Can Lipitor 10 mg tabs be cut in half and taken in half doses?

[danbloom]

I ask because the Lipitor fullpage ads in national magazines say DO NOT BREAK TABLETS and they Lipitor website from Pfizer also says on the meds page DO NOT BREAK TABLETS but my doctor told me to break the 10 mg tabs in half and take just half each day. I wrote to Lipitor's PR department in NYC, a very polite letter, and they so far refuse to answer my emails, preferring to stonewall me, er, pillwall, me, which I do not understand why they would do that. I am a customer. I buy their pills. And they will not answer my simple question. I told Pfizer if they do not answer my polite consumer qusetions I will go to the New York Times and ask for a big news story about this to be written. PR should serve the customer, no? Or is Pfzier so big that they think the patients do not matter.

Reason i ask is my own cardiologist said it is OKAY to break the tabs in half, he even gave me a free pill cutter to cut the tabs, and said either the pill cutter or manually breaking them into two pieces is OKAY and he has been advising patients about this for over 5 years and that HE HIMSELF DID NOT EVEN KNOW of this rule, and he said maybe Pfizer doesn't want customers to save money, that it might all be a bottom line thing. Could that be true? I can't believe a pharm firm would but profits ahead of patients. So i made a blog and I am going to the New York Times with the story too, because Pfizer should not treat patients this way. Am I right or am I wrong? Please tell me before I have another heart attack! SMILE

the advert appeared in Atlantic Monthly magazine, huge two page color ad, that is expensive, that's alot of money to tell people DO NOT BREAK THE TABLETS.

PS: another doctor told me has been prescribing Lipitor for many years and never heard of this rule either.

What could the reason be for DO NOT BREAK THE TABLETS? A medical reason, like oxygen weakens the power of the meds? Or money? PLEASE DISH.

[danbloom]

My carido doc friend in OHIO tells me:

''Dear Danny
I am now really relieved that I didn't give my patient the wrong instructions. I did occasionally instruct my patients to split lipid-lowering pills. You see, when I lower the dosage, I just don't see why we should waste the pills with higher strength, like, "Here is a new prescription for pills of half of the dose. Throw away those higher dose pills." I just don't see how should we waist expensive pills like that. Let's see what Pfizer tells you."

[erijon]

I just think this is much to do about nothing. If your doctor said split the pills, then follow his advice, it's his career on the line so I'm sure he knows what he's doing. It just sounds like you want to force Pfizer to give you an explanation. Pill splitting is common under a physician's care, why does it matter so much in you get an answer from Pfizer?

Here is a detailed explanation and you'll see it's all about the quality of the split and Lipitor is not the only drug with issues;

"Not all tablets split equally well. In a 2002 study, Paxil, Zestril and Zoloft split cleanly with 0% rejects. Glucophage was described as a hard tablet, requiring significant force, causing tablet halves to fly. Glyburide exhibited very poor splitting with many splitting into multiple pieces. Hydrodiuril and Oretic crumbled. Lipitor did not split cleanly, and the coating peeled. The diamond shaped Viagra tablets made location of the midline difficult. The worst result reported was Oretic 25 mg in which 60% of tablets failed to split to within 15% of target weight."

If the pill doesn't split correctly you will get ineffective dosage, it is probably just that simple.

Jon

[ed34]

"Drug companies invested NOTHING to develop statins - they occur naturally"

It would be impossible to do it for nothing. Also the statin I take is synthetic, (atorvastatin).

[erijon]

"Not all of us can volunteer with experts or stay in a Holiday Inn Express every night"

Everyone can, it's a matter of getting off the Internet and getting into the real world, many just don't want to. It's too easy to read stories on the Internet about cover ups and alleged wrong doing and take them as facts.

If not for drug companies, there would be no real money invested in R&D, that's where the next breakthrough will come from.

[twopack]

Drug companies invested NOTHING to develop statins - they occur naturally.  If there hadn't been a patent somehow granted there would have been precious little interest in Rx statins.  The companies DO invest millions to manufacture and promote statins.  

I DO NOT think they (statins or drug companies) are universally bad.  I applaud the real R&D that drug companies do.  It's just not as pure as it sounds.

My statement about refusal to treat is not reckless.  It is fact based on direct experience and observation.  It is also true however that many doctors will continue to consult with patients even when their advise is blatantly ignored.

Yes, data is available about everything and anything as long as you have enough curiosity, time and mistrust to couple with your intellectual, physical, and financial where-with-all to investigate.  Look around you.  Not everyone is fortunate enough to have all those things in one package.  Some people do need advocates for all types of things because there are too many people waiting take advantage of them and too many people who don't even know they exist.  Some people simply don't know what they don't know.  Not all of us can volunteer with experts or stay in a Holiday Inn Express every night.

I apologize danbloom for my contributions toward making a mushroom cloud out of this.  It isn't even about statins is it?  Your question is about the ethics of a company's public warning if that warning is based on economic gain rather than safety, right?  Any answers yet?

[ed34]

I think what has upset a lot of people is the new findings in some patients who suffer from memory loss and other problems associated with statins. Perhaps if someone has normal cholesterol, they shouldn't be put on statins at all, but it does seem they are automatically given to almost all heart patients as a precaution. If there have been issues with people that have normal or low cholesterol and take statins, then perhaps the big drug companies need to at least do more research on this, rather than claim these are unrelated issues. I believe this is their duty and they can then produce their findings. There's no doubt that statins help people with high cholesterol, I have no side effects. I can imagine people with naturally low cholesterol before taking statins may suffer side effects though.
What angers me is that it shouldn't be us arguing over these issues, the drug companies should be finding out. I haven't seen any research by large drug companies on memory loss or other issues with statins, just claims. So perhaps everyone is right, when differing information comes from different sources, human nature says to develop doubt and ask questions.
I think Jon is correct with the money, drug companies invest huge sums in developing the next phase in medication. If they didn't, we wouldn't have statins. It takes years to come up with a new drug and lots of investment. I wonder how much the insurance companies pay out for heart problems related to high cholesterol each year, and how much the National Insurance in the UK has to pay. A box of statins a month must cost much much less than angioplasty or bypass surgery, so it makes sense in many ways.