Medicines suitable for adults with swallowing difficulties

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A number of licensed and unlicensed products in different therapeutic classes are available that are suitable for use in adults with swallowing difficulties.

Included products

Example products suitable for use in swallowing difficulties across therapeutic drug classes are included where:

  • there is particular relevance to primary care
  • there has been a high spend on special-order medicines

Choosing the correct formulation

The choice of medicine should be made on an individual basis taking into account the patient’s clinical need, method of feeding, the practicalities of administration, product quality and cost.

Not everyone can safely swallow thin liquids such as water. Oral liquids and dispersible tablets are only suitable for individuals who can safely swallow thin liquids. Orodispersible tablets may not be suitable for individuals unable to control their swallow. See our guide:

Choosing formulations of medicines for adults with swallowing difficulties

Some adults cannot safely swallow tablets or capsules. A stepwise process for choosing suitable formulations, including crushing tablets, is described.

Giving medicines with food or fluid

If giving crushed tablets or capsule contents with food or drink, always use food or fluid that the patient can swallow safely. For individuals who need a texture-modified diet, the appropriate food texture and fluid consistency will be documented in their swallow assessment report.

Suggested medicines and formulations

Where alternative agents are suggested, therapeutic equivalence is not implied. Patients will require monitoring and possibly dose titration when switching between different agents. In most cases, a special-order medicine will not be required.

Prescribing an unlicensed product or a product for unlicensed use

The prescriber should be aware of the licensed status, route and method of administration of medicines they prescribe.

Prescribers assume greater liability for use of unlicensed medicines and for use of licensed medicines in an unlicensed manner than for licensed medicines used as licensed.

Update history

  1. Change to articles in the series: 'ACEI and ARB suggestions' removed. Separate articles for 'ACEI suggestions' and 'ARB suggestions' added.
  1. Added advice regarding choice of medicine formulation for individuals unable to swallow thin liquids or water, and choice of food or fluid for administering medicines.
  1. Published

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