What type of tablets should be crushed for administration via an enteral feeding tube?

• A. Only immediate release tablets.
• B. Only sustained release tablets.
• C. All tablets.
• D. No tablets should be crushed.

Answer: (A)

Crushing can only be used safely with immediate-release tablets because their design is to release the drug promptly once swallowed. Crushing these pills allows the medication to mix with the tube feeds and dissolve for absorption as intended. In contrast, sustained-release or extended-release tablets rely on coatings or matrices to release the drug slowly over time; crushing them disrupts this mechanism, which can cause a rapid, higher-than-expected dose (dose dumping) and unpredictable blood levels. Enteric-coated tablets are meant to bypass stomach acid or protect the stomach by staying intact until they reach the small intestine; crushing them destroys the coating, can irritate the GI tract or degrade the drug, and alters absorption. So, only immediate-release formulations are appropriate to crush for tube administration, after confirming with guidelines or a pharmacist.