THE APhA COMPLETE REVIEW FOR PHARMACY, 7th Ed

Appendix I: Drugs That Should Not Be Crushed

The following list includes both various slow-release and enteric-coated products that should not be crushed or chewed. Slow-release (SR) products are controlled-release, extended-release, long-acting, or timed-release products. Enteric-coated (EC) products are delayed-release products. In general, capsules containing SR or EC particles may be opened and their contents administered on a spoonful of soft food. However, instruct patients not to chew the particles. (Patients should, in fact, be discouraged from chewing any medication unless it is specifically formulated for that purpose.)

The list should not be considered all inclusive. Generic and alternate brands of some products may exist. Tablets intended for sublingual or buccal administration (not included in this list) should also be administered only as intended, in an intact form.

Drug

Manufacturer

Form

Abletex LA

Able

SR

Aciphex

Eisai

EC

Adalat CC

Schering-Plough

SR

Adderall XR

Shire US

SR

Advicor

KOS

SR

Aerohist

Aero

SR

Aerohist Plus

Aero

SR

Afeditab CR

Watson

SR

Aggrenox

Boehringer Ingelheim

SR

Ala-Hist

Poly

SR

Ala-Hist D

Poly

SR

Aleve Cold & Sinus

Bayer HealthCare

SR

Aleve Sinus & Headache

Bayer HealthCare

SR

Allegra-D 12 Hour

Sanofi-Aventis

SR

Allegra-D 24 Hour

Sanofi-Aventis

SR

Allerx

Cornerstone

SR

Allerx-D

Cornerstone

SR

Allfen

MCR American

SR

Allfen-DM

MCR American

SR

Alophen

Numark

EC

Altoprev

First Horizon

SR

Ambi 45/800

Ambi

SR

Ambi 45/800/30

Ambi

SR

Ambi 60/580

Ambi

SR

Ambi 60/580/30

Ambi

SR

Ambi 80/700

Ambi

SR

Ambi 80/700/40

Ambi

SR

Ambi 1000/55

Ambi

SR

Ambien CR

Sanofi-Aventis

SR

Ambifed-G

Ambi

SR

Ambifed-G DM

Ambi

SR

Amdry-C

Prasco

SR

Amdry-D

Prasco

SR

Amibid LA

Amide

SR

Amrix

ECR

SR

Anextuss

Cypress

SR

Anti-tussive

Qualitest

SR

Aplenzin

Biovail

SR

Aquabid-DM

Alphagen

SR

Aquatab C

Adams

SR

Aquatab D

Adams

SR

Aquatab DM

Adams

SR

Arthrotec

Pharmacia

EC

Asacol

Procter & Gamble

EC

Ascocid-500-D

Key

SR

Ascocid-1000

Key

SR

Ascriptin Enteric

Novartis Consumer

EC

Atrohist Pediatric

Celltech

SR

Augmentin XR

GlaxoSmithKline

SR

Avinza

Ligand

SR

Azulfidine Entabs

Pharmacia

EC

Bayer Aspirin Regimen

Bayer HealthCare

EC

Biaxin XL

Abbott

SR

Bidex-A

SJ

SR

Bidhist

Cypress

SR

Bidhist-D

Cypress

SR

Bisac-Evac

G&W

EC

Biscolax

Global Source

EC

Blanex-A

Blansett

SR

Bontril Slow-Release

Valeant

SR

Bromfed

Victory

SR

Bromfed-PD

Victory

