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Swallowing Pills

Childhood Medications

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Updated July 30, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Swallowing Pills

It seems like swallowing pills is a skill that many kids learn at about age ten years.

Before that, a fear of choking, or simply worrying that pills are too big, keep many kids from swallowing pills.

Unfortunately, some kids aren't swallowing pills even when they are teens, which can sometimes present challenges for treatments of common conditions.

Some teens who can't swallow pills simply chew any medicines they are prescribed, but that isn't possible for many medicines. For example, because of their extended release delivery system, some capsules can not be broken or chewed, such as Concerta.

Alternatives to Swallowing Pills

Of course, the simplest alternative to swallowing pills is to get liquid medications prescribed for your child. That can mean several teaspoons at a time for bigger kids, though.

Chewable tablets, granules, and disintegrating tablets, etc. can be alternatives to swallowing pills and liquid medications for some kids, and can include:

  • Allegra ODT (fexofenadine) Oral Disintegrating Tablets
  • amoxicillin (Amoxil) 250mg Chewable Tablets
  • amoxicillin-clavulanate (Augmentin) 400mg Chew Tabs
  • Clarinex (desloratadine) RediTabs and Claritin (loratadine) RediTabs
  • Methylin (ritalin) Chewable Tablets
  • Orapred ODT (prednisolone) Oral Disintegrating Tablets
  • Prevacid SoluTab (lansoprazole)
  • Singulair Granules and Chew Tablets (montelukast)
  • Zyrtec (cetirizine) Chewable Tablets

Swallowing Pills - Practice

Although ten years is often thought of as the age when many kids learn to swallow pills, it is interesting to note that many kids with chronic medical conditions who take medicines every day often learn to swallow pills much earlier than that. These kids sometimes learn by age six or seven years.

Whatever age you start training, make sure your child isn't at risk for choking, so no preschool age kids or toddlers, and don't push if he isn't ready. Other tips and tricks to help your kids learn to swallow pills can include:

  • practice pill-swallowing by cutting gummy worm candy into small pieces to emulate small pills or capsules, gradually working your way up to larger sizes

  • practice pill-swallowing with a Tic-Tac, choosing a favorite flavor so that if it doesn't work, your child just has a Tic-Tac in his mouth and not a disintegrating pill or capsule.

  • choose candy sizes in four or five different sizes with which to practice, like you might find in a cake or cupcake decorating kit. This way you can start with something as small as a sprinkle and then work your way up in size as your child is able to swallow the item a few times.

  • consider using Pill Glide (a non-prescription flavored spray) or a pill cup (a pill-swallowing cup that has a small basket to hold the pill in place while you take a drink) to help teach your kids to swallow pills

Practicing with smaller items usually works for those kids who are simply afraid of trying to swallow a larger pill because they think they might choke.

Swallowing Pills - Tips and Tricks

If your child has tried to swallow a pill and can't or has gotten stuck at the Tic-Tac stage, then further practice might not be that helpful. These kids need to actually learn to swallow pills or at least learn a different way from what they are doing.

Since it often seems like the pill is just staying in place, it is likely that they are holding it in place with their tongue against the roof of their mouth as they try to swallow. The trick might be to simply learn how to relax their tongue a little as they swallow the pill. Or at least get distracted enough so that the pill goes down.

Other tips and tricks to help kids swallow pills include:

  • put the pill (or Tic-Tac) on the center of their tongue and then try to drink a whole glass of water through a straw. They will hopefully concentrate on the straw and not think about the pill going down.

  • put the pill in a different place on your child's tongue, either back, front, center, side, or even under their tongue, etc., and try again.

  • put the pill on the back of their tongue, take a drink of water, and then tilt their chin down towards their chest before swallowing or put the pill on the front of their tongue and tilt their head back before swallowing.

  • the big gulp method - put the pill on your child's tongue and then tell them to fill their mouth with a lot of water, swish the water all around for 15 seconds, and then swallow.

  • drink a little water before putting the pill in their mouth.

  • gargle for 30 seconds or take a deep breath before trying to swallow the pill.

  • mix the whole pill or capsule with a soft food, like applesauce or yogurt, so that your child doesn't notice the pill as he swallows the food.

  • have your child chew some food, like a cracker or piece of bread, and then place the capsule on his tongue just as he is about to swallow the food.

Don't wait until your child is sick to try to learn how to swallow a pill. Try when he is well and doesn't actually need to swallow a pill yet.

More Alternatives to Swallowing Pills

In some cases, when an alternative to a capsule or pill is not available, you might ask your pediatrician and/or pharmacist for extra help.

First, ask if you can mix the capsule with a food or drink, which is sometimes done with ADHD medicines, like Adderall XR, Vyvance, and Focalin XR, etc., Prevacid, and even Tamiflu capsules.

In other cases, it is possible to compound the pill and make a liquid version or mix tablets into gel capsules, which can be easier to swallow. Young children who need to take malaria prevention medicines often need to visit a compounding pharmacy since there are no liquid versions for these medicines and some younger kids can be prescribed a 1/4 of a tablet, which can be hard for parents to cut on their own.



Sources:

Diamond S. Experience with a pill-swallowing enhancement aid. Clin Pediatr (Phila) - 01-APR-2010; 49(4): 391-3.

Garvie, Patricia A. PhD. Efficacy of a Pill-Swallowing Training Intervention to Improve Antiretroviral Medication Adherence in Pediatric Patients With HIV/AIDS. Pediatrics, Apr 2007; 119: e893 - e899.

Northern County Psychiatric Associates. How To Swallow a Pill. 2004. Accessed March 2011.

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