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

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Some adults cannot safely swallow tablets or capsules. A process for choosing suitable formulations is described, following a stepwise approach.

Using medicines for patients

Preparing and giving medicines for people with swallowing difficulties

Before manipulating a medicine or giving a medicine with food or fluid, check it is safe and appropriate to do so and follow our advice on safe manipulation.

Manipulating medicines for administration to adults with swallowing difficulties

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

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.

Examples of medicines formulations for patients

Medicines suitable for adults with swallowing difficulties

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

ACE inhibitor and angiotensin II receptor antagonist formulations suggested for adults with swallowing difficulties

A range of ACE inhibitors and angiotensin II receptor antagonists are suitable for adults with swallowing difficulties.

Antiplatelet formulations suggested for adults with swallowing difficulties

A range of antiplatelets are suitable for use in adults with swallowing difficulties.

Oral anticoagulant formulations suggested for adults with swallowing difficulties

A range of oral anticoagulants are suitable for adults with swallowing difficulties.

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

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

Selective serotonin reuptake inhibitor (SSRI) formulations suggested for adults with swallowing difficulties

A range of selective serotonin reuptake inhibitors (SSRIs) are suitable for adults with swallowing difficulties.

Statin formulations suggested for adults with swallowing difficulties

A range of statins are suitable for adults with swallowing difficulties.

Thickeners

Defining and identifying thickness of fluids and food for patients with swallowing difficulties

How fluid thickness and food texture are defined for patients with swallowing difficulties, and how to find the recommended level for a patient.

Using thickeners of different types for patients with swallowing difficulties

Gum and starch based thickeners are available; drug-thickener interactions are possible and should be avoided.

Thickening liquid medicines

Thickening liquid medicines should not be used routinely: it is difficult to check fluid consistency which can affect whether the medicine is swallowed safely.

Storage and regulation of thickeners and thickened fluids

Thickeners and thickened fluids have different storage requirements and are regulated in a particular manner.