What presentation of medicine is best for paediatric patients?
With so many different variations of medicine available in a range of formulations, it can be difficult to know which is the right choice for your patient. In this blog, we will be exploring medicines management for paediatric patients.
Why aren’t medicines commonly licensed for children?
It can be difficult for pharmaceutical companies to licence new products for paediatric patients as there is a requirement to do clinical trails involving children to assure safety, efficacy and quality of medicines for this group. This can sometimes prove difficult due to ethical, practical and commercial considerations, especially when the illness is rare in children. [1] [2] [3]
Research has found that children make up 25% of the global population. [4] Therefore, it has been recognised that more needs to be done to ensure new medicines are also licensed for children. Over time it is anticipated that availability will improve due to this. [5]
What are the impacts of this?
As most licensed oral medicines are intended for adults, they are presented in tablet or capsule form. Solid dose forms don’t provide the flexibility of dosing necessary for treating children due to the variability in dosing required through childhood. In addition, many children are unable to swallow tablets or capsules. [2]
Children’s bodies are different in size, but also physically and psychologically when compared to an adult, so they process medication differently. [6]
What are the most suitable medicine formats for paediatric patients
When selecting a medicine for a child, it is important to consider the child’s age, swallowing ability, ease of administration and accessibility of the product. It’s also useful to speak to the child’s parent or carer about the child’s preferences in terms of flavour and formulation. [7]
There is no established age at which children are able to swallow tablets and capsules, as it is a skill which must be learned. Oral liquid formats are the preferred formulation for younger children as they are easier to swallow and allow for more flexible dosing. [7]
Should you crush tablets for children?
We would strongly recommend against doing this. The NHS website states that you shouldn’t crush pills, open capsules or change medicine without getting medical advice. This could stop the medication working properly.[8]
Most tablets are not formulated to be palatable, therefore an unpleasant taste resulting from the crushed tablet may impact a child’s willingness to take the medicine. [7]
There are some types of medicines which should never be manipulated, these include modified release formulations. [7]
For more information on the problems with crushing tablets, visit our page:
Tablet Crushing Issues
How do you give a child medicine that refuses?
There are a few reasons that children may refuse medicine, including not understanding why they need to take it, not liking the taste, or having difficulty swallowing. Here are some techniques that we would recommend implementing in these scenarios [9]:
- Role play
It can help to make giving medicine as fun as possible. You could pretend to give medicine to a doll or teddy bear, which may then encourage the child. - Avoid taste buds
Most taste buds are at the back of the tongue. Administering medicine by putting the medicine inside the cheek can help to avoid them. For older children, a drink of icy cold water before taking the medicine can remove the taste. - Liquid medicine
Oral liquid medicine may be an alternative to tablets for paediatric patients, as it can be much easier to swallow. For more information on oral liquid medicine and children, visit our blog: The Benefits of Liquid Medicines for Paediatric Patients
ROS000059-010 DOP Sept 2023.
- Medicines for Children. Unlicensed medicines. Available at: https://www.medicinesforchildren.org.uk/advice-guides/general-advice-for-medicines/unlicensed-medicines/ Accessed Sept 2023.
- Nunn, A J. ‘Making medicines that children can take’, Licensing of medicines, National Library of Medicine, pp.369-371, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1719550/pdf/v088p00369.pdf. Accessed September 2023.
- Ferro A. Paediatric prescribing: why children are not small adults. Br J Clin Pharmacol. 2015 Mar;79(3):351-3. doi: 10.1111/bcp.12540. PMID: 25371355; PMCID: PMC4345945.
- Statista, Proportion of selected age groups of world population and in regions in 2022, 20/08/22, https://www.statista.com/statistics/265759/world-population-by-age-and-region/. Accessed September 2023.
- RCPCH.The use of unlicensed medicines or licensed medicines for unlicensed applications in paediatric practice. Available at: The use of unlicensed medicines or licensed medicines for unlicensed applications in paediatric practice | RCPCH. Accessed Sept 2023.
