medicine for dd who can't take tablets

[steppemum]

dd is 15. She can't swallow tablets.
We have really tried to teach her, but she can't.
She has poor peristalsis at the back of her throat because she had oesophagal stricture as a child, and I think that they are connected and she cannot physically swallow the tablet past the weak point.

She also is quite sensory sensitive, especially to taste, so she can take calpol melts (chewable) but not disolvable paracetamol tablets as the liquid tastes bad.

But I have been wondering what she will do for any other medications? Are there alternatives available for people who can't swallow? Do I need to get this somehow put more officially on her medical file so that she has access to other types of medicine?

How many tablets can actually be chewed? How do you find out of a capsule can be opened and put on a spoon on jam, or if it has to disolve in the stomach?

She is currently in need of iron and we have tried 2 liquid iron supplements and they both taste too bad for her to take. So any bright ideas there welcome too!

Don't just ask your nearest pharmacist in boots, it can take a while to get all the info and they aren't best placed.
Call your local hospital pharmacy and ask if they have medicines information, anyone can make an enquiry and they have all the resources.
While you can get liquids of most things they are often crushed tablets formulated into a syrup by a specialist company, often for £££ for the privilege.

Can't they be kept in the office?
I know that when DD had life-saving tablets, they kept them for her.

Apple spatone in a smoothie - completely undetectable! I have it every morning.

The doctor prescribing needs to prescribe the liquid version. Our gp did this and the hospital doctors. Beware that a hospital prescription cannot be dispensed in a community pharmacy (this, I learned the hard way). There was one medication that was especially difficult to get in liquid form and we found a pharmacy that had link with a pharmacy lab and they made it up for my mum specially. Sometimes I had to go to a lot of different pharmacies to get the liquid version. I learned to phone them all first! But this was for a huge number of medications (my mum was very ill).

For regular stuff, like paracetamol most are easy to get otc in liquid form or are crushable.

If you use the BNF it tells you what form the specific drug is available in.

Hi op, I'm in my 60s and got a small pill caught in my throat about 40 years ago and have never been able to swallow one since. Once or twice I've had a sneery response from a doctor but no one has ever not been able to prescribe an alternative or indeed refuse one.
After reminding the doctor about an alternative eg to those enormous capsules that I'm amazed anyone can swallow! they firstly look at whether the capsules can be crushed. If they can't because it's slow release medication, then they look at dissolvable tablets and then finally liquid. The only problem with liquid is that sometimes you have to take a huge amount to get the same dose as a tablet. When I was pregnant my teeth stained brown with the liquid iron and was difficult to remove but I'd say that has been the only downside. I can't foresee any problems for dd so don't worry.

Thanks everyone for your help.

Just an update, we found chewable iron tablets on amazon and she's happy with those, so we have finally got her on iron.

I'm looking at various versions of the Ibuprofen and paracetamol.

Lots of useful advice on here. Thanks.

I always struggled with tablets (not for any physical reason) until I was past 30 so I totally sympathise- when nurofen bought out the meltlets it was the best day ever! Weirdly I can now take caplets and small tablets, which is obviously a much cheaper way of doing it.

I was just commenting to agree that the dissolvable versions of some things are so repulsive that I would do without pain relief than take them, at that age, although I did use liquid Calpol into adulthood. With the weird flavours they add to liquid meds I think, personally, you'd be better having the solid version of any medication and putting it into jam as the default strategy/request. There's always a risk that the liquid version of something will be too unpalatable to be any help.

I agree, my gut reaction is that she will not like liquid versions.

I was surprised how many liquid versions were available. I was prescribed liquid Prozac for a while - it made it much easier to taper the dose down when coming off it, than trying to slice up tablets into bits.

I add fruit squash such as Ribena to dissolved paracetamol and that works.

I was also told to hold my nose when taking a tablet (that won't work for her) and swallowing something nasty. I find it works well as long as I do it myself.

She could practice with water first?

In general the majority of tablets can be crushed. Those that are film coated or a slow release type tablet or any other type of coating can't be crushed. There are many types of tablet in orodispersible form which while more expensive than regular tablets can sometimes be better than liquids in terms of shelf life etc. There a plenty of options available and man capsules can be opened too, however not slow release capsules.

I wouldn't be concerned, the prescribing GP may have to liase with a pharmacist when prescribing but there will be options of liquids/orodispersible tablets available.

The problem that you'll tend to run into is that because most adults can swallow tablets if they really need to, the liquid medication strengths tend to be designed for young children, so a dose for a teenager is a lot of volume. Finger crossed for not needing many meds!

I can't take tablets properly either,

Dissolvable paracetomal in a little fizzy drink masks the taste completely unlike juice.

Nurofen meltlet's - taste a weird Lemony flavour, again swig a little fizzy with it it'll dissolve it faster and hide the taste.

Antibiotics - ask for liquid or open the capsule and mix with yogurt.

Any other tablets I try to take and if I can't manage it I just crush it in yoghurt and hope some gets in my system and does its job.

I keep a pack of calpol melt let's in my bag incase I need paracetomal out and about without access to a cup of water, she can do the same for school.

Not really what you asked but do you have one of those proper pill crushers? They turn tablets in to powder. Way easier than crushing with spoons etc.

If it's a pill that's safe to crush you can liquify it in a Calpol syringe (or any other sort of syringe)

https://youtube.com/shorts/dSEQwek3cjk?feature=share4

Mix with a smidge of yogurt and you're off 👍

Thanks all, lots of helpful advice.
x

Mine has just mastered taking tablets at 16.5 - renewed efforts made as she is going away and needs to take anti-malarials. I realise that your daughter's physical issues may mean there is less hope, but the one that worked for DD was looking down and sucking through a straw. (Next problem was sourcing a week's supply of single-use straws - reusable is great for the environment, but washing them is not on without clean water. She now has some festive Christmas paper straws, because that's what I could get in small quantities!)