If medication is mixed with food, how long are they good?

A fellow caregiver asked...

If I crush aspirin, coumadin and a multivitamin, how long can I let it sit in applesauce (because the elderly person would not take it on first attempt) before it is not safe to administer and I must get new pills?

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

When crushing medication, you have to be very careful, especially when it is mixed with food. If you use applesauce, I would only let the medications (that you listed) sit for an hour maximum before I would try to give them again. If the elder refuses them the second time, then I would throw them out and retry again later with new crushed pills. You should be aware that as soon as pills are crushed and mixed with food, they chemically change, and they are no longer considered "stable". Perhaps the applesauce is the issue. If the elder doesn't like applesauce with their pills, you could also try mixing them in chocolate pudding or ice cream.

You wrote that the person you are taking care of is on Coumadin, which really needs to be taken regularly, as it needs to be a therapeutic level to work. If the person you take care of misses doses, then it cannot be effective (and could be potentially dangerous). You should let the elder's health care provider know that it is difficult to give this medication regularly so that they can see if it should still be given to that person.

Some medications should never be crushed. If you ever have any questions about crushing medications, you can always ask the pharmacy where you get your medications for your elder for more assistance.