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Pill Swallowing, Helpful Tips and Ideas

by Jan C. Pryor M.A., CCC-SLP, BCS-S

The NFOSD was previously contacted by freelance journalist Janie Rosman. She was writing an article for Today’s Caregiver magazine and asked for some advice on the subject of pill swallowing difficulty. Jan Pryor provided a write up with a few tips and ideas which may help our readership.

A frequent problem for people with swallowing difficulties is taking pills. Usually the trouble is swallowing large pills. There are several options that simply alter the form of the medication.

1)  Crush the medication or cut it in half: Before crushing medication, one should always contact the pharmacy and/or your physician to be sure this can be done with a particular medication.  Some medications should not be crushed, such as those that are time released (note, you might not know which medications are time released, but some medications that come in capsules are such and are not effective if opened). Many medications are bitter if crushed, and can be put into something like pudding or applesauce to make them more palatable. Check the medication label to be sure the medication can be taken with milk products; it may be easier going down if you take it with milk or ice cream.

2)  Check with the pharmacy or your doctor’s office to see if the medication comes in liquid form.

3)  Taking pills (whole) with yogurt and/or pudding or ice cream works for many people, as the problem often results from the difficulty of juggling a pill (solid) with a liquid (water). When the 2 stay together and move through the throat at the same velocity, people can have an easier time, particularly if the trouble is with small pills.

4)   Compounding pharmacies. There are more and more compounding pharmacies opening thus becoming an available option for people. You can contact these type pharmacies to see if your medication can be reformulated into something that is more easily taken (liquid, dissolves under the tongue, etc). There is usually an increased cost to have your medication reformulated.

5)  In addition, there are products on the market that make the outside of the pill slippery and easier to swallow. One produce is called “Pill Glide” (no endorsement here just giving an example) which you spray on the pill that makes it slippery and easier for folks to swallow.

6)  Vitamins and minerals. Look at which pill is giving you trouble and how important it is. Often, when I talk to patients, the problem is large vitamins, and so we have the discussion about the benefit of the vitamin versus the risk of choking on it. In addition, many multi vitamins come in chewable form or liquid form. Vitamin powders can be added to nutritional drinks and taken that way.

7)  Lastly and most important, If people have trouble with foods sticking in the throat or chest, and/or coughing on liquids in addition to pills, one should contact their physician and notify him/her.  Some of these problems can be the sign of something that needs to be evaluated further and treated, such as webs, strictures, pouches or tumors.