
Medication List
 Crushing Guide for Oral Medication
Dosage Trade Name
# MEDICATION NAME INSTRUCTION AND PREPARATION STEPS REASON FOR NOT CRUSH
form Company

1 acetaZOLAMIDE 250 mg Tablet DO NOT CRUSH (2) Acetazolamide ® Manufacture instruction

2 Acetylsalicylic Acid 100 / 300 mg Tablet DO NOT CRUSH (2) Azera ® Enteric coated tablet

3 Acetylsalicylic Acid 300 mg Tablet Can be crushed (2) Bayer Aspirin

(4)
1.Disperse the tablet in at least 50 mL water until dissolved
4 Acyclovir 200 mg Tablet Virustat®
2.Withdraw the required dose

5 Albendazole 200 mg Tablet Scored tablet can be divided or crushed (2) Vermizole®

6 Alfuzosin HCl 10 mg XR Tablet DO NOT CRUSH (2) Uritab® XL Extend release tablet

7 ALLOPURINol 100 mg
Tablet Can be crushed (1) No-Uric®
8 ALLOPURINol 300 mg

(2)
9 AmiODAROne HCl 200 mg Tablet Can be crushed Sidacorone®

10 AmITRIPTYLIne HCl 10 mg
Tablet NOT recommended Amitriptyline® No specific data are available
11 AmITRIPTYLIne HCl 25 mg

12 AmLODIPine Besilate 5 mg Tablet Scored tablet can be divided or crushed (2) Lodipam®

1.Open Up the Capsule and dilute it with 10 mL water (4)

13 Amoxicillin Trihydrate 500 mg Capsule Omacillin®
2.Withdraw the required dose

14 Apixaban 2.5 mg
Tablet Crush the tablet and mix with water, apple juice, or glucose 5% (5) Eliquis®
15 Apixaban 5 mg

16 ARIPiprazole 10 mg Tablet NOT recommended Arpenia® No specific data are available

17 aTENOLol 100 mg Tablet Scored tablet can be divided or crushed (2) Betaten®

18 aTENOLol 50 mg Tablet NOT recommended Betaten® No specific data are available

19 ATORVAstatin 20 mg Tablet DO NOT CRUSH (3) Atorva® Manufacture instruction

20 ATORVAstatin 40 mg Tablet DO NOT CRUSH (3) Tovast® Manufacture instruction

Hazard
21 azaTHIOprine 50 mg Tablet Tablet can be divided ONLY NOT CRUSH (2) Impurin®
Take precautions

22 azITHROMYCIN 250 mg Capsule Swallow whole capsule, DO NOT CRUSH (4) Zimax® Manufacture instruction

23 Baclofen 10 mg Tablet Scored tablet can be divided or crushed (2) Lioresal®

(1)
24 Betahistine dihydrochloride 8 mg Tablet Can be crushed Lavistina®

25 Bisaodyl 5 mg Tablet DO NOT CRUSH (2) Dulcolax® Gastro-resistant tablet

26 bisOPROLOl Fumarate 2.5 mg Tablet

Scored tablet can be divided or crushed (2) Cardicor®
27 bisOPROLOl Fumarate 5 mg Tablet

28 Bromocriptine Mesilate 2.5 mg Tablet Scored tablet can be divided or crushed (2) Parlodel®

(2)
29 beDESONide 9 mg Tablet DO NOT CRUSH Cortiment® Prolonged release tablet

(2)
30 Cabergoline 0.5 mg Tablet Scored tablet can be divided or crushed Nostifix®

Crush the tablet and mix with at least 30 mL of water, then draw into an
31 Calcium Carbonate 600 mg Tablet (5) Caltrate®
enteral syringe

(1)
32 Calcium Leucovorin 15 mg Capsule Tablets will disperse in 10 mL of water within 5 minutes Unifolin®

33 Calcium, Magnesium, Zinc & Vit D Tablet NOT recommended Osteocare® No specific data are available
 Crushing Guide for Oral Medication
Dosage Trade Name
# MEDICATION NAME INSTRUCTION AND PREPARATION STEPS REASON FOR NOT CRUSH
form Company

(3) Hazard
34 Capecitabine 500 mg Tablet Avoid cutting OR crushing tablets Xeloda®
Take precautions

