Updated June 18, 2014.

Pill splitting, although controversial, has become a popular way for people to save money on some prescription medications. In fact, some of the country's largest health insurers such as UnitedHealth Group, Kaiser Permanente, and the Veterans Affairs Department encourage their members to save money by splitting specific pills in half.

Splitting pills can save you money because drug companies often charge a similar price for varying doses of medication.

Recently, for example, a popular online pharmacy charged $90.00 for 30 tablets of 10 mg of Lipitor (atorvastatin) and $124.00 for 30 tablets of 20 mg of Lipitor. If your doctor had prescribed 10 mg of Lipitor, you could have purchased the larger dose, split the tablet in half and enjoyed a savings of approximately $28.00 each month.

In a Shopper’s Guide to Prescription Drugs, Consumer Reports lists some common medications that can be split safely, including:

• Cialis (tadafil)
• Crestor (rosuvastatin)
• Levitra (vardenafil)
• Lipitor (atorvastatin)
• Norvasc (amlodipine)
• Paxil (paraxetine)
• Proscar (finasteride)
• Synthroid (levothyroxine)
• Viagra (sildenafil)
• Zocor (simvastatin)
• Zoloft (sertraline)
• Zyprexa (olanzapine)

The following types of medications should not be split:

Capsules
Capsules may contain a liquid, powder, or tiny pellets. If the capsule is split, the medication inside may spill and be impossible to divide evenly.

Extended-release medications
Extended-release, or long-acting medications have coatings or ingredients that control how fast the drug is released from the pill.

Splitting these tablets can destroy substances in the coating. This may result in too much of the drug being released at one time, which may cause dangerous side effects, or too little being released, which may cause your health condition to be poorly controlled.

Enteric-coated medications
Enteric-coated pills have a special coating to prevent the release of medication into your stomach. This is designed either to protect your stomach from the drug or to prevent the drug from being destroyed by the acids in your stomach.

Medications that require an exact dose
Some medications require that you get exactly the same dose each time you take it. Even very small deviations can cause problems. Cutting these pills could result in a dose that is too low to be helpful or a dose that is dangerously high. A good example of this is Coumadin (warfarin), a powerful blood thinner, which can cause excessive bleeding if you take too much, or allow blood clots to form if you take too little. Coumadin (warfarin) requires very accurate dosing and even a very slight difference in the cut halves can put you at risk for dangerous bleeding or clotting.

Pill-Splitting Tips

• Talk to your healthcare provider or pharmacist about splitting your prescription medication to find out if it is safe and if a higher dose is available. Your provider will need to write a prescription for the higher dose pill.
• Do not use a knife or razor blade to split pills. The safest and most reliable way is to use a pill splitter, which can be purchased at your pharmacy. Buy one that has a clear cover and a V-shaped tip that allows for an exact placement of the pill. If you are not sure how to use the pill-splitting device, ask your pharmacist to show you how.
• Split one pill at a time and take the pieces on consecutive days. This will assure that within a two-day period, you are taking an accurate dose.
• If you have poor eyesight, tremors, arthritis in your hands, or any form of memory impairment, have a family member or friend help you with pill splitting.

How to Split Pills

Before you try this money saving trick, it’s important that you understand how to properly split a pill.

The following instructions apply to many pill splitting devices sold in pharmacies and online. However, since these devices differ, it’s important that you read the package directions carefully and follow your pharmacist’s instructions.

Step-by-Step Instructions

Step 1: Talk to Your Doctor
Discuss pill splitting with your doctor. If your doctor agrees that pill splitting is safe for you, have her write a new prescription for twice the usual dose. For example, if you are taking 10 mg tablets of Lipitor (atorvastatin), your doctor will write a prescription for 20 mg tablets.

Step 2: Talk to Your Pharmacist
Fill your new prescription at your pharmacy. Ask your pharmacist to recommend a pill splitter and show you how to use it with your new medication dose.

Step 3: Open Your Pill Splitter
At home, place your pill splitter on a flat surface to prevent tipping. Open the cover of the pill splitter and locate the area marked for the pill.

Step 4: Place Your Pill in the Pill Splitter
Place one of your pills in the pill area. Make sure that the pill is placed correctly so it will split into two halves.

Step 5: Cut the Pill in Half
With the pill correctly placed in your pill splitter, firmly hold the pill splitter steady with one hand With your other hand, press the top down slowly but firmly on the pill to cut it.

Step 6: Remove the Pill Halves from the Pill Splitter
Remove your split pill halves and put them in a pill box or container with the name of the medication. Take half a pill as prescribed and the other half when you are next due for a dose, which may be later in the day or the next day.

Warning: Do not make any changes in your medications or the way you take your medications without first discussing it with your doctor. Also, talk with your doctor if you feel you are unable or unsure about pill splitting.