The GoodRx Prescription Savings Blog

The latest updates on prescription drugs and ways to save from the GoodRx medical team

Pill Splitting: When Is It OK?

by Dr. Sharon Orrange on February 4, 2013 at 1:34 pm

If you take prescription drugs to treat a chronic illness, it’s possible to save more than 50% off cost of your medication by simply splitting your pills.

Sadly, it’s not all that easy to know when pill splitting is all right.

Not all pills can be split. However, many doctors and insurance companies are advising this strategy with an increasing number of medicines. (It’s also worth noting that the American Medical Association, the American Pharmacists Association, and most pharmaceutical companies oppose pill-splitting.)

Drugs that can be usually be split include Lipitor (atorvastatin), Zocor (simvastatin), Crestor (rosuvastatin), Norvasc (amlodipine), Zestril (lisinopril), Accupril (quinapril), Glucophage (metformin), Synthroid (levothyroxine), Zyprexa (olanzapine), Celexa (citalopram), Paxil (paroxetine), Zoloft (sertraline), Klonopin (clonazepam), Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil), and a number of others.

Drugs that should usually not be split include capsules, chemotherapy drugs, birth control pills, seizure-related medications, and any pill that has a coating or other controlled- or extended-release feature.

Be sure to check with your doctor prior to splitting any medication.

Some other things to watch for:

• Is it scored? Tablets that are scored can be easily split and have been evaluated by the FDA for safety.

• Invest in a pill splitter. Pill splitters are very inexpensive and carried by most pharmacies. If you’re going to split a pill, spend the $5.

• Only split once. It is only recommended that you split pills in half, not any smaller. The dose per piece is too likely to be uneven and pills may shatter or crumble.

• Unequal halves. Even scored tablets can be difficult to split into two perfect halves, and medicine is sometimes distributed unevenly within a single tablet. Buy a pill splitter to help and don’t split with a knife.

• Crumbs. Tablets that are round or too small may crumble easily or unevenly when split and that will affect the dose you are actually getting.

• Don’t forget! Patients who are given a higher dose pill and told to take half may forget to do so, resulting in a double dose of medication. Splitting is not recommended for patients with poor eyesight, arthritis, memory problems or impaired thinking.

• Don’t split in advance. Some pills may deteriorate after being split, and taking two halves of the same pill consecutively will get you the most even dosing.

• To split or not to split? When in doubt about whether your pill can be split, check the package insert or ask your doctor or pharmacist.

Keep calm and save on . . .

Dr O.


Propecia for Hair Loss: How to Save Your Hair and Your Money

by Dr. Sharon Orrange on April 12, 2012 at 2:21 pm

Propecia (finasteride) a day works for male pattern hair loss. Hair loss is a huge deal for men, some of whom are willing to pay big dollars for years for their Propecia.

Daily use of Propecia for more than 3 months is necessary before benefits are observed, so it does work . . . but at a cost. Remember that continued use is recommended to sustain benefit and when you stop, you will see reversal of what Propecia did within 12 months. Ok now, think about the cost: Propecia is more than a dollar a day so you will be forking out more than 50 bucks a month. But wait, I have a secret for you.

Merck makes both Propecia (1 mg of finasteride) and Proscar (5 mg of finasteride). Proscar, unlike Propecia, is available as generic finasteride. If you can cut your finasteride tablet in three pieces, the difference in cost is striking. You can save a ton of money.

Is it worth it? Yes, Propecia (finasteride) works. In male pattern hair loss, the balding scalp contains increased amounts of DHT compared with hairy scalp. Finasteride decreases scalp and serum DHT concentrations (DHT is what testosterone is converted to).

Is there a downside to Propecia? Not really. In controlled trials of Propecia (finasteride) for the treatment of male pattern hair loss, discontinuation rates were similar to those taking placebo and decreased ejaculate volume was the main complaint.

