To break or not to break (the Lipitor 10 mg pills), that is the question -- What do you say now Pfizer PR department when the New York Times calls you for your opinion on this? Stonewall, er, pillwall the Times, too? LOL....

1. My cardio doc in midwest USA friend tells me:

''Dear Danny ,
I am now really relieved that I didn't give my patients the wrong
instructions re Lipitor. I did occasionally instruct my patients to
split lipid-lowering pills. You see, when I lower the dosage, I just
don't see why we should waste the pills with higher strength, like,
"Here is a new prescription for pills of half of the dose. Throw away
those higher dose pills." I just don't see how should we waist
expensive pills like that. Let's see what Pfizer tells you."

2. second opinion says: MONEY IS A HUGE CONCERN. Perhaps not for Lipitor because it's
generic now. But if more people were concerned about saving in more
places in years past.......well, you know where that is going. Health
care is hardly even about health care anymore. It's big business gone
bad. John Q. pinches pennies while statin makers, et al haul in the
big bucks or a naturally occuring substance.

It's all about money for the Pharm companies. Why do you think they
are pushing combination products so hard? And pushing for every man,
woman and child to take statin drugs not matter their health history
or risks? Statin are a huge money maker for them and they don't want
one penny of it taken away by someone trying to save a few bucks.

It is sad indeed if this is about money at the cost of truth. ***I
applaud dan bloom for asking good qusetions of Pfzier and encourage
him to investigate fully. Just turn down the volume on the hyperbole
a little.

3. Some pills have special coatings or time-release formulations that
would make splitting them dangerous. Cutting such a tablet would make
its absorption unpredictable.

This is not the case with Lipitor, however. Researchers at Veterans
Affairs and Kaiser Permanente in California determined that splitting
atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor)
was an effective way to lower costs without compromising cholesterol
control. The study was published in the Journal of Managed Care
Pharmacy (November/December 2002).

In any case, you should get clear instructions from your doctor.



4. A book I have from my Doctors surgery states that cholesterol is
made in the liver when we sleep. I have also seen reports stating that
the more a person sleeps, the higher their cholesterol and the lower
their good cholesterol. A study also showed how sleep devravation over
a 5 day period reduced cholesterol levels. So, if we spit a statin
pill, will it have the same desired effect? Everyone I know takes
their statin in the evening, so I assume there is a reason for this
backed up by research?

5. Here's another one that answers specific FAQ's about tablet splitting.

http://www.firstcarolinacare.com/pharmacy/splittingfaq.htm

It would appear Big Pharma is rebelling against profit loss by
advertising against pill splitting. Profit drives everything in
pharmaceuticals. Sorry to disappoint you danbloom.

PLEASE NOTE THAT MANY - IN FACT, MOST - TABLETS SHOULD NEVER BE SPLIT
OR CRUSHED UNLESS YOU ARE SPECIFICALLY DIRECTED TO DO SO.

6 . Have you asked a pharmacist? I trust them because they specialize
in the chemistry of the medications. The doctors just prescribe them
with the knowledge that this pill goes for that disease.

Some pills (and definitely capsules) have a protective coating on them
so they dissolve in the proper part of the digestive system. If they
dissolve too early, you may experience unpleasant side effects. Some
are made to trickle into the system over a long period and they
shouldn't be cut and damaged. My Diltiazem is a pill in a capsule so I
should not remove it.

Try asking your pharmacist to see if your particular form of Lipitor can be cut.