Common Oral Dosage Forms That Should Not Be Crushed
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:
- Package inserts obtained from Drugs@FDA available at: http://www.access- data.fda.gov/scripts/cder/drugsatfda/. Accessed 5/25/10.
- Package inserts obtained from DailyMed available at: http://dailymed.nlm.nih. gov/dailymed/about.cfm. Accessed 5/25/10.