Crushing pills can be dangerous, experts warn

LONDON, Oct 26 (Reuters) Crushing pills to make them easier to swallow can be dangerous for patients' health and possibly even fatal, experts warned today.

Pills are frequently broken up to make them easier to take, especially for older people who may struggle to swallow tablets.

But a working party of pharmacists, GPs and lawyers said today in guidelines being issued to doctors that the process could release the contents of a pill too quickly, leading to potentially harmful reactions.

Often the pill has a specially designed coating which releases the drug over a controlled period of time. If these medications are crushed, the drug is released a lot quicker than intended.

This could be of particular importance when drugs such as morphine are involved.

Another is methotrexate, used by those suffering from arthritis and cancer. If crushed, it could kill cells when it comes into contact with the skin.

If Nifedipine, the slow release angina and blood pressure drug, is crushed, patients could suffer dizziness, headaches and an increased risk of stroke or heart attack.

Crushing another drug tamoxifen, which is a hormonal product taken by breast cancer patients, could release substances which are dangerous if inhaled by women who are pregnant.

GPs who tell patients to crush their tablets, or nurses who break them up, are liable to be sued for negligence.

Previous research has shown that 80 per cent of nurses in care homes resort to crushing tablets to help residents take medicines.

David Wright, senior lecturer in pharmacy at the University of East Anglia, who chaired the working party, said alternative methods to crushing are available, including a patch, liquid or inhaler.

''Guidance for nurses has been available since 2002, but hopefully these latest guidelines will raise awareness among a wider audience,'' he said.

''Crushing pills increases the risk of side-effects, of the patient getting a large dose of drug which should be released slowly, or of a drug being cleared from the body too early, before it can do anything.

''Fatalities can happen, but they are not common.'' Wright said doctors needed to check if patients were happy to swallow pills when they are first issued prescriptions, and at follow-up appointments.

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