Crushing medicines can lead to adverse effects

yellow pills in mortar with pestle for crushing medicines

People on more than four medicines a day, and those with swallowing problems, are more likely to be crushing medicines in a bid to make them easier to take—but this can result in adverse effects, new research shows.

Many people have trouble swallowing their medicines—estimated to be around 14%—but crushing them or manipulating them is potentially dangerous, researchers have warned.

The researchers also found that some people attempt to modify their medication even when they have no issues with swallowing.

What is known as ‘the rush to crush’ is potentially dangerous, especially as patients often don’t tell their healthcare professionals about it. Instead, they resort to ‘advice’ from family or friends.

According to researchers, none of the participants in the study had been advised by a pharmacist to modify their medication, nor had sought advice on what to do to make it easier to swallow their medications, said researchers.

“Depending on the tablet or capsule, and the type of medicine, modifying these dosage forms can lead to reduced effectiveness of the medication, and increased risk of adverse effects,” explains Dr Esther Lau, one of the researchers from Queensland University of Technology and the University of Queensland.

“It surprised us that none of the participants received advice about crushing medicines from a pharmacist, but literature has already identified that healthcare professionals are not asking patients often enough about swallowing difficulties.”

Lau is calling on pharmacists to identify and advise people with swallowing difficulties about how to manage their medication regimen.

“Pharmacists are the medication experts and ideally a pharmacist should be involved in advising and providing suitable options for administering medications to patients at risk of swallowing difficulties. However, managing swallowing difficulties should take a multidisciplinary approach; all healthcare professionals need to care for these patients as a team.”

Dr Esther Lau and her colleague Dr Manuel Serrano Santos are also working with an international group of experts advocating for multidisciplinary approach for caring for patients with or at risk of swallowing troubles. Further information will be available at (which is currently under development).

Pharmacists interested in helping their customers who have swallowing difficulties should refer to the Australian Don’t Rush to Crush Handbook, which gives advice on therapeutic options for people unable to swallow tablets or capsules.

The research was published in the Journal of Pharmacy Practice and Research.


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