SR

Bromfenex

Ethex

SR

Bromfenex PD

Ethex

SR

Bromfenex PE

Ethex

SR

Bromfenex PE Pediatric

Ethex

SR

Budeprion SR

Teva

SR

Budeprion XL

Teva

SR

Buproban

Teva

SR

Calan SR

Pharmacia

SR

Campral

Forest

EC

Carbatrol

Shire US

SR

Cardene SR

Roche

SR

Cardizem CD

Biovail

SR

Cardizem LA

Kos

SR

Cardura XL

Pfizer

SR

Carox Plus

Seneca

SR

Cartia XT

Andrx

SR

Cemill 500

Miller

SR

Cemill 1000

Miller

SR

Certuss-D

Capellon

SR

Cevi-Bid

Lee

SR

Chlorex-A

Cypress

SR

Chlor-Phen

Truxton

SR

Chlor-Trimeton Allergy

Schering-Plough

SR

Chlor-Trimeton Allergy Decongestant

Schering-Plough

SR

Cipro XR

Schering-Plough

SR

Claritin-D

Schering-Plough

SR

Claritin-D 12 Hour

Schering-Plough

SR

Claritin-D 24 Hour

Schering-Plough

SR

Coldamine

Breckenridge

SR

Coldex-A

United Research

SR

Concerta

McNeil Consumer

SR

Contac 12-Hour

GlaxoSmithKline

SR

Coreg CR

GlaxoSmithKline

SR

Correctol

Schering-Plough

EC

Cotazym-S

Organon

EC

Covera-HS

Pfizer

SR

CPM 8/PE 20/MSC 1.25

Cypress

SR

CPM 12

Brighton

SR

Creon 5

Solvay

EC

Creon 10

Solvay

EC

Creon 20

Solvay

EC

Cymbalta

Eli Lilly

EC

Dairycare

Plainview

EC

Dallergy

Laser

SR

Dallergy-JR

Laser

SR

Deconamine SR

Kenwood Therapeutics

SR

Deconex

Poly

SR

Deconex DM

Poly

SR

Deconsal II

Cornerstone

SR

Depakote

Abbott

EC

Depakote ER

Abbott

SR

Depakote Sprinkles

Abbott

EC

Despec SR

International Ethical

SR

Detrol LA

Pharmacia

SR

Dexedrine Spansules

GlaxoSmithKline

SR

D-Feda II

WE Pharmaceuticals

SR

D-Hist D

Midlothian

SR

Diabetes Trio

Mason Vitamins

SR

Diamox Sequels

Duramed

SR

Dilacor XR

Watson

SR

Dilantin

Pfizer

SR

Dilantin Kapseals

Pfizer

SR

Dilatrate-SR

Schwarz Pharma

SR

Diltia XT

Andrx

SR

Dilt-CD

Apotex

SR

Dilt-XR

Apotex

SR

Dimetane Extentabs

Wyeth

SR

Disophrol Chronotab

Schering-Plough

SR

Ditropan XL

Ortho-McNeil

SR

Donnatal Extentabs

PBM

SR

Doryx

Warner Chilcott

EC

D-Phen 1000

Midlothian

SR

Drexophed SR

Qualitest

SR

Drihist SR

Prasco

SR

Drixoral

Schering-Plough

SR

Drixoral Plus

Schering-Plough

SR

Drixoral Sinus

Schering-Plough

SR

Drize-R

Monarch

SR

Drysec

AG Marin

SR

D-Tab

Palm

SR

Dulcolax

Boehringer Ingelheim

EC

Duomax

Capellon

SR

Durahist

Proethic

SR

Durahist D

Proethic

SR

Durahist PE

Proethic

SR

Duratuss

Victory

SR

Duratuss CS

Victory

SR

Duratuss DA

Victory

SR

Duratuss GP

Victory

SR

Dynacirc CR

Reliant

SR

Dynahist-ER Pediatric

Breckenridge

SR

Dynex LA

Athlon

SR

Dynex VR

Athlon

SR

Dytan-CS

Hawthorn

