Aren't they all bitter pills?

November 11, 2014 8:33 PM

Do you hate swallowing pills? Let NPR's Nina Totenberg show you how using animated GIFs. A new study shows that the pop bottle technique for tablets and the lean forward method for capsules improve pill swallowing for 60% of people who use the pop bottle and 90% of people who lean forward. For kids, there are extensive resources that teach them how to swallow pills. Why swallowing pills is hard is a subject of study, and is a big deal, since it causes around 40% of people to delay, skip, or avoid taking medicine.
posted by blahblahblah (69 comments total)

Mom taught me to tilt my head forward for capsules and tilt my head back back for non-capsules/tablets when I was taking daily meds on the way to elementary school and having a hard time with some of them. Probably the first lifehack I can recall being exposed to...

I should use that for my autobiography title: Learning How to Pop Pills with Mom
posted by RolandOfEld at 8:44 PM on November 11, 2014 [3 favorites]

I think I must have sorted out the lean forward thing by accident. I figured out that it seemed like much less weird mental pressure to just drop the pill right behind my bottom teeth and then drown everything with some water. Tasting the pill's usually the worst part for me, and that seems to keep the worst of it away.
posted by lauranesson at 8:45 PM on November 11, 2014 [1 favorite]

I always found that thinking of something super salty (like pretzels) makes my mouth water with saliva, and dropping the tablet as far back as I can without choking on it before taking a swig of water helps it drop right down. The extra spit was so it didn't stick to my tongue on the way down and go haywire.
posted by msbutah at 8:48 PM on November 11, 2014

I had horrible trouble swallowing pills as a kid, and my mother eventually bribed me to learn with Smarties (that would be the little Canadian chocolates) when having various medications made up as suspensions became prohibitively expensive. For every smartie I managed to swallow whole, I got 10 smarties to eat.
posted by jacquilynne at 8:48 PM on November 11, 2014 [2 favorites]

I swallow most of my pills dry and then go get a glass of water. I just never had a problem taking pills. Sometimes if I don't swallow fast enough I do get a bitter taste, but that is just an incentive to go faster. With a large pill like a vitamin, for some reason, I size it up between my molars, then away it goes.

The head forward technique for use with capsules makes sense if the capsules do float. The pop bottle one seems like just place pill on tongue and drink water from a water bottle. Isn't that the way you are supposed to do it anyway?
posted by 724A at 8:49 PM on November 11, 2014

I just fill my mouth with water, pop the pill in, and swallow normally. Done that ever since I was a little kid.
posted by zsazsa at 8:50 PM on November 11, 2014 [11 favorites]

Isn't that the way you are supposed to do it anyway?

Probably just having a name to call the thing you're supposed to do anyway makes it easier. I'm not just eating, this is the patented mastication and gastroflexive technique. It's OK to be jealous.
posted by angerbot at 8:52 PM on November 11, 2014

Take a sip or 2 of water 1st, to lubricate your esophagus. Follow with more water; it's possible for a pill to lodge in your esophagus and cause quite a bit of trouble.
posted by theora55 at 8:56 PM on November 11, 2014

I guess I take pills intuitively, but if that many people struggle with it you'd have thought we'd have pill pockets for humans or something by now.
posted by Dip Flash at 8:58 PM on November 11, 2014 [4 favorites]

In cats at least, dry-pilling can lead to erosive esophagitis.
posted by Lexica at 9:11 PM on November 11, 2014 [2 favorites]

I don't typically have a hard time swallowing vitamins/capsules, but bad-tasting pills like antibiotics or prednisone or such? I used to dread those as I'd either not swallow fast enough and get the dreaded bad taste or I'd try to swallow too fast to try to avoid the taste and it'd get caught weirdly in my throat and fragment and then there'd be an even more horrible flavor and sensation explosion and ugh ugh ugh.

Then I realized my dogs won't take pills unless they're in cheese or peanut butter or something because they are wise. So I started just barely coating pills that will taste bad in a thin layer of peanut butter. Totally works for humans, too. NEVER LOOKING BACK.
posted by vegartanipla at 9:19 PM on November 11, 2014 [12 favorites]

I have recently stopped dry swallowing my pills due to weird looks for my significant other. I am debating whether switching to beer as a primary liquid for them is a good or bad thing. (Honestly, I have to stop and think to prevent myself from just dry swallowing a pill. Very occasionally they stick in my throat, but it's work of a second to get a glass of water then.)
posted by Hactar at 9:22 PM on November 11, 2014

Aw, man, I didn't used to have problems taking pills, and then I got an ibuprofen stuck halfway down for long enough to cause several days of inflamed esophagus. Now I have an (entirely psychosomatic) inability to swallow the freaking things and have to take them with a mouthful of food (take-without-food instructions be damned). Never had an issue with the taste of pills though; give me a weird-tasting antibiotic any day over a fruity flavored cough suppressant, from a flavor perspective.
posted by Blue Jello Elf at 9:23 PM on November 11, 2014

I don't remember taking pills as a kid, but I must have taken some, because I can recall asking a kid who was taking an aspirin at school how he could stand that terrible taste, and I haven't taken an aspirin from that day to this.

