You might need certain meds to help you stay healthy, but the act of swallowing them can be unpleasant. Between 10 percent and 40 percent of adults report such difficulty, according to a 2018 review in the journal Patient Preference and Adherence.
Swallowing pills may be especially challenging for older adults, says Rosanne M. Leipzig, M.D., Ph.D., a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York. That’s likely due to “the sheer number of pills they’re taking, the fact that they’re more susceptible to conditions like dry mouth, and the reality that the muscles at the back of the mouth naturally weaken over time,” Leipzig says.
Plus, anxiety about taking pills can create muscle tension, making the task even harder.
Here are six ways to make taking your meds more manageable.
1. Cut or Crush Pills
Check with your pharmacist before altering any medications, says Jeannie Lee, Pharm.D., a clinical associate professor of geriatrics at the University of Arizona College of Pharmacy.
Some meds lose their effectiveness or become toxic when cut or crushed. If you get the okay, try using a pill cutter, available in most drugstores.
To crush a pill, wet it with a few drops of water, let it soften for 5 minutes, squish it between two spoons, then mix it with something like applesauce or yogurt.
2. Address Dry Mouth
Some drugs that older adults take can make dry mouth worse, according to a 2018 review of 52 studies published in the Journal of the American Geriatrics Society.
To help minimize dry mouth, sip plenty of water and avoid caffeine. You can also chew sugarless gum to stimulate saliva flow, says Bri Palowitch, Pharm.D., of the American Society of Consultant Pharmacists. Certain mouthwashes, such as Biotène Dry Mouth Oral Rinse and ACT Dry Mouth Mouthwash, may also help.
Ask your doctor or pharmacist whether any of your current meds cause dry mouth and whether there are any alternatives.
3. Perfect Your Technique
For a problematic tablet, try placing it on your tongue and then closing your lips around the opening of a bottle of water. Using a sucking method, swallow some water and the pill. With a capsule, try putting it on your tongue, taking a sip of water, tilting your chin toward your chest, then swallowing.
Both methods are significantly more effective than simply trying to swallow with a sip of water, according to a 2014 study published in the journal Annals of Family Medicine.
There are also products on the market such as pill-swallowing cups and straws that mimic these techniques.
4. Use Different Fluids
Taking pills with slightly warm water is better than with cold water, Lee says.
You can also try a thicker fluid, such as juice. (Just keep an eye on the sugar and salt content, and beware of potential food-drug interactions.) An over-the-counter thickener such as Thick-It may also help, she suggests.
Another option is applesauce, because it contains pectin, a substance that makes it slippery and can help a pill slide down your esophagus more easily.
5. Try Other Forms
If you really can’t get a pill down, check with your pharmacist to see whether it’s available as a disintegrating tablet or in a liquid form, Lee recommends. Even if it’s not commercially available, a local independent pharmacy can often make a liquid version for you.
Special aids such as Pill Glide (a spray) and Medcoat (a coating) may help too, though research is limited. And using these products can become expensive over time, Palowitch says.
6. Rethink Your Regimen
An annual medication review, where you meet with your physician or pharmacist to go over everything you’re taking, can help reduce the number of pills you need as well as flag any that may be causing dry mouth.
If you’re also having trouble swallowing food and drinks, see your physician to rule out other problems, such as chronic heartburn, that could be causing these symptoms.
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