SR

Easprin

Harvest

EC

EC Naprosyn

Roche

EC

Ecotrin

GlaxoSmithKline

EC

Ecotrin Adult Low Strength

GlaxoSmithKline

EC

Ecotrin Maximum Strength

GlaxoSmithKline

EC

Ecpirin

Prime Marketing

EC

Ed A-Hist

Edwards

SR

Effexor-XR

Wyeth

SR

Efidac 24 Chlorpheniramine

Novartis Consumer

SR

Efidac 24 Pseudoephedrine

Novartis Consumer

SR

Enablex

Novartis

SR

Endal

Pediamed

SR

Entab-DM

Rising

SR

Entercote

Global Source

EC

Entex LA

Andrx

SR

Entex PSE

Andrx

SR

Entocort EC

Prometheus

EC

Equetro

Shire US

SR

ERCY

Warner Chilcott

SR

Ery-Tab

Abbott

EC

Eskalith-CR

GlaxoSmithKline

SR

Execof

Larken

SR

Exefen-DM

Larken

SR

Exefen-DMX

Larken

SR

Exefen-PD

Larken

SR

ExeTuss-DM

Larken

SR

Extendryl G

Fleming

SR

Extendryl JR

Fleming

SR

Extendryl SR

Fleming

SR

Extress-30

Key

SR

Extress-60

Key

SR

Feen-a-mint

Schering-Plough

EC

Femilax

G&W

EC

Fero-Folic-500

Abbott

SR

Fero-Grad-500

Abbott

SR

Ferro-Sequels

Inverness Medical

SR

Ferrous Fumarate DS

Vita-Rx

SR

Fetrin

Lunsco

SR

Flagyl ER

Pharmacia

SR

Fleet Bisacodyl

C.B. Fleet

EC

Focalin XR

Novartis

SR

Folitab 500

Rising

SR

Fortamet

First Horizon

SR

Fumatinic

Laser

SR

Genacote

Wax

EC

GFN 500/DM 30

Cypress

SR

GFN 550/PSE 60

Cypress

SR

GFN 550/PSE 60/DM 30

Cypress

SR

GFN 595/PSE 48

Cypress

SR

GFN 595/PSE 48/DM 32

Cypress

SR

GFN 600/Phenylephrine 20

Cypress

SR

GFN 600/PSE 60/DM 30

Cypress

SR

GFN 1000/DM 50

Cypress

SR

GFN 1200/DM 60

Cypress

SR

GFN 1200/DM 60/PSE 60

Cypress

SR

GFN 1200/Phenylephrine 40

Cypress

SR

GFN 1200/PSE 50

Cypress

SR

Gilphex TR

Gil

SR

Giltuss TR

Gil

SR

Glucophage XR

Bristol-Myers Squibb

SR

Glucotrol XL

Pfizer

SR

Glumetza

Depomed

SR

G/P 1200/75

Cypress

SR

Guaifenex DM

Ethex

SR

Guaifenex GP

Ethex

SR

Guaifenex PSE 60

Ethex

SR

Guaifenex PSE 80

Ethex

SR

Guaifenex PSE 85

Ethex

SR

Guaifenex PSE 120

Ethex

SR

H 9600 SR

Hawthorn

SR

Halfprin

Kramer

EC

Hemax

Pronova

SR

Histacol LA

Breckenridge

SR

Hista-Vent DA

Ethex

SR

Hista-Vent PSE

Ethex

SR

Humavent LA

WE Pharmaceuticals

SR

Humibid

Adams

SR

Humibid DM

Carolina

SR

Humibid LA

Carolina

SR

Iberet-500

Abbott

SR

Iberet-Folic-500

Abbott

SR

Icar-C Plus SR

Hawthorn

SR

Imdur

Schering-Plough

SR

Inderal LA

Wyeth

SR

Indocin SR

Forte Pharma

SR

Innopran XL

Reliant

SR

Invega

Janssen

SR

Isochron

Forest

SR

Isopro

Rugby

SR

Isoptin SR

FSC

SR

Kadian

Alphagen

SR

Kaon-Cl 10

Savage

SR

Keppra XR

UCB

SR

Klor-Con 8

Upsher-Smith

SR

Klor-Con 10