But I liked chewing ice, and sitting around one summer afternoon between 5th and 6th grades with a glass of ice cubes about an inch and a half on a side from our freezer, I found myself wondering what it would be like to swallow one without chewing it first.

Ow.
posted by jamjam at 9:23 PM on November 11, 2014

Don't use winter-cold tap water or refrigerator water. If the water's too cold, it can freeze up your swallowing muscles just enough to mess you up.
posted by serena15221 at 9:25 PM on November 11, 2014

Now I have an (entirely psychosomatic) inability to swallow the freaking things...give me a weird-tasting antibiotic any day over a fruity flavored cough suppressant, from a flavor perspective

Now that I've written this down, it sounds like an O'Henry story: caught between the acceptably-flavored pills I can't bear to swallow and the easily-swallowable suspension I can't bear to taste!
posted by Blue Jello Elf at 9:26 PM on November 11, 2014 [3 favorites]

I found myself wondering what it would be like to swallow one without chewing it first.

As a kid I found myself wondering what it would be like to tie a string onto a peanut and swallow the peanut. After pulling it back up from the depth of an inch or two, the peanut suddenly just went all the way down, seemed like about a foot or more. I couldn't pull it back out, so I just wadded up the other end of the string and swallowed that too.
posted by StickyCarpet at 9:34 PM on November 11, 2014 [9 favorites]

Sucking water through a straw can make it easier, especially with children who may not understand the pill swallowing otherwise. You create a vacuum by sucking and have your head tilted forward (so the esophagus doesn't constrict), and down it goes when you swallow. I straw swallowed my gigantic horse vitamins for pregnant ladies or else I choked on them.

I have a terrible time with tablets, especially if they're cylinders (like regular Tylenol) rather than tapered (like Advil). Did you know you can only buy regular strength Tylenol in tablets, not caplets? And you can't have the extra strength caplets when pregnant ...

(The secret is to buy children's chewable, but you don't learn that until after the pregnancy is over!)
posted by Eyebrows McGee at 9:36 PM on November 11, 2014 [2 favorites]

As a kid I found myself wondering what it would be like to tie a string onto a peanut and swallow the peanut. After pulling it back up from the depth of an inch or two, the peanut suddenly just went all the way down, seemed like about a foot or more. I couldn't pull it back out, so I just wadded up the other end of the string and swallowed that too.

I refuse to google for it, but the story I read many years ago of the determined fellow who incremented a roll of floss through himself in order to full-body-floss made an impression on me.
posted by Dip Flash at 9:38 PM on November 11, 2014 [2 favorites]

It's amazing just watching the gifs. They swallow pill after pill after pill after pill. I'm mesmerized.
posted by mochapickle at 9:50 PM on November 11, 2014

people always freak out when i dry swallow 6-8 lactaid at once but that kind of shock and horror is really good prep for what they will be forced to behold when whatever it is i am preparing to hungrily devour arrives at the table.
posted by poffin boffin at 10:04 PM on November 11, 2014 [5 favorites]

Once while hospitalized I flushed an anti-biotic pill down the toilet. For reasons, I was having an extra hard time swallowing pills and I'd been taking so many horrible and unpleasant pills while there (here, we crushed up this iron supplement for you but the easy-swallow skin of the pill doesn't really crush so we'll just leave hunks of that in there. Oh yeah, and pretty much as soon as it's removed from the bottle the pill is going to start smelling like something burning and it's going to taste like something burnt, and that little non-crushed pill skin will hold it against your tongue no matter what you do. UGH! I actually cried when, after days of this torture, a nurse asked me if maybe I would prefer a liquid iron supplement. THere's a liquid?!? WTF did they put me through that for?)

Anyway, I digress bitterly. The point is that I was feeling completely powerless and angry and in a moment of childish, tantrum-y rebellion, I flushed the pill. Taking pills was horrible and I just didn't feel like I could do it that day, with that pill. And that flushed pill has weighed on my conscience ever since. I keep thinking "what if I caused a resistant bacterium to evolve?" and of course I would never know if I did.

