Do Not Crush Guide
Commonly used medications in Aged Care which cannot be crushed
Generic Name
Alendronate
Brand Name
Fosamax, Adronat,
Alendro, Ossmax,
Alendronate AN
Fosamax Plus, Dronalen
Plus
Nesina
Nesina Met
Information
Do not Crush, chew or suck tablet. May irritate
mucosa and oesophagus. Can be dispersed in
water.
Do not Crush, chew or suck tablet. May irritate
mucosa and oesophagus.
Film-coated tablet - swallow whole.
Alternatives
Aclasta, Prolia
Fungilin
Do not chew or swallow whole. Dissolve
lozenges slowly in mouth.
Aspirin
Cartia, Astrix cap
Aspirin with
dipyridamole
Asasantin SR
Bisacodyl
Bisalax, Dulcolax, Lax-Tab
Bisoprolol
Bicor, Bicard, Bispro, Biso,
Bisoprolol AN
Invokana
Tegretol CR
Cartia should not be crushed, chewed or broken.
Astrix capsules can be opened but do not crush
or chew pallets.
Pellets within the capsule are sustained release
and must not be crushed. The capsule may be
opened and pellets mixed with water or yoghurt.
Enteric coated and irritant, crushing can impair
efficiency
Film-coated. Do not crush or chew. May be
dispersed.
Film-coated tablets. Swallow whole.
Do not crush or chew. Tablets may be halved
along score line and swallowed whole.
Nystatin (Nilstat) oral
drops or miconazole
(Daktarin) oral gel.
Solprin (Soluble Aspirin)
Alendronate with
colecalciferol
Alogliptin
Alogliptin +
metformin
Amphotericin
Canagliflozin
Carbamazepine
Carvedilol
Dilatrend, Dicarz,
Carvedilol AN
Ceclor CD, Karlor CD,
Keflor CD, Ozcef
Film-coated tablets may be dispersed.
Celecoxib
Celebrex
Mix capsule contents with apple sauce.
Chlorpromazine
Largactil
Colchicine
Colgout, Lengout
Dabigatran
Pradaxa
Desvenlafaxine
Pristiq
Diclofenac
Voltaren, Fenac
Very irritant to mucosa (may cause oesophageal
ulceration) and can cause contact dermatitis.
Tablets may be crushed only for eternal tube
administration (liquid is preferable)
Pregnant staff must not handle crushed or
dispersed tablets
Swallow whole and do not open capsule (risk of
bleeding may increase)
Sustained release. Do not divide, crush, chew or
dissolve
Irritant to mucosa. Do not crush, break or chew
Diltiazem
Vasocardol CD, Cardizem
CD, Diltiazem Sandoz
Sustained release pellets in capsule. May open
and add pellets to soft food or liquid.
Dothiepin
Dothep
Doxycycline
Doryx, doxy, Doxylin
Film coated. Crushed tablets have anaesthetic
effect on mouth.
Very irritant to mucosa, do not crush, break or
chew.
Cefaclor
Sustained-release. Do not cut, crush or chew.
Nil
Nil
Separate dipyridamole
immediate-release tablet
and soluble aspirin.
Suppository or enema
Nil
Nil
Immediate release tablets
or suspension. Dose
adjustment may be
required.
Non film-coated tablets
may be crushed.
Oral suspension. Dose
adjustment may be
required.
Other crushable NSAIDs
such as Meloxicam
Syrup or injection.
Nil
Nil
Nil
Suppository, gel or oral
liquid.
Immediate release tablet.
Dose adjust may be
requirement.
Nil
Enteric-coated pellets- can
be dispersed in water or
soft food followed by
plenty of water.
Do not Crush Guide – Commonly used Medications in Aged Care which cannot be crushed © Martina Boules March 2015
Page 1
Duloxetine
Cymbalta, Drulox
Dutasteride
Dutasteride with
tamsulosin
Entacapone
Avodart
Duodart
Erythromycin
EES, Eryc, Emycin, Mayne
pharma Erythromycin
Nexium
Esomeprazole
Enteric-coated pellets in capsule. Do not open or
chew capsule.
Irritant to mucosa
Tamsulosin pellets are sustained release. Do not
crush or chew.
Crushed tablets may stain mouth orange. Bitter
taste, mix with jam, honey or orange juice
Irritant to mucosa and bitter. Capsules may be
opened but do not crush or chew pellets.
Enteric coated granules. Do not crush or chew.
May be dispersed in non-carbonated liquid.
Sustained release. Do not break, crush or chew.
Nil
Elixir (ferro-liquid) or
ferrous fumerate (Ferro F
tablets) may be crushed
Fefol, FGF
Irritane to mucosa. Do not break, crush or chew
sustained release tablets. Fefol capsule may be
opened but sustained release tablets must not
be crushed.