35 caPTOPRil 25 mg Tablet Scored tablet can be divided or crushed (2) Acetab®

36 caPTOPRil 50 mg Tablet Scored tablet can be divided or crushed (2) Omapril®

37 carBAMazepine 200 mg ,400 mg CR Tablet Tablet can be divided ONLY NOT CRUSH (2) Tegretol® CR Slow release tablet

38 carBAMazepine 200 mg Tablet Scored tablet can be divided or crushed (2) Tegretol®

39 carbiMAZOLe 5 mg Tablet DO NOT CRUSH (5) Neomercazole® Manufacture instruction

40 Carvedilol 25 mg Tablet Scored tablet can be divided or crushed (2) Carvidol®

41 cephaLEXin 250 mg Capsule DO NOT CRUSH (2) Cephadar® Sensitisation to cephalosporins

(5)
42 Cetirizine HCl 10 mg Tablet Can be crushed Omcet®

43 Chloroquine PO4 250 mg, 150 mg Tablet Scored tablet can be divided or crushed (2) Resochin®

(2)
44 chlorproMAZINE HCl 25 mg Tablet DO NOT CRUSH Largactil® Manufacture instruction

45 Cholecalciferol (Vit. D3) 10,000 unit Capsule DO NOT CRUSH (2) Divad® 100000 IU Gelatin capsule

46 Cinacalcet 30 mg Tablet DO NOT CRUSH (2) Endolet® Manufacture instruction

(2)
47 Cinnarizine 25 mg Tablet Scored tablet can be divided or crushed Stugeron®

Crush the tablet and mix with 20–60 mL of water, then draw into an enteral
48 ciPROFLOXAcin HCl 250 mg Tablet Ciprocin®
syring (5)

49 ciPROFLOXAcin HCl 500 mg Tablet Scored tablet can be divided or crushed (2) Omacip®

50 cLARITHROMYcin 250 mg Tablet Scored tablet can be divided or crushed (2) Clarixin®

51 Clindamycin HCl 150 mg Capsule Open the capsule and disperse the contents in 10 mL of water (1) Dalacin®-C

Hazard
52 Clomiphene Citrate 50 mg Tablet DO NOT CRUSH (3) Fertab®
Take precautions

53 clomiPRAMINE HCl 25 mg Tablet DO NOT CRUSH (4) Anafranil® Manufacture instruction

54 cloNIDine HCl 150 mcg Tablet Scored tablet can be divided or crushed (2) Catapresan®

55 Clopidogrel 75 mg Tablet Can be crushed and mixed with 10 mL water (1) Plavix® OR Clogrel®

56 Cloxacillin Na 250 mg Capsule NOT recommended Klox® No specific data are available

57 Co-Amoxiclav 375 mg Tablet

(2)
Scored tablet can be divided or crushed Amoclan®
58 Co-Amoxiclav 625 mg Tablet

59 Co-Careldopa 125 mg Tablet Scored tablet can be divided or crushed (2) Credanil®

60 Co-Careldopa 275 mg Tablet Scored tablet can be divided or crushed (2) Levomed®

61 Co-Trimoxazole 960 mg Tablet Scored tablet can be divided or crushed (2) Bactrim®

Can be crushed and dispersed within 2 minutes when placed in 10 mL of

62 Colchicine 500 mcg Tablet Yashicolsin®
water (1)

(4) Hazard
63 Cyclophosphamide 50 mg Tablet DO NOT CRUSH Endoxan®
Take precautions

64 cycloSERINE 250 mg Tablet Can be crushed (2) Coxerin®

65 cycloSPORINE 25 mg Capsule
(1)
NOT suitable for administration via feeding tube Neoral® Soft gelatin capsules
66 cycloSPORINE 50 mg Capsule
 Crushing Guide for Oral Medication
Dosage Trade Name
# MEDICATION NAME INSTRUCTION AND PREPARATION STEPS REASON FOR NOT CRUSH
form Company

67 cycloSPORINE 100 mg Capsule NOT suitable for administration via feeding tube (1) Neoral® Soft gelatin capsules

68 Dapsone 100 mg Tablet SHOULD NOT BE CRUSHED (2) Dapsone® Manufacture instruction

Crush the tablet and mix with water, then draw into an enteral syringe or
69 Deferasirox 360 mg Tablet (5) Jadenu®
Crush the tablet and mix with a spoonful of yoghurt or apple puree

