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Common Oral Dosage Forms That Should Not Be Crushed

 

Image removed.Common Abbreviations for Release Characteristics of Drug Products

 

CC = coat core

CD = controlled dose CR = controlled release DR = delayed release

 

EC = enteric coated ER = extended release LA = long acting

SA = sustained action

 

SL = sublingual

SR = sustained release XL = extended release XR = extended release

 

 

Brand Name and Dosage Form

Generic Name

Reason

ABILIFY DISCMELT® Tablet*

Aripiprazole

Orally disintegrating

ABSTRAL® Sublingual Tablet

Fentanyl citrate

Sublingual tablet

ACIPHEX® Tablet EC

Rabeprazole sodium

Delayed release

ACTIQ® Lozenge

Fentanyl citrate

Transmucosal lozenge

ACTONEL® Tablet

Risedronate sodium

Gastroesophageal irritant

ADALAT® CC Tablet

Nifedipine

Extended release

ADDERALL XR® Capsule*

Mixed amphetamines

Extended release; may sprinkle on applesauce

ADVICOR® Tablet

Niacin/Lovastatin

Extended release

AFEDITAB® CR Tablet*

Nifedipine

Extended release

AFINITOR® Tablet

Everolimus

Skin or mucous membrane irritant

AGGRENOX® Capsule SA

Aspirin/Dipyridamole

Extended release

ALAVERT® D-12 ALLERGY-SINUS

ER Tablet*

Pseuoephedrine/Loratadine

Extended release

ALEVE® SINUS & HEADACHE

ER Caplet*

Naproxen sodium/ Pseudoephedrine

Extended release

ALLEGRA® ODT Tablet*

Fexofenadine

Orally disintegrating

ALLEGRA-D® 12 HOUR ER Tablet*

Pseudoephedrine/Fexofenadine

Extended release

ALLEGRA-D® 24 HOUR ER Tablet*

Pseudoephedrine/Fexofenadine

Extended release

ALLEGRA® ODT Tablet*

Fexofenadine

Orally disintegrating

ALTACE® Capsule

Ramipril

Manufacturer guidance: may sprinkle on

4 ounces of applesauce or mix in 4 ounces of water or apple juice

ALTOPREV® Tablet*

Lovastatin

Extended release

AMBIEN® CR Tablet*

Zolpidem tartrate

Extended release

AMITIZA® Capsule

Lubiprostone

Soft gelatin capsule

AMNESTEEM® Capsule

Isotretinoin

Gastroesophageal irritant; potential teratogenic effects

AMPYRA® ER Tablet

Dalfampridine

Extended release

AMRIX® Capsule ER*

Cyclobenzaprine HCl

Extended release

APLENZIN™ ER Tablet*

Bupropion HBr

Extended release

APRISO™ ER Capsule

Mesalamine

Extended release

 

 

Brand Name and Dosage Form

Generic Name

Reason

APTIVUS® Capsule*

Tipranavir

Oil emulsion; unpleasant taste

ARICEPT® Tablet*

Donepezil

5 mg and 10 mg tablets: bitter taste;

23 mg tablet: risk of increased absorption

ARICEPT® ODT Tablet*

Donepezil

Orally disintegrating

ARTHROTEC® EC Tablet

Diclofenac sodium/Misoprostol

Delayed release

ASACOL® EC Tablet

Mesalamine

Delayed release

ASACOL® HD DR Tablet

Mesalamine

Delayed release

ATELVIA® DR Tablet

Risedronate

Delayed release

AUGMENTIN XR® TAB*

Amoxicillin/ Potassium clavulanate

Extended release

AVINZA® Capsule*

Morphine sulfate

Extended release; contents may be sprinkled on applesauce

AVODART® Softgel

Dutasteride

Mucous membrane irritant; absorption through the skin, and could result in unintended fetal exposure and abnormalities

AZULFIDINE® EN-TAB*

Sulfasalazine

Delayed release

BAYER® 8-HOUR Caplet SA*

Aspirin

Extended release

BAYER® ASPIRIN EC Tablet*

Aspirin

Delayed release

BIAXIN® XL Tablet*

Clarithromycin

Extended release

BONIVA® Tablet

Ibandronate sodium

Gastroesophageal irritant

BONTRIL® Capsule SA

Phendimetrazine tartrate

Extended release

CALAN® SR Caplet SA*

Verapamil HCl

Extended release

CAMPRAL® DR Tablet

Acamprosate calcium

Delayed release

CARBAGLU® Tablet

Carglumic acid

Manufacturer guidance: have not studied effects of altering tablets; must disperse tablet in water prior to administration

