*gulp* *ack* *phtoo*

March 31, 2008 5:07 PM

Why make one enormous pill instead of two smaller ones?

I recently bought some One-A-Day multivitamins (because my gyno guilted me) and tried, for days, to take them whole. I just couldn't do it, no matter how many times I tried- I'd always choke and have to spit the pill out. I finally just chopped one in half and took the halves individually, and there was no problem whatsoever.

I remember having this same problem when I had to take Valtrex for a really bad cold-sore-plus-staph-infection. That time, I was able to make myself swallow them whole because it seriously looked like my lip was going to fall off if I didn't, and because they were so expensive, but it was still pretty difficult for me.

It's maddening, because (aside from the whole 'One-A-Day' name thing) it seems like there's absolutely no reason not to make these huge, single-dose pills into half-dose ones, and just say 'take two'. Is there an actual reason for doing it this way?

Also- if anyone knows of a multivitamin that's two small pills a day, I'd love to know about it.

posted by showbiz_liz to health & fitness (34 comments total)

There are packets of vitamins that break down the nutrients into different types (fat- and water-soluble, etc.) that are both more effective - generally due to high potency way above the ridiculous RDA standards - and smaller per-pill, though they aren't tiny either. Any health food store should be able to help you out.
posted by kcm at 5:11 PM on March 31, 2008

Centrum makes a daily chewable kind. They don't taste so good, but at least you don't have to swallow a huge pill. Or any pill.
posted by AsRuinsAreToRome at 5:16 PM on March 31, 2008

I think it's a marketing thing. Being able to say "Just one pill contains all the blah..." is worth something. It's also a perceived quality thing. People think one 500mg vitamin is somehow "stronger" (therefore better) than two 250mg ones.

"Damn, I have a bad headache. Should I buy the 250mg pills or the 500mg ones? Hell yeah, 500." - Joe Sixpack
posted by ctmf at 5:17 PM on March 31, 2008 [1 favorite has favorites]

I just asked my partner this yesterday, although not about vitamins. He takes 12 pills every morning, including two enormous HIV-related pills. I told him I'd have a lot of trouble swallowing that one if I had to take it. It typically takes him two swallows of water to get it down.

One trend I've noticed, having once worked in IT for the marketing department of a company that made HIV meds, is that the marketing folks really did see value in saying that there was "only one pill" instead of two or three or four. This was, of course, in the context of times when HIV patients had to take a whole series of meds at set times, with or without food, and so on. Very complicated. Having a single huge pill instead of bunch of little ones makes things simpler, and makes it easier to "comply" with one's medication regimen.
posted by Robert Angelo at 5:19 PM on March 31, 2008

I've been avoiding multivitamins for years because of just this problem. Flintstones vitamins never choked anybody, though, and they're better than nothing.

If you have to take a medicinal capsule that's too big, try buttering it first. I did this when I had to take a gigantic pill some time ago.
posted by Countess Elena at 5:21 PM on March 31, 2008 [2 favorites has favorites]

Yeah, I think that maybe for the majority of people one pill is simply more attractive than two. Even if they're smaller.

And cutting pills in half is always an option (those little pill cutting devices are easy), whereas fusing two into one (for those preferring fewer over smaller) is impossible.

I took Flintstones for a while (yes, as a 30-something adult). Frankly it's hard for me to have them around because I might OD on their candy-goodness. As an adult who can swallow about six pills in one gulp, I went back to the adult kind so as to not create a shortage for others. :)
posted by iguanapolitico at 5:28 PM on March 31, 2008

Actually, 2 flintstones a day is just fine for an adult. I had gastric bypass and that is what I was told to take to meet all my special nutritional needs. Feel free to chew away!!
posted by pearlybob at 5:42 PM on March 31, 2008

I always take Flintstones. I just think it's better to take vitamins with 50% RDA than vitamins with 150% or whatever ridiculousness. Especially with fat-soluble vitamins.
posted by sondrialiac at 5:43 PM on March 31, 2008

People can't keep straight a number of pills from a given bottle. Especially if it's a person with lots of meds and moderate confusion, keeping track that it's two-of-these in the morning three-of-these in the morning, two-of-these morning and night is bound to fail.

