Effect of Tablet Splitting on Serum Cholesterol Concentrations

• Published in: The Annals of pharmacotherapy 2002-02, Vol.36 (2), p.205-209
• Main Authors: Duncan, Megan C, Castle, Sharon S, Streetman, Daniel S
• Format: Article
• Language: English
• Subjects: Atorvastatin Calcium; Biological and medical sciences; Cholesterol - blood; Cholesterol, LDL - blood; Cross-Over Studies; Drug Costs; Female; General and cellular metabolism. Vitamins; Heptanoic Acids - administration & dosage; Heptanoic Acids - economics; Heptanoic Acids - pharmacology; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Pyrroles - administration & dosage; Pyrroles - economics; Pyrroles - pharmacology; Retrospective Studies; Simvastatin - administration & dosage; Simvastatin - economics; Simvastatin - pharmacology; Tablets; West Virginia
• ISSN: 1060-0280; 1542-6270
• DOI: 10.1345/aph.1A233

OBJECTIVE: To evaluate the effects of tablet splitting on low-density lipoprotein (LDL) cholesterol and total cholesterol values in patients taking simvastatin and atorvastatin. DESIGN: A retrospective chart review of total cholesterol and LDL cholesterol values of patients instructed to split simvastatin or atorvastatin between January 1999 and November 2000. SETTING: Veterans Affairs Medical Center in Huntington, WV. PATIENTS: Patients were included if they were taking simvastatin or atorvastatin with regular lipid management and follow-up laboratory results. Patients were required to remain on the same milligram-per-day dose at least 6–8 weeks before and after tablet-splitting initiation and have cholesterol values drawn at least 6 weeks after initiation of both whole-tablet and half-tablet dosing. Patients were excluded if they had a triglyceride level >400 mg/dL or were noncompliant on the basis of pharmacy records and provider notes. MEASUREMENT OUTCOMES: The primary end points were changes in total cholesterol and LDL cholesterol values before and after the patient was switched to half-tablet therapy. RESULTS: The overall results for this review demonstrated no statistically significant increase in total cholesterol and LDL cholesterol concentrations. Total cholesterol and LDL cholesterol values actually decreased from presplitting to postsplitting, p = 0.017 and p = 0.003, respectively. CONCLUSIONS: The investigation showed that half-tablet dosing was as effective as whole-tablet dosing. The program will be continued as a part of quality patient care at the Huntington Veterans Affairs Medical Center.