Like Flossieteacake I've had to get creative with a tablet splitter over the years & find these invaluable. In fact, I've amassed a vast collection of these great little devices, as some proved too blunt to be much use. Initially used for Liothyronine, which is a very powerful medication a small subset of hypothyroid patients need, that for years was only available in the UK in tiny 20 mcg tablets it was necessary to quarter.
When I know there's the possibility of starting any new medication I search for it on the web beforehand to see what forms & doses it comes in so I can ask for tablets as opposed to capsules if need be & to start on the lowest dose & if it seems sensible, to halve that. So I second getting_old's suggestion of splitting tablets & taking daily instead of alternate days if this is an option for you, as this consistency may present less of a challenge for your body to maintain stability.
Being a small adult I think can be one reason standard doses may be too much for some of us - I'm more or less young teen size & was shocked when as an inpatient in my late 50s I questioned an admirably vigilant student nurse who brought me only 1.5 paracetamol for post-op pain, instead of the standard adult dose of 2 that I'd taken when needed all my adult life. She'd taken my 17-ish BMI into account & told me the computer says 1.5 is the max dose for someone your size

. I now never take more than 1.5 at a time!
Also as we age, our bodies may become less efficient at processing medication, so I think it makes sense to pay attention to what they may be trying to tell us. Getting medics to accept a side effect is intolerable or too great a trade off, can be another challenge, adding unhelpful stress into the equation.
When I read through this thread before posting it struck me as a very good & touching example of what the ladies of MM do so well - it's supportive, helpful & caring

Wx