Is it safe to crush and mix Zoloft (sertraline) 50mg, Abilify (aripiprazole) 20mg, hydroxyzine 25mg, and clonidine 0.1mg into applesauce?

Medication Administration: Crushing and Mixing Zoloft, Abilify, Hydroxyzine, and Clonidine with Applesauce

Not all of these medications should be crushed and mixed with applesauce, as doing so could alter drug absorption, efficacy, and safety profiles. Specifically, Abilify (aripiprazole) should not be crushed, while the other medications may be crushed with certain precautions.

Individual Medication Considerations

Zoloft (sertraline) 50mg

• Can be crushed and mixed with applesauce, as it does not have extended-release or enteric-coated properties that would be compromised by crushing 1
• Should be administered immediately after mixing to prevent degradation of the active ingredient 2

Abilify (aripiprazole) 20mg

• Should NOT be crushed as this may alter its absorption characteristics and potentially affect its efficacy 3
• Aripiprazole has specific pharmacokinetic properties that could be disrupted by crushing 4
• Consider consulting with a pharmacist about alternative formulations (liquid form may be available) 2

Hydroxyzine 25mg

• Can be crushed and mixed with applesauce 1, 3
• No specific contraindications to crushing this medication have been documented 3

Clonidine 0.1mg

• Can be crushed and mixed with applesauce 5
• However, be aware that clonidine requires careful dosing, as it is generally reserved as a last-line agent due to CNS adverse effects 5
• Avoid abrupt discontinuation of clonidine, which may induce hypertensive crisis; clonidine must be tapered to avoid rebound hypertension 5

Important Precautions When Crushing Medications

• Use separate crushing equipment for each medication to prevent cross-contamination 3
• Crush tablets completely to ensure uniform dosing 3
• Administer immediately after crushing and mixing to prevent degradation 1
• Mix with a small amount of applesauce to ensure complete consumption 2
• Do not crush multiple medications together - crush and mix each one separately 3

Common Pitfalls to Avoid

• Crushing extended-release or enteric-coated formulations can lead to dose dumping and potential overdose 1
• Using shared crushing equipment without proper cleaning can lead to cross-contamination between medications 3
• Mixing crushed medications with certain foods or liquids may affect drug stability or absorption 1
• Medication particles from crushing may expose the person administering the medication to potentially harmful drug substances 1
• Incomplete consumption of the medication-food mixture may result in underdosing 6

Alternative Approaches

• For Abilify specifically, inquire about liquid formulations instead of crushing tablets 2
• Consider consulting with the prescribing physician about alternative medications or formulations if swallowing difficulties are persistent 2
• Ensure proper documentation of medication administration method in patient records 3

Always consult with a pharmacist or healthcare provider before modifying any medication dosage form, as crushing tablets can sometimes significantly alter drug efficacy and safety 1, 2.