Medicines for Problems swallowing pills

What it is

Problems swallowing pills — difficulty swallowing tablets or capsules — are common, and can affect people of any age. For many people, the difficulty is not due to a physical problem with swallowing food and drink, but specifically relates to tablets or capsules, often involving a combination of the physical act and anxiety or a fear of the pill getting stuck or of gagging. Some people have always found pills hard to swallow, while others develop difficulty (for example after a bad experience of a pill getting stuck). Difficulty swallowing pills can be a real problem, because it can make people anxious about taking medicines, avoid or skip needed medicines, or not take them properly, which can affect their health — so it is worth addressing. It is important to distinguish this common difficulty (specifically with pills) from a more general problem with swallowing (dysphagia) — where a person has difficulty or discomfort swallowing food, drink, or saliva, or food sticking — which can have various causes and should be assessed by a doctor. For the common difficulty with swallowing pills specifically, there are helpful techniques and strategies that make it easier for many people, and, where needed, alternatives are often available (such as different formulations of a medicine). The key message is that difficulty swallowing pills is common and usually manageable — with simple techniques, and alternatives where needed — so it should not prevent someone from taking medicines they need, and it is worth asking a pharmacist or doctor for help.

How it is treated

Problems swallowing pills are usually manageable with simple techniques and, where needed, alternative options, so they should not stop someone taking needed medicines — and a pharmacist or doctor can help. For the common difficulty with swallowing tablets or capsules specifically, several techniques can help, and different ones suit different people, so it is worth trying them: taking pills with plenty of water, and ensuring the mouth and throat are not dry; particular techniques for different pill types — for example, the "pop-bottle" method (for tablets: putting the tablet on the tongue, closing the lips tightly around a bottle of water, and drinking with a sucking action) and the "lean-forward" method (for capsules, which float: putting the capsule on the tongue, taking a sip of water without swallowing, tilting the head forward/chin down, and then swallowing) can make swallowing easier; taking the pill with food or a thicker drink (if the medicine allows), or placing it towards the back of the tongue, helps some people; and staying relaxed, as anxiety can make swallowing harder — practising with something small, and calm breathing, can help reduce the fear over time. It is important, however, not to change how a medicine is taken without checking, because some tablets and capsules should not be crushed, opened, chewed, or altered (as this can affect how they work or cause harm) — so a pharmacist should be asked before crushing or splitting any medicine. Where swallowing pills remains difficult, a pharmacist or doctor can help by advising on techniques and, importantly, on alternatives: many medicines are available in different forms (such as liquids, dissolvable or soluble tablets, or other formulations), or a similar medicine in an easier form may be an option, so that the person can take the treatment they need. It is important to seek advice rather than skipping or not taking needed medicines because of difficulty swallowing them. Separately, if a person has a more general problem with swallowing — difficulty, discomfort, pain, or food or drink sticking when swallowing food and drink (not just pills), or a persistent sensation of something stuck — this should be assessed by a doctor, as swallowing problems (dysphagia) can have various causes needing investigation. The reassuring messages are that difficulty swallowing pills is common and usually manageable — with simple techniques and, where needed, alternative formulations — that it should not prevent taking needed medicines, and that a pharmacist or doctor can help; while a more general swallowing problem should be assessed.