70 Deferasirox 500 mg Tablet DO NOT CRUSH (2) Defirox® Manufacture instruction

71 Deferiprone 500 mg Tablet DO NOT CRUSH (4) Kelfer® Manufacture instruction

72 Desloratadine 5 mg Tablet NOT recommended Desloratadine® No specific data are available

73 Desmopressin 60 mcg Tablet Can be crushed (2) Minirin Melt®

74 Dexamethasone 0.5 mg Tablet Scored tablet can be divided or crushed (2) Dexamed®

(1)
75 Dexamethasone 4 mg Tablet Can be dispersed in water Dexamethasone®

76 Diclofenac Potassium 50 mg Tablet DO NOT CRUSH (2) Diclopid® Manufacture instruction

(2)
77 dIGOXin 0.25 mg Tablet Scored tablet can be divided or crushed Lanoxin® and Digoksin®

78 dilTIAZem HCl SR 90 mg Tablet DO NOT CRUSH (2) Dilzem® Prolonged Release Tablet

79 Diosmin + Hesperidine 500 mg Tablet NOT recommended Daflon® No specific data are available

(2)
80 Domperidone 10 mg Tablet DO NOT CRUSH Dompy® Manufacture instruction

(3)
81 Donepezil Hydrochloride 5 mg Tablet DO NOT CRUSH Dementile® Manufacture instruction

82 Doxycycline Hyclate 100 mg Capsule DO NOT open capsules as the contents are irritant (1) Tabocin® Irritant

83 Dutasteride + Tamsulosin HCl 0.5 mg/0.4 mg Capsule DO NOT CRUSH (2) Duodart® Modified-release

84 Dydrogesterone 10 mg Tablet Scored tablet can be divided or crushed (2) Duphaston®

85 Empagliflozin 25 mg Tablet NOT recommended Jardiance® No specific data are available

86 Enalapril Maleate 10 mg Tablet Scored tablet can be divided or crushed (2) Korandil®

Hazard
87 Entecavir 0.5 mg Tablet DO NOT CRUSH (5) Hepavir®
Take precautions

88 ERYthromycin Stearate 250 mg Tablet Can be crushed (2) Omathrocin®

89 Escitalopram 10 mg Tablet
Scored tablet can be divided or crushed (2) Citoxal®
90 Escitalopram 20 mg Tablet

91 Ethambutol 100 mg Tablet DO NOT CRUSH (2) EMB-Fato®l Manufacture instruction

92 Ethambutol 400 mg Tablet Scored tablet can be divided or crushed (2) Lybutol®

Insoluble in aqueous media, but tablets disperse in 10 mL of water within 5

93 Ezetimibe 10 mg Tablet Zelex®
minutes if shake (1)

94 Febuxostat 40 mg Tablet Can be crushed (2) Agout®

Ferrous Sulphate 190 mg (5)

95 Tablet DO NOT divide, crush, chew or disperse Feromin® Manufacture instruction
(60 mg Elemental Iron)

(2)
96 Fevadol Plus Tablet DO NOT CRUSH Fevadol® Plus Manufacture instruction

97 Finasteride 5 mg Tablet Disperse within 5 minutes when placed in 10 mL of water (1) Finiscar®

(2)
98 Flecanide Acetate 100 mg Tablet Scored tablet can be divided or crushed Flecatab®

(1)
99 Fluconazole 50 mg Capsule Powder from capsules can be mixed with10 mL water Cadivast®
 Crushing Guide for Oral Medication
Dosage Trade Name
# MEDICATION NAME INSTRUCTION AND PREPARATION STEPS REASON FOR NOT CRUSH
form Company

100 Fludrocortisone 100 mcg Tablet Dispersed in water within 1 minute, give immediately after dispersing (1) Fludrocortisone®

101 Folic Acid 5 mg Tablet Scored tablet can be divided or crushed (2) Befolvit®

Disperse the tablet in 10–20 mL of water in an oral dispenser.The tablet will

102 Furosemide 40 mg Tablet (5) Lasix®
disperse in 2 to 5 minutes

103 gliBENCLAMide 5 mg Tablet Scored tablet can be divided or crushed (2) Glibil®

104 gliCLAZide 30 mg Tablet DO NOT CRUSH (2) Diamicron® MR Modified release tablet

105 gliCLAZide 80 mg Tablet Scored tablet can be divided or crushed (2) Glaze®

106 gliMEPIRide 2 mg Tablet Scored tablet can be divided or crushed (2) Amaglime®

107 gliMEPIRide 3 mg Tablet Scored tablet can be divided or crushed (2) Amaglime®