The one positive of that experience is that now I understand medical non-compliance in a way I didn't before. It's (or at least can be sometimes) a you're-not-the-boss-of-me cry of the powerless who are tired of being told to do unpleasant things for their own good.

Anyway, not that these would have helped me then, but I still hate taking pills and maybe now I'll find it easier. Thanks.
posted by If only I had a penguin... at 10:21 PM on November 11, 2014 [6 favorites]

I take a lot of pills every day -- every night, actually, and some in the morning -- and some of them are formulated as time release, and have to go down whole. But I take four other PM medications, too, and just for the hell of it I chew them to grit, then toss the no-chew pills into my mouth and swallow the whole mess/mass with a big swallow of water. Another day done.

Aspirin -- I take half an aspirin every 24 hours, keep the blood slippery, cheap heart attack prevention -- let me tell you, aspirin totally tastes like shit. So does ambien -- jesus christ. Klonopin, on the other hand, I love the shit, it tastes like mints -- you'd not do well to leave them around if you've got any little kids about. It's not minty enough to overcome the other garbage I've chewed up but hey, take what you can get, right? Oh, and alieve -- I do not know what dog-shit tastes like, but I have my suspicions, after chewing this garbage up, time to time. Man.

My morning batch o' stuff is swallowed whole, except for that big honkin' multivitamin, which used to be attempted to be swallowed whole, but often balked, no matter what trick I tried; it'd get caught in my throat at least once a week. Then last year I thought "Hey, it can't be worse than the unhappy-fest of my night-time proclivities" and I chewed the thing up, and it's not bad at all. Not something you'd sprinkle over cookies or whatever, but compared to my night-time lunacy it's a dance with a beautiful woman.

I don't have any idea why I started to chew the stuff up; I do like to suffer (I mean, I enjoy reading AskMe relationship questions, and sometimes answering them, that's a clue right there, wouldn't you think?) and it's just turned into a habit; some people do sit-ups every morning, I chew that nasty garbage every night. So who knows why it started, but I damn sure do remember being happy noting the face that this amazingly loving therapist pulled when I told her about it, ten years ago or maybe twelve, she was all frowny and shocky looking, bordering distaste maybe, and she asked me about it, and it made me happy. Same thing with my oldest sister -- all frowny, head shaking, etc. (I'm used to that with my sister, and she's used to it with me, I'm lucky she loves me, she'd clout me with a pan otherwise, or a shoe, whatever.) Same thing when I told my current shrink, who loves me as much as that therapist did but wonders wtf sometimes, I'm sure of it -- wouldn't you? I sure do. Anyways, it's not like I started doing it for frowns/shock, but it does make it fun. Or something.
posted by dancestoblue at 10:25 PM on November 11, 2014 [1 favorite]

DancesToBlue: Have you tried baby aspirin? Baby aspirin is delicious! Not low-dose aspirin for adults, but the actual little orange chewable pills for kids. They're hard to find these days and I think most places you have to ask the pharmacist for them so the pharmacist can warn you about reye's syndrome. Anyway, these are so delicious that when I was a kid I would like about having a headache so my mom would give them to me. Seriously. Delicious. Candy. Yum.

Man, I wish I had some baby aspirin.
posted by If only I had a penguin... at 10:29 PM on November 11, 2014

Am i the only one who just, you know, puts it in my mouth and swallows?
posted by cmoj at 10:31 PM on November 11, 2014 [2 favorites]

>>
Same here. It's not bad at all if you place the pill at the back of your tongue.
posted by ana scoot at 12:24 AM on November 12, 2014

I've been sick lately, & have been through several rounds of these ridiculously large antibiotics. I really wish they'd make them smaller & have you take two, because even if you chop them in half, it's still choking me every time I have to take. A couple of times I've straight up choked, & gone in to panic mode, pouring water in my throat to melt them, making me dread taking these. I've never had problems w/ other pills, but these antibiotics seem to be absurdly large.
posted by broken wheelchair at 12:28 AM on November 12, 2014

BJE, do you chew your bite of food and then throw the pill into your mouth right before you swallow? This is the only way I could get pills to go down as a kid/teen and now it's kind of like making bunny loops to tie my shoelaces -- I've just been doing it weird/wrong so long that I don't see any need to change. It did ruin dried apricots for me though because one winter of foul-tasting antibiotics, I exclusively used dried apricots as the pill-priming mouthful. Come to think of it, applesauce was ruined for me because my parents would "hide" ground up medication in a spoonful of applesauce. I CAN SEE THE WHITE POWDER AND APPLE SAUCE ISN'T A STRONG ENOUGH FLAVOR TO COVER IT UP.

