Preparing medicines for administration to adults with swallowing difficulties

Karoline Brennan, Senior Medicines Information Pharmacist, North West Medicines Information CentrePublished Last updated See all updates

How to disperse tablets in water, crush tablets and open capsules safely for adults with swallowing difficulties.

About preparing medicines

People with swallowing difficulties need medicines in a form they can take safely. For many people the best option will be to crush tablets or open capsules and give with soft food.

Choosing formulations of medicines for adults with swallowing difficulties needs to be considered before you can prepare and administer the medicine.

Carers should only crush tablets or open capsules on the direction of the prescriber, following instructions in the patient’s medicines administration record (MAR) chart or care plan.

Dispersing tablets in water without crushing

Many immediate-release tablets will disperse sufficiently in water without the need for crushing.

Place the tablet into a medicine pot or oral syringe, add 10ml water (larger volumes may be needed for some tablets) and allow the tablet to disintegrate. Make sure the pot or syringe is rinsed and the rinsing water administered to ensure the full dose is given.

Only crush medicines one at a time; do not disperse different medicines together. Dispersing should only be performed immediately before administration.

Crushing tablets

For medicines that are suitable for crushing, crush using a tablet crusher, crushing syringe or pestle and mortar. A crushing syringe is preferred for medicines where you must avoid environmental contamination and exposure of a carer (e.g. cytotoxics).

Only crush medicines one at a time; do not crush all the patient’s medicines together. Crushing should be performed immediately before administration.

Using a tablet crusher or pestle and mortar

Crush the tablet to a fine powder

If you will be giving the medicine with water, use an oral syringe to add 10-20ml water to the mortar. Mix well, then draw into the syringe and administer. Rinse the mortar with a little more water and administer the rinsing water to ensure the full dose is given.

Using a crushing syringe

Crush the tablet to a fine powder in the crushing syringe

If you will be giving the medicine with water, draw up 10-20ml water and administer. Then draw up another 10-20ml water, shake and administer to ensure the full dose is given.

Opening capsules

Some hard gelatin capsules can be opened and their contents (powder or granules) mixed with water or administered with food. Some capsules may be too small to be easily manipulated and opened.

Pull the two sides of the capsule apart and tip the contents into a medicine pot.

If you will be giving the medicine with water, use an oral syringe to add 10-20ml water. Stir, then draw into the syringe and administer. Rinse the pot with a little more water and administer the rinsing water to ensure the full dose is given.

Capsules should only be opened immediately before administration.

Other specific areas

Understanding why people take medicines with soft food or thickened fluid

Giving medicines this way can be a safe and practical option for people with swallowing difficulties, with their knowledge and consent.

Giving medicines safely with food or thickened fluid

Use food and fluid of correct consistency or texture (IDDSI level) and that does not interact with the medicine; our tips help you achieve this for patients.

Learn more

Swallowing difficulties

All our advice on using medicines safely and effectively in patients with swallowing difficulties

Change history

  1. Title changed from Manipulating to Preparing. About Preparing section added.
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