Finasteride, Propecia, and Proscar are all the same medication at much different prices – ask your doctor about it.

Dr O.

Propecia is typically not covered by insurance, and costs about $70 – $75 per month. Merck, the manufacturer, also offers up to $60 off the first 90-day supply, and up to $200 off the fourth 90-day supply, for a savings of $260 in your first year. In contrast, finasteride is covered by most insurance plans as a Tier 1 medication – meaning you’ll pay only your lowest copay – and it can be found for as low as $10 – $20 per month.


10 Reasons You Need to Talk to Your Doctor About the Cost of Your Medications—Today!

by Dr. Sharon Orrange on February 22, 2012 at 2:58 pm

1) 1 in 4 patients skip meds to save money. If you are doing this, your doctor needs to know.

2) Communicating about the economics of medications is part of your doctor’s job.

3) Your doctor should realize that higher cost means less compliance (you won’t take your pills everyday). We both lose.

4) Both doctors and patients are on the same team: yours. Patients need to get the best health care within the constraints of the current system.

5) Writing the prescription isn’t always enough. Patients have to fill the prescription and take the medication as well.

6) Your out-of-pocket prescription drug costs can play a big role in how well you follow doctors’ orders.

7) Your doctor has an obligation to consider costs when prescribing meds.

8) It’s possible the biggest “side effect” of your medication is cost, and you need to know this before you get to the pharmacy.

9) You and your doctor can explore alternatives such as: generic medications, splitting higher-dose pills, reviewing med lists to cut out nonessential or less important drugs, patient assistance programs, and getting samples.

10) Initiating the conversation as a patient will help avoid potential awkwardness. Seriously? Yes, doctors say the reason they don’t bring cost of meds up with their patients more often is they want to avoid making their patient feel awkward.

Dr O.


Top 7 Ways to Lower the Cost of Your Meds in 2012

by Dr. Sharon Orrange on January 3, 2012 at 11:28 am

In this economy people wonder what to do if they can’t afford their medications. First off, if you can’t afford your medicines talk to your doctor or pharmacist, but do not skip doses in an effort to save money.

Here are some important ways to lower the cost of your medications:

1) Ask for generic substitutes: Ask your doctor or pharmacist if any of the medicines you take are “brand-name” medications. If so, ask if they can be switched for less expensive “generic” medications. Many newer medicines do not come as generics, so it’s not always possible to switch, but it can save a lot of money even if you have insurance.

2) Ask about splitting pills: Find out if the pills you take are safe to split in half. Many prescription medications cost the same no matter what strength the pill is. Pills that can be safely split usually include those that have a line or score down the center for breaking and those that are flat, round, or long and narrow. Medicines that come in capsules or in pills that have a slow or delayed release should not be split.

3) Shop around, buy in bulk: Another way to cut the costs of your medicines is to shop around. Pharmacies do not charge the same prices for the same medicines so find out which pharmacies or stores have the best price. Many places also offer discounts for buying 100 pills or more at once.

4) Use your insurance wisely; there are three things you need to know to get the most out of your insurance coverage:

– Get a list of the drugs covered by your plan (the “formulary”).

– Get information about co-pays.

– Know about tiers. Insurance companies put drugs into different tiers with different co-pays. Tier 1 drugs are usually the cheapest, Tier 3 the most expensive.

5) Mail-order options: This will save you money on medicines you take for 3 months or longer. Mail-order is a good idea only after you know for sure that you will be taking a medicine at the same dose for at least 3 months.

6) Get help paying for the medicines you need: There are state and federal programs that help people pay for their medications, as well as programs paid for by non-profit groups and by drug companies.

7) Beware of foreign or Internet-only pharmacies: Stay away from any pharmacy that will sell you prescription medications without a prescription from a doctor who has actually seen you. Some Internet and foreign pharmacies are not licensed or inspected the way they should be and may sell you medicines that are expired or even fake.

Dr O.


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