Question

A patient arrives to the clinic with the complaint that she has not felt well since returning from Mexico. She explains that she had purchased medications in Mexico because they were so much cheaper than at her pharmacy. Her dementia medication only came in timed-release capsules and was twice the dose but she still decided to buy it and cut it in half. What is the problem with this scenario and why? Then document your discussion with the patient.

Answer 1

The problem is sassociated with splitting of timed release capsule. Extended-release tablets and capsules can’t be cut.

Pill splitting can be a problem for pills with a small therapeutic window. This refers to a pill that needs to be taken in very controlled, precise doses and in dementia you need to take a precise dose. Some of the drugs used to treat for dementia has small therapeutic window .

“Pill-splitting a medication with a small therapeutic window is concerning because any deviation from the recommended dose, even a small percentage, can have serious consequences and that's why the patient is not feeling well since returning from Mexico because she is using the medication by splitting it since then.