From the FDA Drug Label
The tablets are designed for sustained release of the drug in the gastrointestinal tract; sustained-release characteristics are not altered when the tablet is divided in half.
- Splitting Verapamil SR tabs is allowed as the sustained-release characteristics are not altered when the tablet is divided in half 1.
From the Research
No, you should not split verapamil SR (sustained-release) tablets, as this can disrupt the special coating or matrix system that controls the drug release rate, potentially leading to higher peak concentrations in the bloodstream and increasing the risk of side effects such as low blood pressure, dizziness, or headaches 2.
Reasons to Avoid Splitting Verapamil SR Tablets
- Splitting sustained-release tablets can cause too much medication to be released at once, leading to higher peak concentrations in the bloodstream and increasing the risk of side effects.
- It may also result in periods where there is insufficient medication in the system, reducing effectiveness for controlling conditions like high blood pressure or angina.
- The evidence from the most recent and highest quality study suggests that splitting sustained-release preparations is inappropriate due to the potential for alteration of the rate of drug release for some products 2.
Alternatives for Difficulty Taking Current Dose
- If you're having difficulty taking your current dose, contact your healthcare provider to discuss alternatives such as:
- Switching to a different strength tablet
- Switching to a different formulation of verapamil that might better meet your needs
Importance of Consistent Blood Levels
- Verapamil SR is specifically designed to release the medication slowly over time to maintain consistent blood levels throughout the day.
- Consistent blood levels are crucial for effectively controlling conditions like high blood pressure or angina, and for minimizing the risk of side effects.
Evidence Supporting the Recommendation
- The most recent and highest quality study on the topic of tablet splitting found that there is little evidence to support concerns regarding loss of mass, weight variability, chemical instability, or non-compliance, but did find evidence to support the inappropriateness of splitting sustained-release preparations 2.
- Other studies have highlighted the importance of consistent blood levels of verapamil for effectively controlling conditions like high blood pressure or angina, and for minimizing the risk of side effects 3, 4, 5, 6.