Normacol Plus
Do not crush or chew granules
Neurontin, Gabapentin,
Nupentin, Gantin
Mix granules with jam,
honey or yoghurt.
Nil
Comtan
Felodipine
Felodipine with
ramipril
Ferrous sulphate
Ferrous sulphate
with ascorbic acid
Ferrous sulphate
with folic acid
Frangula with
sterculia
Gabapentin
Felodur, Plendil, Felodil
Triasyn
Galantamine
Reminyl, Galantyl
Gliclazide
Diamicron MR, Glyade
MR, Oziclide MR
Rapid breakdown, use immediately. Capsule may
be opened and the contents mixed with apple
sauce or orange juice
Sustained release. Capsules may be opened but
do not crush or chew pellets. Mix pellets with
yoghurt or apple sauce.
Sustained release. Tablets may be halved along
score line and swallowed whole
Glyceryl trinitrate
Hydromorphone
Anginine, Lycinate
Jurnista
Sublingual tablet, ineffective if swallowed.
Sustained release. Do not break, crush or chew.
Indapamide
Natrilix SR
Sustained release. Do not crush or chew.
Isosorbide
dinitrate
Isosorbide
mononitrate
Isordil
Sublingual tablet. Ineffective if swallowed.
Imdur, Duride, Monodur,
Imtrate, Isomonit,
isorbide
Zoton, Zopral
Sustained release. Do not crush or chew. Imdur,
Duride and Monodur brand of 60mg tablet may
be halved and swallowed whole.
Do not crush or chew fastab, but may disperse in
small amount of water (without crushing or
chewing). Capsule may be opened and enteric
coated granules given with apple, orange or
tomato juice. Rinse cup to ensure entire dose is
given.
Swllow film coated tablets whole
Capsules may not be opened, crushed, chewed
or dispersed. Tablets may be halved along the
score line and swallowed whole.
Lansoprazole
Ferrogradumet
Ferrograd C
Levetiracetam
Levodopa with
benserazide
Keppra,Kepcet,Levecetam
Madopar
Levodopa with
Carbidopa
Lithium carbonate
Sinemet CR
Sustained release. Do not crush, chew or divide
Quilonum SR
Sustained release. Do not crush, chew or
dissolve. Avoid with hot beverages
Melatonin
Circadin
Sustained release. Do not crush or chew
Nil
Nil
Suspension
Granules
Nil
Nil
Immediate release 80mg
tablet (equivalent to
sustained release 30mg)
Sublingual spray.
Immediate release tablets
or liquid. Dose adjustment
may be required.
Immediate release tablets.
Dose adjustment may be
required.
Glyceryl trinitrate
sublingual spray.
Nil
Nil
Oral Liquid
Disperse tablet (Madopar
Rapid) in 25-50mL and
give within 30 minutes.
Dose adjustment may be
required.
Immediate release tablet
(e.g. Sinemet or Kinson)
Immediate release tablets,
dose adjustments may be
required.
Nil
Do not Crush Guide – Commonly used Medications in Aged Care which cannot be crushed © Martina Boules March 2015
Page 2
Mesalazine
Salofalk, Mesasal,
Pentasa, Mezavant
Metformin
Metoprolol
Diabex XR, Diaformin XR,
Metex XR
Toprol XL, Minax XL
Mirtazapine
Avanza, Axit, Mirtazon
Bitter taste. Swallow tablets whole. Soltabs
should not be crushed.
Morphine Sulphate
Kapanol, MS Contin, MS
Mono
Naproxen
Naprosyn SR, Proxen SR
Sustained release. Capsules may be opened but
do not crush pellets. Pellets and granules (for
suspension) may be mixed with a 30mL of water
or food for administration within 30 minutes.
Sustained release. Do not crush, chew or
disperse.
Nifedipine
Adalat Oros, Adefin XL,
Addos XR
Light sensitive. Do not use broken immediate
release tablets
Nystatin
Olanzapine
Nilstat
Zyprexa, Lanzek, Zypine
Swallow whole
Irritant to eyes and skin if crushed. Swallow
whole.
Omeprazole
Losec, Acimax, Omperal,
Ozmep, Probitor,
Meprazol, Pemzo
Oxycodone
Oxycodone with
naloxone
Paliperidone
Pancrelipase
Oxycontin CR
Targin
Enteric coated/film coated tablets with enteric
coated granules. Do not crush break or chew.
Only Acimax, Losec and Omepral may be
dispersed. Capsules may be opened and mixed
with apple sauce, yoghurt or juice without
crushing enteric coated pellets.
Sustained release. Do not crush or chew.
