Can fluvoxamine be crushed? (3+ reasons)

In this article, we will discuss whether fluvoxamine tablets can be crushed or not. We will also discuss the reasons for crushing the tablet, potential risks and side effects associated with crushing fluvoxamine tablets and alternative administration methods for fluvoxamine.

Can Fluvoxamine be crushed?

Yes, fluvoxamine tablets can be crushed if you have difficulty swallowing it as a whole. However, it is not recommended without consulting your healthcare provider or pharmacist. (1)

These tablets are often designed to release the medicine in a specific way and breaking them might mess that up. If you’re having trouble swallowing the tablets, talk to your doctor. They can suggest alternative ways to take the medicine like liquid form. (1)

Always follow the instructions provided by your healthcare provider and the information on the medication label. 

How to properly crush fluvoxamine?

Advice: If your doctor says that it’s okay to crush the medication he has prescribed for you, you can use a tablet crusher, a special syringe made for crushing or a mortar and pestle.

Instructions:

• Crushing syringe: A crushing syringe is a preferable option as it helps avoid spreading the medicine in the air by allowing the medication to be crushed directly into the syringe, providing a convenient way to administer crushed medication. Thereby reducing the chances of environmental contamination. 
• Tablet crusher: Place the tablet you need to crush in the tablet crusher. Some crushers have a small compartment for holding the tablet. Make sure the crusher is clean and securely closed to avoid spillage.
• Mortar and pestle: It is a traditional method which contains a small bowl (mortar) and a grinding tool (pestle). Place the tablets in a mortar and crush them using a pestle.

It’s crucial to note that not every medication can be crushed like enteric-coated tablets, as doing so may affect their effectiveness.

Also, storing crushed tablets is generally not recommended as it may increase the risk of contamination because powders are more prone to be affected by moisture. Consult with your healthcare provider or pharmacist for any further guidance in this regard.

What does research suggest?

A study was conducted in which researchers tested 24 different devices that are used to crush tablets to see how much of the medicine was lost during the process. (5)

They tested devices with disposable cups, bags, no separate vessels and mortar with pestle. They crushed a tablet and tried different methods to recover the crushed medicine, like tapping it out or mixing it with water. 

The goal was to find out how much medicine was lost during the crushing. They found that tapping out the crushed tablet from the devices led to the least loss, an average of about 5.8%. 

This study has the potential for direct consumption of tablets by the patient, minimizing overall drug loss in the entire crushing and transfer process. (5)

What are the reasons for crushing fluvoxamine tablets?

Here are some potential reasons why a healthcare professional might recommend crushing fluvoxamine tablets: (1,2)

Difficulty swallowing:

If you have difficulty swallowing the tablets, your healthcare professional might consider alternative forms of the medication, such as a liquid or a different formulation that is easier to swallow. (4)

Individualized treatment plan:

In certain cases, a healthcare provider might prescribe a specific dosage that requires altering the form of the medication, such as crushing a tablet to get a more precise dose.

Pediatric or Geriatric patients:

Crushing tablets might be necessary for certain populations, such as children or elderly people who may have difficulty swallowing whole tablets.

It’s important to emphasize that altering the form of medication should only be done under the supervision and recommendation of your healthcare provider.

What is the impact of crushing on fluvoxamine’s effectiveness?

Crushing fluvoxamine tablets can potentially impact the medication’s effectiveness, especially if the tablets are designed as extended-release or controlled-release formulations. (2,3)

These tablets are usually made to release the medicine slowly in your body. If you crush them the medicine might be released too quickly, altering the therapeutic effects which can cause problems. (3)

Crushing the tablets may disrupt this controlled-release mechanism, causing the medication to be absorbed differently in the digestive system, leading to fluctuations in the drug levels in the bloodstream. (2)

It’s crucial to follow the instructions of your healthcare provider regarding how to take fluvoxamine or any other medication. 

What are the side effects of crushing fluvoxamine tablets?

Crushing fluvoxamine tablets can change how the medicine works and absorbs in the body and may increase the risk of certain side effects. Common side effects of crushed fluvoxamine include: (1,3)

• Dosing irregularities: If you crush the tablet, it may lead to uneven distribution of the medication. You might get too much or too little drug at any given time which can impact its effectiveness. 
• Rapid release: Some tablets are made to release the medicine slowly over time, providing a sustained effect. Crushing the tablet can cause the drug to be released all at once.
• Gastrointestinal irritation: Some medicines are made to be released in the stomach or intestine. Crushing tablets can expose the drug to the stomach lining and cause irritation.
• Unpleasant taste: Some medications are coated to have a specific taste to make them more palatable. Crushing them can make them taste bitter.
• Interaction with food: Crushing tablets may interfere with the way a medication interacts with food or the digestive process. This can affect the absorption of the drug and how it works. 

What are the alternatives to crushing fluvoxamine?

Alternatives to crushing fluvoxamine tablets include alternative formulations and administration methods. Here are some common alternatives: (3)

• Oral solution/ Liquid form: Fluvoxamine is available in oral solution or liquid form. This can be a suitable option for those who have difficulty swallowing tablets.
• Extended-release capsules: Fluvoxamine may be available in extended-release capsules. These capsules are designed to release medication slowly over an extended period. 
• Orally disintegrating tablets: These tablets dissolve quickly in your mouth, so you don’t need water. 
• Compounded formulations: A compounding pharmacy is available for you to make a personalized version of your medication.

Always consult with your healthcare provider before considering any alternative administration methods. 

Conclusion:

In this article, we have discussed the crushing of fluvoxamine tablets for ease of swelling in patients who can’t consume tablets as a whole. We have also discussed a few alternative methods for their easy administration like liquid dosage forms.

In my opinion, always consult with your healthcare provider regarding medication use and administration. They can help determine the most appropriate option based on your specific situation, ensuring that you receive medication in a form that is both effective and suitable for your needs.

References