- Prescribing medicines for patients with dysphagia (A Handbook for Healthcare Professionals), edited by Prof. D.J Wright (2011)
- Smith L, Leggett C, Borg C. Administration of medicines to children: a practical guide. Aust Prescr. 2022 Dec;45(6):188-192. doi: 10.18773/austprescr.2022.067. Epub 2022 Nov 30. PMID: 36479324; PMCID: PMC9722353.
- NHS, ‘Problems swallowing pills’, 31/08/23, https://www.nhs.uk/conditions/problems-swallowing-pills/. Accessed September 2023
- Oxford University Hospitals NHS Trust, ‘Tips to help your child to take medicine’, https://www.ouh.nhs.uk/patient-guide/leaflets/files/11990Pmedicine.pdf. Accessed September 2023.
What presentation of medicine is best for paediatric patients?
With so many different variations of medicine available in a range of formulations, it can be difficult to know which is the right choice for your patient. In this blog, we will be exploring medicines management for paediatric patients.
Why aren’t medicines commonly licensed for children?
It can be difficult for pharmaceutical companies to licence new products for paediatric patients as there is a requirement to do clinical trails involving children to assure safety, efficacy and quality of medicines for this group. This can sometimes prove difficult due to ethical, practical and commercial considerations, especially when the illness is rare in children. [1] [2] [3]
Research has found that children make up 25% of the global population. [4] Therefore, it has been recognised that more needs to be done to ensure new medicines are also licensed for children. Over time it is anticipated that availability will improve due to this. [5]
What are the impacts of this?
As most licensed oral medicines are intended for adults, they are presented in tablet or capsule form. Solid dose forms don’t provide the flexibility of dosing necessary for treating children due to the variability in dosing required through childhood. In addition, many children are unable to swallow tablets or capsules. [2]
Children’s bodies are different in size, but also physically and psychologically when compared to an adult, so they process medication differently. [6]
What are the most suitable medicine formats for paediatric patients
When selecting a medicine for a child, it is important to consider the child’s age, swallowing ability, ease of administration and accessibility of the product. It’s also useful to speak to the child’s parent or carer about the child’s preferences in terms of flavour and formulation. [7]
There is no established age at which children are able to swallow tablets and capsules, as it is a skill which must be learned. Oral liquid formats are the preferred formulation for younger children as they are easier to swallow and allow for more flexible dosing. [7]
Should you crush tablets for children?
We would strongly recommend against doing this. The NHS website states that you shouldn’t crush pills, open capsules or change medicine without getting medical advice. This could stop the medication working properly.[8]
Most tablets are not formulated to be palatable, therefore an unpleasant taste resulting from the crushed tablet may impact a child’s willingness to take the medicine. [7]
There are some types of medicines which should never be manipulated, these include modified release formulations. [7]
For more information on the problems with crushing tablets, visit our page:
Tablet Crushing Issues
How do you give a child medicine that refuses?
There are a few reasons that children may refuse medicine, including not understanding why they need to take it, not liking the taste, or having difficulty swallowing. Here are some techniques that we would recommend implementing in these scenarios [9]:
- Role play
It can help to make giving medicine as fun as possible. You could pretend to give medicine to a doll or teddy bear, which may then encourage the child. - Avoid taste buds
Most taste buds are at the back of the tongue. Administering medicine by putting the medicine inside the cheek can help to avoid them. For older children, a drink of icy cold water before taking the medicine can remove the taste. - Liquid medicine
Oral liquid medicine may be an alternative to tablets for paediatric patients, as it can be much easier to swallow. For more information on oral liquid medicine and children, visit our blog: The Benefits of Liquid Medicines for Paediatric Patients
ROS000059-010 DOP Sept 2023.
The Link Between Alzheimer’s Disease and Dysphagia
Dysphagia and Alzheimer’s disease are often linked.[1]
Rosemont is dedicated to providing healthcare professionals with accurate information to aid in the management of patients with these conditions.
What is dysphagia?
Dysphagia refers to a difficulty with swallowing. People with dysphagia can find it hard to swallow certain foods and liquids or cannot swallow at all. Indications that a patient may be experiencing dysphagia include coughing or choking whilst eating, regurgitating food and weight loss. [2]. For our full list of symptoms, visit our webpage: Swallowing Difficulties Symptoms
Does Alzheimer’s disease cause dysphagia?
