Which statement is true about crushing medications?

Which statement is true about crushing medications?

• A. All extended- or sustained-release drugs can be crushed
• B. Do not crush any extended- or sustained-release drugs
• C. Crushing improves accuracy of dosing
• D. Crushing always reduces risk of interactions

Answer: (B)

Extended-release formulations are designed to release the drug gradually over time. Crushing them disrupts that release mechanism, which can cause a sudden surge of medication in the body (dose dumping) and lead to toxicity or serious adverse effects. Many extended-release tablets also have special coatings to protect the stomach or control where in the gut the drug is absorbed; crushing would ruin these coatings and alter absorption, potentially causing irritation or reduced effectiveness. Because of these risks, the safe rule is not to crush any extended- or sustained-release drugs. If a patient has difficulty swallowing, discuss alternatives with a pharmacist or prescriber, such as a different formulation, a liquid version, or a non-oral route. Crushing does not improve dosing accuracy and can increase the risk of interactions due to unpredictable drug levels, so the other statements aren’t correct.

Extended-release formulations are designed to release the drug gradually over time. Crushing them disrupts that release mechanism, which can cause a sudden surge of medication in the body (dose dumping) and lead to toxicity or serious adverse effects. Many extended-release tablets also have special coatings to protect the stomach or control where in the gut the drug is absorbed; crushing would ruin these coatings and alter absorption, potentially causing irritation or reduced effectiveness. Because of these risks, the safe rule is not to crush any extended- or sustained-release drugs. If a patient has difficulty swallowing, discuss alternatives with a pharmacist or prescriber, such as a different formulation, a liquid version, or a non-oral route. Crushing does not improve dosing accuracy and can increase the risk of interactions due to unpredictable drug levels, so the other statements aren’t correct.