Stretching prescription medication can prove deadly.

Whether you're treating a chronic condition or trying to stock your medicine cabinet with the basics, medications can be pricey.

To cut costs, you may be considering splitting pills or taking a medication after it has expired (though staring down a bottle of Tylenol purchased during the Clinton administration can make even staunch stomachs uneasy). You may well be wondering if cutting pills or ignoring use-by dates is really safe.

As if often the case in medicine, that's a simple question with a long answer.

Pill Splitting

It's basic math: Cutting pills in half can make a bottle of medication last twice as long. And if you only need half a pill to get the job done, splitting seems to make sense.

Some medications lend themselves to being halved, but certain others should never be split, says Dr. Norman Tomaka, a clinical consultant pharmacist in Melbourne, Fla. Splitting extended-release capsules, for instance, would cause a dose that's intended to be administered over several hours to be ingested all at once. In some cases, that might result in nothing more than a stomachache. But with drugs such as anti-seizure medications that need to be constantly active in the body, a sudden dose that then tapers off quickly could pose serious health risks.

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Splitting pills can be dangerous

The practice of splitting tablet forms of medications is a risky technique, Medical News Today reported.

Researchers found that nearly one-third of split tablet fragments varied from the recommended dosage by 15% or more, according to a study which was published in the January issue of the Journal of Advanced Nursing. Medical experts are concerned because with some medications, there is a narrow margin between therapeutic and toxic doses. They say the practice is widespread in all healthcare sectors.
"It is done for a number of reasons: to increase dose flexibility, to make tablets easier to swallow and to save money for both patients and healthcare providers,” the study's lead author, Dr. Charlotte Verrue, told Medical News Today. “However, the split tablets are often unequal sizes and a substantial amount of the tablet can be lost during splitting."