Want to split Controlled Release sleeping pills
November 2, 2014 8:27 AM   Subscribe

I want to split my Ambien CR (controlled release) pills. The internet says not to, as does the insert I got with them. What Bad Thing is going to happen when I do?

I take Ambien occasionally when I really can't get to sleep. My pills are 10mg; I usually take half of one. I have no bad effects from them, either when I take a whole or a half, though neither dose keeps me asleep for more than about 3 hours. I tried the CR, and they didn't make enough difference to be worth the extra cost.

So I now have a few leftover CRs, and they're 12.5mg each. I know I can take the whole ones without a problem, but since I really don't feel like I need that big a dose, and I don't have as many Ambien as I'd really like to have, I'd much rather split them and take a half at a time. Given that I'm willing to deal with not being able to predict how long the Ambien effect will last, and also with not knowing exactly how much Ambien I'm getting with either half, is there really any reason I shouldn't split them and take halfs?
posted by still_wears_a_hat to Health & Fitness (16 answers total) 1 user marked this as a favorite
Consult your doctor- who knows your medical history- please.
posted by maya at 8:41 AM on November 2, 2014 [2 favorites]

While I can't speak for Ambien CR specifically, I know from some things I've been on (with diagrams in the literature) that extended release pills often have layered coatings: An outer coating, some drugs, some coating, some drugs, some coating, some drugs, etc. The control relies on dissolving the coatings one at a time to get each dose of drugs one at a time.

If that's the case here, if you split the pill, you get all the drugs at once. That is bad. DO NOT DO.
posted by Sys Rq at 8:44 AM on November 2, 2014 [20 favorites]

What Sys Rq said. If you tamper with the extended release mechanism (the coating), you get all the drugs at once. This could theoretically result in an overdose.
posted by amro at 8:48 AM on November 2, 2014 [3 favorites]

Yeah, with controlled-release medications, generally if you alter the pill you destroy the controlled-release mechanism and you get it a) all at once or b) according to a different and unpredictable release schedule. It's not a good idea.
posted by mskyle at 9:11 AM on November 2, 2014 [1 favorite]

I think she recognizes that she'll get it all at once, and is wondering if that's a problem given that half of 12.5mg is less than her 10mg dose of non-controlled release version where she presumably gets the 10mg all at once.
posted by jacquilynne at 9:14 AM on November 2, 2014 [5 favorites]

Sys Rq is correct. Many controlled-release pills have a coating that aids in the release. Breaking the CR pill will defeat that coating.
posted by Thorzdad at 9:16 AM on November 2, 2014

Actually, it looks like she splits the 10mg pills (and thus takes 5mg at once). It looks to me as though she's thinking if she splits the 12.5mg pill, that will result in a 6.25mg dose.

OP, you need to call your pharmacist and ask them this question. Generally, coated, extended-release, and controlled-release drugs should never be split. I can see your argument for why it might not be an issue in your case, but that's only a question a pharmacist can answer for you.
posted by pecanpies at 9:17 AM on November 2, 2014 [3 favorites]

She says that she often splits the 10mg pills because she doesn't need the full dose, but that she also has taken them whole and it hasn't been a problem. It sounds like 10mg was the prescribed dose for the immediate-release pills. Maybe she could step back in and clarify.

Some extended release pills are meant to be tamper proof so trying to crush them will ruin them, but I think that's mainly stuff like Oxy where they're trying to keep people from crushing and injecting or snorting the drugs.
posted by jacquilynne at 9:30 AM on November 2, 2014

Response by poster: Yes, to clarify, I can take 10mg and even 12.5mg at once with no problem. It's just more than I need, and I'd rather take less if I can. Would taking half a pill ever result in anything more than taking a whole pill at once?
posted by still_wears_a_hat at 10:06 AM on November 2, 2014

Would taking half a pill ever result in anything more than taking a whole pill at once?

I'm extremely not a doctor, but it seems like taking half of an opened time-released pill would result in your body absorbing it all at once, while taking a whole pill, regardless of whether it's time-released or not, will certainly involve some delay in absorption, due to stomach acids taking some time to work their way into it (especially if it is layered, as mentioned above). I think this is what people are getting at as the important factor here, rather than the difference in dosage.
posted by jessicapierce at 10:33 AM on November 2, 2014 [2 favorites]

My doctor told me that there is some kind of binding in the controlled release Ambien where taking half of it really has no effect, rather the opposite of what people are saying with the all dose at once. That said, I would talk to the doctor and or pharmacist about this.
posted by sweetkid at 10:52 AM on November 2, 2014

I'm not a doctor, and I can't speak for anyone but myself, but I personally wouldn't think twice about cutting one in half and taking it.

I've been taking Ambien on and off for several years, and my understanding and experience is that Ambien is good at putting people to sleep, but not so good at keeping them asleep. The inside of an Ambien CR tablet is the drug with some kind of binding that takes longer to dissolve; the exterior is the drug with an 'instant release' binding. I don't know the proportions of the drug in each binding. The idea is to make a sleeping pill that puts you to sleep and keeps you asleep. How well does this work? i don't know.

For sure, check with your doctor or pharmacist. And if they say "NO! Don't do that or you'll die!" please let us all know, because I've never ever heard of any pill that acts like that. If it was seriously an issue for some reason, I'd expect to see a lot of strong warnings on the packaging against ingesting damaged pills, not to mention "handle with care".

I'm assuming you got these pills from your doctor, right? Because if you have some oddball medical condition where Ambien might hurt you, your doctor is not going to hand you an Rx and tell you "don't use more than N mg a day"; they're not going to give you an Rx in the first place.
posted by doctor tough love at 12:10 PM on November 2, 2014

You've already found the easy answer to your implied question of whether you can do this anyway, which is to look at the insert and find NO - DO NOT DO THIS, but for the more thorough and fulfilling answer you already have a professional on retainer dedicated to helping you with exactly this.

If you are in the US, the bottle that your prescription came in should have a phone number on it that will get you the pharmacist who filled your prescription. Pharmacists are much more than just shopkeepers for drugs, and go through extensive educations to learn about the the mechanics, chemistry, pharmacodynamics, and pharmacokenetics of the drugs they dispense. This is a question your pharmacist will be extremely overqualified to educate you on at as much length as you like.

To be clear, NO - DO NOT DO THIS, is already the correct answer.

posted by Blasdelb at 2:47 PM on November 2, 2014 [2 favorites]

My 10mg Ambien XR pills are scored in order to break in half. I told my doctor I do it to make them last. He had no comments.
posted by Che boludo! at 4:22 PM on November 2, 2014

The FDA changed the dosage recommendations for zolpidem/Ambien in 2013 to 5 mg or 6.25 mg CR for women and they also recommended this dose for men; they did say that men who need more can go to 10 mg or 12.5 mg CR.

I've found my pharmacist to be the supreme guru of medication questions always and I'd strongly recommend consulting a pharmacist before cutting any controlled-release medication in half, certainly Ambien, which is not exactly a drug known to be harmless - many people can't take it at all.
posted by aryma at 5:14 PM on November 2, 2014

For what it's worth, I totally don't think you're going to DIE if you do this, I just think it might not work the way you want it to, and then you've wasted a pill that you're trying to conserve.
posted by mskyle at 7:29 AM on November 3, 2014 [1 favorite]

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