When they refuse to take their pills
Watch this before you crush one
I just posted a new video, and I want you to watch it before you crush another pill.
Not all pills can be crushed, and crushing the wrong pill can cause significant overdose.
The rules are simple. But they matter.
Your parent looks at you and says “No.”
Or maybe they’ve physically lost the ability to swallow large tablets safely.
Your first instinct? Reach for a pill crusher. Hide it in food. Problem solved, right?
Not quite.
Here’s what most caregivers don’t know: crushing a tablet could lead to an over dose, the dust present a health hazard for anyone near by, or prevent the pill from working at all. What might seem like a simple task could be a high stakes gamble. Here are the dangers to look out for.
Watch for the Extended-Release Medications
Look at your parent’s pill bottles right now. Do you see the words “Extended-Release” or the letters ER, XR, XL, or CR on the label?
If you do, stop. Do not crush that pill.
Those letters mean the medication is designed to release slowly over 24 hours. Crush it, and you destroy that time-release coating. Now your parent’s body gets 24 hours of medicine in one second.
That could be a dangerous overdose.
But What If There’s No ER or XR on the Label?
You see a pill with a score line down the middle and think, “That must mean it’s safe to crush.”
Unfortunately, no.
The only safe way to know is to call your pharmacist and ask the first question. While you are talking to the pharmacist, ask if it comes in a different form:
“Can I safely crush this medication?”
“Does this medication come in a liquid or patch form?”
In the video, I review what to look for and how to ask the pharmacist.
The Calcium Rock
Let’s say the pharmacist confirms the pill is safe to crush. Now you’re thinking: mix it into pudding or yogurt, right?
Hold on.
Pudding and yogurt contain calcium. And calcium acts like a magnet to certain medications — binding to them so your parent’s body can’t absorb them at all.
Crush a thyroid pill (like levothyroxine) or certain antibiotics (like Cipro) and mix them into dairy? The calcium and the medication bind together into a calcium rock. It’s like your parent never took the pill.
Applesauce is generally safer because it doesn’t contain calcium. But you still need to ask the pharmacist: “Is it safe to mix this specific medication with applesauce or dairy?”
The “Brew It Like Coffee” Rule
Here’s something most caregivers don’t know:
If you crush a pill and let it sit in applesauce for hours, the medication starts to oxidize and lose potency — just like brewed coffee loses their flavor and gets off flavors when exposed to air.
The rule is simple:
Crush it fresh (don’t crush it hours in advance)
Mix it into applesauce right before giving it
Have your parent take it immediately
I explain this rule in detail in the video.
Hazardous! (The video exclusive)
There is another reason to not crush a pill, and it isn’t about keeping your parent safe. In the video I review several hazardous medications that you shouldn’t crush, why crushing causes a hazard, and how to keep everyone in the house safe.
Watch the 7-minute video here:
What About Medication Patches?
If swallowing becomes impossible, a skin patch can feel like a miracle. Stick it on, forget about it, no argument.
Except patches have their own hidden problems:
Always remove the old patch before applying a new one (or you risk an accidental overdose)
Never put a heating pad over a medication patch (heat makes the medicine absorb way too fast)
Always place the patch on the upper back or shoulder blade (so your parent can’t peel it off — and never place a new patch on the same spot as the old one, which can cause overdose)
In the video, I walk you through all three patch safety rules — including why reusing the same skin spot is dangerous.
The MyRxPro Caregiver’s Toolkit
If you’re already managing multiple medications for your parent, I created something for you.
The MyRxPro Caregiver’s Toolkit includes:
Complete lists of medications available as liquids and patches (so you know exactly what to ask for)
Medication lists you can use
Doctor appointment scripts that get you 8 minutes of actual attention instead of dismissal
Download your free Caregiver’s Toolkit!
What You’ll Learn in the Video
What to look for on the label
What to ask your pharmacist
Why calcium-containing foods (pudding, yogurt) can make medications useless
The “brew it like coffee” rule for crushed medications
The 3 patch safety rules that prevent overdose
Watch the 7-minute video here:
The Bottom Line
It’s not obvious what to do when your parents refused to take a medication. You might be tempted to crush the tablet but here is how to do that safely:
Check the labels today.
Call the pharmacist tomorrow.
Ask if you can crush it.
Ask about switching to a liquid or patch.
And if you need to crush something, grab the applesauce — and use it immediately.
Just a few steps. That’s all it takes to keep your parent and yousafe.
Peace and wellness,
David Lee, PharmD, PhD, founder of MyRxPro
❤️ Thank you to everyone who picked up Fewer Pills, More Paws this past week! 🐾
Here’s the honest truth about books like this: They don’t grow through marketing budgets. They grow through word-of-mouth.
If Fewer Pills, More Paws helped you, the single most powerful thing you can do is leave a review. On Amazon. On Goodreads. Wherever you bought it.
Reviews don’t just help me. They help the next caregiver who’s drowning in medication chaos and doesn’t know where to turn. Your review might be the thing that makes them pick up the book instead of giving up.
Other MyRxPro YouTube Videos you might be interested in:
The period after a hospitalization is the most dangerous times for medication errors. Medications are often discontinued, started, paused, and restarted, resulting in a confusing puzzle that is more high stakes than a crossword puzzle. This video gives you a 5 minute checklist to lookout for to keep your loved ones safe.
If your parent is wobbly on their feet, could it be the medications? This video reviews 5 medications that could be the cause.