Tablet splitting (Tabletten teilen)

Abstract

The splitting of scored tablets provides many advantages. One benefit is to achieve dose flexibility to account for the huge inter-individual differences in dose requirements for instance in paediatric and geriatric patients, which are often not covered by the available strengths in the market. Moreover, large-sized tablets can be swallowed more easily if broken before swallowing and medication costs can often be reduced by splitting brands with higher strength. But not all tablets, mostly unscored tablets, are suitable for splitting. Splitting of extended release formulations can result in an overdose by uncontrolled release of the active component and degradation of the compound can occur if an enteric coating is destroyed by the splitting process. Whether tablets are suitable for splitting depends on the properties of the active component (e.g. light sensitivity), the galenics, the shape of the tablet, and the shape of the scoreline. Moreover, not all patients are informed, able or willing to split tablets and the majority of the elderly population is not capable of breaking tablets. When split tablets are prescribed it is therefore important to view the shape of the tablet, to assess the patient's ability and willingness to break tablets, to properly inform the patient about the appropriate way of splitting, and if necessary to suggest (and instruct) the use of a tablet splitting device.