Trouble Swallowing Pills? Here’s What You Can Do About It

A “hard pill to swallow” isn’t just an old saying for people who have difficulty taking medication.

Whether the cause is emotional or physical, up to 40% of us have difficulty taking prescription and over-the-counter pills and tablets.

Sometimes the problem is as simple as changing the form of your medication or the way you take it. Other times, the problem can hint at something more serious.

Either way, it’s a significant problem — but one that can often be resolved.

Why Is Taking Pills Hard?

For a significant number of patients, anxiety causes them to have trouble taking pills. Other reasons include:

• Maybe you’re in too much of a hurry, trying to gulp down medication on the way out the door at the start of a busy day.
• Children may have a lingering memory of a traumatic experience while taking a pill, like the sensation of choking or gagging. 
• Older adults might not be drinking enough and are experiencing dehydration, which can lead to dry mouth and difficulty swallowing.
• The size of your tonsils or oropharynx (your throat) can make a difference in how easily the medicine goes down. 
• Certain medications are delivered through particularly large pills. So are some over-the-counter supplements.
• A less common condition called dysphagia — which occurs more frequently in older people — makes it difficult for people to swallow anything, including their medication. 

Potentially Dangerous Consequences

If swallowing pills is uncomfortable, you may become inclined to skip or even stop taking your medication. One survey found that of those who reported having trouble swallowing pills, a significant portion either delayed, skipped or stopped taking their medication as a result.

Skipping or halting medication can be risky if you’re managing conditions like high blood pressure, or deadly if you have certain diseases.

What You Can Do

If you’re having trouble swallowing tablets or capsules, your first step is to tell your health-care provider.

They can recommend some potential solutions, but just as important, can conduct an exam to help determine why you’re having difficulty. While unlikely, it may be something that suggests a more serious condition. You may be referred to an ear-nose-throat specialist for more tests.

More likely, your aversion to taking pills is related to something less serious that can be resolved through several different means, including:

• Change the way you swallow pills. People often put a pill in their mouth, take a drink and throw their head back. In fact, most medications float in liquid, which means that by tilting your head back, you’re most likely causing the pill to move away from your throat. This also tightens the back of the throat.  Instead, put the pill in the middle of your tongue, take a drink of water, and tilt your head slightly forward so the pill moves toward your throat, then swallow the pill with the water.
• Slow down. Too many people try to choke down their medication while in a hurry. If you have trouble taking medicine, find a calm, distraction-free place and take your time. Drink some water first, then take your medication with water. Never take your medicine without liquid like actors do on TV. 
• Take your medicine with food. Try putting your pill in a teaspoon of apple sauce, pudding or jelly and swallowing that way.
• Ask your doctor about alternatives. Some medications that normally come in pill form also are available in liquid form, though you’ll want to see if your insurance would cover it. Also ask your doctor or pharmacist whether medications can be crushed or cut in half to make them smaller and easier to swallow. Never do this without first consulting a health-care provider!
• Consult an occupational therapist. They can help you learn how to swallow medication with less difficulty.
• Consider sprays and gels. You can buy over-the-counter, edible lubricants that make swallowing pills easier.