Pantoprazole
Paracetamol
Somac, Salpraz, Panto,
Sozole, Ozpan
Panadol Osteo
Paroxetine
Aropax, Paxtine, Extine
Phenytoin
Dilantin
Piroxicam
Potassium chloride
Feldene, Mobilis
Duro K, Slow K, Span K
Pramipexole
Pregabalin
Sifrol ER
Lyrica
Invega
Creon
Coated for timed release, do not crush/chew
tablets or granules. May add granule to soft food
and swallow without chewing. Disperse Pentasa
tablets in 50mL
Sustained release, Do not crush, break or chew
Suppository or enema
Sustained release. Tablets may be halved along
the score line and swallowed whole.
Immediate release tablets,
dose adjustments may be
required.
Soltabs disintegrate
rapidly in the mouth or
may be dispersed in
water.
Immediate release, liquid
(Ordine) or injection
Do not crush, divide or chew.
Do not chew or crush capsules or granules.
Swallow capsules whole with fluid or may mix
contents with fluid/soft food
Enteric coated. Do not crush, break or chew
Sustained release. Do not crush or chew.
Bitter taste and anaesthetic effect if crushed or
chewed. May be broken in half and swallowed
whole.
Opening capsules may increase bioavailability
and risk of toxicity
Opening capsules may cause GI irritation
Sustained release and irritant. Do not crush,
chew or suck
Sustained release. Do not crush, break or chew.
Capsule contents may be dispersed in water
Immediate release tablets
Immediate release tablets
or suspension. Dose
adjustment may be
required.
Adalat immediate release
tablets may be crushed for
immediate administration.
Oral drops
Injection; Wafers
dissolved in the mouth or
dispersed in noncarbonated beverage.
Brands that may be
dispersed or capsule.
Immediate release tablets,
capsules, liquid or
suppositories.
Injection
Nil
Granules
Immediate release tablets,
Elixir or suppositories.
Dose adjustment may be
required.
Nil
Infatabs or oral
suspension. Dose
adjustment may be
required.
Dispersible tablets
Effervescent tablets
(Chlorvescent)
Immediate release tablets
Nil
Do not Crush Guide – Commonly used Medications in Aged Care which cannot be crushed © Martina Boules March 2015
Page 3
Pyridostigmine
Quetiapine
Rabeprazole
Ranitidine
Mestinon
Seroquel XR
Pariet, Rabzole, Prabez
Zantac, Ausran, Rani 2,
Ulcaid
Sustained release
Sustained release. Do not crush, break or chew
Enteric coated. Do not crush or chew
Do not crush or chew.
Immediate release tablets
Immediate release tablets
Nil
Effervescent tablet or
syrup
Risedronate
Actonel, Actonel EC, Acris
Aclasta, Prolia
Risperidone
Roxithromycin
Risperdal Quiklet
Rulide, Biaxsig, Roxar,
Roximycin
Kombiglyze XR
Do not crush, chew or suck tablet. May irritate
mucosa and oesophagus. Non-EC tablet 30 or
35mg tablets may be dispersed in 70mL, stirred
and administered after 2 minutes.
Do not split or chew
Irritant. Swallow whole
Sustained release. Do not crush, break, chew or
cut.
Use separate, immediate
release tablets. Frequency
may need changing.
Crushable 100mg, syrup
or sugar-free liquid.
Non-enteric coated
tablets
Nil
Nil
Syrup. Dose adjustment
may be required.
Sprinkle Capsules (sprinkle
capsule contents on soft
food and swallow without
chewing)
Immediate release tablets,
injection or oral liquid.
Dose adjustment may be
required.
Nil
Saxagliptin with
metformin
Sodium valproate
Epilim, Valpro
Sulfasalazine
Salazopyrin EN, Pyralin
EN
Flomaxtra
Palexia SR
Nuelin SR
Tamsulosin
Tapentadol
Theophylline
Enteric coated. Irritant to mucosa. Do not break
tablets
Enteric coated
Sustained release. Do not crush, break or chew.
Swllow whole
Tablets may be halved along score line and
swallowed whole.
Swallow tablets whole.
Topiramate
Topamax, Tamate,
Epiramax
Tramadol
Tramal SR, Zydol SR,
Durotram SR, Tramedo SR
Sustained release. Do not crush, break or chew.
Venlafaxine
Efexor XR, Altven, Elaxine
SR, Venlexor XR
Do not divide, crush, chew or disperse capsule
contents. May be sprinkled onto soft food and
swallowed without chewing.
Verapamil
Isoptin SR, Cordilox SR,
Veracpas
Verapamil with
trandolapril
Tarka
Sustained release. Tablets may be halved along
score line and sallowed whole. Capsules may be
opened but do not crush pellets
Sustained release. Do not break, crush or chew
Zolpidem
Stilnox CR
Sustained release. Do not divide, crush or chew
tablet
Injection or oral liquid.
Dispersible tablets
Immediate release tablets.
Dose adjustment may be
required.
Separate immediate
release tablets. Dose
adjustments may be
required.
Immediate release tablets
Do not Crush Guide – Commonly used Medications in Aged Care which cannot be crushed © Martina Boules March 2015
Page 4