You pretty much have to use them in a single-shot or AS a single-shot.
Example...you have a side-by-side. You can load a cut shell in one barrel and fire it just fine. Load 'em with two cut shells and the recoil from the first will screw up the second...possibly enough to cause it to detach and make all kinds of mess inside the second barrel.
You could put a conventional shell of any sort in the second barrel, as long as you knew which barrel was going to go off first and that it would be the cut shell first at bat.
Same with a pump or auto-loader: manually put a cut shell first up the pipe, conventional rounds after that.
On edit: think of these as the Glaser's bigger older and meaner brother