(1)
108 Granisetron HCl 1 mg Tablet Dispersed in 10 mL of water and shaken for 5 minutes Kytril®

109 Haloperidol 1.5 mg Tablet Can be crushed (2) Avant®

(2)
110 hydrALAZINE HCl 25 mg Tablet Can be crushed Hydralazine®

111 hydroCHLOROthiazide 25 mg Tablet Can be crushed (2) Remedica®

112 Hydrocortisone 10 mg Tablet

(2)
Scored tablet can be divided or crushed Hydrocortisone®
113 Hydrocortisone 5 mg Tablet

(2)
114 Hydroxychloroquine SO4 200 mg Tablet DO NOT CRUSH Quinoricl® Manufacture instruction

The content of capsule can be emptied into a glass of water and taken Hazard
115 hydroxyUREA 500 mg Capsule Cureaml®
immediately (2) Take precautions

116 hyoscine BUTYLbromide 10 mg Tablet Can be crushed (1) Spasmopan®

117 Ibuprofen 400 mg Tablet DO NOT CRUSH (2) Omafen® Manufacture instruction

It is difficult to crush owing to their small size and coating, but once
118 Imipramine HCl 10 mg Tablet Imipramine® Not recommended
crushed it disperses well in water and flush (1)

119 Imipramine HCl 25 mg Tablet Scored tablet can be divided or crushed (2) Imipramine®

120 Indapamide 1.5 SR Tablet DO NOT CRUSH (2) Normalix® Sustained-release tablet

121 Indomethacin 25 mg Capsule DO NO OPEN CAPSULE (2) Indomethacin® Manufacture instruction

122 Irbesartan 150 mg + Hydrochlorothiazide 12.5 mg Tablet DO NOT CRUSH (2) Co-Aprovel® Manufacture instruction

123 Irbesartan 150 mg Tablet Tablets disperse in 10 mL water within 2–5 minutes to give fine milky
dispersion with some larger particles;these break up when drawn into the Irovel®
124 Irbesartan 300 mg Tablet syringe and flush down an NG tube without blockage (1)

125 Isoniazide 100 mg (INH) Tablet

Scored tablet can be divided or crushed (2) Isoniazide®
126 Isoniazide 300 mg (INH) Tablet

127 Isosorbide Dinitrate 10 mg Tablet Scored tablet can be divided or crushed (2) Isorem®

(1)
128 Isosorbide Dinitrate 20 mg Tablet DO NOT CRUSH Actavis® Manufacture instruction

(3) (7)
129 Itraconazole 100 mg Capsule DO NO OPEN CAPSULE Tracon® Manufacture instruction

130 lamoTRIgine 100 mg Tablet Can be crushed (4) Lamira®

(4)
131 lamoTRIgine 50 mg Tablet Can be crushed Lamictal®

132 Lercanidipine HCl 10 mg Tablet Scored tablet can be divided or crushed (2) Lercardip®
 Crushing Guide for Oral Medication
Dosage Trade Name
# MEDICATION NAME INSTRUCTION AND PREPARATION STEPS REASON FOR NOT CRUSH
form Company

Hazard
133 Letrozole 2.5 mg Tablet DO NOT CRUSH (2) Femara®
Take precautions

134 LevETIRAcetam 500 mg Tablet Scored tablet can be divided or crushed (2) Epitam®

135 Linagliptin 5 mg Tablet NOT recommended Trajenta® No specific data are available

136 Linezolid 600 mg Tablet NOT recommended Zyvox® No specific data are available

137 Loperamide HCl 2 mg Capsule NOT recommended Imodium® No specific data are available

138 Loratadine 10 mg Tablet Scored tablet can be divided or crushed (2) Lohist®

139 Maprotiline HCl 25 mg Tablet Don’t divide or crush (4) Epalon® Manufacture instruction

140 Mebendazole 100 mg Tablet Scored tablet can be divided or crushed (2) Vermox®

(2)
141 medroxyPROGESTERone Acetate 5 mg Tablet Scored tablet can be divided or crushed Provera®

142 Mefenamic Acid 500 mg Tablet Scored tablet can be divided or crushed (2) Mafepin®

143 Meloxicam 15 mg Tablet

Scored tablet can be divided or crushed (2) Coxicam®
144 Meloxicam 7.5 mg Tablet

145 Mercaptopurine 50 mg Tablet DO NOT CRUSH (2) Puri-nethol® Manufacture instruction

(2)
146 Mesalazine 500 mg Tablet Scored tablet can be divide ONLY not crush Pentaza® Slow release tablet

