Abstract
Swallowing problems and the required dose adaptations needed to obtain optimal pharmacotherapy may be a hurdle in the use of tablets in daily clinical practice. Tablet splitting, crushing, or grinding is often applied to personalise medication, especially for the elderly and children. In this study, the performance of different types of (commercially available) devices was studied. Included were splitters, screwcap crushers, manual grinders, and electric grinders. Unscored tablets without active ingredient were prepared, with a diameter of 9 and 13 mm and a hardness of 100–220 N. Tablets were split into two parts and the difference in weight was measured. The time needed to pulverise the tablets (crush time) was recorded. The residue remaining in the device (loss) was measured. The powder was sieved to obtain a particle fraction >600 µm and <600 µm. The median particle size and particle size distribution of the later fraction were determined using laser diffraction analysis. Splitting tablets into two equal parts appeared to be difficult with the devices tested. Most screwcap grinders yielded a coarse powder containing larger chunks. Manual and especially electric grinders produced a finer powder, making it suitable for administration via an enteral feeding tube as well as for use in individualised preparations such as capsules. In conclusion, for domestic and incidental use, a screwcap crusher may provide sufficient size reduction, while for the more demanding regular use in hospitals and nursing residences, a manual or electric grinder is preferred.
Highlights
The oral route is the most common, convenient, and safe way for drug administration.Oral solid dosage forms are preferred by patients and are stable and broadly available from industrial manufacturers with consistent quality
The use of a screwcap crusher requires a lot of manual force
Manual grinders are user-friendly, effective, and can be applied in the professional setting for occasional to not too frequent use. They are more expensive than screwcap crushers
Summary
The oral route is the most common, convenient, and safe way for drug administration. Oral solid dosage forms are preferred by patients and are stable and broadly available from industrial manufacturers with consistent quality. Dose adjustment is commonly achieved through tablet splitting, whereas crushing or grinding (together referred to as pulverisation) are for different reasons applied on tablets. Pulverisation may be used to ease swallowing, for dose adaptations (e.g., preparing capsules) or for administration via an enteral feeding tube [1,2,3]. Paediatric and geriatric patients may benefit from operations personalising the dose, it should be realised that this usually falls outside of the terms of the drug’s product license. Paediatric and geriatric patients may benefit from operations personalising the dose, it should be realised that this usually falls outside of the terms of the drug’s product license. 4.0/).
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