are not designed for splitting (tablets are not scored), there is an increased likelihood that they will split unevenly, crumble or shatter, according to Dr. Cook. "In this instance, the practice of pill splitting may put patients at risk of receiving too little or too much medication, either depriving them of the intended therapeutic benefit of the medication or exposing them to unintended side effects such as dizziness or tiredness. The best way to be confident that a patient consistently gets the intended amount of medication is to take the 5 mg tablet as prescribed."

The research is consistent with a study in the March/April 2002 issue of the Journal of the American Pharmacists Association (APhA) which found that tablet splitting generally resulted in a lack of uniformity, even when the tablets were scored. The APhA, along with The National Association of Boards of Pharmacy and the American Society of Consultant Pharmacists are among groups opposing mandated tablet splitting by patients. The newly published "Tablet Splitting: Evaluating Appropriateness for Patients Tool for pharmacists from the 2003-2004 APhA Strategic Directions Committee" appears in the May-June Journal of the American Pharmacists Association.

About the Study

Dr. Cook, a licensed pharmacist, and two fourth-year PharmD students at the Ernest Mario School of Pharmacy conducted the study, which evaluated the weight variability of 90 cyclobenzaprine HCl 10 mg tablets. Each of the three participants split a total of 30 tablets - 15 each with a commonly used tablet splitting device and a kitchen knife.

Prior to splitting, each whole tablet was weighed on a special scale and the weight was recorded. The participants practiced the splitting technique with each device with up to four tablets; the weights of which were not included in the analysis.

After each tablet was split, the individual fragment weights were measured and recorded. A theoretical half-f
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Contact: Cattaliya Snider
sniderc@ruderfinn.com
310-479-9929
McNeil Consumer & Specialty Pharmaceuticals
18-May-2004

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