Don't Rush to Crush+ updates

Updates are released in March, June, September and December.

Don't Rush to Crush moves to a new home with Therapuetic Guidelines

Monograph updates (114)

  • Antimicrobials
  • Diabetes

New monographs (2)

  • Dapagliflozin and metformin
  • Flucytosine

Monographs with significant changes (5)

  • Biktarvy (new dispersion data)
  • Cabotegravir (crushing advice removed)
  • Cefuroxime (additional liquid formulation available)
  • Pyrazinamide (dispersion data removed)
  • Sulfadiazine (dispersion data removed)

Deleted monographs (15)

  • Baloxavir
  • Cobicistat
  • Efavirenz
  • Emtricitabine
  • Ertuglifozin
  • Eviplera
  • Fosamprenavir
  • Harvoni
  • Ribavirin
  • Saquinavir
  • Sofosbuvir
  • Stribild
  • Tripranavir
  • Trizivir
  • Zepatier

Extensive dispersion testing of more than 100 cardiovascular medicines, including testing for suitability of administration into size 8 French enteral feeding tubes.

Monograph review updates (83)

  • Cardiovascular
  • Comparative information for ACE inhibitors
  • Comparative information for statins

New monographs (4)

  • Amiloride and hydrochlorothiazide
  • Icosapent ethyl
  • Macitenatan and tadalafil
  • Mavacamten

Monographs with significant changes (26)

  • Amlodipine (new dispersion data)
  • Aspirin (new dispersion data)
  • Atenolol (new dispersion data)
  • Atorvastatin (new dispersion data)
  • Bisoprolol (new dispersion data)
  • Carvedilol (new dispersion data)
  • Chlortalidone (new dispersion data)
  • Colestyramine (new dispersion data)
  • Furosemide (new dispersion data)
  • Hydrochlorothiazide (new dispersion data)
  • Irbesartan (new dispersion data)
  • Labetolol (new dispersion data)
  • Lisinopril (new dispersion data)
  • Olmesartan (new dispersion data)
  • Perhexiline (new dispersion data)
  • Phytomenadione (monograph name change)
  • Propnaolol (new dispersion data)
  • Rramipril (new dispersion data)
  • Rosuvastatin (new dispersion data)
  • Sotalol (new dispersion data)
  • Trandolapril (new dispersion data)
  • Tranexamic acid (new dispersion data)
  • Valsartan (new dispersion data)
  • Verapamil (new dispersion data)
  • Warfarin (new dispersion data)

Deleted monographs (5)

  • Disopyramide
  • Eprosartan
  • Etacrynic acid
  • Fosinopril
  • Quinapril

Extensive dispersion testing of more than 60 neurology medicines, including testing for suitability of administration into size 8 French enteral feeding tubes.

Monograph review updates (75)

  • Analgesics
  • Immunosuppressants
  • Neurology medicines including antiepileptics, Parkinson disease, migraine, multiple sclerosis and dementia medicines
  • Lithium

New monographs (7)

  • Budesonide modified-release
  • Budesonide ODT
  • Levodopa with benserazide
  • Levodopa with carbidopa
  • Levodopa with carbidopa and entacapone
  • Opicapone
  • Rimegepant

Monographs with significant changes (15)

  • Baclofen (new dispersion data)
  • Carbamazepine (new dispersion data)
  • Entacapone (new dispersion data)
  • Gabapentin (new dispersion data, new reproductive hazard warning)
  • Phenytoin (new dispersion data)
  • Pregabalin (new reproductive hazard warning)
  • Primidone (new dispersion data)
  • Rasagiline (new dispersion data)
  • Ropinirole (new dispersion data)
  • Stiripentol (change in advice re: opening the capsule)
  • Sulthiame (new dispersion data)
  • Topiramate (new dispersion data)
  • Trihexyphenidyl (new dispersion data)
  • Vigabatrin (new dispersion data)
  • Zonisamide (new dispersion data)

Deleted monographs (2)

  • Budesonide
  • Levodopa

The General information section has been completely reviewed and updated, and includes new information about tablet technologies that are not suitable for crushing, and the size of tablets and capsules as a potential choking risk.

Extensive dispersion testing of more than 60 gastrointestinal medicines, including testing for suitability of administration into size 8 French enteral feeding tubes.

Monograph review and updates (141):

  • gastrointestinal medicines, including new dispersion data and updated Comparative information for proton pump inhibitors
  • cancer therapies
  • electrolytes
  • chelators and binders
  • enzyme replacement therapies
  • ivacaftor (and combinations)

New monographs (7):

  • aluminium hydroxide
  • Orkambi
  • ritlecitinib
  • selumetinib
  • Symdeko
  • tepotinib
  • Trikafta

Monographs with significant changes (24):

  • Balsalazide (dispersion data)
  • Dabrafenib (formulation, administration)
  • Entrectinib (administration)
  • Esomeprazole (dispersion data)
  • Gilteritinib (administration)
  • Lansoprazole (dispersion data)
  • Lenvatinib (administration)
  • Mebeverine (dispersion data)
  • Mesalazine (dispersion data)
  • Metoclopramide (dispersion data)
  • Midostaurin (compounded suspension)
  • Nintedanib (administration)
  • Nizatidine (dispersion data)
  • Obeticholic acid (dispersion data)
  • Omeprazole (formulation)
  • Pantoprazole (dispersion data)
  • Patiromer sobitex calcium (administration)
  • Pomalidomide (administration)
  • Ruxolitinib (compounded suspension)
  • Sotorasib (administration)
  • Trametinib (formulation)
  • Ursodeoxycholic acid (dispersion data)
  • Vemurafenib (administration)
  • Vorinostat (hazard classification)

September 2026

Mental health

December 2026

Rheumatology

March 2027

Genitourinary

Gynaecological

Hormones & Corticosteroids

Thyroid and bone

Vitamins and supplements