Many people have trouble swallowing medication because pills feel different than food when we put them into our mouths. But swallowing is a natural function that we don’t think about most of the time. When we are born, we already know how to swallow! So, this blog is about ideas you can try to make swallowing medication easier.
Why worry?
Part of the problem with swallowing a pill is the worry that it will get “stuck” in your throat. But the average bite of food is much larger than most pills. So, relax. Look at how little that pill is compared to a fork loaded with food…
Use your normal swallowing process
First, it’s a common misunderstanding that “gravity” will help a pill go down, and some people tip their head back when they try to swallow their medication. But tipping the head back actually makes the throat narrower, making it harder to swallow.
Think about when you swallow food. You chew the food and as you swallow it, you are looking down at your plate, planning your next mouthful. In this position your throat is more open, making swallowing easier. Your tongue moves the food to the center of your mouth then pushes it back to where the muscles in the throat take over, pushing it down to your stomach. You certainly don’t need to tip your head back to make a mouthful of food go down easily!
So, with a pill, of course you don’t want to chew it (unless your prescription says to do so!). If your mouth is dry, take a drink of water first. Or, take a drink of water anyway, dry mouth or not, just to “practice” your normal swallowing movements. Place the pill on the front part of your tongue, not at the back where you may be more likely to stimulate the gag reflex. With your chin down, take another large sip of water and pretend the pill is a piece of meat you have already chewed up. Do the same swallowing movement you did with the drink of water you just took.
If the pill does seem to get "stuck", continuing to drink water usually does the trick to move it along. And eating a bite of solid food afterward, such as a piece of bread, does an even better job of ensuring that pill makes it all the way down into the stomach.
Capsules and coated tablets may easier...
If it’s a powder-filled capsule you’re trying to swallow, it will float up to the back of your throat when your chin is lowered and be the first thing to go down when you swallow the water. Easy peasy! The capsule shell also becomes slippery when it gets wet, making it slide down easily. These are reasons that capsules are easier to swallow than tablets.
Many tablets have a coating that quickly becomes slippery, making them easier to swallow than uncoated ones. You may have noticed an “easy to swallow” version of Tylenol that has a red coating like this.
But uncoated tablets can easily be carried by the water as the tongue naturally pushes it toward the back of the throat. I just think “meat” when I’m swallowing. Meat is usually still a lump even after it’s been chewed.
For some people, taking a small spoonful of a food you don’t need to chew, like apple sauce or yoghurt, can work better than water, since the thickness decreases the feel of the tablet in the mouth. It’s a little inconvenient to carry apple sauce around if you take tablets several times a day, but could be a “stepping stone” to learn to swallow pills more easily. Like everything else, swallowing pills gets easier with practice.
And if none of that works?
If none of this works for you, you could consider crushing the medication. However, it’s very important that you make sure this won’t change how the pill works. Delayed-acting and time-release tablets cannot be crushed, as this will allow all the medication to be absorbed into your system right away. Be sure to ask your pharmacist if it’s ok to do before trying this.
Most pharmacies carry pill crushers that can make this easier, and many of these devices leave the crushed bits in a little container to make it easy to mix with a soft food, like apple sauce, yoghurt or pudding. You also could try crushing the tablet between 2 spoons, as in the photo, if you don't have a tablet crusher:
Another option for some medications, is to get it in liquid form. Again, this is not for controlled-release medications. If the medication is not commercially available as a liquid, sometimes your pharmacist can prepare a liquid for you from the tablets. I often did this as a compounding pharmacist.
So, if necessary, ask your pharmacist about this possibility. They will likely need to research whether the drug is stable in solution, as some medications can quickly degrade when dissolved in water, and they may want to discuss this change with your doctor. Occasionally, when a drug could not be dissolved in a watery base, I would mix it with an oil, such as canola oil, and flavour it with peppermint oil (for example, aspirin for a child).
So, if you have trouble swallowing pills there are many solutions. I hope something in this article will help you take your medication more easily! And, of course, like everything else, you will get better at taking pills with practice!
