Metformin or Glucophage is a large pill that many people struggle to take. Some people have trouble swallowing, or need smaller doses. Individuals who have had bariatric or stomach surgeries have more successful outcomes if pills are crushed or cut.
Immediate release (IR) Metformin or Glucophage can be crushed or cut without damaging the medication. However, the Metformin extended release (ER) formulas cannot be cut, crushed, or dissolved as it will ruin the active timing release of the medication.
Listed below are the two different forms of Metformin (IR and ER), how the medications work and what happens if you cut, crush or dissolve the medication.
For further information on Metformin or are not quite sure if it is right for you read my in depth article on what is Metformin.
Crushing, Cutting or Chewing Metformin (Glucophage) Immediate Release (IR)
Metformin 500 mg (or other doses), immediate release formula, can be cut, or split without changing the properties of the drug.
I recommend using a pill cutter designed for this task, vs. using a sharp knife. This will assure a clean cut without injury, and you have a better chance of retrieving both halves when the task is complete.
Some medications will have a “score” in the middle, making it easier to divide.
Be sure to use your split tablets sooner than later, to minimize exposure to air and moisture.
Keep all of your medications in the original, airtight, labeled, prescription bottle.
What Happens if you Cut Metformin Extended Release (ER)
The extended release (ER) Metformin (Glucophage XR, Glumetza ER, Fortamet ER) cannot be cut, crushed, or dissolved in water. Swallow this capsule whole with a full glass of water.
Each of the 3 extended release formulas have a different technology or mechanism for releasing the medication. Cutting, crushing or dissolving in water will change the timing of the release of active medication.
The following will explain the technology of Metformin ER and why cutting, crushing or dissolving will damage the pill.
Metformin Extended Release Technology Explained:
Listed below are the 3 types of extended release Metformin pills and how they work.
Glucophage XR (metformin hydrochloride extended-release tablets)
Creates a polymer matrix system forming a gel on the surface of the tablet after it comes in contact with fluid after entering the GI tract. The active drug is then able to diffuse through the gel slowly over an extended period of time. (Source)
Has a gastro-retentive technology where the pill floats in the stomach for an extended period of time. This technology keeps the pill in the stomach for a long period of time slowly delivering Metformin through the membrane to a person’s upper gi tract over the extended period. (Source)
Fortamet, Single Composition Osmotic Technology (S.C.O.T.)
Fortamet has a technology where the medication slowly exits through a small hole in the specially designed tablet. This type of tablet has a small hole created by a laser and is more often to leave a Ghost pill in your stool. It has an outer layer that ends up passing through your intestines and into the stool. (Source)
Is There A Liquid Form of Metformin?
Many people that have a hard time swallowing pills often look for something in a liquid form because it is easier to swallow.
There is a liquid form of Metformin called Riomet extended release which is dosed 500 mg per teaspoon. This liquid form of Metformin comes with a warning for lactic acidosis when alcohol is consumed in excess. It also warns of B12 deficiency and hypoglycemia when combined with insulin.
Metformin Ghost Pill, (Ghost Pill In Stool)
A small amount of patients have reported to me that they will notice their Metformin in their stool. Two highly recommended endocrinologists I worked with at St. Luke’s Hospital in Duluth Minnesota (Dr. Robert Sjoberg-now retired and Dr. Derrick Aippolaini) report that this is nothing to worry about. Your medication has been absorbed. It is just the casing of the medication you see.
If you have further questions about your Metformin, or any other medications, contact your pharmacist for assistance.
If you are in need of immediate attention, call your local emergency center.