Many people have trouble swallowing a tablet or a capsule. Difficulty swallowing is called dysphagia (dis-fa´ji-a). Do not despair. There are some things you can do to make it easier.
Some people prefer to swallow tablets that are oval shaped instead of round; these are called caplets. Also some medications have a gel coating on them that makes them easier to swallow.
Occasionally pills are available in a chewable or dissolvable form so they do not have to be swallowed whole. Another way to make it easier to swallow a tablet or a capsule is to put it in a small piece of banana or a miniature marshmallow to make it more slippery.
Sometimes the medication may be available in a liquid form or the pharmacist can prepare it specially. However, liquids may take more time to make or they may be more expensive than a solid form.
A dry mouth can also make it harder to swallow pills. A helpful idea is to drink a sip of water before you take the pill, place the pill on the back of your tongue, then swallow the pill right away with a full glass of water. It is also a good idea to take bedtime doses of pills 15 to 30 minutes before lying down.
The dry mouth that makes it difficult to swallow the pill may be a side effect of the medication itself (see Table 1). Some other causes of dry mouth include old age and diseases such as cancer or a stroke. To overcome a dry mouth, try sucking on ice chips or sugarless candy. Sometimes the pill might seem too large to swallow.
Many tablets can be split into halves or quarters and pharmacies sell pill splitters to help you do this. Some people prefer to crush the pills and sprinkle them on a soft food like pudding or applesauce but bear in mind that some medications should not be taken with food. Other pills should not be split or crushed because they may have a protective (enteric) coating, they may be in a sustained release form or they may be bitter (see chart).
If you are not sure if the pills that you have can be divided or crushed, ask the pharmacist. Sometimes crushing pills will have an effect on how fast the drug is absorbed into your system and this may cause a problem.
It does not matter whether you are taking a prescription or non-prescription medication, you must follow the instructions exactly. Often medications, such as antibiotics, can be less effective if not taken at the proper times. Also do not stop taking antibiotics when you feel better. Some of the bacteria causing the illness may still be there and they will quickly start to multiply again, if you give them a chance.
Do not hesitate to ask your doctor or pharmacist if the medication you are taking may cause side effects such as nausea, drowsiness or a skin rash. Also, it is important not to take additional medications without consulting a doctor or a pharmacist because two or more medications may interact with one another. It is a good idea to have all of your prescriptions filled at the same pharmacy.
When possible, try to buy non-prescription medications at the same store so the pharmacist can check references on a computer to see if there are any problems taking the drugs together. A potential problem may occur if you purchase an herbal medication at a health food store. Take the product to your pharmacist to be checked. This way you can be sure it will be okay for you to take with your other medications or with the illness that you have.
If people forget to take medications, or take them incorrectly, it is called non-compliance. A compliance aid may be helpful if you have trouble remembering to take your pills. If you take several medications, it helps to have a reminder card to refer to. This card lists the medications you are on, when to take them, what they look like, and what they are for. In case there is an emergency, this will also help those giving you care.
Another helpful tool if you sometimes forget a dose is a pill reminder container or dosette. Dosettes are available for one day (with four compartments - one for each time of day), or weekly (with seven compartments - one for each day of the week), or a combination (with four compartments for each of the seven days of the week). In some cases the pharmacist can put your medications in a special blister package card. The card has transparent windows so you can check to see if you have forgotten to take a dose.
Some people prefer to set an alarm to remind them that it is time to take the next dose. It is possible to purchase dosettes with a timer built into them. If you are traveling, it may be convenient to take a collapsible cup with you so that you can get water from a fountain to take your medication.
Pharmacists often recommend that pills be taken at a certain time of day to get the most benefit or to avoid side effects. Some medications are to be taken with food to decrease the chance of an upset stomach. Others are taken at meal times so it is easier to remember to take each dose. Some pills only need to be taken once daily.
Some should be taken with breakfast because they may cause a bothersome side effect if taken at bedtime. For instance, diuretics, commonly called water pills, such as furosemide (Lasix™) or hydrochlorthiazide (Hydrodiuril™), may make you visit the bathroom at night if taken in the evening.
Some pills, such as medications that lower cholesterol or treat ulcers, work better if they are taken before the largest meal of the day.
Some pills are to be taken at bedtime if they cause drowsiness. These drugs include antidepressants such as amitriptyline (Elavil™) or sedatives such as lorazepam (Ativan™).
Research has shown that some medications should not be taken with large amounts of grapefruit juice because of increased side effects, such as with felodipine (Plendil™), terfenadine (Seldane™, and cyclosporine (Sandimmune Neoral™).
If you have trouble remembering to take your medications, how to take them, or when to take them, there is one simple rule to follow: ask your pharmacist. People are taking more responsibility for their own health in these times of health care cutbacks and one aspect of that is understanding the proper way to take pills. Improvements in compliance will reduce the number of lab tests, visits to doctors and hospitals. In turn, this will help keep costs down and may keep you healthier.