CARBATROL® ER Capsule*

Carbamazepine

Extended release; may sprinkle on applesauce

CARDENE® SR Capsule SA*

Nicardipine HCl

Extended release

CARDIZEM® CD Capsule*

Diltiazem HCl

Extended release

CARDIZEM® LA Tablet*

Diltiazem HCl

Extended release

CARDURA® XL Tablet*

Doxazosin mesylate

Extended release

CARTIA XT® Capsule*

Diltiazem HCl

Extended release

CECLOR® CD Tablet SA*

Cefaclor

Extended release

CEFTIN® Tablet*

Cefuroxime axetil

Strong, persistent, bitter taste if crushed

CELLCEPT® Capsule*

Mycophenolate mofetil

Skin or mucous membrane irritant; potential teratogenic effects

CELLCEPT® Tablet*

Mycophenolate mofetil

Skin or mucous membrane irritant; potential teratogenic effects

CHLOR-TRIMETON® Repetab*

Chlorpheniramine maleate

Extended release

CIPRO® XR Tablet*

Ciprofloxacin

Extended release

CLARAVIS® Capsule

Isotretinoin

Gastroesophageal irritant; potential teratogenic effects

CLARINEX® Reditabs*

Desloratadine

Orally disintegrating

CLARINEX-D® 12 HOUR Tablet*

Pseudoephedrine/Desloratadine

Extended release

CLARITIN® Reditabs*

Loratadine

Orally disintegrating

 

 

 

Brand Name and Dosage Form

Generic Name

Reason

CLARITIN-D® 12 HOUR Tablet SA*

Pseudoephedrine/Loratadine

Extended release

CLARITIN-D® 24 HOUR Tablet ER*

Pseudoephedrine/Loratadine

Extended release

COLACE® Capsule*

Docusate sodium

Liquid-filled capsule; unpleasant taste; possible mucous membrane irritation

COLAZAL® Capsule

Balsalazide disodium

Staining; may sprinkle on applesauce but teeth and/or tongue staining may occur

COLESTID® Tablet*

Colestipol HCl

Manufacturer guidance: have not studied effects of altering tablets

COMMIT® Lozenge

Nicotine polacrilex

Lozenge; reduced absorption if chewed or swallowed

CONCERTA® Tablet ER*

Methylphenidate HCl

Extended release

COREG® CR Capsule*

Carvedilol phosphate

Extended release

COVERA-HS® Tablet SA*

Verapamil HCl

Extended release

CREON® Capsule EC

Pancreatin/Lipase/ Protease/Amylase

Delayed release; may sprinkle contents on a small amount of acidic soft food with a pH of 4 or less, such as applesauce, at room temperature. The soft food mixture should be swallowed immediately without crushing or chewing, and followed with water or juice to ensure

complete ingestion.

CYMBALTA® Capsule

Duloxetine HCl

Delayed release

CYTOVENE® Capsule

Ganciclovir

Skin or mucous membrane irritant

DEPAKENE® Capsule*

Valproic acid

Mucous membrane irritant

DEPAKOTE® SPRINKLE Capsule*

Divalproex sodium

Delayed release; may sprinkle contents on a small amount (teaspoonful) of soft food, such as applesauce or pudding

DEPAKOTE® DR Tablet*

Divalproex sodium

Delayed release

DEPAKOTE® ER Tablet*

Divalproex sodium

Extended release

DETROL® LA Capsule SA*

Tolterodine tartrate

Extended release

DEXEDRINE® SPANSULE®*

Dextroamphetamine sulfate

Extended release

DEXILANT™ DR Capsule

Dexlansoprazole

Delayed release; may sprinkle contents on 1 tablespoon of applesauce immediately prior to administration

