If you or someone you care for struggles to swallow pills, you should always discuss this with your doctor or pharmacist.
Alternative forms of the medicine are sometimes available, or you may just need to experiment with some simple swallowing techniques.
This page gives some basic advice and outlines the clinical and legal issues around crushing tablets or opening capsules.
This advice applies to:
- adults who have difficulty swallowing pills
- parents of children who struggle to swallow pills
- nurses or carers of people with dysphagia (swallowing problems)
Finding an alternative form
If you or the person you care for finds it hard to swallow capsules or tablets, you can ask your doctor or pharmacist if there is an alternative form of the medicine, or check the Swallowing difficulties website.
Your pills may also be available in one of the following forms:
- a liquid – especially useful for people with dysphagia who rely on a feeding tube
- a dispersible (tablet that disintegrates in water)
- a buccal (tablet that dissolves when held between cheek and gum)
- a patch
- a suppository (inserted into the bottom or vagina)
- a cream
- an inhaled version
If you feel unsure about giving medicine – for example, you're not sure how to give liquid medicine via a feeding tube – seek the advice of a doctor or pharmacist.
Crushing tablets or opening capsules
You can ask your doctor or pharmacist if your tablets can be crushed, or your capsules opened and dispersed in water, before taking them, as only certain tablets or capsules can be given this way.
The following preparations should never be crushed without seeking professional advice first:
- CR or CRT (controlled release, or controlled release tablet)
- LA (long acting)
- SR (sustained release)
- TR (time release)
- TD (time delay)
- SA (sustained action)
- XL (extended release)
These medications are designed to be released over a predetermined period of time, say 12-24 hours.
Generally when crushing a tablet or opening a capsule, the dose is released over 5-10 minutes resulting in an initial overdose (and a higher chance of side effects) followed by a period without medication.
A nurse or carer of someone with dysphagia should not alter the form of a medicine by crushing or opening it unless they have been instructed to do so by a doctor.
If you crush or open the medicine to give to another person, you are administering the medicine in an unlicensed form. If you hadn't consulted a doctor about it, this would render you personally liable for any harm caused and you would have to justify your actions in the event of an adverse reaction.