Proton pump inhibitor (PPI) formulations suggested for adults with swallowing difficulties

Karoline Brennan, Senior Medicines Information Pharmacist, North West Medicines Information CentrePublished

A range of proton pump inhibitors are suitable for adults with swallowing difficulties.

Omeprazole: licensed options

Capsules

Contain enteric-coated pellets and are licensed to be opened and the contents mixed with water, fruit juice or apple sauce. The pellets must not be crushed or chewed. Losec capsules can also be sucked and the pellets swallowed with water. Check the relevant SPC for details.

Dispersible tablets (Losec MUPS, Mezzopram)

Contain enteric-coated pellets and are licensed to be broken and dispersed in a spoonful of water or mixed with fruit juice or apple sauce. Do not use milk or carbonated water. The pellets must not be crushed or chewed. Check the relevant SPC for details.

Oral suspension

Provided as powder to be reconstituted with water before dispensing. Once reconstituted, it has an expiry of 28 days and requires fridge storage. This is a licensed product.

Lansoprazole: licensed options

Capsules

Contain granules and are licensed to be opened and the contents mixed with a small amount of water, apple or tomato juice, or sprinkled onto a small amount of soft food. The granules must not be crushed or chewed. Check the relevant SPC for details.

Orodispersible tablets

Can be placed on the tongue and sucked; they will disperse in the mouth, releasing gastroresistant microgranules that are swallowed with the patient’s saliva. The tablets can also be dispersed in water and given via an oral syringe. The granules must not be crushed or chewed. This is a licensed product.

Note: lansoprazole orodispersible tablets must be swallowed to be effective. The drug is not absorbed sublingually.

Esomeprazole: licensed options

Tablets

Licensed to be dispersed in water (not carbonated water or other liquid) before administration. Check the relevant SPC for details.

Capsules

They are nearly all licensed to be dispersed in water (not carbonated water or other liquid) before administration. Check the relevant SPC for details.

Granules for oral suspension

They are licensed to be dispersed in water before administration. The suspension will thicken on standing. The granules must not be chewed or crushed.

Other options

Licensed products used in unlicensed manner

In view of the licensed options available, it is unlikely a licensed product would need to be used in an unlicensed way

Special-order products

In view of the licensed products available, special-order preparations should not be required.