A spoonful of peanut butter + sriracha would have been much more effective.
posted by spamandkimchi at 12:53 AM on November 12, 2014 [2 favorites]

I've never swallowed a pill in my life - and no amount of bribery or help will fix that. I chew pills before I swallow - and let me tell you, paracetemol tastes bloody horrible!
posted by salmacis at 1:19 AM on November 12, 2014

At some point I learned to put some water in my mouth, put the pill in the water, and then drink more water and swallow everything. I think it started with some giant decongestant pills at some point in my teens.

Today, I cannot take pills dry- I take daily allergy meds (thankfully no more bc-- yay IUDs). I discovered that if I don't have water but do have yogurt that pill-inside-yogurt also works. (Assuming the med isn't a don't-take-with-dairy type).
posted by nat at 1:46 AM on November 12, 2014

I've never swallowed a pill in my life - and no amount of bribery or help will fix that. I chew pills before I swallow - and let me tell you, paracetemol tastes bloody horrible!
posted by salmacis at 1:19 AM on November 12
I had to check wikipedia to find out that what you're calling paracetemol is acetaminophen aka tylonol and you bet, it tastes really bad. Voice of experience. And after my long screed above, I got to thinking what other pills I'd chewed, remembered back, lo those long years gone by, 1981, my faded youth, driving around Houston eating percodans, but it wasn't killing the hurt fast enough, wasn't getting me high fast enough, so I started chewing them up instead of just swallowing them, and those dudes are bitter. Yech. Thank goodness I had plenty of beer to chase them with.
posted by dancestoblue at 3:35 AM on November 12, 2014

But does anyone know how to get a cat to swallow a pill, instead of biting the hand that feeds it and then horking up the pill afterwards if you manage to get it down in the first place?
posted by Blackanvil at 3:49 AM on November 12, 2014

Both of my kids fill their mouths with water (no swallowing), then slip the pill in their mouth between pursed lips, then swallow the lot. It's the most bizarre thing, and I have no clue where they learned that method from.
posted by Thorzdad at 4:41 AM on November 12, 2014 [1 favorite]

But does anyone know how to get a cat to swallow a pill, instead of biting the hand that feeds it and then horking up the pill afterwards if you manage to get it down in the first place?

Assuming you're doing the kitty burrito method, once you've gotten the pill into the throat (using a pill shooter), you're supposed to hold their head up and gently stroke downward along their neck/throat. Eventually, they'll swallow.

Even doing the burrito, though, my big guy can inflict damage, so we avoid pilling at all costs. Unfortunately, we've not found any other way to get him medication. He knows when his food has been dosed, and he's not into the usual kitty treats.
posted by Thorzdad at 4:45 AM on November 12, 2014

I've dry-swallowed ever since I was a kid.

Erosive esophagitis, eh?
posted by Iridic at 5:05 AM on November 12, 2014

As a child I dreaded taking pills, and fought furiously with my mother whenever I had to take my medicine. However that all changed when around age 8 I was given a biography of Harry Houdini to read. Reading about how Houdini would swallow keys and then regurgitate them later as a means of escape fascinated me. This was a skill I wanted to learn, so I started to try to teach myself how to do it.

First I started with gum, because it was small and soft, and after several tries of nearly choking myself, near vomiting, and lots of swallowed gum I finally started to get the knack of catching and keeping the gum in my esophagus. From gum I moved onto baby carrots and berries, however I never did work my way up to actual keys. But from that point on I no longer had trouble with pills.

Eventually as I aged I realized that my new found skill didn't impress my classmates as much as I hoped. I also gave up the thought of becoming a magician ( I have what they call 'stupid fingers'). As an adult I've stopped a swallow midway and brought up a couple of pills once. My wife after handing me what she thought was 25 mg pills, but were actually 800 mg. So up it came to verify. This of course horrified her-- even more so than seeing me dry swallow the handful of pills in the first place.

I don't think I can really explain my technique, nor do I really do any of the techniques in the article, I just open my mouth, and then open my throat, and down they go.
posted by nulledge at 5:09 AM on November 12, 2014 [8 favorites]

This is one of those strange disjunctive moments where you discover there's a big chunk of the planet that you never knew existed even though you'd been walking right past every day of your life.

Pills are hard to swallow? It's weird, you are all weird, this is all just weird. Weird.
posted by aramaic at 5:54 AM on November 12, 2014 [2 favorites]

It's weird, you are all weird, this is all just weird. Weird.

My doctor said much the same thing when I told her I would need to take antibiotics in suspension, as there was no way a large pill was going down my throat.

Actually, what she said was, "Are you five?!"

