Is It Safe to Cut Cholesterol-Lowering Drugs in Half?

Many types can be halved, but certain ones should not

Sometimes, people split their pills to make a prescription last longer and help them save money. But is it safe to cut cholesterol-lowering medications like Crestor or Lipitor in half?

First, it's important to remember that high cholesterol can increase your risk of having a heart attack or stroke. Taking cholesterol-lowering medications can reduce these health risks.

It's important to take medications as prescribed by your provider. Otherwise, your risk of potentially life-threatening health consequences of high cholesterol will go up. In some cases, though, your healthcare provider may prescribe pills to cut in half to help save money while still providing the right dosage.

This article will go over which cholesterol-lowering medications are safe to cut in half and which cholesterol drugs cannot be split. You will also learn the best way to split cholesterol pills.

Pills pouring out of bottles on counter
Andrew Soundarajan / Getty Images

Cholesterol Pills You Can Cut in Half

Cutting your cholesterol pills can help you cut medication costs. Your provider might even be able to prescribe the pills in higher doses. That way, you can cut them in half and get more pills that are in the dose you need.

However, you cannot split every kind of cholesterol pill. Some medications will not work if they've been cut in half, and might even be dangerous to take.

Scored Pills

Some pills have a line or groove on them. The line is called a "score." Pills that are scored are easier to split because the line helps you get two equal halves. A general rule of thumb is that scored pills are safe to cut. Some pills that are not scored are also safe to split, but you should always check with your provider or pharmacist before cutting a pill.

Most cholesterol-lowering medications are not scored. The exception is gemfibrozil (Lopid) tablets.

Even though they aren't scored, your provider may say that it's OK to cut these cholesterol-lowering pills in half:

  • Simvastatin (Zocor)
  • Atorvastatin (Lipitor)
  • Lovastatin (Mevacor)
  • Fluvastatin (Lescol)
  • Rosuvastatin (Crestor)
  • Pravastatin (Pravachol)
  • Pitavastatin (Livalo)
  • Ezetimibe (Zetia)

How to Split Cholesterol Pills

Even if your cholesterol medication is safe to split in half, it can be hard to cut them into equal parts if they don't have that helpful groove. Having poor vision or arthritis can make it especially difficult.

Pill splitters are inexpensive tools that you can get at the pharmacy, grocery store, or online. You can also ask your pharmacist to cut the tablets in half for you.

Here are step-by-step instructions for cutting your cholesterol pills in half with a pill splitter:

  1. If you just bought a pill splitter, rinse it off before you use it for the first time. Make sure it is completely dry before you get started.
  2. Make sure that the plastic part covering the blade (a safety feature) is intact. Also check that the blade only comes out when you lower the lid.
  3. Place the pill you want to cut on the rubber part of the splitter. Usually, it will be narrow at one end and you can push the pill snugly up against the wall.
  4. Make sure the score (line) in the pill lines up with where the blade will go when you push down the top of the cutter. This will help you get an even split.
  5. Carefully push down until the blade touches the pill. You don't need to apply too much pressure to cut it—you'll probably hear it break and see it split into two pieces.
  6. If you need to split the pill in half again, open the lid and move one of the pill halves into the narrow end of the cutter.
  7. Repeat the steps to split the pill halves until you have as many as you need.
  8. Rinse your pill cutter after each use and let it dry completely before you use it again.

Can I Cut Pills Without a Pill Splitter?

A pill cutter or splitter is the safest and most accurate way to halve your pills. If you use a knife or scissors, not only are you more likely to hurt yourself, but you won't be able to equally split the pills. If your pills are different sizes, you may end up taking the wrong dose.

If you don't have a pill cutter at home or do not feel comfortable using one, ask your pharmacist to split the pills for you before you pick up your prescription.

Cholesterol Pills You Cannot Cut in Half

Extended-release or sustained-release formulations of pills cannot be split. The pills are made to release medication slowly into the body over a longer time. Pills of this kind may have SR, ER, or XL after the drug name on the label.

If you cut these pills, they can lose their ability to release the medication over time. Instead, you may get a large dose of medication at once when you take it, which could be dangerous.

Extended-release cholesterol medications that cannot be cut in half include:

  • Altoprev (extended-release lovastatin)
  • Niaspan (extended-release niacin)
  • Lescol XL (extended-release fluvastatin)
  • Trilipix (delayed-release fenofibric acid)

Capsules are another form of the drug that cannot be cut in half. With this type of pill, the drug is inside an oval-shaped covering that can be soft or a bit hard (for example, it might be made with gelatin).

If you cut these pills in half, it can cause too much of the medication to be released from the capsule and too fast. That means you may end up getting too low of a dose.

Cholesterol-lowering capsules that cannot be split include:

  • Purified Omega-3 fatty acids (Lovaza, Epanova, Vascepa)
  • Gemfibrozil (capsule only)

There are also other types of medications that cannot be crushed or cut. Usually, the manufacturer will include a warning on the bottle.

Other cholesterol drugs that cannot be split include:

  • Fenofibrate (Tricor, Antara)
  • Colestipol (Colestid)
  • Colesevelam (WelChol)

Can You Take Crestor or Atorvastatin Every Other Day?

If you don't want to split your pills, you might wonder if you can take your cholesterol medication every other day or night instead.

Always take your cholesterol medication exactly as your provider prescribes it for you. You can ask them if it's OK for you to take your cholesterol medication every other night, as some studies have shown that this schedule is safe and effective for some patients.

Summary

If you take medication to manage your cholesterol, you might wonder if it's OK to cut your pills in half to save money on prescriptions. Some cholesterol medications like Lipitor and Crestor are safe to split. Others, like those that are extended-release or come in capsules, cannot be split.

You should always ask your provider or pharmacist before cutting your pills in half. You can also ask your pharmacist to cut the pills for you. If you want to split your cholesterol pills at home, the safest and most accurate way is using a pill-cutter.

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5 Sources
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