If manufacturers doubled the size, then people who only need half the dose would have to cut the pill. Maybe everyone figures it's easier to take two tablets than to cut one, big, one. :) Besides, there's always the chance your doctor will decide you don't need to take as much of a dose, and instead, you should take only one - and think how glad you'd be that you didn't have to cut the big tablet.
:).
Some bigger pills would then be too difficult for some people to swallow.
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