Can aripiprazole be crushed?

Aripiprazole Tablet Administration: Crushing Options

Aripiprazole tablets should not be crushed due to potential alterations in drug absorption and efficacy. Instead, alternative formulations should be considered for patients with swallowing difficulties.

Why Aripiprazole Should Not Be Crushed

• Crushing tablets can significantly alter drug absorption, potentially resulting in overdose or underdosing, which may compromise treatment efficacy 1
• The practice of crushing tablets poses risks to both patients and healthcare providers, including potential exposure to drug particles 1
• Crushing tablets is generally considered a last resort option that may contravene professional requirements and potentially endanger patient safety 2

Alternative Formulations Available

• For patients with swallowing difficulties, aripiprazole is available as orally disintegrating tablets (ODT), which dissolve in the mouth without requiring water 3
• Oral soluble films (OSF) of aripiprazole are bioequivalent to orally disintegrating tablets and offer another alternative for patients who have difficulty swallowing conventional tablets 3
• These alternative formulations maintain bioequivalence to standard tablets while addressing swallowing difficulties 3

Clinical Considerations

• When treating patients with schizophrenia who have difficulty swallowing, the formulation choice should be considered during initial prescription rather than modifying standard tablets 4
• For patients receiving aripiprazole for conditions like delirium in cancer patients, the medication is available in immediate-release formulations that may be more appropriate than attempting to crush standard tablets 4
• If a patient is unable to take oral medications at all, injectable formulations of aripiprazole are available, including once-monthly and once every two months options 5

Important Precautions

• Healthcare providers should always check with a pharmacist before modifying any medication, as crushing can destroy special coatings designed for controlled release or gastric protection 6
• Patients should be explicitly instructed not to crush or split medications without consulting their healthcare provider or pharmacist 6
• When treating elderly patients, who may be more likely to have swallowing difficulties, special consideration should be given to using appropriate formulations rather than modifying tablets 4

Best Practices

• Before considering crushing any medication, healthcare providers should research the impact on the drug's pharmacokinetics and consider alternative formulations 1
• For patients requiring aripiprazole who cannot swallow tablets, orally disintegrating tablets or oral soluble films should be prescribed instead of attempting to modify standard tablets 3
• When switching between formulations, maintain the same dosing schedule as the bioequivalence has been established between different aripiprazole formulations 3