How to Swallow a Pill

Here are 3 strategies to help the medicine go down

If the expression “a hard pill to swallow” is reality for you, you’re not alone. Pill dysphagia, or trouble swallowing pills, is very common, even for people who don’t struggle to swallow food or liquids.

Swallowing a pill, however, is an important skill to learn. Knowing how to swallow a pill or tablet correctly helps make sure the right dose reaches the right place at the right time, so your treatment works as intended.

“Many pills are designed to be swallowed whole because the coating or formulation control how the medicine is absorbed in your body for accurate dosing and fewer side effects,” says Mark Harlor, SLP, a speech-language pathologist in Geisinger’s Ear, Nose and Throat Department. “Not knowing how to swallow a pill can cause some to gag or choke while trying or worse, keep them from following their medication regimen.”

Having to swallow pills — especially larger pills or capsules — can be frustrating and downright stressful. The good news is, with a few straightforward techniques and a bit of practice, most people learn to take tablets and capsules comfortably and safely.

Causes for pill swallowing difficulty

Some people struggle to swallow pills due to previous negative experiences, while others may have physical conditions that make pill swallowing difficult.

Treatment for certain neurologic conditions like Parkinson’s disease, gastroesophageal reflux disease or esophageal disorders can cause sensory or movement problems in the throat. This often causes people to feel like a pill is stuck in their throat.

Dry mouth and throat from certain medications, heavy smoking or alcohol consumption, or autoimmune diseases like Sjogren’s Syndrome can make it more difficult for a pill to slide down easily.

In other cases, a person may develop a fear of swallowing pills because of a previous negative experience like choking.

“Phagophobia is an intense fear of swallowing pills, foods or liquids,” says Mr. Harlor. “When a person becomes anxious to swallow, it can cause tension in the muscles responsible for swallowing and reduced saliva production in the mouth. Both of these factors interrupt the natural process of swallowing.”

Effective strategies on how to swallow a pill

With some practice, swallowing pills can become routine.

“You can try swallowing small candy pieces like Tic Tacs^® to practice and build confidence,” suggests Mr. Harlor. “Then, gradually increase the candy size until it’s close in size to your prescription. Then switch to your medication.”

He offers 3 strategies on how to swallow a pill:

Use a straw

The most well-known method is to take your pill with plenty of water: A well-lubricated throat helps the pill slide down more easily. But adding a straw to this method can make it easier. Sucking liquid through a straw triggers your natural swallowing reflex.

Start by taking a few sips of water to moisten your mouth.
Place the pill on your tongue near the back of your throat. Just be careful you don’t put it so far back that it causes a gag reflex.
Through a straw, drink a steady gulp of water and swallow the pill. Follow up with more water to encourage the pill to go down.

Tilt your head forward

For large capsules, a slight chin tuck (lowering your chin toward your chest) can help.

Place the capsule on your tongue.
Take a medium sip of water, but don’t swallow yet.
Tilt your chin toward your chest, then swallow the water and pill together.

“A common misconception is to tilt your head back when swallowing pills to help them go down easier,” says Mr. Harlor. “But instead, this opens up the airway and increases the risk of choking.”

Take it with food

Another helpful method is to swallow a pill in a spoonful of applesauce, yogurt or pudding, and follow up with a drink of water. The soft, creamy texture can help it go down easier. Just be sure to check the medication doesn’t need to be taken on an empty stomach.

Is it OK to crush or chew pills?

It depends, so never crush, chew or split pills in half unless your provider or pharmacist specifically says it’s safe. Some drugs are meant to be taken whole as a pill or tablet.

“Pills like extended-release, slow-release or delayed-release must stay intact to work correctly,” says Mr. Harlor. “Crushing these medicines can change the dose and their effectiveness, irritate your mouth or throat, or increase the risk of adverse reactions.”

What can I do if I’m still struggling to swallow a pill?

If none of these strategies work despite much practice, you can ask your pharmacist about alternatives. It may be possible to get your medicine in another form, such as a powder, liquid or dissolving tablet.

Also, don’t be afraid to bring it up to your provider. Ongoing problems could indicate an underlying emotional or physical issue, such as a health condition, anxiety or fear due to a previous bad experience. Your provider can offer personalized coaching or, if necessary, refer you to an ear, nose and throat physician and speech-language pathologist for further evaluation and swallowing therapy.

“We don’t want you to quit taking your medicine because you can’t swallow it,” says Mr. Harlor. “Consistently skipping doses can make your condition worse, if not dangerous. We’re here to help offer solutions to make sure you can take your medicine safely and confidently.”