It's not just consumers, physicians prefer meds with an easy schedule (once-a-day) because of the empiric fact that people are better at taking them.
posted by a robot made out of meat at 5:48 PM on March 31, 2008

Flintstones actually has a chewable gummy form that supposedly tastes very good. Check it out here.
posted by Aanidaani at 5:51 PM on March 31, 2008

For prescription meds, the caplets can be very specifically designed for things like time-release into the blood stream or quick absorption or whatever. Dividing them in half may not be possible under those circumstances.
posted by jacquilynne at 6:29 PM on March 31, 2008

Nth the chewable vitamins. There's one brand that even makes sour gummy worm vitamins. :)
posted by sixcolors at 6:47 PM on March 31, 2008

I saw vitamin gummy bears in the store the other day.
posted by Jacqueline at 7:50 PM on March 31, 2008

My wife takes the gummy bears.
posted by dmd at 7:53 PM on March 31, 2008

Does it have a score? Place your thumbs in close, either side of the line and snap in towards you. Not quite as neat but if there isn't a score, make one and then snap it. Too easy :)
posted by mu~ha~ha~ha~har at 8:00 PM on March 31, 2008

Put the pill on your tongue, take a mouthful of water, bow your head forward, and then swallow. This relaxes your gag reflex, and the pill will bob up on the water to the back of your throat, making it much easier to get down.

Also - "high potency way above the ridiculous RDA standards" is not always a good thing, as some vitamins are toxic in high doses.
posted by Caviar at 8:05 PM on March 31, 2008

I take a number of supplements and usually swallow them 3-4 at a time. The secret is putting them all the way at the back of your tongue, as far back as you can without gagging. If you put them in the front, they have to travel further and there is a better chance you won't get them down the first time and they will end up somewhere uncomfortable. (My personal worst: inhaling a small chromium picolinate pill.) You will be tempted to make a hollow for the pills in your tongue and put them there, but that won't work nearly as well.
posted by kindall at 9:07 PM on March 31, 2008

I totally agree with you showbiz_liz! I hate swallowing pills, and two smaller pills would be my preference too. If its any help, I have discovered that when I am really having trouble with a pill, it is easier for me to swallow it using yogurt instead of water. I think it is because the yogurt is thicker, and therefore its harder to detect the pill in the mouthful, so I can't get all freaked out about it. Plus when you swallow a mouthful of yogurt you are expecting something a bit lumpy, but not so with water.
posted by Joh at 10:27 PM on March 31, 2008

I concur with kindall, that the best way to take large pills is to stick them right at the back of your tongue and then take a big gulp of water... The water flows in and knocks the pill down your throat before you know what's happened! I used to have SO much trouble taking pills until I found this out

I know this doesn't really answer the OP's question, but hopefully is some help anyway!
posted by ranglin at 2:49 AM on April 1, 2008

I can't swallow pills very well either. I take those Centrum chewables someone mentioned. I've tried every method out there, and I still can't do swallow pills. I wish more manufacturers made liquid medicines (to piggy back, why don't they?). I can deal with gross tastes.
posted by bluefly at 4:03 AM on April 1, 2008

Countess, buttering a pill just sounds awesome. I want to go home and do that now.
posted by ericales at 4:14 AM on April 1, 2008 [1 favorite has favorites]

Along the lines of what Joh said, I find it way easier to swallow pills with a mouthful of food than a gulp or two of water. Of course, this only works for pills that can or should be taken with food.
I take a bite of food, chew, and when my swallow reflex is about to kick in, I just toss the pill toward the back of my throat. Follows the food right down, and the nasty bulk of the pill is much less noticeable when there's yummy food all around it.
posted by bassjump at 4:39 AM on April 1, 2008

Back a zillion years ago I was prescribed some horsepill vitamins. I had never been able to take ANYTHING bigger than a chewable baby aspirin, so I was stumped. The doc suggested I train myself by using a milkshake and a straw, and swallowing the pill with those. The straw seemed to help me direct the pill better, and the milkshake acted like Joh's yogurt.

Now I can take anything, no matter the size, with just some water or soy milk.
posted by tigerjade at 6:09 AM on April 1, 2008

Hunh, does this mean I have an excuse to buy those Spider-Man vitamins now? *coughnerdcough*

Aaaalso, uh, I would go with the pill-slicer trick if none of the swallowing tricks help, but since I'm here, if I may be permitted to piggyback with a question that's not really worth an askme of its own, at least in my case - how much does "take with food/take without food" really matter? I try and pay attention to the "take with full glass of water" commands, but I can't always eat on command, or at least not very much.
posted by bettafish at 6:25 AM on April 1, 2008

Same problem for years, but thicker liquids are better than water, e.g. orange juice, and absolutely agree with looking down to avoid the gag reflex, i.e. pill in mouth, move it towards the back on one side (to avoid the epiglottis), then drink with head slightly downwards. Do not tip your head back.
posted by idb at 6:33 AM on April 1, 2008

For prescription meds, the caplets can be very specifically designed for things like time-release into the blood stream or quick absorption or whatever. Dividing them in half may not be possible under those circumstances.

