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

There are no suitable licensed formulations of fluvoxamine. Other SSRIs are available in suitable formulations and may be preferred.

Citalopram 40mg/ml oral drops

Available as a licensed product that should be mixed with water, orange juice or apple juice before administration. The drops have an expiry of 12 or 16 weeks once opened (depending on brand) and do not require fridge storage.

Citalopram drops are not bioequivalent to citalopram tablets; four drops (8mg) is equivalent in effect to one 10mg tablet.

Escitalopram 20mg/ml oral drops

Available as a licensed product and can be mixed with water, apple juice or orange juice before administration. The drops have an eight-week expiry once opened and do not require fridge storage.

Fluoxetine 20mg/5ml oral solution

Available as a licensed product. The oral solution has a 30- or 60-day expiry once opened (check the relevant SPC for details) and does not require fridge storage.

Fluoxetine 20mg dispersible tablets

Available as a licensed product. A whole or half tablet can be dispersed in half a glass of water and taken orally. The tablets should not be crushed or chewed.

Sertraline 50mg/5ml oral suspension

Available as a licensed product. The SPC advises it should be administered with a glass of water. The suspension has an expiry of two months once opened and does not require fridge storage.

Sertraline 100mg/5ml concentrate for oral solution

Available as a licensed product that must be diluted before use. Each dose should be diluted with around 120ml (one glass) of water, ginger ale, lemon/lime soda, lemonade or orange juice and given immediately. The concentrate has an expiry of 30 days once opened and does not require fridge storage.

Licensed medicines used ‘off-label’

Citalopram, escitalopram, paroxetine or sertraline tablets

Can be crushed and/or dispersed in water, or crushed and given with soft food. The tablets are film-coated and contents may taste bitter or unpleasant. Crushed sertraline and paroxetine tablets may have a local anaesthetic effect on the tongue.

Fluoxetine capsules

Can be opened and the contents dispersed in water or given with soft food.

Special-order medicines

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

There are no SSRI preparations listed in Part VIIIB of the Drug Tariff.

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