147 metFORMIN HCl 850 mg Tablet Tablets are film coated but can be crushed if required, it do not disperse Glucophage®
well in water owing to the size of the tablet, but do crush easily and
(1)
148 metFORMIN HCl 500 mg Tablet disperse well in water . Omformin®

149 metHOTREXATe 2.5 mg Tablet

Hazard
(1)
The tablets will dispersed in water Ebewe® Take precautions to avoid
exposure to the cytotoxic agent
150 metHOTREXATe 10 mg Tablet

151 methylDOPA 250 mg Tablet NOT recommended Aldomet® No specific data are available

152 metOCLOPRAMIDe HCl 10 mg Tablet Scored tablet can be divided or crushed (2) Primperan®

153 metroNIDAZOLE 500 mg Tablet Disintegrate within 2–5 minutes when placed in 10mL of water (1) Riazole®

154 Mirtazapine 30 mg Tablet Scored tablet can be divided or crushed (2) Mirzagen®

155 Montelukast 10 mg Tablet NOT recommended Proncast® No specific data are available

Chewable
156 Montelukast 4 mg NOT recommended Airfast® No specific data are available
Tablet

157 MOXifloxacin HCl 400 mg Tablet DO NOT CRUSH (2) Moxive® Manufacture instruction

158 Multivitamin Tablet NOT recommended Multivitamin® No specific data are available

159 Mycophenolate Mofetil 500 mg Tablet DO NOT CRUSH (2) Cellcept® Teratogenic

160 Nebivolol 5 mg Tablet Scored tablet can be divided or crushed (2) Nebilet®

Hard (2)
161 Netupitant/Palonosetron (300 mg/0.5mg) DO NOT CRUSH Akynzeo® Manufacture instruction
Capsule

(2)
162 NIFEdipine 20 mg (retard) Capsule DO NOT CRUSH Adalat® retard Time-release tablets

163 niMODipine 30 mg Tablet Can be crushed (1) Nimtop®

(1)
164 Nitrofurantoin 100 mg Capsule Capsule can be opened and contents mixed with Water Uvamin®

165 Olanzapine 5, 10 mg Tablet Can be crushed and mix with juice or milk (2) Pranza®
 Crushing Guide for Oral Medication
Dosage Trade Name
# MEDICATION NAME INSTRUCTION AND PREPARATION STEPS REASON FOR NOT CRUSH
form Company

166 Omeprazole 10 mg MUPS Tablet DO NOT CRUSH (2) Losec® MUPS Manufacture instruction

167 Omeprazole 20 mg Tablet Can be crushed and dissolved in 10 mL of 8.4% sodium bicarbonate (1) Omedra®

168 Ondansetron HCl 4 mg Tablet

Tablets can be disperse in water within 3 minutes in 5 mL water (5) Zoron®
169 Ondansetron HCl 8 mg Tablet

170 Orphenadrine Citrate 100 mg Tablet DO NOT CRUSH (4) Orphenadrine® Citrate Extend release tablet

171 Oseltamivir 75 mg Capsule DO NOT BREAK OR CHEW THE CAPSULE (2) Oselta® Manufacture instruction

172 Oxybutynin HCl 5 mg Tablet Scored tablet can be divided or crushed (2) Ditropan

173 Pantoprazole 20 mg Tablet DO NOT CRUSH (2) Proton® Enteric coated

(2)
174 Paracetamol 500 mg Tablet Scored tablet can be divided or crushed Panadrex®

175 penicillAMINE 250 mg Capsule Mix contents of capsule with fruit juice or chilled pureed fruit (3) Cupripen®

(2)
176 Pentoxifylline 400 mg Tablet DO NOT CRUSH Trental® Modified -release tablet

(2)
177 Perampanel 2 mg Tablet DO NOT CRUSH OR SPLIT Fycompa® Manufacture instruction

178 Perindopril 5 mg Tablet NOT recommended Tenyoryl® No specific data are available

(1)
179 Phenoxymethylpenicillin 250 mg Tablet Avoid crushing the tablets owing to the risk of sensitisation to penicillin Penopen® Sensitisation to penicillin

The powder can be poured from the capsules and mixed with 10 mL of
180 Phenytoin Na 100 mg Capsule Epanutin®
water (1)

