Using our advice

Please see Medicines suitable for adults with swallowing difficulties

The choice of medicine formulation should be made on an individual basis, taking account of patient factors. Follow our stepwise guide Choosing formulations of medicines for adults with swallowing difficulties

Licensed medicines in suitable formulations

Warfarin 1mg/1ml oral suspension

Available as a licensed preparation. It does not require fridge storage and has an expiry of 28 days once opened.

Apixaban tablets

Film-coated but are licensed to be crushed and dispersed in water, glucose 5%, apple juice or apple puree.

Edoxaban (Lixiana) tablets

Film-coated but are licensed to be crushed and mixed with water or apple sauce.

Rivaroxaban (Xarelto) tablets

Film-coated but are licensed to be crushed and mixed with water or apple puree. Crushed 15mg and 20mg strengths should be immediately followed by food.

Rivaroxaban granules for oral suspension 1mg/1ml

After reconstitution, the suspension has an expiry of 14 days. It does not require fridge storage.

This preparation is only licensed for neonates, children and young people under 18 years of age, not adults.

Licensed medicines used in an unlicensed manner

Warfarin tablets

Can be crushed and/or dispersed in water or crushed and given with soft food.

Apixaban, edoxaban and rivaroxaban tablets

Can be crushed and given with soft food. (They are licensed to be given with apple puree/apple sauce.)

Dabigatran capsules must not be opened; bioavailability of the capsule contents may be increased by 75% when taken without the shell.

Special-order medicines

In view of the licensed options available, special-order preparations are unlikely to be required.

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