Why Pill Splitting Saves Money-But Can Also Hurt You
Many people in New Zealand and around the world are splitting pills to cut their medication bills. It sounds simple: buy a 40mg tablet instead of two 20mg ones, snap it in half, and save up to half the price. For some, it’s a lifeline. A 68-year-old in Auckland splitting her lisinopril saves $1,200 a year. But for others, it’s a gamble with their health. The FDA says not all pills can be split-and splitting the wrong one can land you in the hospital.
When Pill Splitting Actually Saves Money
Not every medication follows the same pricing rules. Some drugs cost the same whether you buy one high-dose tablet or two low-dose ones. Others? The higher dose is way cheaper per milligram. That’s where savings kick in.
Take atorvastatin (Lipitor). A 40mg tablet costs $4.27. Two 20mg tablets? $3.48 total. Split the 40mg and you save 38%. Same with lisinopril: a 20mg tablet costs $4.00. Two 10mg tablets? $4.50. Splitting saves you 11%. Statins, blood pressure meds, and some antidepressants often follow this pattern.
But here’s the catch: sertraline (Zoloft) is the opposite. A 100mg tablet costs $0.12. Two 50mg tablets? $0.16. Splitting here costs more. Always check prices before you split. GoodRx and pharmacy discount apps can show you real-time pricing-no guesswork.
Which Pills Should Never Be Split
Some pills aren’t meant to be cut. Splitting them doesn’t just reduce savings-it risks your life.
- Extended-release tablets (like metformin ER, Adderall XR, or OxyContin): These have special coatings that release medicine slowly. Splitting breaks that coating, dumping the whole dose at once. That’s how people end up in the ER.
- Enteric-coated pills (like omeprazole or aspirin): These are designed to pass through your stomach and dissolve in the intestines. Splitting ruins that, causing stomach upset or no effect at all.
- Narrow therapeutic index drugs: Warfarin, digoxin, levothyroxine, and tacrolimus. Even a 5-10% dose change can be dangerous. One woman in Wellington split her Synthroid and ended up with a TSH level so high she needed emergency treatment.
The FDA says: if the package insert doesn’t say it’s safe to split, assume it’s not. Don’t rely on the score line. Some scored pills are still unsafe to split.
The Only Safe Way to Split a Pill
Using a knife, scissors, or your fingers? That’s not splitting. That’s gambling.
The only tool you should use is a pill splitter. These cost $3-$10 at any pharmacy. They have a V-shaped holder and a retractable blade that cuts cleanly down the middle. Studies show they keep dose variation under 15%. Knife splitting? That’s 25-72% variation. That’s not a half-dose-that’s a wild guess.
Here’s how to do it right:
- Wash your hands and wipe the splitter with alcohol after each use.
- Only split one pill at a time.
- Split immediately before taking it. Don’t pre-split and store them. Moisture and heat ruin the medicine-especially after 24 hours.
- If the half crumbles or looks uneven, throw it out. Don’t try to eat the smaller piece.
Most people need 3-5 tries to get consistent splits. Don’t get frustrated. Practice with a dummy pill first. Some pharmacies even give free training.
Always Talk to Your Pharmacist First
Pharmacists are your best resource. They know which pills can be split, which can’t, and how to check the package insert. Most people skip this step-and that’s where things go wrong.
A 2022 survey found 41% of people who split pills without professional advice noticed their meds didn’t work as well. One Reddit user split a time-release amlodipine and ended up in the hospital with dangerously low blood pressure. Another split her hydrochlorothiazide and got dizzy all day because one half had twice the dose.
Ask your pharmacist:
- Is this pill approved for splitting?
- Is there a lower-dose version available?
- Can you recommend a patient assistance program?
- Is there a generic or alternative drug that costs less?
Many drug companies offer free or discounted meds for low-income patients. Some pharmacies have discount cards that cut costs by 30-50%-without the risk of splitting.
What If You’ve Already Been Splitting Pills?
If you’ve been splitting pills without knowing the risks, don’t panic. But do act now.
Check your meds against this list:
- Is it extended-release? → Stop immediately.
- Is it coated? → Stop immediately.
- Is it for heart, thyroid, or blood thinning? → Stop immediately.
- Does it crumble when you split it? → Stop.
If you’re unsure, take your pill bottle to your pharmacy. Ask them to check the package insert. If it’s safe, get a pill splitter. If it’s not, ask about alternatives.
Also, keep track of how you feel. Dizziness, heart palpitations, fatigue, or sudden mood changes could be signs of dose imbalance. Get your blood tested if you’re on warfarin, levothyroxine, or digoxin.
Alternatives to Pill Splitting
Pill splitting isn’t the only way to save. In fact, it’s the riskiest.
Here are safer options:
- Pharmacy discount cards (GoodRx, SingleCare): Save 30-50% on most prescriptions. Free to use.
- Manufacturer patient assistance programs: Many drug makers give free meds to low-income patients. Apply online-it takes 10 minutes.
- Generic versions: Always ask if a generic is available. They’re often 80% cheaper.
- 90-day supplies: Some plans offer lower copays for 3-month fills.
- Mail-order pharmacies: Often cheaper than local stores.
One study found patient assistance programs saved users 53% on average-better than splitting, with zero risk.
The Bottom Line
Pill splitting can save money-but only if done right, and only for the right pills. It’s not a hack. It’s a medical decision.
If you’re considering it:
- Don’t assume a score line means it’s safe.
- Never split extended-release, coated, or high-risk meds.
- Use a pill splitter-not a knife, not your fingers.
- Split right before you take it.
- Always talk to your pharmacist first.
For many, splitting is a necessary step to afford medicine. But for others, it’s a dangerous shortcut. The goal isn’t just to save money-it’s to stay healthy while doing it.
