title: Tablet splitting: a review of weight and content uniformity.
abstract: OBJECTIVE
  To describe the product integrity and ethical/ legal issues associated with tablet splitting.
  
  
  METHODS
  PubMed (1966-June 2011), International Pharmaceutical Abstract (1975-June 2011), and bibliographic searches were conducted.
  
  
  METHODS
  All studies that evaluated the weight/dose variations (N = 13) of split tablets were included.
  
  
  METHODS
  The American Pharmacists Association guidelines, recommendations from the Food and Drug Administration, and clinical studies evaluating product integrity of split tablets were used to provide an overview of issues related to this practice. Legal considerations from various sources were also included.
  
  
  RESULTS
  The practice of tablet splitting is increasing and is associated with variations in drug distributions related to the tablet-splitting technique and other causes. The first part of this two-part series will evaluate the product integrity and practice-related issues associated with tablet splitting.
  
  
  CONCLUSIONS
  The majority of the studies associated with tablet splitting reveal large fluctuations in weight/dosage, but few studies evaluate variability with narrow therapeutic index medications. Therefore, the clinical impact of these variations is not globally applicable across medication classes. Although tablet splitting has the potential to save patients and health care organizations a significant amount of money, appropriateness of tablet splitting should be determined for individual medications and individual patients. Assessments should include an evaluation of patient understanding and physical abilities for tablet splitting.
authors.affiliation: Samford University Global Drug Information Service, McWhorter School of Pharmacy, Birmingham, AL, USA.
authors.forename: Maisha Kelly
authors.initials: MK
authors.lastname: Freeman
authors.forename: Whitney
authors.initials: W
authors.lastname: White
authors.forename: Maryam
authors.initials: M
authors.lastname: Iranikhah
mesh_terms: D016527:Drug Costs; D004355:Drug Stability; D004358:Drug Therapy; D017408:Guidelines as Topic; D006801:Humans; D007880:Legislation, Drug; D010353:Patient Education as Topic; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D013607:Tablets / Q000191:economics / Q000592:standards*; D014481:United States
chemical_list: D004364:Pharmaceutical Preparations; D013607:Tablets