Swallowing Pills

November 16, 2004 11:15 AM

PillsFilter. You'd think that a woman my age could swallow pills, but you'd be wrong. As I chewed several children's Tylenols this morning, I told myself that there had to be a way to master this skill. I should add that the problem is not the size of the pill, but the actual swallowing-without-chewing bit--even with teensy-tiny pills, my throat closes up. Any suggestions, before I manage to contract some deadly illness that requires the daily ingestion of an entire pharmacy?
posted by thomas j wise to health & fitness (33 comments total)

Swallow with liquid. As in, put the pill in your mouth (one), take a swig (two), and swallow the whole thing at once (three!).
posted by padraigin at 11:20 AM on November 16, 2004

...and, contrary to my Mum's advice, don't bother with putting it on the back of your tongue. Just pop it in your gob, swill, swallow. It only took me 25 years to work this out.
posted by punilux at 11:24 AM on November 16, 2004

Practice with M&Ms, or even better, those tiny baking M&Ms. It may just be a matter of doing it until you can do it, and you don't want to do that with Tylenol.
posted by blueshammer at 11:31 AM on November 16, 2004

I also hate to swallow pills. Now that I'm taking a daily vitamin which is pretty HUGE, this issue has been coming up for me.

Here's what I do: I put water (or other drink) in my mouth first, then put the pill in. This keeps me from tasting the pill, which seems to send the signal to my throat to shrink. Once I have the water and pill in my mouth, I toss my head back and swallow quickly. It works very well.

Another thing that helps is to take the pill with a flavored drink - milk, soymilk, tea, whatever - so that you don't taste the pill.
posted by widdershins at 11:32 AM on November 16, 2004

My girlfriend cannot swallow pills with water or other liquid -- she uses yogurt, bread, or something else to eat, to help her swallow them.
posted by Vidiot at 11:44 AM on November 16, 2004

It took me a long time to be able to learn how to swallow pills. I had to start by swallowing Tic-Tacs with water. Now I can swallow pill tablets without water.

This has to be my most exciting post EVAR.
posted by grouse at 11:44 AM on November 16, 2004

I had major problem with this when I was younger, and it really became an issue when I got one of the usual pill-requiring extended childhood illnesses. My mom took care of this by cubing up a ton of cheese (ah, the power of...) and having me pop a pill into my mouth just before swallowing some cheddar or the like. The complex mouthfeel and familiar, comforting flavor completely disguised the pill.

Eventually I got so used to the idea of the pills that I didn't need cheese, and by now I don't even bother with water to take down even serious horse-pill vitamins. You can do it!
posted by clever sheep at 11:49 AM on November 16, 2004 [1 favorite has favorites]

I had the same difficulty as a child, and the doctor suggested practicing with empty gelatin capsules. You can get them at health food stores, and there's no worry about choking on them, as they start to dissolve pretty quickly.
posted by hsoltz at 12:02 PM on November 16, 2004

As someone who has to take a (small) handful of pills on a daily basis, I second Widdershins' method -- a small gulp of water held in the mouth, then a quick toss of the pill as you toss your head back. Goes down the hatch everytime for me.
posted by scody at 12:10 PM on November 16, 2004

Speed is definitely key, and pretend you're not swallowing a pill at all, just a gulp of water.
posted by agregoli at 12:14 PM on November 16, 2004

I agree with the water thing. If you think about the pill swallowing, it'll get stuck. Happens to me every time if I think too much about it.

If I just tell myself I'm swallowing water it goes right down.
posted by loquacious at 12:23 PM on November 16, 2004

I'm stuck with a hypothyroidism problem for life, and I've been swallowing two pills every day since 1990. These days, I don't even bother with the water. I just pop them in and down they go. It gets to be like brushing your teeth after you've done it long enough.
posted by madman at 12:25 PM on November 16, 2004

I wasn't able to swallow pills until I was fifteen or so, which led to all kinds of problems when a liquid or chewable formulation wasn't available for a drug I needed.

I was eventually able to conquer it with the help of a pill glass (link provided only as an example, not an endorsement of this particular one). It features a "pocket" or "shelf" near the rim of the glass where you place a pill, and you fill the rest of the glass with water (or other liquid). As you drink the liquid, it washes the pill into your mouth as well.

Keep at it--it's not an instantaneous solution, and when I started using it I still gagged on the pill more often than not. But with time, I was eventually able to swallow pills even without the help of the special glass.

