Can I split my pills? And other prescription questions you’ve always wanted answered

Can I split my pills?

The short answer is yes, but there’s a right way to do it. In some cases, buying and splitting a double dose of your drug can save a lot of money compared to buying the dosage you are prescribed directly. Most prescriptions come in a variety of doses, and in many cases, higher and lower doses cost the same. Some doctors will even prescribe a double dose with instructions to split to save you money. Here’s how you can do it safely.

First and foremost, never increase or decrease the dosage of your prescriptions without discussing it with your doctor. If side effects are bothering you or you think your medication isn’t working, your doctor can help to address these issues directly. If you and your doctor agree that you can safely halve your pills, make sure to purchase a pill splitter so that you are getting equal doses each day. Remember that items like pill splitters are good candidates for using funds from a health savings account.

READ MORE: Should you have an HSA?

Most pills, including antidepressants and cholesterol- or thyroid-regulating medications, can be split. Others, such as birth control pills, capsules containing powders or liquids, and pills with hard coatings, should not be split. Whether or not a pill can be split is listed under the “how supplied” section of the professional package insert. If you’ve lost the package insert, your pharmacist knows which brands, types and classes of drugs can safely be cut in the interest of saving money.

What do the codes on pills mean?

The series of letters and numbers on your pills—whether prescription or over-the-counter—is called an identifier. The U.S. Food and Drug Administration (FDA) requires all oral medications carry an identifier so that, along with the pill’s shape and color, the code will identify any drug by active ingredient, manufacturer and dosage. This is so you, your doctor and your pharmacist can easily look up the code online should you find a stray pill. If you mix up similar-looking pills and don’t know how to look it up, call your pharmacy—they can identify it for you.

Are generics really as good as brand name drugs?

Yes. The FDA applies the same requirements for strength, purity and quality for all prescription drugs, whether generic or brand name. The only differences allowed are inactive ingredients (such as preservatives and binding agents), shape and color. While inactive ingredients may cause an adverse reaction, this is also possible with brand-name drugs. People with food allergies are more likely to have reactions to these ingredients, so make sure your doctor has an up-to-date list of your allergies.

Why can’t I have grapefruit juice with some of my medications?

Molecules called enzymes are required for anything complex to be broken down and used in the body. Grapefruit juice has certain components that block the action of an enzyme that breaks down certain medications. This results in a higher concentration of medication in the bloodstream, which could be toxic and potentially result in an overdose.

With other drugs, grapefruit juice causes the enzyme to overact, resulting in a lower-than-expected concentration of drug in the bloodstream, which could be dangerous because it deprives you of the medication you need. Either way, if your doctor or pharmacist advises against drinking grapefruit juice or other citrus juice while on a medication, listen closely. This reaction can occur up to 24 hours after the grapefruit juice (or grapefruit flesh) is consumed, and you don’t want a glass of juice to land you in urgent care or the emergency room.

What is the difference between a cream and an ointment?

Both creams and ointments are topical medications that work by absorbing the active ingredient through pores in the skin. So what’s the difference? Creams are water-based and ointments are oil-based. Although both types of preparation contain water and oil, creams have roughly equal water and oil content whereas ointments have much more oil—about an 80/20 ratio. Creams absorb more quickly into the skin, so they’re better when what you need is fast-acting treatment. Ointments are generally prescribed when a slower absorption is required.

What is a controlled substance? Drug schedules?

All illegal and legal prescription narcotics and stimulants (and a few other types of drugs) are considered controlled substances by the Drug Enforcement Administration. Controlled substances are classified into five schedules according to accepted medical usage, relative abuse potential and likelihood of causing dependence.

Schedule I substances are considered to be unsafe, have no medical benefit and a high potential for abuse—Schedule I drugs like heroin, peyote and Ecstasy are illegal. Marijuana is classified as a Schedule I drug, and although it has been legalized for medical and recreational use in some states, it is still illegal at the federal level. Schedule II drugs, like oxycodone and morphine, are considered to have high potential for abuse but are also medically viable. The classification scales down to Schedule V, which consists mainly of cough syrups with low amounts of codeine.

Lacie Glover writes for NerdWallet Health, a website that empowers consumers to find high quality, affordable health care and insurance.