Gene asked
I am have trouble swallowing whole pills of Vicodin. Can they be crushed?
At a glance
- Vicodin (hydrocodone/acetaminophen) tablets are scored and can be split. Although they technically can be crushed, hydrocodone/acetaminophen liquid preparations are generally a better alternative.
Answer
There are a variety of considerations to take into account when determining whether or not a medication can safely be crushed or chewed. These considerations include:
- Dosage form (e.g. tablet, capsule)
- Release properties (e.g. immediate-release, extended-release)
- Exposure risks (some are teratogenic/carcinogenic)
- Drug instability
- Changes in pharmacokinetic properties
- Irritation
- Taste
- Coating
In regard to Vicodin (hydrocodone/acetaminophen) tablets, it can be crushed or chewed and it is not listed on the Institute for Safe Medication Practices product list for medications that shouldn't be crushed.
Nevertheless, it generally isn't recommended to crush or chew Vicodin.
Although Vicodin tablets don't have an extended-release mechanism, they are not formulated to be crushed or chewed.
The tablet powder is chalky, does not contain flavoring agents and may cause esophageal irritation, as the protective coating around the tablet has been destroyed.
They are only recommended to be split if necessary (they contain a score mark down the middle of the tablet).
A better alternative would be to use a liquid formulation. Hydrocodone/acetaminophen liquids are available via prescription if you are having trouble with the solid dosage forms and doses can easily be converted.
It is important to note that there are a variety of extended-release hydrocodone products (e.g. Zohydro, Hysingla) that should never be crushed, chewed or split.
Doing so will ruin the extended-release properties of the drug, potentially causing the entire dose to be released at once, greatly increasing the risk of side effects or even death.
So overall, if you need to split your Vicodin (hydrocodone/acetaminophen) tablet once, that is perfectly safe to do. Most tablets, as mentioned above, have a 'score' mark to facilitate accurate splitting.
If you find it necessary to crush or chew Vicodin (hydrocodone/acetaminophen) tablets, ask your doctor about a liquid formulation.
References
- Oral Dosage Forms That Should Not Be Crushed. ISMP
- Hyset Prescribing Information. DailyMED
- Pharmacokinetic comparison of oral solution and tablet formulations of citalopram: a single-dose, randomized, crossover study. PubMed
- Comparative pharmacokinetics of voriconazole administered orally as either crushed or whole tablets. PubMed
- Bioavailability Study of Oral Liquid and Tablet Forms of α-Difluoromethylornithine. Clinical Cancer Research