Upsher-Smith

SR

Klor-Con M10

Upsher-Smith

SR

Klor-Con M15

Upsher-Smith

SR

Klor-Con M20

Upsher-Smith

SR

Klotrix

Bristol-Myers Squibb

SR

K-Tab

Abbott

SR

K-Tan

Prasco

SR

Lescol XL

Novartis

SR

Levall G

Athlon

SR

Levbid

Alaven

SR

Levsinex

Schwarz Pharma

SR

Lexxel

AstraZeneca

SR

Lialda

Shire

EC

Lipram 4500

Global

EC

Lipram-PN10

Global

EC

Lipram-PN16

Global

EC

Lipram-PN20

Global

EC

Liquibid-D

Capellon

SR

Liquibid-D 1200

Capellon

SR

Liquibid-PD

Capellon

SR

Lithobid

Capellon

SR

Lodrane 12 hour

ECR

SR

Lodrane 12D

ECR

SR

Lodrane 24

ECR

SR

Lodrane 24D

ECR

SR

Lohist-12

Larken

SR

Lohist-12D

Larken

SR

Lusonex

Wraser

SR

Luvox CR

Jazz Pharmaceuticals

SR

Mag Delay

Major

EC

Mag64

Rising

EC

Mag-SR Plus Calcium

Cypress

SR

Mag-Tab SR

Niche

SR

Maxifed

MCR American

SR

Maxifed DM

MCR American

SR

Maxifed DMX

MCR American

SR

Maxifed G

MCR American

SR

Maxiphen DM

Ambi

SR

Medent DM

SJ

SR

Medent PE

SJ

SR

Mega-C

Merit

SR

Melfiat

Numark

SR

Menopause Trio

Mason Vitamins

SR

Mestinon Timespan

Valeant

SR

Metadate CD

Celltech

SR

Metadate ER

Celltech

SR

Methylin ER

Mallinckrodt

SR

Micro-K

Ther-Rx

SR

Micro-K 10

Ther-Rx

SR

Mild-C

Carlson

SR

Mindal DM

Breckenridge

SR

Montephen

Monte Sano

SR

MS Contin

Purdue

SR

Mucinex

Adams

SR

Mucinex D

Adams

SR

Mucinex DM

Adams

SR

Multi-Ferrous Folic

United Research

SR

Multiret Folic-500

Amide

SR

Mydex

Larken

SR

Mydocs

Centurion

SSR

Myfortic

Novartis

EC

Nacon

Cypress

SR

Nalex-A

Blansett

SR

Naprelan

Blansett

SR

Nasatab LA

ECR

SR

New Ami-Tex LA

Amide

SR

Nexium

AstraZeneca

EC

Niaspan

Kos

SR

Nicomide

Sirius

SR

Nifediac CC

Teva

SR

Nifedical XL

Teva

SR

Nitrocot

Truxton

SR

Nitro-Time

Time-Cap

SR

Nohist

Larken

SR

Nohist-Plus

Larken

SR

Nohist-Plus JR

Larken

SR

Norel SR

U.S. Pharmaceuticals

SR

Norpace CR

Pharmacia

SR

Obstetrix EC

Seyer Pharmatec

EC

Omnihist LA

WE Pharmaceuticals

SR

Opana ER

Endo

SR

Oramorph SR

AAI Pharma

SR

Oracea

Collagenex

SR

Oruvail

Wyeth

SR

Oxycontin

Purdue

SR

Palcaps 10

Breckenridge

EC

Palcaps 20

Breckenridge

EC

Pancrease

McNeil Consumer

EC

Pancrease MT 10

McNeil Consumer

EC

Pancrease MT 16

McNeil Consumer

EC

Pancrease MT 20

McNeil Consumer

EC

Pancrecarb MS-4

Digestive Care

EC

Pancrecarb MS-8

Digestive Care

EC

Pancrecarb MS-16

Digestive Care

EC

Pancrelipase 4500

Mutual

EC

Pangestyme CN 10

Ethex

EC

Pangestyme CN 20

Ethex

EC

Pangestyme EC

Ethex

EC

Pangestyme MT 16

Ethex