DIAMOX® SEQUELS Capsule SA*

Acetazolamide

Extended release

DILACOR® XR Capsule*

Diltiazem HCl

Extended release

DILANTIN® Capsule*

Phenytoin sodium

Extended release

DILATRATE®-SR Capsule*

Isosorbide dinitrate

Extended release

DILT-CD Capsule*

Diltiazem HCl

Extended release

DITROPAN® XL Tablet SA*

Oxybutynin chloride

Extended release

DOLOBID® Tablet

Diflunisal

Manufacturer guidance: have not studied effects of altering tablets

DONNATAL EXTENTABS®*

Phenobarbital/Hyoscyamine/ Atropine/Scopolamine

Extended release

DORYX® DR Tablet*

Doxycycline hyclate

Delayed release

DRIXORAL® COLD & ALLERGY

Tablet SA

Pseudoephedrine/ Dexbrompheniramine

Extended release

DROXIA® Capsule

Hydroxyurea

Skin or mucous membrane irritant

 

 

Brand Name and Dosage Form

Generic Name

Reason

DUEXIS® Tablet*

Famotidine/Ibuprofen

Unique tablet-in-tablet formulation

DULCOLAX® Tablet EC*

Bisacodyl

Delayed release

DYNACIN® Capsule

Minocycline HCl

Gastroesophageal irritant

DYNACIRC® CR Tablet SA*

Isradipine

Extended release

EC-NAPROSYN® Tablet EC*

Naproxen

Delayed release

ECOTRIN® Caplet EC*

Aspirin

Delayed release

EFFEXOR® XR Capsule SA*

Venlafaxine HCl/ Venlafaxine ER

Extended release; package insert includes the following additional guidance: “may be

administered by carefully opening the capsule and sprinkling the entire contents on a spoonful of applesauce. This drug/food mixture should

be swallowed immediately without chewing and followed with a glass of water to ensure complete swallowing of the pellets.”

EMBEDA® Capsule

Morphine sulfate/Naltrexone

Extended release

ENABLEX® Tablet

Darifenacin hydrobromide

Extended release

ENTOCORT® EC Capsule

Budesonide

Granules are delayed release; while not FDA approved for opening, the manufacturer has data on file demonstrating the stability of sprinkling the contents of capsules on 15 g of applesauce immediately prior to administration.

EQUETRO® Capsule*

Carbamazepine

Extended release; may sprinkle on food, such as a teaspoon of applesauce or other similar

food products

ERYC® Capsule EC*

Erythromycin base

Delayed release

ERY-TAB® Tablet EC*

Erythromycin base

Delayed release

ESKALITH CR® Tablet SA*

Lithium carbonate

Extended release

EVISTA® Tablet

Raloxifene HCl

Unpleasant taste; potential for impaired fertility or teratogenicity

FACTIVE® Tablet

Gemifloxacin mesylate

Manufacturer guidance: have not studied effects of altering tablets

FAZACLO® ODT*

Clozapine

Orally disintegrating

FENTORA® Buccal Tablet

Fentanyl citrate

Buccal tablet has erratic/reduced absorption if crushed, chewed or swallowed

FERRO-SEQUELS® Tablet SA

Ferrous fumarate/ Docusate sodium

Extended release

FLAGYL® ER Tablet SA*

Metronidazole

Extended release

FLOMAX® Capsule

Tamsulosin HCl

Modified-release granules; while not FDA approved for opening, the manufacturer has data on file demonstrating it could be opened and the contents administered in a small quantity of acidic fruit juice (e.g., orange, grape) or acidic soft food (e.g., applesauce, yogurt).

FOCALIN® XR Capsule*

Dexmethylphenidate HCl

Extended release; may sprinkle contents onto a spoonful of applesauce

FORTAMET® ER Tablet*

Metformin HCl

Extended release

FOSAMAX PLUS D® Tablet*

Alendronate/Vitamin D3

Gastroesophageal irritant

FOSAMAX® Tablet*

 

 

 

 

Alendronate

Gastroesophageal irritant

 

 

Brand Name and Dosage Form

Generic Name

Reason

GLEEVEC® Capsule

Imatinib mesylate

Skin or mucous membrane irritant; may be dispersed in a glass of water or apple juice (approximately 50 mL for a 100-mg tablet, and 200 mL for a 400-mg tablet) and stirred with a spoon and administered immediately.