Alzheimer’s disease is the most common cause of dementia in older people, affecting memory and cognitive abilities. The high prevalence of dysphagia among patients with dementia is a result of the neurological changes caused by the disease. The prevalence of dysphagia in moderate to severe Alzheimer’s patients is estimated to be between 84-93%. [1]
What happens when Alzheimer’s disease patients can’t swallow?
As Alzheimer’s disease progresses to the later stages, dysphagia may manifest. Without appropriate interventions, this can lead to unintended weight loss, dehydration, and malnutrition. [3] Read on to learn more about how to provide support to individuals experiencing Alzheimer’s disease and dysphagia.
How do you help someone with Alzheimer’s disease?
People with Alzheimer’s may need some assistance with eating and drinking. You can help them by following these steps:
- Simplify meals. Always cut food into small pieces and encourage patients to sip from a cup, rather than drinking through a straw or taking large gulps. Serve soft foods or blend dishes.[4]
- Be patient. Never hurry the patient. Encourage them to take their time and make sure they swallow each mouthful before taking another bite. [4] Additionally, maintain mealtime as a distraction-free environment, for example, avoiding television or music. [5]
- Choose the right time. Ensure that your patient is always sitting upright, including up to 20 minutes after eating. [4] You should serve food when they are most rested, which may mean they need to rest 30 minutes before eating. [5]
- Keep good oral hygiene. Encourage your patients (or their carers) to clean their teeth twice a day and recommend that they visit the dentist regularly. [4] Painful teeth or dentures can make it difficult to chew, affecting swallowing. [5]
Rosemont offers a range of oral liquid medications that might present a more manageable alternative to solid-dose medications for patients experiencing dysphagia and dementia.
ROS000036-010 DOP Aug 2023
- Mira A, Gonçalves R, Rodrigues IT. Dysphagia in Alzheimer’s disease: a systematic review. Dement Neuropsychol. 2022 Jul-Sep;16(3):261-269. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762388. Accessed August 2025.
- NHS Inform. Dysphagia (swallowing problems) Available at: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/dysphagia-swallowing-problems/ Accessed Aug 2025.
- Alzheimer’s Society, ‘How physical and sensory difficulties can affect eating’, https://www.alzheimers.org.uk/get-support/daily-living/eating-physical-sensory-difficulties Accessed Aug 2025.
- National Institute on Aging, ‘Caring for a Person With Late-Stage Alzheimer’s Disease’, 27/05/2021, https://www.nia.nih.gov/health/caring-late-stage-alzheimers-disease Accessed Aug 2025.
- WebMD, ‘Chewing and Swallowing Problems From Alzheimer’s’, 27/11/2022, https://www.webmd.com/alzheimers/chewing-swallowing-problems Accessed Aug 2025.
The Benefits of Liquid Medicines for Paediatric Patients
Are you caring for a patient who is an infant, child, adolescent or young adult? In this blog, we will be discussing the benefits of liquid medicines for paediatric patients with dysphagia.
How do you give a child liquid medicines?
Before administering a medicine it is important to fully read the patient information leaflet which accompanies the medicine. If you have any questions following this, refer these to your healthcare professional. Please use the measuring device provided with the medicine or by your Pharmacist as this is the most appropriate option for the medicine the patient has been prescribed.
For small children, an oral syringe is often the best option. When using an oral syringe, follow these steps:
- Wash your hands and ensure the child is sitting upright
- Shake the bottle unless otherwise stated
- Remove the top from the bottle and insert the bottle adapter if necessary.
- Insert the top of the oral syringe into the bottle adapter.
- Turn the bottle upside down and pull the plunger until the medicine reaches the volume required.
- Gently remove the oral syringe from the bottle adapter.
- Put the top back on the bottle.