EC

Pangestyme UL 12

Ethex

EC

Pangestyme UL 18

Ethex

EC

Pangestyme UL 20

Ethex

EC

PanMist DM

Pamlab

SR

PanMist JR

Pamlab

SR

PanMist LA

Pamlab

SR

Panocaps

Breckenridge

EC

Panocaps MT 16

Breckenridge

EC

Panocaps MT 20

Breckenridge

EC

Papacon

Consolidated Midland

SR

Para-Time SR

Time-Cap

SR

Paser

Jacobus

SR

Pavacot

Truxton

SR

Paxil CR

GlaxoSmithKline

SR

PCE Dispertab

Abbott

SR

PCM LA

Cypress

SR

Pendex

Cypress

SR

Pentasa

Shire US

SR

Pentopak

Zoetica

SR

Pentoxil

Upsher-Smith

SR

Phenabid

Gil

SR

Phenabid DM

Gil

SR

Phenavent

Ethex

SR

Phenavent D

Ethex

SR

Phenavent LA

Ethex

SR

Phenavent PED

Ethex

SR

Phendiet-105

Truxton

SR

Phenytek

Mylan Bertek

SR

Phlemex-PE

Cypress

SR

Plendil

AstraZeneca

SR

Poly Hist Forte

Poly

SR

Poly-Vent

Poly

SR

Poly-Vent Jr

Poly

SR

Prehist D

Marnel

SR

Prevacid

Tap

EC

Prilosec

AstraZeneca

EC

Prilosec OTC

Procter & Gamble

SR

Pristiq

Wyeth

SR

Procanbid

Monarch

SR

Procardia XL

Pfizer

SR

Prolex PD

Blansett

SR

Prolex D

Blansett

SR

Pronestyl-SR

Bristol-Myers Squibb

SR

Proquin XR

Esprit

SR

Prosed EC

Star

EC

Proset-D

Blansett

SR

Protid

Lunsco

SR

Protonix

Wyeth

EC

Prozac Weekly

Eli Lilly

EC

Pseubrom

Alphagen

SR

Pseubrom-PD

Alphagen

SR

Pseudocot-C

Truxton

SR

Pseudocot-G

Truxton

SR

Pseudovent

Ethex

SR

Pseudovent 400

Ethex

SR

Pseudovent DM

Ethex

SR

Pseudovent PED

Ethex

SR

Quibron-T/SR

Monarch

SR

Quindal

Qualitest

SR

Ralix

Cypress

SR

Ranexa

CV Therapeutics

SR

Razadyne ER

Ortho-McNeil

SR

Reliable Gentle Laxative

Ivex

EC

Requip XL

GlaxoSmithKline

SR

Rescon-Jr

Capellon

SR

Rescon-MX

Capellon

SR

Respa-1st

Respa

SR

Respa-AR

Respa

SR

Respa-BR

Respa

SR

Respa-DM

Respa

SR

Respa-PE

Respa

SR

Respahist

Respa

SR

Respahist-II

Respa

SR

Respaire-60 SR

Laser

SR

Respaire-120 SR

Laser

SR

Rhinacon A

Breckenridge

SR

Risperdal Consta

Janssen

SR

Ritalin LA

Novartis

SR

Ritalin-SR

Novartis

SR

Rodex Forte

Legere

SR

Rondec-TR

Biovail

SR

Ru-Tuss

Carwin

SR

Ryneze

Stewart-Jackson

SR

Rythmol SR

Reliant

SR

SAM-e

Pharmavite

EC

Sanctura XR

Allergen

SR

Scopohist-PE

Larken

SR

Seroquel XR

AstraZeneca

SR

Simcor

Abbott

SR

Simuc-GP

Cypress

SR

Sinemet CR

Bristol-Myers Squibb

SR

Sinutuss DM

WE Pharmaceuticals

SR

Sinuvent PE

WE Pharmaceuticals

SR

Slo-Niacin

Upsher-Smith

SR

Slow Fe

Novartis Consumer

SR

Slow Fe with Folic Acid

Novartis Consumer

SR

Slow-Mag

Purdue

EC

Solodyn

Medicis

SR

Stahist

Magna

SR

St. Joseph Pain Reliever

