How to Take Oral Medications Properly

The most common way people take medications is orally (by mouth). Depending on what your physician prescribed, your oral medication can be swallowed, chewed, or placed under your tongue to dissolve.

Medications that you swallow travel from your stomach or intestine into your bloodstream and then are carried to all parts of your body. This process is known as absorption. The speed with which absorption occurs depends on several factors:

• The type of medication you are taking (e.g., liquid or tablet)
• Whether you take your medication with food, after food or on an empty stomach
• The ability of your medication to pass into your bloodstream. Some medications have a special coating and dissolve slowly in your stomach
• How your medication reacts with the acid conditions in your stomach
• Whether your medication interacts with other medications you are taking at the same time

If a quick effect is desired, your physician may prescribe a medication that will dissolve in your mouth and rapidly enter your bloodstream.

In general, you should take tablets and capsules with water. For example, taking certain pills, such as Lipitor (atorvastatin) and Viagra (sildenafil), with grapefruit juice can cause potentially dangerous side effects. Additionally, milk can block the absorption of some antibiotics, such as Cipro (ciprofloxacin).

Your health care provider or pharmacist will tell you whether you should take your medication on an empty stomach or before or after eating. This information is very important because food in your stomach and intestine can interfere with your medication dissolving and pass into your bloodstream. Make sure to follow the directions on your prescription very carefully.

If you have trouble swallowing your medication, tell your physician and pharmacist. They may be able to provide you with a liquid form of the medication or a pill that is smaller and easier to swallow.

Liquid medications are good for children and adults (especially older adults) who are not able to swallow tablets or capsules. Many liquid medications, including both prescription drugs and over-the-counter drugs, are made for children and are flavored to mask the taste of the medication.

Before measuring the proper dose of liquid medication, make sure to shake the bottle as some of the medication may have “settled” at the bottom.

Most often, you will be told to measure the medication using a teaspoon (please remember that teaspoons are smaller than tablespoons). To a physician and pharmacist, a teaspoon means 5 milliliters (ml) of medication. Many household teaspoons are different sizes and hold more or less than 5 ml. Therefore, you might get too much or too little medication on your spoon.

Measure your liquid medication carefully. Ask your pharmacist for a spoon, medicine cup, medicine dropper, or a syringe without a needle meant specifically for measuring medications. Your pharmacist can show you how to properly use these. Many over-the-counter liquid medications come with a small medicine cup attached to the top of the bottle.

Certain medications are placed under the tongue (sublingual) or between the teeth and the cheek (buccal). These medications are absorbed quickly into the bloodstream through the lining of the mouth and are used to relieve symptoms almost immediately.

Some examples of sublingual medications are Nitrostat and other nitroglycerin preparations used to treat angina (chest pain) and Suboxone (buprenorphine with naloxone), which is used to treat heroin dependence and narcotic painkillers.

Although most oral medications are swallowed, some are released in the mouth by chewing, dissolving slowly or melting on the tongue. Many of these medications are sold over-the-counter.

• Chewable tablets should be chewed until they have completely dissolved. Chewable tablets are not meant to be swallowed. Examples of chewable tablets include Tylenol Chewable and many brands of children’s vitamins.
• Chewing gum medications have a minimum time that they must be chewed to assure that the entire amount of drug has been released, often up to 30 minutes. Examples of medicated chewing gums include Nicorette Gum (nicotine) and Aspergum (aspirin).
• Lozenges are meant to be “sucked” on like hard candy and allowed to dissolve slowly in your mouth. They should not be swallowed. Examples of medicated lozenges include Commit (nicotine) and Cepacol (benzocaine).
• Softchew medications are meant to melt in your mouth or to be chewed. Examples of Softchew medications are Triaminic Softchew Cold and Allergy Medication (chlorpheniramine and pseudoephedrine) and Rolaids Soft Chew (calcium carbonate).

Swallowing pills can be an unpleasant and uncomfortable experience for some. If you have difficulty swallowing pills, there are things that you can do to facilitate this process. For example, German researchers found success with the following technique called the "pop bottle method." This technique was tested with tablets.

1. Open a bottle of water or soda bottle filled with water.
2. Place the tablet on your tongue and close your mouth around the opening of the bottle.
3. Tilt your head back and keep your mouth sealed in the water bottle. Don't let any air into your mouth. Suck the water into your mouth and swallow the tablet and water.

Please note that this intervention has not been tested extensively, and, if interested, you should discuss this technique with your physician before you try it. Furthermore, if you have difficulty swallowing in general, you should probably be evaluated by your physician for dysphagia.

On a final note, always read the instructions carefully and take your medications as recommended. If you have any doubts or concerns, contact your physician or pharmacist.