GLUCOPHAGE® XR Tablet SA*

Metformin HCl

Extended release

GLUCOTROL® XL Tablet SA*

Glipizide

Extended release

GLUMETZA® ER Tablet*

Metformin HCl

Extended release

GRALISE™ Tablet*

Gabapentin

Specialized tablet technology requires intact tablets be administered for proper absorption

GUAIFENEX® PSE Tablet SA*

Guaifenesin/Pseudoephedrine

Extended release

HALFPRIN® Tablet EC*

Aspirin

Delayed release

HISTATAB® D Tablet

Pseudoephedrine/ Dexchlorpheniramine/ Scopolamine

Extended release

HORIZANT™ ER Tablet*

Gabapentin enacarbil

Extended release

HYCAMTIN® Capsule

Topotecan HCl

Skin or mucous membrane irritant

HYDREA® Capsule

Hydroxyurea

Skin or mucous membrane irritant

ICAPS® AREDS FORMULA Tablet

Beta-Carotene/Vitamin C/ Vitamin E/Minerals

Delayed release

ICAPS® Tablet

Vitamin B2/Vitamin A/ Vitamin C/Vitamin E/Lutein/ Zeaxanthin/Minerals

Delayed release

ICAPS® Tablet SA

Multivitamin/minerals

Delayed release

IMDUR® Tablet SA*

Isosorbide mononitrate

Extended release

IMITREX® Tablet*

Sumatriptan succinate

Specialized tablet technology requires intact tablets be administered for proper absorption

INDERAL® LA Capsule SA*

Propranolol HCl

Extended release

INDOCIN SR® Capsule SA*

Indomethacin

Extended release

INTELENCE® Tablet

Etravirine

If difficulty swallowing, may disperse the tablets in a glass of water. Once dispersed, stir the dispersion well and the patient should drink it immediately. The glass should be rinsed with water several times and each rinse completely swallowed to ensure the entire dose is consumed.

INTUNIV® ER Tablet*

Guanfacine HCl

Extended release

INVEGA® ER Tablet

Paliperidone

Extended release

ISOPTIN® SR Tablet SA*

Verapamil HCl

Extended release

ISORDIL Tablet SL*

Isosorbide dinitrate

Sublingual tablet

JALYN™ Capsule

Dutasteride/Tamsulosin

Mucous membrane irritant

KADIAN® Capsule SR*

Morphine sulfate

Extended release; may sprinkle on applesauce

KALETRA® Tablet*

Lopinavir/Ritonavir

Film-coated tablet; bitter taste; decreased absorption when crushed

KAON-CL® Tablet SA

Potassium chloride

Extended release

 

 

Brand Name and Dosage Form

Generic Name

Reason

K-DUR® Tablet SA*

Potassium chloride

Extended release; may dissolve in 4 ounces of water and drink contents followed by adding another 1 ounce of water, swirling and drinking, followed by adding another 1 ounce of water, swirling and drinking.

KEPPRA® Tablet*

Levetiracetam

Bitter taste

KEPPRA® XR Tablet*

Levetiracetam

Extended release; bitter taste

KETEK® Tablet

Telithromycin

While not FDA approved for breaking or crushing, the manufacturer has data on file demonstrating the stability when crushing and mixing with 8 ounces of ENSURE® immediately prior to administration

KLONOPIN® Wafers*

Clonazepam

Orally disintegrating

KLOR-CON® Tablet SA*

Potassium chloride

Extended release

K-TAB® Tablet SA*

Potassium chloride

Extended release

LAMICTAL® Tablet*

Lamotrigine

Bitter taste

LAMICTAL® ODT™ Tablet*

Lamotrigine

Orally disintegrating

LAMICTAL® XR Tablet*

Lamotrigine

Extended release

LAMISIL® Granules packet*

Terbinafine HCl

Film-coated granules; may sprinkle the contents of each packet on a spoonful of pudding or other soft, non-acidic food such as mashed potatoes and swallow the entire spoonful (without chewing); do not use applesauce or fruit-based foods.