- Once the liquid is in the oral syringe, put the tip of the syringe inside the child’s mouth, between the gums and the inside surface of the cheek
- Squirt a small amount into the side of the child’s mouth and allow them to swallow, before administering more medicine
- Give the child a drink to wash down the medicine
- Wash the syringe with warm, soapy water and leave to dry away from heat and sunlight
Another option is to administer the medicine using a cup or spoon. This may be suitable for older children. To do this, you must:
- Wash your hands and ensure the child is sitting upright
- Shake the bottle unless stated otherwise on the label.
- Carefully pour the medicine into the medicine cup or medicine spoon according to the dose on the label.
- Give the dose to your child
- Give the child a drink to wash down the medicine
- Wash the cup or spoon in warm, soapy water and leave to dry away from heat and sunlight
What are the benefits of liquid medicines?
Easy to swallow
There is a concern at what age children can safely swallow tablets and capsules, it is generally thought to be around 6 years old [2]. An oral liquid medicine may be an easier to swallow option and therefore a more appropriate option for younger patients. [3]
Palatable
Rosemont’s oral liquid medicines are designed to palatable to ensure acceptability, aiding adherence to medication regimes[3].
The most appropriate dose is received
A liquid medicine allows prescribed doses to be much more flexible, ensuring the dose is age appropriate. Dose titration also allows for identification of effective dosages for an individual, based on patient response. [4]
For more information on liquid medicines for paediatric patients, visit this page: Children’s Medicine.
ROS000027-011 DOP May 2023
- Great Ormond Street Hospital for Children NHS, ‘How to give your child liquid medicines’, 04/2020, https://www.gosh.nhs.uk/conditions-and-treatments/medicines-information/how-give-your-child-liquid-medicines/. Accessed May 2023.
- EMA CHMP Reflection Paper: Formulation of choice for the paediatric population (2006) Available at https://www.ema.europa.eu/en/documents/scientific-guideline/reflection-paper-formulations-choice-paediatric-population_en.pdf Accessed July 2023.
- EMA CHMP & PDCO Guideline on pharmaceutical development of medicines for paediatric use (2013). Available at: https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-pharmaceutical-development-medicines-paediatric-use_en.pdf Accessed July 2023.
- Schuck RN, Pacanowski M, Kim S, Madabushi R, Zineh I. Use of Titration as a Therapeutic Individualization Strategy: An Analysis of Food and Drug Administration-Approved Drugs. Clin Transl Sci. 2019 May;12(3):236-239. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510374/ Accessed June 2023
What presentation of medicine is best for paediatric patients?
With so many different variations of medicine available in a range of formulations, it can be difficult to know which is the right choice for your patient. In this blog, we will be exploring medicines management for paediatric patients.
Why aren’t medicines commonly licensed for children?
It can be difficult for pharmaceutical companies to licence new products for paediatric patients as there is a requirement to do clinical trails involving children to assure safety, efficacy and quality of medicines for this group. This can sometimes prove difficult due to ethical, practical and commercial considerations, especially when the illness is rare in children. [1] [2] [3]
Research has found that children make up 25% of the global population. [4] Therefore, it has been recognised that more needs to be done to ensure new medicines are also licensed for children. Over time it is anticipated that availability will improve due to this. [5]
What are the impacts of this?
As most licensed oral medicines are intended for adults, they are presented in tablet or capsule form. Solid dose forms don’t provide the flexibility of dosing necessary for treating children due to the variability in dosing required through childhood. In addition, many children are unable to swallow tablets or capsules. [2]
Children’s bodies are different in size, but also physically and psychologically when compared to an adult, so they process medication differently. [6]
What are the most suitable medicine formats for paediatric patients
When selecting a medicine for a child, it is important to consider the child’s age, swallowing ability, ease of administration and accessibility of the product. It’s also useful to speak to the child’s parent or carer about the child’s preferences in terms of flavour and formulation. [7]
There is no established age at which children are able to swallow tablets and capsules, as it is a skill which must be learned. Oral liquid formats are the preferred formulation for younger children as they are easier to swallow and allow for more flexible dosing. [7]
Should you crush tablets for children?
