Can Seroquel 100mg Tablets Be Crushed?
Quetiapine (Seroquel) 100mg tablets can be crushed for administration, but this should only be done when absolutely necessary for patients with swallowing difficulties, and requires careful consideration of the risks and proper technique.
When Crushing May Be Appropriate
Quetiapine is listed as "oral route only" in clinical guidelines, indicating it is designed for oral administration but does not have specific formulation restrictions that absolutely prohibit crushing 1.
Crushing should be reserved for patients with genuine dysphagia or those unable to swallow tablets, as it should be considered a last resort rather than routine practice 2, 3.
The practice is widespread in clinical settings, particularly for elderly patients and those in long-term care facilities with swallowing difficulties 3, 4.
Critical Safety Considerations
Crushing tablets carries significant risks that must be weighed against the necessity:
Altered drug absorption can result in overdose or underdosing, potentially rendering treatment ineffective or causing toxicity 2.
The person crushing the tablets is exposed to drug particles that may be allergenic or have other harmful effects 2.
Improper crushing technique can reduce the actual medication dose the patient receives and compromise treatment efficacy 4.
Proper Crushing Technique (If Necessary)
Mix crushed quetiapine with a small amount of soft food or liquid vehicle immediately before administration 4.
Administer the entire mixture promptly to ensure the full dose is received 4.
Do not crush tablets in advance or store crushed medication, as the active ingredient may degrade on contact with light, moisture, or food 2.
Important Clinical Context
Quetiapine causes sedation and orthostatic hypotension, which are particularly concerning in elderly or frail patients 1.
Starting doses should be low (25mg) in vulnerable populations, with careful titration 1.
The medication requires monitoring for metabolic effects with long-term use 1.
Alternative Approaches to Consider First
Consult with a pharmacist to determine if a liquid formulation or alternative medication in a more suitable form is available 4.
Coordinate with the entire care team (physicians, pharmacists, nurses, speech therapists) to develop an individualized medication administration plan 4.
Reassess whether the medication is truly necessary if crushing poses significant risks 2.