Dosages involving splitting tablets: common but unnecessary?

Objectives Prescribing of treatments with dosages involving split tablets is common. Many patients report they have difficulties in dividing the tablets and in following the prescribed treatment. The objective of this study was to examine to what extent dosages involving split tablets are prescribed in Sweden. Methods The dosage text strings were analysed on prescriptions dispensed during one month at Swedish pharmacies on all tablet formulations for beta-blockers, calcium blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers (ARBs), lipidlowering agents, levothyroxine, neuroleptics, anxiolytics, hypnotics/sedatives and selective serotonin reuptake inhibitors (SSRIs). Numbers and percentages of prescriptions with split tablets were compared with all dispensed prescriptions. Key findings Six hundred thousand prescriptions on tablet formulations for the investigated drugs were dispensed. Ten per cent of the prescriptions had a dosage where tablets have to be split. Hypnotics and SSRIs had the highest proportions, accounting for 22 and 19% of prescriptions involving split tablets. SSRIs constituted 30% of the prescriptions with split tablets. Dosages with split tablets varied with drug across patient age but not across gender. In 45% of the cases with levothyroxine and SSRIs, a tablet strength fitting the prescribed dosage was licensed and available. Furthermore, it would have been possible to avoid splitting tablets by adjusting and combining existing licensed strengths for more than 80% of the prescriptions. Conclusions Prescribing of dosages involving the splitting of tablets was common and constituted 10% of the prescriptions for tablet formulations. Many prescriptions on dosages with split tablets can be avoided if physicians adjust prescribing to licensed and available strengths fitting the prescribed dosages.