Seconding jacquilynne - don't cut or chew your pills if they're time-release!
posted by cabingirl at 7:03 AM on April 1, 2008

It's maddening, because (aside from the whole 'One-A-Day' name thing) it seems like there's absolutely no reason not to make these huge, single-dose pills into half-dose ones, and just say 'take two'. Is there an actual reason for doing it this way?

I'm guessing they tested the pills with focus groups, and determined that the size of normal one-a-day multivitamins isn't that bothersome to a lot of people. I take one each day, and it never occurred to me that anyone would find it too big to swallow.
posted by Greg Nog at 8:39 AM on April 1, 2008

I can't stand the nasty taste of most pills, so I put them under my tongue. I take some water in my mouth, then pull my tongue down and back, followed by a kind of forward "scooping" motion. This causes a current that pushes the pills to the back of my mouth, and then I swallow. It's worked for me since I was a kid with pills of all sizes. Just be careful not to trap the pill between your tongue and the roof of your mouth!
posted by owtytrof at 8:40 AM on April 1, 2008

Put the pill on your tongue, take a mouthful of water, bow your head forward, and then swallow. This relaxes your gag reflex, and the pill will bob up on the water to the back of your throat, making it much easier to get down.

I've found this to work well with some pills, but not with any of the multivitamins I've ever used, because the multivitamins don't float. Tilting my head forward just makes them roll down into the front of my mouth. I'm with the "back of the tongue" people in this case.

For the original question, definitely try two of the kids' vitamins. They're smaller and tastier.
posted by vytae at 8:42 AM on April 1, 2008

I wish more manufacturers made liquid medicines (to piggy back, why don't they?).

The last time one of my cats needed an antibiotic (he gets in fights with neighbor kitties & comes home with exciting wounds), I asked the vet why he couldn't get a liquid. He takes liquid medication really easily, and of course getting a cat to swallow a pill is a PITA.

She said that the amount of medication that was needed to be effective for his size (15 pounds) would be an insane amount of liquid compared to a single fairly large pill. I'd guess that the same is true for humans.

how much does "take with food/take without food" really matter?

I asked my doc about that once; with some things (antibiotics for one IIRC) it does actually affect the absorption, with others it's just a matter of avoiding stomach upset. That's then a matter of personal constitution.

Also, I take fish oil pills, and find that I don't get fishy "aftertaste" if I eat them right before eating something.
posted by epersonae at 9:28 AM on April 1, 2008

Another saying I'll have to look into the chewy vitamins. I'm more than happy to take several---my problem is remembering to take any, at all, rather than only taking half of them---but I can't take the big pills.

I have such a bad gag reflex, I've triggered it brushing my teeth. As I said to Ms Monkey the other day, those One-A-Day vitamins are beyond horsepills, they're like horse suppositories.... I damn near threw up the last time I tried to take one.
posted by FlyingMonkey at 10:54 AM on April 1, 2008

Also - "high potency way above the ridiculous RDA standards" is not always a good thing, as some vitamins are toxic in high doses.

The RDA guidelines were written in 1979 and are therefore very out of date, meaning that we actually need a lot more vitamins and nutrients these days than the RDA states. Taking less (or even the full) RDA is hardly worth it according to some.

Also note that the cheaper the vitamins the less potency and quality they contain, again, making them virtually null and void. Sadly you need to buy the most expensive ones to reap the benefits.
posted by Happycat79 at 12:14 PM on April 1, 2008

Another saying I'll have to look into the chewy vitamins. I'm more than happy to take several---my problem is remembering to take any, at all, rather than only taking half of them---but I can't take the big pills.

I found switching to a chewable helped with this, too. I keep a candy dish of children's chewable vitamins and tums sitting on the counter by the front door. I eat them as I walk by, something I'm much more likely to do than remember to fetch my bottle of pills and take them with a glass of water.
posted by jacquilynne at 3:03 PM on April 1, 2008

Revisiting an old post: I know this isn't answering the question, but as far as "how to make swallowing pills easier" goes, I recommend learning how to "open up" the throat. For me it's not about where I position the pill in my mouth, it's about the ability to kind of open up my throat to let the pills slide down. You know those people you've seen who can chug a pint of liquid in 0.75 seconds? They're not swallowing really hard or really fast, they've just kind of opened up their throat to let the liquid go down. Same principle with downing a shot of alcohol.

So, I don't actually just open up my throat and let the pills go down on their own (I'm not as good at it as those 0.75 second guys), but I do open up my throat as much as I can, and then with one mere swallow of water to help them along, I can take several horsepills at once. The more your throat fights the pills by closing up, the more you gag. Instead, open up and let it all in. :) Practice with a glass of water and no pills. If you ever get good at it, try it with a vitamin and see if it helps.
posted by iguanapolitico at 11:42 AM on April 13, 2008