Phosphate Sandoz 500 mg

181 Tablet Tablet will dissolve in 20 mL of water (2) Phosphate® Sandoz
(16.1 mmoL Phosphate)

182 Phytomenadione / Vit. K1 10 mg Tablet Scored tablet can be divided or crushed (2) Kenadion®

183 Pioglitazone 15 mg Tablet DO NOT CRUSH (2) Glados® Manufacture instruction

Potassium Chloride 600 mg

184 Tablet DO NOT CRUSH (2) K-Clor® Modified-release tablet
(8 mEq Potassium)

185 Pramipexole 0.18 mg Tablet Scored tablet can be divided or crushed (2) Sifrol®

186 Prazosin HCl 1 mg Tablet Scored tablet can be divided or crushed (2) Atodel®

187 prednisoLONE 20 mg Tablet Scored tablet can be divided or crushed (2) Corotrope®

188 PrednisoLONE 5 mg Tablet Tablet dissolves within 2 minutes to give a clear pink Solution (1) Predo®

189 propRANOLol HCl 10 mg Tablet

(3)
Dose may be DILUTED with a small quantity of milk or fruit juice Indicarin®
190 propRANOLol HCl 40 mg Tablet

191 Propylthiouracil 50 mg Tablet Scored tablet can be divided or crushed (2) Propylthiouracil ®

192 Pyrazinamide 500 mg Tablet Can be crushed and mixed with water (1) Pyrazinamide®

193 Pyridostigmine Br 60 mg Tablet Can be crush (2). Mestinon®

(1)
194 Pyridoxine HCl/Vit. B6 40 mg Tablet Tablets disintegrate within 5 minutes when placed in 10 mL of water Pyridoxine®

(3)
195 QUEtiapine Fumarate 100 mg Tablet Crush dose using immediate-release formulation, mix in 10 mL water Seroquel®

196 QUEtiapine Fumarate 200 mg XR Tablet DO NOT CRUSH (2) Seroquel®XR Extend release tablet

197 Repaglinide 0.5 mg Tablet

NOT recommended NovoNorm® No specific data are available
198 Repaglinide 1 mg Tablet
 Crushing Guide for Oral Medication
Dosage Trade Name
# MEDICATION NAME INSTRUCTION AND PREPARATION STEPS REASON FOR NOT CRUSH
form Company

199 rifaMPICin 150 mg Capsule

The powder can be poured from the capsules and mixed with 10 mL of
Rifadin®
water (4)
200 rifaMPICin 300 mg Capsule

201 risperiDONE 2 mg Tablet Scored tablet can be divided or crushed (2) Ridon®

202 Rivaroxaban 15 mg Tablet

Tablets may be crushed and mixed with apple juice immediately prior to
Varoxa®
use (3)
203 Rivaroxiban 20 mg Tablet

204 Rosuvastatin Calcium 10 mg Tablet

Tablets can be disperse in water within 5 minutes in 10 mL water (1) Ivarin®
205 Rosuvastatin Calcium 20 mg Tablet

206 Senna 8.6 mg Tablet Can be crush (2) Sena®

(2)
207 Sevelamer Carbonate 800 mg Tablet DO NOT CRUSH , but it is easly dispersed in at least 15 mL water Renomer® Manufacture instruction

208 Simethicone 180 mg Tablet NOT recommended Actcal® plus No specific data are available

(2)
209 Sodium Bicarbonate 325 mg (3.9 mEq Sodium) Tablet Can be crush Sodium Bicarbonate

(2)
210 Sodium Valproate 200 mg Tablet DO NOT CRUSH OR CHEW Depakine® Gastro resistant tablet

211 Sodium valproate 500 mg Tablet Scored tablet can be divide ONLY NOT CRUSH (2) Depakine® chrono Prolonged release

212 Solifenacin 10 mg Tablet

DO NOT CRUSH (2) Urilax® Manufacture instruction
213 Solifenacin 5 mg Tablet

214 Sotalol HCl 80 mg Tablet Scored tablet can be divided or crushed (2) Medo-Sotalol®

215 Spironolactone 100 mg Tablet

The tablets will disperse in 10 mL of water (1) Aldactone®
216 Spironolactone 25 mg Tablet

217 Sulfasalazine 500 mg Tablet DO NOT CRUSH (2) Salazopyrin® Extended release tablet

218 Sulpiride 50 mg Capsule Can be crush (2) Genprid®

219 SUMAtriptan 50 mg Tablet DO NOT CRUSH (2) Imigran® Manufacture instruction

Hazard
220 TACrolimus 1 mg Capsule Contents pour easily from capsule contents can be mixed with water (1) Prograf®
Take precautions