LESCOL® XL Tablet*

Fluvastatin sodium

Extended release

LETAIRIS® Tablet

Ambrisentan

Potential teratogenic effects; insoluble in water or acidic solutions

LEVBID® Tablet SA*

Hyoscyamine sulfate

Extended release

LEXXEL® Tablet SA*

Enalapril maleate/Felodipine

Extended release

LIALDA® Tablet SA

Mesalamine

Delayed release

LIPRAM-UL® Capsule EC

Lipase/Protease/Amylase

Delayed release

LITHOBID® Tablet SA*

Lithium carbonate

Extended release

LODINE® XL Tablet SA*

Etodolac

Extended release

LODRANE® 24 ER Capsule

Brompheniramine maleate

Extended release

LODRANE® 24D Capsule SA

Pseudoephedrine/ Brompheniramine

Extended release

LOVAZA® Capsule

Omega-3-acid ethyl esters

Liquid-filled capsule

LUVOX® CR Capsule*

Fluvoxamine maleate

Extended release

MAG-TAB® SR Caplet*

Magnesium

Extended release

MAXALT MLT® Tablet*

Rizatriptan

Orally disintegrating

MELATONIN Tablet SA*

Melatonin

Extended release

MELATONIN Tablet SL*

Melatonin

Sublingual tablet

MESTINON® TIMESPAN*

Pyridostigmine bromide

Extended release

METADATE CD® Capsule*

Methylphenidate HCl

Extended release; may sprinkle on applesauce

METADATE ER® Tablet SA*

Methylphenidate HCl

Extended release

METHYLIN® ER Tablet*

Methylphenidate HCl

Extended release

METOZOLV® ODT Tablet*

Metoclopramide

Orally disintegrating

 

                                        

 

 

Brand Name and Dosage Form

Generic Name

Reason

MICRO-K® EXTENCAPS*

Potassium chloride

Extended release; may sprinkle the contents of the capsule onto a spoonful of cool, soft food (e.g., applesauce or pudding), and follow with a glass of cool water or juice to ensure complete swallowing of the microcapsules.

MINOCIN® Capsule

Minocycline HCl

Gastroesophageal irritant

MIRAPEX® ER Tablet*

Pramipexole

Extended release

MOXATAG® ER Tablet*

Amoxicillin trihydrate

Extended release

MS CONTIN® Tablet SA*

Morphine sulfate

Extended release

MUCINEX® Tablet*

Guaifenesin

Extended release

MUCINEX® D ER Tablet*

Guaifenesin/Pseudoephedrine

Extended release

MUCINEX® DM ER Tablet*

Guaifenesin/Dextromethorphan

Extended release

MYCELEX® TROCHE

Clotrimazole

Lozenge requires approximately 30 minutes to dissolve in mouth for proper absorption

MYFORTIC® Tablet

Mycophenolate sodium

Delayed release

NAMENDA® XR Capsule

Memantine

Extended release; may sprinkle on applesauce

NAPRELAN® Tablet SA*

Naproxen sodium

Extended release

NEXAVAR® Tablet

Sorafenib tosylate

While only FDA approved for swallowing whole, the manufacturer has data on file demonstrating the stability of dissolving two 200 mg tablets in 2 ounces of water for 5 minutes, adding 6 ounces of room temperature water and drinking immediately, followed by rinsing the glass several times and drinking the contents.

NEXIUM® Capsule*

Esomeprazole magnesium trihydrate

Delayed release; may sprinkle on applesauce

NIASPAN® Tablet SA

Niacin

Extended release

NICOTINIC ACID Capsule SA

Niacin

Extended release

NIFEDIAC® CC Tablet*

Nifedipine

Extended release

NIFEDICAL XL® Tablet*

Nifedipine

Extended release

NIRAVAM® Tablet*

Alprazolam

Orally disintegrating

NITRO-BID® Capsule SA*

Nitroglycerin

Extended release

NITROQUICK® Tablet SL

Nitroglycerin

Sublingual tablet

NITROSTAT® Tablet SL

Nitroglycerin

Sublingual tablet

NORFLEX™ Tablet SA

Orphenadrine citrate

Extended release

NORPACE® CR Capsule

Disopyramide phosphate

Extended release

NORVIR® Tablet*

Ritonavir

Altered bioavailability

NULEV® Tablet*

Hyoscyamine sulfate

Orally disintegrating

OFORTA® Tablet

Fludarabine phosphate

Skin or mucous membrane irritant

OLEPTRO™ ER Tablet*

Trazodone

Extended release

ONSOLIS® Soluble film

Fentanyl citrate

Transmucosal film; decreased absorption if swallowed

OPANA® ER Tablet*

Oxymorphone HCl

Extended release

ORACEA® Capsule*

Doxycycline

Delayed release

ORAMORPH® SR Tablet SA*

Morphine sulfate

Extended release

 

 

