Difficulty Swallowing Pills?
Don’t crush or split without asking. There may be a better form.
Difficulty swallowing pills is common in adults. Crushing, splitting or opening them can change how a medicine works, sometimes dangerously. Here is how to check, what alternatives exist, and when to see a doctor.
Prefer to speak with us first? Call (647) 348-2323
- Never crush
- Extended-release, enteric-coated and some other medicines unless a pharmacist says it is safe.
- Alternatives
- Liquids, dispersible or chewable tablets, patches, creams or other forms where suitable.
- See a doctor
- Choking, coughing with meals, food sticking, or weight loss.
Why swallowing pills can be hard
Difficulty swallowing, called dysphagia, has many causes. They include a dry mouth from medications or conditions, throat or oesophageal problems, stroke and other neurological conditions, and anxiety. Pills can feel large, stick in the throat, or cause gagging. Some people avoid taking medicine because of it, which can undermine treatment.
If swallowing is a new problem, or it is worsening, or accompanied by coughing, choking, hoarseness or weight loss, please see a doctor. It may need assessment, and a speech-language pathologist (Speech-Language & Audiology Canada) can help with safe swallowing techniques.
Do not crush, split or open extended-release (often “ER”, “XL”, “SR” or “CR”) or enteric-coated tablets or capsules without checking. Crushing can release the whole dose at once, which may be dangerous, or can destroy the medicine. Some medicines are also hazardous to handle when crushed.
Simple tips to try first
- Sit upright and take a sip of water before the pill to moisten your mouth and throat.
- Tilt your head slightly forward, not back, for most tablets. For capsules, some people find tilting slightly back helps.
- Take one pill at a time with plenty of water, unless your pharmacist says otherwise.
- Ask whether your tablet is allowed to be taken with food, applesauce or yogurt, since some are not.
- Ask whether the tablet is small enough to be split on the score line, or whether a smaller strength exists.
Alternatives your pharmacist and prescriber can explore
Depending on the medicine, other options may exist: an oral liquid or suspension, a dispersible or chewable tablet, a different capsule size, a patch, a cream, or a different drug in the same class that comes in an easier form. Switching needs a prescriber’s agreement, since doses and absorption differ.
When no commercial option exists, a prescriber can ask for a compounded oral liquid or other form. We prepare these in our Level C compounding room, often with flavouring to improve taste, and can leave out specific ingredients you need to avoid. Liquids usually have a shorter shelf life than tablets and may need to be refrigerated; we write the storage instructions and discard date clearly on the label. Compounded preparations have not been evaluated by Health Canada in the same way as approved products, and not every medicine can be made as a stable liquid. See our pediatric compounding page for the kinds of flavoured liquids we prepare.
What to ask your pharmacist
- Can this tablet be crushed, split or opened? What happens if it is?
- Is there a liquid, chewable or dispersible form of this medicine?
- Can I take it with food or a drink, and which ones?
- Can the dose be given as fewer or smaller pills?
- Does my caregiver need to know anything about handling it?
Bring your full medication list. A pharmacist can often spot a simpler way to arrange your doses.
Related Compounding Services
These pages explain related services we offer.
How It Works
Start with your prescriber
Your prescriber can fax (647) 351-2323 or send an e-prescription. You can also text a photo of your prescription to (647) 348-2323, or tap Request.
We review and prepare
A pharmacist reviews the prescription, confirms cost and coverage with you, then prepares it. Questions go to your prescriber, not to guesswork.
Free delivery or pickup
Most compounds are ready within 24–48 hours. Pick up at 2240 Lake Shore Blvd W #107 or get free delivery across the GTA.
Questions about difficulty swallowing pills? Talk to a pharmacist
Our pharmacists can answer questions about difficulty swallowing pills, review your current medications and coordinate with your prescriber.
Call (647) 348-2323, text a photo of your prescription, or start a request, and we will help you understand your options for difficulty swallowing pills.
Difficulty Swallowing Pills FAQ
Can I crush my pills?
Only if a pharmacist confirms it is safe for your medicine. Extended-release and enteric-coated products should not be crushed.
Is there a liquid version of my medicine?
Some medicines have a commercial liquid. For others, a prescriber can ask for a compounded liquid if it can be made stable.
Why do liquids have a shorter shelf life?
Medicines are generally less stable in liquid form, so they may need refrigeration and a shorter discard date. We write this on the label.
Can you make it taste better?
Often. We can add flavour to compounded liquids, and we can leave out ingredients you need to avoid.
When should I see a doctor?
If you cough or choke when eating or drinking, food sticks, you lose weight, or swallowing is getting worse.
Do you help caregivers?
Yes. Bring the medication list and we will explain safe handling and options.
Is it covered by insurance?
Some private plans cover some compounded prescriptions. We check first and give a cost estimate.
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2240 Lake Shore Blvd W #107, Etobicoke, ON M8V 0B1
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