Is it possible for a person to crush a sustained release tablet for fast action?
Generally, yes. That is why patients are advised not to break sustained released tablets. However, there are certain sustained release forms that may not be as prone to this such as novel solid forms of the active pharmaceutical ingredient that dissolve more slowly. If the "sustained release" effect is achieved at the molecular level, crushing would have little effect. Hope this helps.
The question is not specific enough. It depends on the individual patient, the indication and the drug you're dealing with.
Would you crush Selozok XR if you had to? Or maybe Efexor Exel? And what about Ranexa XR? I would. Just take into account the studies (e.g. first studies with ranolazine were done with shorter acting formulation) and dosing frequency.
It depends on type of sustained release tablet. If it was coated by coating membrane to control drug release (reservoir type), you cannot crush it because it will cause dose dumping and produce adverse effects.
Sustained release (SR) tablets should NOT be crushed. Once crushed, the contained drug will be exposed to the aqueos environment for rapid dissolution and absorption and hence behaves like an immediate release product or suspension. The mechanism controlling the drug release is no longer functional (membrane controlled, osmotic controlled or even matrix system). Also, take note that the dose of sustained release products is usually higher than their immediate release counterparts (eg diclofenac SR is 100mg and diclofenac IR is only 50mg), therefore it is not advisable to crush the SR products, as it will result in adverse effects if the drug has a narrow therapeutic index. Crushing the SR tablet will actually result in "dose dumping" which can happen to sustained release tablet formulations if they are not well formulated. Theophlline, an old drug, epitomises the advantages of SR products when SR products were first introduced into the market in the sixties. However, some theophlline SR products showed dose dumping when taken with food and patients suffered from adverse effects. Read up further on dose dumping by SR products to understand this more.
We take alot of efforts to develop an SR product and hence they are usually more expensive. Why do you want to crush it? If need to crush a tablet for faster absorption/bioavailability/onset of action, then it is better to crush an immediate release tablet of the drug.
If you crush extended release formulations, you will obtain a immediate release of active principle. It could be dangerous, the posology will be affected and the dosage received will be higher in shortest time, leading to toxicity in some cases.
of course no this affect the design of your formulation and will not be any more sustained release
Sustained release tablet is for sustaining the release of drug and crushing it will lead to dose dumping. If one need faster action then crush the IR dosage form for further fast release.
Almost not or it will be no more sustained release tablet. Better to opt for conventional formulation if it needs to be crushed by any reason.
The only exceptions that I know to this rule are Nifiedipine m/r tablets (adalat retard UK) which can be crushed for dispersed administration through a feeding tube. Generally it is inadvisable to crush any other preparations if they are modified release. Some modified release capsules have also been shown to be safe when opened and the contents dispersed in water. It is advisable to contact your local pharmacy or medicines information department for local preparation advice.
If you need some thing to act fact you can crush IR tablet. Why would you crush sustained release tablet
The answer is NO. If you want fast action from your tablet then why you prepare SR formulations? In some cases where you prefer onset of action faster than you can calculate initial loading dose accordingly.
If you want a fast action then you can go for immediate release tablet, but if crush the sustained release tablet , the purpose of preparing sustain release tablet gets waste.
Regarding crushing Adalat Retard (UK) for administration via feeding tubes: The modified release mechanism is achieved by incorporating nifedipine of different particle sizes hence influencing the rate of absorption from the GI tract as this is related to the partcicle size. Crushing Adalat Retard will alter the particle size and can thus influence the dose response to individual doses, thus dispersing the tablets may be a more suitable advice although doses should be administered asap given the light instability of nifedipine. Where porlonged treatment with a dihydropyridine calcium channel blocker should and administration via feeding tube is necessary an alternative should be considered.
The reason for formulating the SR medications -sustained release is to sustain its activity for a prolonged period and certainly not for faster or immediate effect.
If you need an immediate action of the medications then you have the options of the IR formulations (Immediate release).
There are various resources that clearly explains that some drugs are not supposed to be crushed, out of that many Sustained Release or controlled release formulations are included- the reason behind that is the nature of these preparations will be altered if these are crushed.
I suppose added some points to the discussion.
If it is coated diffusion controlled and not having any retarding polymer in tablet matrix then you can crush to get fast onset of action provided you check dose.
In general, you should not crush sustained release tablet, especially, reservoir type or membrane controlled tablet. If you break the coating membrane, you will get overdose drug because the system will lost controlled release properties.
You should never crush any sustained release tablets. SR tablets are designed in such a way to release the active medicament in the body slowly over a period of time to maintain constant drug level in the body. If you crush it then it will lose its property. If you look properly on the packing labels of the SR tablets then it is always mentioned: "Tablets should be swallowed whole and should not be broken, crushed or chewed."
No,if it is crushed it will lose it's ability to release the drug in a controlled way leading to enhanced side effects,so never try to crush it.
Crushing an oral dosage form with sustain release capability might be dangerous but what would be the alternative way to administer it when no other dosage form of the same drug is not available?
You can not crush the SR tablet but you can formulate the other controlled release dosage form like bilayer tablet by which you can compesate your objective of rapid onset as well as SR action
No SR tablets is formulated in such a way to release the medicament over a period of hours , so never crush the SR formulations.The answer is big NO.
What a lot of parrots in here. Not one person has given a detailed explanation of what happens to the dose on crushing for the purpose of rapid release.
What would be the effective dose then, and why would it necessarily be dangerous?
Mostly the responses on here could have just as easily have been read off the packet.
crushing of the SR dosage will provide the patient with a dose larger than the therapeutic dose (dose dumping) and will cause drawbacks according to the drug type and how much drug is the dosage
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