Brand Name and Dosage Form

Generic Name

Reason

ORAVIG™ Buccal Tablet

Miconazole

Buccal tablet has erratic absorption if crushed, chewed, or swallowed

ORGANIDIN® NR Tablet*

Guaifenesin

Bitter taste

ORUVAIL® Capsule SA*

Ketoprofen

Extended release

OXYCONTIN® Tablet SA*

Oxycodone HCl

Extended release

PANCREASE® MT Capsule EC

Lipase/Protease/Amylase

Delayed release

PANCRECARB® MS-Capsule EC

Lipase/Protease/Amylase

Delayed release

PANCRELIPASE Capsule EC

Lipase/Protease/Amylase

Delayed release

PARCOPA® Tablet

Carbidopa/Levodopa

Orally disintegrating

PAXIL CR® Tablet*

Paroxetine HCl

Extended release

PCE® DISPERTAB®*

Erythromycin base

Coated particles

PENTASA® Capsule SA

Mesalamine

Extended release

PEXEVA® Tablet*

Paroxetine mesylate

Manufacturer guidance: have not studied effects of altering tablets

PHENYTEK® Capsule*

Extended phenytoin sodium

Extended release

PLENDIL® Tablet SA*

Felodipine

Extended release

PRADAXA® Capsule

Dabigatran etexilate mesylate

Increased exposure; opening capsule results in a 75% increase in bioavailability.

PREVACID® Capsule DR*

Lansoprazole

Delayed release; may sprinkle on one tablespoon of applesauce, ENSURE® pudding, cottage cheese, yogurt or strained pears.

PREVACID® Solutab*

Lansoprazole

Orally disintegrating; delayed release

PREVACID® Suspension DR*

Lansoprazole

Delayed release

PREVACID® 24HR DR Capsule*

Lansoprazole

Delayed release

PREZISTA® Tablet

Darunavir ethanolate

Manufacturer guidance: have not studied effects of altering tablets

PRILOSEC® Capsule DR*

Omeprazole

Delayed release; may sprinkle on 1 tablespoon of applesauce

PRILOSEC® OTC Tablet*

Omeprazole magnesium

Delayed release

PRISTIQ® Tablet

Desvenlafaxine succinate

Extended release

PROCARDIA XL® Tablet*

Nifedipine

Extended release

PROPECIA® Tablet

Finasteride

Potential teratogenic effects

PROQUIN® XR Tablet*

Ciprofloxacin HCl

Extended release

PROSCAR® Tablet

Finasteride

Potential teratogenic effects

PROTONIX® DR Tablet*

Pantoprazole sodium

Delayed release

PROZAC® WEEKLY™ Capsule*

Fluoxetine HCl

Delayed release

QUINAGLUTE® Dura-Tabs

Quinidine gluconate

Extended release

QUINIDEX EXTENTABS®*

Quinidine sulfate

Extended release

RANEXA® Tablet

Ranolazine

Extended release

RAPAMUNE® Tablet

Sirolimus

Manufacturer guidance: have not studied effects of altering tablets

RAZADYNE® ER Capsule*

Galantamine

Extended release; may sprinkle on applesauce or yogurt immediately prior to administration

REMERON SOLTAB®*

Mirtazapine

Orally disintegrating

RENAGEL® Tablet

Sevelamer HCl

Swells in water and could lead to an obstruction

 

 

Brand Name and Dosage Form

Generic Name

Reason

RENVELA® Tablet

Sevelamer carbonate

Swells in water and could lead to an obstruction

REQUIP® XL Tablet*

Ropinirole HCl

Extended release

REVLIMID® Capsule

Lenalidomide

Potential teratogenic effects

REYATAZ® Capsule

Atazanavir sulfate

While not FDA approved for opening, the manufacturer has data on file demonstrating the stability of sprinkling the contents of two capsules on 4 ounces of applesauce immediately prior to administration.

