Abstract
Usually, drug tablets are dispensed without splitting. However, in clinical practice, tablets are sometimes split for patients who need to adjust their dosage or when the prescribed dose tablet is not available at the hospital or pharmacy. In such cases, it is necessary to minimize the impact of tablet splitting on the loss of mass and drug elution behavior. Therefore, in this study, we aimed to provide a safer, and more reliable drug treatment, and thus, we examined the status of split dispensing the tablets of sitagliptin, a diabetes treatment drug with a high prescription frequency, in hospitals. We also examined the appropriate method for tablet splitting and evaluated its effects on the drug elution behavior at the time of splitting.
Sitagliptin tablets were used in more than 90% of 34 surveyed facilities, and at least 80% of them used only the standard 50 mg tablet. At all facilities that used only 50 mg tablet, split tablets were dispensed only when 25 mg dose was prescribed. Therefore, comparison of tablets split using scissors to those using a spatula revealed that there was significantly less variation in the half-tablets split using scissors than in those using a spatula (p < 0.01). Additionally, comparison of the elution rates of 50 mg Januvia® half tablets to whole 25 mg Januvia® tablets revealed that the drug elution behaviors differed significantly.
Therefore, even for tablets with a score line, such as Januvia® tablets, tablet splitting using scissors with little variation is an appropriate division method, and even at the same dose, the dissolution rate over time may differ between the ready-made products and split tablets, and therefore, it is an easy method. However, it was considered undesirable to dispense the medicine in split doses.
