What options exist if you can’t swallow tablets?

When you, or a loved one, struggle to swallow tablets, it can make managing health feel pretty tough. This common challenge (known as “dysphagia” in medical terms) affects children, the elderly, and even pets, but it shouldn’t stand in the way of effective treatment.

We specialise in transforming difficult to take medications into alternative formats that are easier to administer and more pleasant to consume. In this guide, we explore the various custom dosage forms available to help you move beyond the traditional “pill”.

In this fact sheet, we’ll explore:

• Why Swallowing Tablets Can Be A Challenge
• Liquid Alternatives: Suspensions and Solutions
• Dissolvable Options: Troches and Lozenges
• Absorption Through the Skin: Topical Gels and Creams
• The Role of Suppositories
• Custom Flavours for Better Compliance
• References
• Video transcript

Why Swallowing Tablets Can Be A Challenge

The difficulty of swallowing pills is a widespread issue that doctors often overlook. Whether it is a child facing a large capsule, an individual with a sensitive gag reflex, or an elderly patient with a medical condition, the sensation of a large tablet getting stuck is a significant barrier to medication compliance.

And if a patient skips doses because they dread the delivery method, their health outcomes suffer.

Liquid Alternatives: Suspensions and Solutions

One of the most effective ways to bypass the need for swallowing solids is to convert the medication into a liquid format. There are a couple of types to consider:

• Solutions: The medication is completely dissolved in a liquid base.
• Suspensions: The medication is suspended in a liquid, which is ideal for drugs that do not dissolve easily.

These formats are particularly beneficial for pediatric care and for patients with feeding tubes, ensuring the active ingredients are delivered safely and accurately.

Dissolvable Options: Troches and Lozenges

For those who want to avoid liquids but still cannot swallow pills, sublingual or buccal options are excellent alternatives.

• Troches: These are small, medicated lozenges that sit between the cheek and gum or under the tongue.
• Rapid Dissolving Tablets: These “disappear” in the mouth almost instantly, allowing the active drug to enter the system without the need for water or swallowing effort.

These methods often allow the medication to enter the bloodstream directly through the mucosal lining, which can sometimes result in faster absorption.

Absorption Through the Skin: Topical Gels and Creams

Many people are surprised to learn that a wide variety of medications can be absorbed through the skin. By using specialized transdermal bases, a compounding pharmacy can create:

• Topical Creams: Applied directly to the skin to deliver systemic medication.
• Gels: Often used for pain management or hormonal treatments.

This “through the skin” approach is a game-changer for patients with severe nausea or those who have had gastrointestinal surgery.

The Role of Suppositories

While sometimes a sensitive topic, suppositories remain a highly effective delivery method, especially in European medicine and pediatric care. They allow for rapid delivery of medication when a patient is vomiting or unable to take anything by mouth. They provide a reliable, confident way to ensure the patient receives their required dose during acute illness.

Custom Flavours for Better Compliance

A major benefit of compounding is the ability to customise the taste. Whether it is making a bitter medicine taste like strawberry for a child or tuna-flavoured for a pet, improving the palatability of a dose is key to ensuring the treatment plan is followed. Better taste leads to better compliance, which ultimately leads to better health outcomes.

If commercial medicines are letting you down because of their format, speak to your doctor about a compounded alternative. At National Custom Compounding, we work with you and your healthcare provider to find the perfect fit.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065591

Video Transcript

Hi there. Something that we often get, questions for is what options exist if you can’t swallow tablets? Now this can definitely be applicable to kids. It can be applicable to animals. It could be applicable to adults that really just don’t like that sensation of a large tablet getting stuck in the back of your throat. So definitely look from a starting point. Compounding pharmacies are well suited to assist in this type of situation, and some of the dosage forms that are quite beneficial are obviously more liquid based. So we might make a suspension, we might make a solution. We could also do a thing like a lozenge. We have a product called a troche which dissolves in the mouth. And that would carry the active drug as well into the body without having to swallow it. It’ll disappear like a rapid dissolving tablet. And certainly there are a variety of ingredients that might move through the skin easily. So we could look at using a topical cream or a gel to do that. Or alternatively, especially in Europe, suppositories are really popular. A little bit uncomfortable to talk about at times, but kids that need medicine delivered quickly can use a suppository with a great deal of confidence. Best thing about compounding pharmacies, like I’ve said many times, is we can do whatever is required for that patient at that particular time. We’ll use the active ingredients that are required from the doctor’s prescription, we’ll make it into a dosage form, and talk to the doctor along the way, and the patient to make sure everyone’s happy and brought up to speed. And then the end result should be that when a patient gets a dosage form that suits them, that tastes like they want. And again, we can customise flavors to a great deal. They should be able to take it in a more compliant way and hopefully get a better health outcome from doing it. So if you feel like you’ve had these situations where commercial medicines let you down, it’s not in a form that you like, why not speak to your doctor then come and speak to someone like us at National Custom Compounding, and we can work with you on a dosage form, that will help you overcome the challenge of what do you do if you can’t swallow a tablet? Hope this has helped and have a great day.