Algorithm for the medication management of adults with swallowing difficulties:
- Before prescribing or administering a medication, always check that the patient is able to swallow the prescribed format.
- Before crushing tablets or opening capsules (or recommending this practice), always check that the drug is licensed to be administered in this way. Check the Product data sheet or phone the manufacturer of the drug to obtain this information. Unless it is specifically licensed to be crushed or opened never undertake or recommend this practice.
- Prescribe or ask for a prescription for a suitable liquid alternative which the patient may find easier to swallow. Almost all solid medications are available as liquids. For more information about liquid medicines, ask a pharmacist, the local Medicines Information Centre or refer to the British National Formulary (BNF) for a comprehensive list of liquids.
- If the patient has problems swallowing a liquid medicine, consider alternative routes of administration for example transdermal, buccal, rectal or parenteral.