Accuracy of Tablet Splitting

We attempted to determine the accuracy of manually splitting hydrochlorothiazide tablets. Ninety‐four healthy volunteers each split ten 25‐mg hydrochlorothiazide tablets, which were then weighed using an analytical balance. Demographics, grip and pinch strength, digit circumference, and tablet‐splitting experience were documented. Subjects were also surveyed regarding their willingness to pay a premium for commercially available, lower‐dose tablets. Of 1752 manually split tablet portions, 41.3% deviated from ideal weight by more than 10% and 12.4% deviated by more than 20%. Gender, age, education, and tablet‐splitting experience were not predictive of variability. Most subjects (96.8%) stated a preference for commercially produced, lower‐dose tablets, and 77.2% were willing to pay more for them. For drugs with steep dose‐response curves or narrow therapeutic windows, the differences we recorded could be clinically relevant.