Back then, a pill glass was carried by many drug stores, but that was many years ago so I don't know if they're so common today.
posted by DevilsAdvocate at 12:28 PM on November 16, 2004

I would concur with widdershins--

use "gel caps" which get slimy when they come into contact with water. Then put some water in the mouth first. Put the pill in, swish it around, and swallow the water. The pill will be slimy from the gel and water and should go down quickly. Try not to think about it.
posted by cell divide at 12:39 PM on November 16, 2004

My mom used to take about six vitamin pills every day. She'd just put them into her mouth all at once, take a big swig of liquid, and swallow. Have no idea how she managed that.

For big pills, like the glucosamine ones I take, I find that they must indeed go on the back of the tongue. Otherwise they tend to turn sideways and get stuck.

If possible, prefer capsules or even caplets to tablets. I've had some relatively small tablets get stuck and once had to self-Heimlich one out of my right bronchus. Switched to a capsule form and I can easily swallow two of them at once.
posted by kindall at 1:12 PM on November 16, 2004

Don't tilt your head back--it constricts your throat.
posted by ajr at 1:16 PM on November 16, 2004

Unless there's a special reason not to, I say mash the pill(s) up [press them tightly between two spoons and turn them into powder] and put them in a spoonful of chocolate syrup or applesauce or a glass of grape juice, and then follow it down with a glass of water. I have the pill problem on and off, but I can choke down any foul tasting food, for some reason.
posted by jessamyn at 1:42 PM on November 16, 2004

Fill a tall glass of water. Put the pill in your mouth and start drinking. It'll go down eventually, even on the third or fourth swallow. Just keep at it. Eventually, you need only a little or no water. Once you know you can do it, it gets easier because you don't worry about it. However, when you do start to worry, it gets tough. I had magnesium pills that just disintergrated on contact with my mouth. I eventually had to throw them out, simply because my mind insisted I could not swallow them.
posted by stoneegg21 at 2:18 PM on November 16, 2004

Unless there's a special reason not to, I say mash the pill(s) up

WARNING! DANGER WILL ROBINSON, DANGER!

My parents did that to me when I was about 12. I reminded them that the doctor said not to. They did it anyway, presumably believing that I was just trying to get out of it, and I spent the next day vomiting; after the second time, it was just a mouthful of bile and stomach acid every half-hour to an hour. Whee.

I would only mash up a pill if you have some special reason to know that it is safe to do so. Otherwise, assume you shouldn't. Never with anything that's time-release.
posted by ROU_Xenophobe at 2:21 PM on November 16, 2004

I learned to swallow pills when I was a teenager but it took me a month or two of daily practicing. My method was to start with something small. Really small. M&Ms, even the mini ones, are too big. Think, like, a dried lentil or something. Go through your cupboards and find all the little tiny foods that you own. Drown them in immense amounts of water to wash them down. One of the mistakes that many people make is trying to take one pill with one swallow of water. Put the "pill" in your mouth (not near the back, that just gets your gag reflex churning, somewhere on the tip of your tongue) and keep gulping down the water until the pill isn't in your mouth anymore. If you can get the one small thing to work while draining a glass of water, then gradually work on a) bigger things and b) smaller amounts of water. I worked my way up to peanut M&Ms on a small mouthful of water over the course of time, and can now swallow almost anything but uncoated aspirin (too chalky) with no water at all.

The whole process was a massive pain in the ass, and I won't pretend it's easy, but my mother was getting tired of spending $100 to buy me antibiotics in liquid form that could be had for $10 in capsules.
posted by jacquilynne at 2:32 PM on November 16, 2004 [1 favorite has favorites]

The "mash pills up" idea is only a good idea IF YOU KNOW IT IS SAFE, as ROU_X says above. Fortunately, your pharmacist should have information about that for every prescription medication's formulation. It's worth asking about every new medication if you do have a swallowing issue.

Me, I'm a partisan of the "fill your mouth with water, toss the pill in, then drink some more water and gulp madly" school. If you do it this way, you'll never notice the floating pill as it wanders down your gullet.
posted by Sidhedevil at 2:56 PM on November 16, 2004

Thanks, everyone. Now I have a great excuse to eat a bag of M&Ms (although, I've got to say, you usually want to taste the chocolate...).
posted by thomas j wise at 3:28 PM on November 16, 2004

I always swallow a mouthful of water (or milk, or whatever) first before putting a pill in my mouth, because it wets your throat and helps the pill slide through easier. Maybe that's psychological; the only pills I'm taking right now are huge pink vitamin tablets. So swallow water, then pill on tongue, then more water.
posted by tracicle at 4:05 PM on November 16, 2004

Wow, I'm surprised this is so tough.

