From the Guidelines
Yes, amlodipine tablets can be crushed if you have difficulty swallowing them whole, as indicated in the study published in Pediatrics in 2011 1. After crushing, you can mix the medication with a small amount of soft food like applesauce or yogurt to make it easier to take. Be sure to consume the entire mixture immediately to ensure you get the full dose. Don't crush extended-release or controlled-release formulations of amlodipine (which would be labeled as "ER," "XR," "SR," or similar), as this could release too much medication at once and potentially cause side effects. If you're unsure about your specific amlodipine formulation, consult your pharmacist or healthcare provider before crushing. Crushing is particularly helpful for elderly patients or those with swallowing difficulties, but it's essential to take the full dose right away and not store the crushed medication for later use, as this could affect its stability and effectiveness. It's also worth noting that while there are general guidelines for crushing medications, such as those discussed in the Clinical Nutrition journal in 2020 1 and the Journal of the National Comprehensive Cancer Network in 2024 1, the specific guidance for amlodipine is most relevant from the Pediatrics study 1. Some key points to consider when crushing medications include avoiding the practice whenever possible due to potential risks, being mindful of the choice of dosage form for administration through an enteral feeding tube, and consulting a pharmacist for advice on administration through enteral feeding tubes. However, for amlodipine, the most direct and relevant guidance comes from the Pediatrics study, which explicitly mentions that amlodipine can be compounded into stable extemporaneous suspensions 1.
From the Research
Crushing Amlodipine
- Crushing tablets or opening capsules can have serious clinical consequences for the patient, including alteration of the drug's absorption, resulting in overdose or underdosing 2.
- There is no direct evidence in the provided studies that specifically addresses the effects of crushing amlodipine.
- However, a study on the palatability of crushed antihypertensive drugs, including amlodipine, found that the palatability score of amlodipine was lower compared to other drugs, such as lercanidipine 3.
- Amlodipine is a long-acting calcium channel blocker with a sustained-release formulation, and crushing it may disrupt its release properties, potentially leading to overdose or underdosing 2.
- Studies on amlodipine have focused on its efficacy and safety in treating hypertension, as well as its pharmacokinetic properties, but not specifically on the effects of crushing the tablet 4, 5, 6.