Choosing the correct formulation
Choosing medicines formulations in swallowing difficulties
17 December 2024Some adults cannot swallow tablets or capsules safely. We describe a process for choosing suitable formulations, including crushing tablets.
Checking if tablets can be crushed or capsules opened
17 December 2024We suggest information resources and points to consider before crushing tablets or opening capsules.
Checking if medicines can be given with food
17 December 2024Many medicines can be given safely with a spoonful of soft food. Use the suggested resources and clinical considerations to support decision-making.
Examples of medicines formulations for patients
Medicines suitable for adults with swallowing difficulties
17 December 2024A number of licensed and unlicensed products in different therapeutic classes are available that are suitable for use in adults with swallowing difficulties.
ACEI suggestions for adults with swallowing difficulties
20 June 2024A range of Angiotensin Converting Enzyme inhibitors (ACEI) formulations are suitable for adults with swallowing difficulties
ARB suggestions for adults with swallowing difficulties
20 June 2024A range of angiotensin II receptor antagonists (angiotensin receptor blockers, ARB) formulations are suitable for adults with swallowing difficulties.
Clozapine use in adults with swallowing difficulties
31 May 2023Guidance on clozapine administration including crushing tablets, importance of not missing doses and practical considerations regarding switching formulations
Parkinson’s disease medicines in swallowing difficulties
13 June 2022Guidance to help you ensure your patients with Parkinson’s Disease are able to get the most from their medicines if they develop swallowing difficulties
Antiplatelet suggestions for adults with swallowing difficulties
1 July 2021A range of antiplatelet formulations are suitable for use in adults with swallowing difficulties.
PPI suggestions for adults with swallowing difficulties
1 July 2021A range of proton pump inhibitor (PPI) formulations are suitable for adults with swallowing difficulties.
SSRI suggestions for adults with swallowing difficulties
1 July 2021A range of selective serotonin reuptake inhibitor (SSRI) formulations are suitable for adults with swallowing difficulties.
Statin suggestions for adults with swallowing difficulties
1 July 2021A range of statin formulations are suitable for adults with swallowing difficulties.
Anticoagulant suggestions for adults with swallowing difficulties
1 July 2021A range of oral anticoagulant formulations are suitable for adults with swallowing difficulties.
Preparing and administering medicines to patients
Why and how medicines are given with soft food or thickened fluid
17 December 2024Giving medicines with food or fluid may be needed for people with swallowing difficulties or for covert administration. Practical advice is provided.
Advising how to crush or disperse tablets and open capsules
17 December 2024How to disperse tablets in water, crush tablets and open capsules safely for oral administration in adults.
Thickeners
Thickeners and thickened fluids
17 December 2024Follow specific product information when using thickeners. Avoid mixing starch-based thickeners with macrogol (polyethylene glycol) laxatives.
Thickening liquid medicines
17 December 2024Liquid medicines should not be thickened routinely. It is difficult to check fluid consistency and this can affect whether the medicine is swallowed safely.
Enteral feeding tubes
How enteral feeding tubes affect medicines
8 March 2022A knowledge of the different types of enteral feeding tube is important when recommending options for medicines administration
Assessing injectables for enteral administration
13 August 2024Clinical decisions on the use of injectable formulations for enteral administration should be guided by safety and practicality.