Pill Crushers take tablets and mash them into powder. The powder form of the drug is easier to consume for some patients that have difficulty swallowing, refuse to take their medications, or need to reduce the size of large medications for easier ingestion. The powdered form of the tablet can be sprinkled on food or mixed in a drink. These tablet crushers work well for pets as well that refrain from consuming prescribed pills.
- Advantages of Pill Crushing
- Types of Pill Crushers
- Selecting the Best Pill Crusher or Grinder
- Top Ten Manual Tablet Crushers
- Top Two Automatic Pill Crushers
- Medical Studies
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Pill Crushing History
Pill crushers have been around for a long time with extensive use by apothecaries. The mortar and pestle pill crusher is a symbol for many pharmacies even today but currentlyrarely used by pharmacists. The mortar is the bowl, and the grinding handle is the pestle. Apothecaries would grind herbs and medicines in the mortar to formulate a custom prescription for each patient.
Today, pill crushing takes place in hospitals, nursing homes, or the patient’s home. For inpatient care, the use of crushed tablets for administration is largely due to patient swallowing difficulties or the refusal to swallow tablets.1 Acetaminophen is the most commonly crushed tablet in hospitals because of its difficulty with swallowing.2
The Challenges of Tablet Smashing Devices
Several medical studies of pill crushing devices have found that there can be a significant loss of medication between the crushing to patient consumption stages with some devices. One medical study noted the importance of rinsing the crushing device twice and the patient’s direct consumption of the crushed medication along with the rinse to receive as much of the prescribed medication as possible.3
Additionally, some studies have found that there are some medications not suitable for crushing. For instance, extended-release or slow-release medications, skin or membrane irritants, as well as foul-tasting pills, are not good candidates for crushing. A list of these medications is at the following link: "Oral dosage forms that should not be crushed."4
Advantages of Tablet Crushing
- Aids patients that are unable to swallow large tablets
- Aids patients that refuse to take tablets
- Smashing pills is fast and easy with the right device.
- Disposable cups and pouches reduce dosage loss.
- Most devices are portable.
- May be mixed with food or drink.
Disadvantages of Tablet Crushing
- Some devices require dexterity and strength from patients that may be frail.
- Patient compliance may be an issue for some patients.
- Risk of incorrect dosing.
- Potential dosage loss.
- Potential patient non-compliance due to additional efforts.
- Requires thorough cleaning between use to prevent possible cross-contamination.
Types of Pill Crushing Devices
- Mortar and Pestle – is an antique, apothecary two-piece system made with silicone, porcelain, hardwood, stainless steel, or stone. Requires labor, but offers easy cleanup.
- Twist Screw Type – most popular and least expensive, place your pill in the chamber, twist the knob and crush. Use of this product requires some dexterity on the part of the user.
- Scissor Type – position the tablet in the jaw of the scissors, bring the handles together, and the tablet divides into two equal parts.
- Lever Type – employs a lever to apply force to crush tablets. Place pills into a bag to prevent cross-contamination. The bag goes into a slot, press down on the lever to crush the pills.
- Mill Grinder – place pill in the chamber, turn the handle to activate the crushing mechanism.
- Electric Crushers – place tablet in the chamber, close lid, and press a button.
- Crushing Syringe – crushes tablets, mixes with liquid and then administers liquified medication for enteral feeding.
Disposable Cups and Bags
Grinders and lever type crushers commonly employ the use of disposable cups or disposable bags for containment and for patient administration of the medication. Manual grinders use disposable bags to contain the medication while electric pill grinders use disposable cups to capture the crushed medication and to administer it to the patient.
Selecting the Best Pill Crusher
Pill crushers fall into two main groups—manual and automatic. The automatic devices use batteries or AC to power the grinder. Among the manual devices are numerous options. They include the age-old mortar & pestle to the simple screw-type, both requiring some patient dexterity and strength. Combo devices blend a tablet smasher with a cutter or with storage. Some combo devices provide a cup for mixing and administering the medication with liquid. There are also the lever and grinder types that require less dexterity and strength. The automatic devices offer ease and convenience. Frail patients should find automatic devices suitable since they donot require any strength to operate. The infographic above displays the different types of devices and how they match up with patient abilities.
Top Ten Manual Pill Crushers
Silent Knight – lever style device used with pouches.
Metal Pill Crusher – a lever style smasher from Graham-Field.
EZY Dose – twist style grinder with easy grip base and cap.
Pill Crusher Pouches – designed for insertion into a lever device or you can just hammer the tablets into powder.
Medline Pill Crusher – twist type with transparent base for observation. This device comes with storage and knobs on the side for better grip.
Equadose Pill Grinder – grinder design with a handle crank. Grinds to a fine powder everytime.
Apex Pulverizer – twist type with transparent base for observation. This device comes with storage and wing grips on the cap for better grip.
Pill Mill – grinder style that is nearly effortless to use.
MaxGrind – twist type with anti-slip rubber grip and serving cup.
HealthSmart Pill Crusher – twist type with transparent base for observation. Grip ridges located on the cap and base for better grip. This device comes with a two-compartment storage area in the cap.
Top Two Automatic Pill Crushers
First Crush Gen2 Automated – electric pill grinder that grinds tablets to powder and places it into a dosing cup.
Powdercrush – 5 second, battery-powered tablet crusher. Battery charger included.
- 1. Haw C, Stubbs J. Administration of medicines in food and drink: A study of older inpatients with severe mental illness. International Psychogeriatrics 2010; 22: 409.
- 2. Thong, Min Yew, Yady J. Manrique, and Kathryn J. Steadman. "Drug loss while crushing tablets: Comparison of 24 tablet crushing devices." PloS one 13.3 (2018): e0193683, 3.
- 3. Thong, p. 12.
- 4. Mitchell, John F. "Oral dosage forms that should not be crushed." Institute for Safe Medication Practices 7 (2011).
- Haw C, Stubbs J. Administration of medicines in food and drink: A study of older inpatients with severe mental illness. International Psychogeriatrics 2010; 22: 409–416.
- Thong, Min Yew, Yady J. Manrique, and Kathryn J. Steadman. "Drug loss while crushing tablets: Comparison of 24 tablet crushing devices." PloS one 2018 13.3: e0193683, 3.
- Mitchell, John F. "Oral dosage forms that should not be crushed." Institute for Safe Medication Practices 7 (2011).
- Salmon, Damien, et al. "Pharmaceutical and safety considerations of tablet crushing in patients undergoing enteral intubation." International journal of pharmaceutics443.1-2 (2013): 146-153.
- Grimminck, Angela. "A review of devices that improve patient compliance." Canadian Pharmacists Journal 131.3 (1998): 41.
- Paradiso LM, Roughead EE, Gilbert AL et al. Crushing or altering medications: What's happening in residential aged‐care facilities? Australasian Journal of Ageing 2002; 21: 123–127.
- Barnes L, Cheek J, Nation RL, Gilbert A, Paradiso L, Ballantyne A. Making sure the residents get their tablets: Medication administration in care homes for older people. Journal of Advanced Nursing 2006; 56: 190–199.