221 Tadalafil 20 mg Tablet DO NOT CRUSH (2) Snafi® Manufacture instruction

(4) Hazard
222 Tamoxifen Citrate 10 mg Tablet Can be crush Genox®
Take precautions

223 Telmisartan 80 mg Tablet Tablets disperse in 10 mL of water if shaken for 5 minutes (1) Nizortan®

224 Temozolomide 5 mg Capsule

Hazard
Capsule can be opened and contents mixed with water (4) Temodal® Take precautions to avoid
exposure to the cytotoxic agent
225 Temozolomide100 mg Capsule

(2)
226 Thalidomide 50 mg Tablet Tablet SHOULD NOT be chewed or sucked Talidex® Manufacture instruction

(1)
227 Theophylline 300 mg Tablet Scored tablet can be divide ONLY NOT CRUSH riaphyllin® Modified-release tablets

(4) Hazard
228 Thioguanine 40 mg Tablet Disperse the tablet in 20 mL of water. It will disperse in 2 to 5 minutes Lanvis®
Take precautions

229 Thyroxine Na 100 mcg Tablet DO NOT CRUSH OR DIVIDE (2) Eltroxin® Manufacture instruction

(2)
230 Thyroxine Na 25 mcg Tablet Scored tablet can be divided or crushed
Euthyrox®
231 Thyroxine Na 50 mcg Tablet Scored tablet can be divided or crushed (2)
 Crushing Guide for Oral Medication
Dosage Trade Name
# MEDICATION NAME INSTRUCTION AND PREPARATION STEPS REASON FOR NOT CRUSH
form Company

232 Ticagrelor 90 mg Tablet Can be crushed (2) Brilinta®

233 Topiramate 100 mg Tablet

Crush the tablets and suspend the fine particles in water, making a slurry
Topamax®
and administering immediately (1)
234 Topiramate 25 mg Tablet

Tablets can be crushed and suspended in 10 ml water. Tablets disperse in

235 Tranexamic Acid 500 mg Tablet Femic®
2–5 minutes (1)

236 Tretinoin 10 mg Capsule Puncture the capsule and squeeze contents onto a fatty food, mix (3) Vesanoid® Teratogenic

237 Ursodeoxycholic Acid 300 mg Tablet NOT recommended Ursodeoxycholic Acid No specific data are available

Hazard
238 valGANciclovir 450 mg Tablet Can be crushed (4) Valcyte®
Take precautions

239 Valsartan 160 mg Tablet Can be crushed (3) Anginet®

(3)
240 Valsartan 80 mg Tablet Can be crushed Tabuvan®

241 Valsartan + Sacubitril 50mg, 100mg, 200 mg Tablet Can be crushed (3) Entresto®

(2)
242 Venlafaxine 75, 150 mg Capsule DO NOT CRUSH OR OPEN Vexal® XR Extend release capsule

243 Verapamil HCl 40 mg Tablet Can be crushed (4) Caveril®

Hazard
244 Vigabatrine 500 mg Tablet Scored tablet can be divided or crushed (2) Sabril®
Take precautions

245 Vitamin B1 + B6 + B12 Tablet NOT recommended Neurovit® No specific data are available

(2)
246 Vitamin E 400 unit Capsule DO NOT CRUSH OR CHEW Vitamin E® Gelatin capsule

247 Voriconazole 50 mg Tablet

Can be crushed (1) Vfend®
248 Voriconazole 200 mg Tablet

249 Warfarin Na 1 mg Tablet

Rising®
250 Warfarin Na 2 mg Tablet

251 Warfarin Na 10 mg Tablet Scored tablet can be divided or crushed (2)

252 Warfarin Na 3 mg Tablet Wrfarin®

253 Warfarin Na 5 mg Tablet

 REFERENCES

(1) Handbook of drug Administration via

Enteral Feeding Tube, 3rd edition 2015.
(2) Medication company leaflet.
(3) Lexicomp.
(4) Medsafe Data Sheets and Consumer
Medicines Information
www.medsafe.govt.nz
(5) Society of Hospital Pharmacists of
Australia. Don’t rush to crush handbook.
First edition; Dec 2011.
(6) ISMP list of Oral Dosage Forms That Should
Not Be Crushed