Many medications require a coating that protects the throat as you swallow it. If you divided the pill, you would end up with the medication being exposed too early.
Many medications are highly potent, meaning they work in really small quantities. These need to be released slowly; if you mix them in with some other substances, the pill can dissolve more slowly and get the dosage correct.
Many medications are unable to sit on a shelf for a long time; these pills need specific other chemical mixed in to ensure that they stay functional while sitting in the store.
All of this is to say that the size is unrelated to needing to divide it.
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