Break me off a piece of that...Lipitor?

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As health care costs steadily rise, some people try to cut corners by splitting pills or holding on to certain medications past their expiration date but are such practices safe? An article in yesterday s Los Angeles Times provides readers with some guidance to these questions and offers useful tips that may help save some money at the pharmacy. For instance, many drug manufacturers charge a lower price per milligram of drug when you purchase a higher dose pill. So if you fill a prescription for double the dosage, you can use a pill splitter to halve the tablets, which will save on costs but won t change your dosage regimen.

But before you start breaking pills apart, there are a few things you need to keep in mind, cautions ACSH s Dr. Gilbert Ross. First, always double-check with your doctor to ensure that any sort of tampering with your pills is safe, he says. Second, never split liquid gelcaps or capsules that contain powder or granules. The same applies to extended-release capsules or those that contain an enteric coating, since doing so might release a high level of medication into your body at once, which can be very dangerous.

Since 1979, the FDA has required drug makers to label all medications with an expiration date, often one year from the date the prescription is filled. But for some drugs, especially those in solid form, the shelf-life can actually be longer. Abiding by the expiration date, then, is not a hard and fast rule, says ACSH s Dr. Josh Bloom, since the majority of solid drugs will be safe and effective for months or sometimes even years past this time, depending on the method of storage. In the absence of light, moisture, and heat, Dr. Bloom explains, many compounds can be stable much longer, although there is no way for the consumer to know which, so this should never be assumed. One notable exception is the antibiotic tetracycline, which will slowly decompose to give a toxic byproduct, even in the pill form so throw it out as soon as it expires. Liquid and gel medications are also more prone to developing mold or becoming rancid; therefore, it s a good idea to toss them out as close as possible to the expiration date.