McNeil Consumer

EC

Sudafed 12 Hour

Pfizer

SR

Sudafed 24 Hour

Pfizer

SR

Sudahist

Larken

SR

Sudal DM

Atley

SR

Sudal SR

Atley

SR

Sudatex-DM

Larken

SR

Sudatex-G

Larken

SR

Sudatrate

Larken

SR

Sudex Tab

Atley

SR

Sular

First Horizon

SR

Sulfazine EC

Qualitest

EC

Symax Duotab

Capellon

SR

Symax-SR

Capellon

SR

Tarka

Abbott

SR

Taztia XT

Andrx

SR

Tegretol-XR

Novartis

SR

Tenuate Dospan

Sanofi-Aventis

SR

Theo-24

UCB

SR

Theochron

Forest

SR

Theo-Time

Major

SR

Tiazac

Forest

SR

Time-Hist

MCR American

SR

Toprol XL

AstraZeneca

SR

Totalday

National Vitamin

SR

Touro Allergy

Dartmouth

SR

Touro CC

Dartmouth

SR

Touro CC-LD

Dartmouth

SR

Touro DM

Dartmouth

SR

Touro HC

Dartmouth

SR

Touro LA

Dartmouth

SR

Touro LA-LD

Dartmouth

SR

Tranxene-SD

Ovation

SR

Trental

Sanofi-Aventis

SR

Trikof-D

Respa

SR

Trinalin Repetabs

Schering-Plough

SR

Trituss-ER

Everett

SR

Tussafed-LA

Everett

SR

Tussall-ER

Everett

SR

Tussi-Bid

Capellon

SR

Tussicaps

Mallinckrodt

SR

Tusso-DM

Everett

SR

Tusso-HC

Everett

SR

Tylenol Arthritis

McNeil Consumer

SR

Ultrabrom

WE Pharmaceuticals

SR

Ultrabrom PD

WE Pharmaceuticals

SR

Ultracaps MT 20

Breckenridge

EC

Ultram ER

Ortho-McNeil

SR

Ultrase

Axcan Scandipharm

EC

Ultrase MT12

Axcan Scandipharm

EC

Ultrase MT18

Axcan Scandipharm

EC

Ultrase MT20

Axcan Scandipharm

EC

Uniphyl

Purdue

SR

Uni-Tex

United Research

SR

Urimax

Xanodyne

EC

Uritact-EC

Cypress

EC

Urocit-K 5

Mission

SR

Urocit-K 10

Mission

SR

Uroxatral

Sanofi-Aventis

SR

Utira

Hawthorn

SR

Veracolate

Numark

EC

Verelan

Schwarz Pharma

SR

Verelan PM

Schwarz Pharma

SR

Videx EC

Bristol-Myers Squibb

EC

Vivitrol

Cephalon

SR

Vivotif Berne

Berne Products

EC

Voltaren

Novartis

EC

Voltaren-XR

Novartis

SR

Vospire

Dava

SR

Vospire ER

Dava

SR

We Mist LA

WE Pharmaceuticals

SR

We Mist II LA

WE Pharmaceuticals

SR

Wellbid-D

Prasco

SR

Wellbid-D 1200

Prasco

SR

Wellbutrin SR

GlaxoSmithKline

SR

Wellbutrin XL

GlaxoSmithKline

SR

Wobenzym N

Marlyn

EC

Woman's Wellbeing Menopause Relief

Consumer Choice

SR

Xanax XR

Pharmacia

SR

Xedec II

Cypress

SR

Xiral

Hawthorn

SR

Xpect-AT

Hawthorn

SR

Xpect-HC

Hawthorn

SR

Xpect-PE

Hawthorn

SR

Zephrex LA

Sanofi-Aventis

SR

Zmax

Pfizer

SR

Zorprin

Par

SR

Zotex-12D

Vertical

SR

Zyban

GlaxoSmithKline

SR

Zyflo CR

Critical Therapeutics

SR

Zymase

Organon

EC

Zyrtec-D

Pfizer

SR

Reference

LaGow B, ed. Drug Topics Red Book. Montvale, N.J.: Thomson Healthcare; 2009.