We would strongly recommend against doing this. The NHS website states that you shouldn’t crush pills, open capsules or change medicine without getting medical advice. This could stop the medication working properly.[8]
Most tablets are not formulated to be palatable, therefore an unpleasant taste resulting from the crushed tablet may impact a child’s willingness to take the medicine. [7]
There are some types of medicines which should never be manipulated, these include modified release formulations. [7]
For more information on the problems with crushing tablets, visit our page:
Tablet Crushing Issues
How do you give a child medicine that refuses?
There are a few reasons that children may refuse medicine, including not understanding why they need to take it, not liking the taste, or having difficulty swallowing. Here are some techniques that we would recommend implementing in these scenarios [9]:
- Role play
It can help to make giving medicine as fun as possible. You could pretend to give medicine to a doll or teddy bear, which may then encourage the child. - Avoid taste buds
Most taste buds are at the back of the tongue. Administering medicine by putting the medicine inside the cheek can help to avoid them. For older children, a drink of icy cold water before taking the medicine can remove the taste. - Liquid medicine
Oral liquid medicine may be an alternative to tablets for paediatric patients, as it can be much easier to swallow. For more information on oral liquid medicine and children, visit our blog: The Benefits of Liquid Medicines for Paediatric Patients
ROS000059-010 DOP Sept 2023.
What presentation of medicine is best for paediatric patients?
With so many different variations of medicine available in a range of formulations, it can be difficult to know which is the right choice for your patient. In this blog, we will be exploring medicines management for paediatric patients.
Why aren’t medicines commonly licensed for children?
It can be difficult for pharmaceutical companies to licence new products for paediatric patients as there is a requirement to do clinical trails involving children to assure safety, efficacy and quality of medicines for this group. This can sometimes prove difficult due to ethical, practical and commercial considerations, especially when the illness is rare in children. [1] [2] [3]
Research has found that children make up 25% of the global population. [4] Therefore, it has been recognised that more needs to be done to ensure new medicines are also licensed for children. Over time it is anticipated that availability will improve due to this. [5]
What are the impacts of this?
As most licensed oral medicines are intended for adults, they are presented in tablet or capsule form. Solid dose forms don’t provide the flexibility of dosing necessary for treating children due to the variability in dosing required through childhood. In addition, many children are unable to swallow tablets or capsules. [2]
Children’s bodies are different in size, but also physically and psychologically when compared to an adult, so they process medication differently. [6]
What are the most suitable medicine formats for paediatric patients
When selecting a medicine for a child, it is important to consider the child’s age, swallowing ability, ease of administration and accessibility of the product. It’s also useful to speak to the child’s parent or carer about the child’s preferences in terms of flavour and formulation. [7]
There is no established age at which children are able to swallow tablets and capsules, as it is a skill which must be learned. Oral liquid formats are the preferred formulation for younger children as they are easier to swallow and allow for more flexible dosing. [7]
Should you crush tablets for children?
We would strongly recommend against doing this. The NHS website states that you shouldn’t crush pills, open capsules or change medicine without getting medical advice. This could stop the medication working properly.[8]
Most tablets are not formulated to be palatable, therefore an unpleasant taste resulting from the crushed tablet may impact a child’s willingness to take the medicine. [7]
There are some types of medicines which should never be manipulated, these include modified release formulations. [7]
For more information on the problems with crushing tablets, visit our page:
Tablet Crushing Issues
How do you give a child medicine that refuses?
There are a few reasons that children may refuse medicine, including not understanding why they need to take it, not liking the taste, or having difficulty swallowing. Here are some techniques that we would recommend implementing in these scenarios [9]:
- Role play
It can help to make giving medicine as fun as possible. You could pretend to give medicine to a doll or teddy bear, which may then encourage the child. - Avoid taste buds
Most taste buds are at the back of the tongue. Administering medicine by putting the medicine inside the cheek can help to avoid them. For older children, a drink of icy cold water before taking the medicine can remove the taste. - Liquid medicine
Oral liquid medicine may be an alternative to tablets for paediatric patients, as it can be much easier to swallow. For more information on oral liquid medicine and children, visit our blog: The Benefits of Liquid Medicines for Paediatric Patients
ROS000059-010 DOP Sept 2023.