Q&A: Swallowing Pills Difficulty

Q.

"Pain points! My 3 years old son is required to have medication every morning and evening which requires 5 tablets each time that we need to make it powder and mix it with food.

But it is always such a pain as they taste horrible even we mix it with really sweet thing like honey or chocolate sauce. And he still spit them out whenever he can. Any tips and tricks that you tried to help your kids to take medication?

Thanks a lot!!"

~Szulan

A.

things that have worked for our dog that requires a LOT of meds, some of which are bitter, & they get sick of the same thing 15x’s+/day:

mushy soup (not great if doesn’t eat it since can’t tell how much of meds actually got),

mashed potatoes (current best),

mashed sweet potatoes,

sticking it inside a Mac and cheese noodle hidden with other noodles,

peanut butter,

warm fluffy naan bread (the stone fire Costco one that you put in air fryer to toast is best),

pushed into a small piece of chicken or chicken nugget or French fry,

stuck into a small bite of cheesecake,

stuck into a small cheese ball,

smushing it into a shredded turkey ball with tiny bit of cranberry sauce,

sticking it into a stove top stuffing,

sticking it into a bread roll,

sometimes (rarely) a small amount of ice cream (hard depending on consistency and how melted it is) or thicker greek-style yogurt,

sprinkling it into tasty veggie fried rice (mixed results if granules don’t taste good).

We found spacing meds out so fewer pills at one time worked best so not overwhelmed with so many meds in one sitting, although depending on how many, that can be harder to handle, but not if it means it they’ll actually take it.

Found that similar textures worked best.

Nothing thin or watery because then the pill texture stands out more.

If you sandwich it, meaning give regular food without pill to make sure in the mood to eat that food, then give food bite with hidden pill, then regular food without pill immediately, that helps.

Also, ask your pharmacist which pills taste the most bitter.

I save those to give last, so at least I know the others were taken first, and then if they spit the bitter one out, take a break and try again with a different food a little later.

If you give the bitter ones first, and they spit out, they are unlikely to want to even try to take the others at that moment. Also, give most important meds first so that those get in in case they get fatigued with trying to take the other pills.

I try hard NOT to crush pills, because if they’re not completely consumed at the same time, it’s a nightmare to try to figure out the timing of the next dose since I have to recalibrate based off of when finished vs. when started, since I’d follow-up dose taken too soon (like based off of time when you first started trying to give the medicine), you run the risk of overdose or seizure if too close together, which is terrifying.

Use a pill cutter to cut up doses.

I’ve had to cut pills to as small as 1/8th of a pill, so if it’s a pill that you’re able to crush, you should be able to cut it into fractional pieces (ask the pharmacist, first).

Make sure the fractions you cut them into are predictable (ex: pill 1 is always cut into 1/4 pieces, pill 2 is always cut in half, etc., based on medication disease and pill size).

Also, depending on manufacturer, some pills have less filler and are smaller and easier to swallow, so it might be worth checking with pharmacist about that.

Sometimes that means going to a different pharmacy chain, but it’s worth it if it means pills that are and easier size or volume for the same active ingredient.

The precitability in fractional size makes a difference because it’s easier to record if they got a partial dose.

Smooshing in between soft food is important so that they can’t use their tongue to wiggle the embedded fractional pill out easily.

Most people don’t liquify their foods in their mouths that they swallow (smoothies and soups and broths are already liquified before eating them), so people actually swallow small bits of food after a little bit of chewing, if any, so a more reasonable goal is just getting the bits down to those small fractional sizes that they’re no more than 1-2 chews, if any, before they swallow the remainder, just as they would with regular food that doesn’t have medicine in it.

You may also be able to ask to have the medicine compounded at a compounding pharmacy, but if they spit out liquids they don’t liked that may be hard and cost more.

Some places do compound smaller pills or chewable versions.

You can also ask if there’s another medication delivery system that may work better for administration (injection or transdermal meds or otherwise or a long-acting slow release version of medicine or one with less frequent intervals).

Good luck

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