RISPERDAL® M-Tab ODT*

Risperidone

Orally disintegrating

RITALIN LA® Capsule*

Methylphenidate HCl

Extended release; may sprinkle on small amount of applesauce

RITALIN-SR® Tablet SA*

Methylphenidate HCl

Extended release

RYBIX® ODT Tablet*

Tramadol HCl

Orally disintegrating

RYTHMOL® SR Capsule*

Propafenone HCl

Extended release

RYZOLT™ ER Tablet*

Tramadol HCl

Extended release

SANCTURA XR® Capsule*

Trospium chloride

Extended release

SAPHRIS® Tablet Sublingual

Asenapine

Sublingual tablet

SELZENTRY® Tablet

Maraviroc

Manufacturer guidance: have not studied effects of altering tablets

SENSIPAR® Tablet

Cinacalcet HCl

Manufacturer guidance: have not studied effects of altering tablets

SEROQUEL XR® Tablet*

Quetiapine fumarate

Extended release

SIMCOR® Tablet

Niacin/Simvastatin

Extended release

SINEMET® CR Tablet SA*

Carbidopa/Levodopa

Extended release

SLO-RELEASE IRON Cap*

Ferrous sulfate

Extended release

SLOW FE® Tablet*

Ferrous sulfate

Extended release

SOLODYN® ER Tablet

Minocycline HCl

Extended release

SOTRET® Capsule

Isotretinoin

Gastroesophageal irritant; potential teratogenic effects

SPRYCEL® Tablet

Dasatinib

Respiratory irritant if crushed; potential teratogenic effects

STAVZOR® DR Capsule*

Valproic acid

Delayed release

STAXYN™ ODT Tablet*

Vardenafil

Sublingual tablet

STRATTERA® Capsule

Atomoxetine HCl

Ocular irritant

SUBOXONE® Sublingual Film

Buprenorphine HCl/ Naloxone HCl

Sublingual film

SUBOXONE® Tablet SL

Buprenorphine HCl/ Naloxone HCl

Sublingual tablet

SUBUTEX® Tablet SL

Buprenorphine HCl

Sublingual tablet

SUDAFED® 12 Hour Tablet SA*

Pseudoephedrine sulfate

Extended release

SUDAFED® 24 Hour ER Tablet*

Pseudoephedrine HCl

Extended release

SULAR® Tablet SA

Nisoldipine

Extended release

SURFAK® Softgel

Docusate calcium

Liquid-filled capsule; unpleasant taste; possible mucous membrane irritation

TARKA® Tablet SA*

Trandolapril/Verapamil HCl

Extended release

 

 

Brand Name and Dosage Form

Generic Name

Reason

TASIGNA® Capsule

Nilotinib hydrochloride

While not FDA approved for opening, the manufacturer has data on file demonstrating the stability of sprinkling the contents of capsules on 1 – 2 teaspoons of applesauce immediately prior to administration.

TEGRETOL® XR Tablet SA*

Carbamazepine

Extended release

TEMODAR® Capsule

Temozolomide

Skin or mucous membrane irritant

TESSALON® Perles Capsules

Benzonatate

Liquid-filled gelatin capsule; severe hypersensitivity reactions (including bronchospasm, laryngospasm and cardiovascular collapse) have been reported, which are possibly related to local anesthesia from sucking or chewing the capsule instead of swallowing it

THEO-24® Capsule SA*

Theophylline anhydrous

Extended release

THEO-DUR® Tablet SA*

Theophylline anhydrous

Extended release

TIAZAC® Capsule SA*

Diltiazem HCl

Extended release; may sprinkle on a spoonful of applesauce. The applesauce should be swallowed immediately without chewing and followed with a glass of cool water to ensure complete swallowing of the capsule contents. The applesauce should not be hot, and it should be soft enough to be swallowed without chewing.

TOPAMAX® Tablet*

Topiramate

Bitter taste

TOPAMAX® Sprinkle Capsules

Topiramate

May sprinkle contents on a small amount (teaspoon) of soft food; bitter taste if crushed

TOPROL® XL Tablet SA*

Metoprolol succinate

Extended release

TOVIAZ® ER Tablet

Fesoterodine fumarate

Extended release

TRACLEER® Tablet

Bosentan

Potential teratogenic effects; while not FDA approved for crushing, the manufacturer has data on file demonstrating the stability of dissolving the tablet in 10 – 20 mL of lukewarm water and administering it immediately. The container in which the tablet was disintegrated should be rinsed with water, and this water should also be administered.

