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Question
A patient has difficulty swallowing tablets and asks the technician if their extended-release metoprolol succinate (Toprol-XL) can be crushed. What should the technician do?
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Answer
A.Refer the question to the pharmacist — crushing extended-release tablets can cause the full dose to release at once
B.Crush the tablet and mix it with applesauce, since this is safe for all tablets
C.Tell the patient it is fine to crush since it is a small tablet
D.Advise the patient to take twice the usual number of pills if crushed
Crushing an extended-release tablet destroys the delivery matrix that controls the drug's release over time, causing 'dose dumping' and a risk of toxicity from receiving the full extended-release dose immediately. Not all tablets are safe to crush, and doubling the dose would compound the danger rather than fix it.