I can swallow pills without water. Usually I make up a spit gob in my mouth to make it easier, but otherwise, feh.

I've never experienced a problem doing this with water, although "dry" it can be a problem if you can't get the damn thing to move.

What is your reaction to this, people that are having trouble?
posted by shepd at 4:24 PM on November 16, 2004

You're just lucky, shepd.

I couldn't swallow pills either until I was an adult, and still have to have liquid to do it.

I just put the pill way back on the very back of my tongue and take a drink of water and that does it. It didn't work when I was younger, though. I dunno, overdeveloped gag reflex or something, maybe. Because most pills are just not that big.

At any rate, the problem was real and very frustrating.
posted by litlnemo at 4:46 PM on November 16, 2004

Here's the way I thought about it (I was aspirinphobic as a kid): swallowing a pill should be easy because you routinely swallow much larger things in one go. I found it frustrating to take aspirin because it would stick to my tongue, cheek, or palette on the way in. I found the solution: I retract my tongue and set the pill just behind my lower teeth, take in a swig of liquid and toss it all back in one go.
posted by plinth at 5:34 PM on November 16, 2004

I hate this too. Here's what I can manage. Have a glass of water (actually any drink will do, as long as it's in an open glass, not a bottle or can) ready. Place the pill at the back of your tongue, quickly take a big mouthfull of water and swallow as fast as possible.

If the pill moves to my teeth, I'm screwed, but this is the best way I've found to fight the reflex that places unchewed items to the side of my mouth when I'm drinking.

I don't tilt my head back. It's the volume of liquid, not the angle that makes the difference.
posted by krisjohn at 7:32 PM on November 16, 2004

I still have a lot of trouble swallowing any pill larger than one of those little red advils or something. I've just gotten used to chewing them up, even the super nasty tasting ones. If I do have to swallow a time-release pill or something, I find that using something with a little more weight than water helps, like orange juice or milk. The pill just sort of floats more, instead of sinking down to your tongue, and it goes down a lot easier. I still have to psych myself out to swallow them whole, but eventually you get the hang of it.
posted by majcher at 8:33 PM on November 16, 2004

Slightly OT, but I'm taking some Chinese herbal pills right now which are round, and they are so easy to swallow...I can do ten of them in one gulp (with water), while I can only do a single flat pill of similar size with one gulp of water. I think Western medicines are made to be easy to handle during manufacture and processing, not to be easy to swallow.
posted by gokart4xmas at 10:08 PM on November 16, 2004

I can't do it at all. Never have been able to. I don't intend to try and learn either.
posted by salmacis at 2:25 AM on November 17, 2004

Quite a few meds (like that tylenol) do come in liquid versions and compounding pharmacists can make nearly any medication up in a liquid or, increasingly, transdermal (delivered through the skin) form. That's one of the things they do: make stuff so that people can actually get them down. You may want to chat with a compounder (typically smaller locally-owned pharmacies have a compounder on staff, rather than the mega-corp retail prescription places) to see just what all they can do for you. While learning to take a pill may seem like the obvious thing, if your phobia is severe, it might be more manageable to just find a way to accomodate it.
posted by salt at 8:26 AM on November 17, 2004

When I was a kid, my mom managed to teach me using the wonder of imagination. She would tell me, "pretend you're really, really thirsty, in the desert thirsty." And as a kid with an enormous imagination, I would picture how thirsty you'd be and how desperate to get that water down and my throat would just open up. I still occasionally use that tactic today. Can't explain it, but it works for me.
posted by GaelFC at 5:20 PM on November 17, 2004 [1 favorite has favorites]

Another proponent of the take with water approach. I take a nice deep breath, place pill on tongue, take a big gulp of water, and swallow. If you hold your breath your taste reflex won't come into play as much.

Practice sounds good if you are truly anxious about it, but it wasn't that difficult for me to make the transition. The key is a lot of the water (or whatever) so the pill doesn't touch your teeth, roof of mouth, side of throat, etc.

Good luck!
posted by somethingotherthan at 10:03 PM on November 17, 2004 [1 favorite has favorites]