TRENTAL® Tablet SA

Pentoxifylline

Extended release

TREXIMET® Tablet

Sumatriptan succinate/ Naproxen sodium

Specialized tablet technology requires intact tablets be administered for proper absorption

TRILIPIX® DR Capsule

Fenofibric acid (choline)

Delayed release

TYLENOL® 8 Hour Caplet*

Acetaminophen

Extended release

TYLENOL® ARTHRITIS Caplet SA*

Acetaminophen

Extended release

ULTRAM® ER Tablet*

Tramadol HCl

Extended release

UNIPHYL® Tablet SA*

Theophylline anhydrous

Extended release

UROCIT®-K ER Tablet

Potassium citrate

Extended release

UROXATRAL® Tablet

Alfuzosin HCl

Extended release

VALCYTE® Tablet*

Valganciclovir hydrochloride

Potential risk of respiratory, skin or eye irritation if crushed; potential teratogenic effects

VERELAN® Cap pellet*

Verapamil HCl

Extended release; may sprinkle on applesauce

VERELAN® PM Cap pellet*

Verapamil HCl

Extended release; may sprinkle on applesauce

 

 

Brand Name and Dosage Form

Generic Name

Reason

VESICARE® Tablet

Solifenacin succinate

Manufacturer guidance: have not studied effects of altering tablets

VIDEX® EC Capsule*

Didanosine

Delayed release

VIMOVO™ Tablet*

Esomeprazole magnesium/ naproxen

Delayed release

VIOKASE® Tablet

Lipase/Protease/Amylase

Delayed release

VIRAMUNE® XR™ ER Tablet*

Nevirapine

Extended release

VOLTAREN® Tablet EC

Diclofenac sodium

Delayed release

VOLTAREN-XR® Tablet SA

Diclofenac sodium

Extended release

VOSPIRE ER® Tablet*

Albuterol sulfate

Extended release

VOTRIENT™ Tablet

Pazopanib hydrochloride

Manufacturer guidance: clinically significant increase in absorption when crushed

VYVANSE™ Capsule

Lisdexamfetamine dimesylate

Package insert states: “VYVANSE™ capsules may be taken whole, or the capsule may be opened and the entire contents dissolved in a glass of water. The solution should be consumed immediately and should not be stored.”

WELLBUTRIN SR® Tablet*

Bupropion HCl

Extended release

WELLBUTRIN XL® Tablet*

Bupropion HCl

Extended release

XANAX XR® Tablet*

Alprazolam

Extended release

ZEGERID® Capsule*

Omeprazole/Sodium bicarbonate

Manufacturer guidance: have not studied effects of altering tablets; bitter taste

ZELAPAR® ODT Tablet*

Selegiline HCl

Orally disintegrating

ZENPEP® DR Capsule

Lipase/Protease/Amylase

Delayed release

ZOFRAN ODT® Tablet*

Ondansetron

Orally disintegrating

ZOLINZA® Capsule

Vorinostat

Skin or mucous membrane irritant

ZOMIG® ZMT Tablet*

Zolmitriptan

Orally disintegrating

ZONEGRAN® Capsule

Zonisamide

While not FDA approved for opening, the manufacturer has data on file demonstrating the stability of sprinkling the contents of each capsule on 55 g of applesauce or chocolate pudding or into 75 mL of water or apple juice immediately prior to administration.

ZORTRESS® Tablet

Everolimus

Skin or mucous membrane irritant

ZUPLENZ® Oral Soluble Film*

Ondansetron

Buccal tablet has erratic absorption if crushed, chewed, or swallowed

ZYBAN® Tablet SA*

Bupropion HCl

Extended release

ZYFLO CR® Tablet

Zileuton

Extended release

ZYPREXA® ZYDIS Tablet*

Olanzapine

Orally disintegrating

ZYRTEC-D® Tablet*

Pseudoephedrine/Cetirizine

Extended release

ZYTIGA™ Tablet

Abiraterone acetate

Manufacturer guidance: Have not studied effects of altering tablets; insoluble in water

*Alternative formulations (e.g., immediate-release formulations, oral solutions, etc.) may be available. An adjustment in the dose and frequency of administration for the alternative agent may be necessary. The final choice of therapy is a decision that should be made by the prescriber based on the individual patient characteristics and clinical situation.

 

 

References:

  1. Package inserts obtained from Drugs@FDA available at: http://www.access- data.fda.gov/scripts/cder/drugsatfda/. Accessed 5/25/10.
  2. Package inserts obtained from DailyMed available at: http://dailymed.nlm.nih. gov/dailymed/about.cfm. Accessed 5/25/10.