Bonus points to the pharmacist who made up the prescription and asked, cooingly, "Aw, is this for your little girl?"
posted by thomas j wise at 6:07 AM on November 12, 2014 [7 favorites]

I don't think I learned to swallow pills until I was close to my teenage years because up until then any medicines I ever needed to take were liquids, with the exception of occassional non-baby aspirin. My mom got me to take regular aspirin by dissolving it in a teaspoon with orange juice so it was like a liquid medicine. I got so used to the taste of dissolved aspirin that to this day I don't mind the sharp bitterness of it (although now I just swallow them whole).
posted by triggerfinger at 6:21 AM on November 12, 2014

i can swallow agnolotti whole, unconsciously, but choke on tiny pills and have to chew them - will try
posted by maiamaia at 6:31 AM on November 12, 2014

perhaps i should boil the pills till they're as soft as agnolotti?
posted by maiamaia at 6:31 AM on November 12, 2014

I was completely unable to swallow pills as a kid. I didn't learn how until I got my wisdom teeth out at 18 and couldn't deal with the pain anymore.
posted by drezdn at 6:38 AM on November 12, 2014

BJE, do you chew your bite of food and then throw the pill into your mouth right before you swallow?

Yep, chew food, put pill in mouth, encase pill in food, swallow with water. I find dry oats actually work pretty well, since they'll stick together around the pill.
posted by Blue Jello Elf at 6:49 AM on November 12, 2014

I didn't learn to swallow pills until I was 12, when I cut my arm very badly and was threatened by my dad with gangrene and amputation if I didn't take my antibiotics. I practiced with tic tacs.

Nowadays, I always fill my mouth with water, put a pill in, and drink more water to flush it down. You don't even notice the pill.
posted by showbiz_liz at 6:56 AM on November 12, 2014

Pills are hard to swallow? It's weird, you are all weird, this is all just weird. Weird.

I only learned a couple of years ago how to swallow pills (I'm 25). I effectively trained myself to do it when I started having to take a birth control pill every day and now I can swallow normal sized pills fairly easily. For me it's directly related to my emetophobia (which is a complex phobia that in my case is combined with an intense fear of choking/not being able to breathe). The prospect of taking a pill used to make me emotionally and physically anxious, to the point of breaking down in tears with frustration at not being able to do something that 99% of the human race seemed to find so easy. I used to make all sorts of excuses to not take medication and it ended up compounding my fear of germs (see also: the complexities of emetophobia) since I refused to become ill because I was scared of having to take pills. The few periods of my life where I've had to take antibiotics for whatever reason were incredibly stressful.

These days I'm OK. I can take a pill when I need to, even in front of other people! I still get nervous about it, but I figure I can deal with it. Learning to do it was a huge step for me - I announced the first time I swallowed a paracetamol tablet to my boyfriend like I'd conquered quantum theory or something. I know it's weird and ridiculous, believe me, but seeing this post and learning that I'm not alone is, holy shit, pretty mind-blowing.
posted by fight or flight at 7:00 AM on November 12, 2014 [5 favorites]

My problem isn't with the big horse-pills. I have trouble with these tiny little specks the doctor has me on. I can't keep from inhaling them, it's aweful!
posted by The 10th Regiment of Foot at 7:02 AM on November 12, 2014

No matter how much water I drink, pills always get stuck in my throat. I don't know whether a lifetime's singing has altered the topography in there, or what. I have handy dissolving painkillers in case of a nighttime headache, but will have to try the lean-forward method and see if it works.
posted by Pallas Athena at 7:25 AM on November 12, 2014

Swallowing is supposed to look like this. You make a nice lump in your mouth, you tilt your tongue back to make it move down, and the automatic swallow reflex kicks in. The epiglottis moves really quickly, the lump of food/liquid moves all at once into your esophagus, and down it goes into your stomach. That's how your body is designed; we're supposed to swallow things in packages like that.

Swallow a pill does not make a nice package. Water + a tiny piece of hard bitter awfulness - or worse, a dry tiny piece of hard bitter awfulness - does not equal a nice package. The first time I watched a swallow study (x-ray swallow video basically) of someone swallowing a pill, I was dumbstruck. It was the worst bolus ever. Why would we make anyone try to swallow a pill ever? No wonder people have trouble with them, yuck.
posted by a hat out of hell at 7:56 AM on November 12, 2014 [4 favorites]

It never occurred to me that anyone wouldn't be able to swallow a pill without any conscious effort until we tried to get my daughter to swallow a "kid-friendly" fish oil capsule (pill-shaped gel cap with flavoring on the exterior) several years ago. Kids today can get to the ripe old age of 12 and only ever take liquid medicine, or at least mine did, so it just never came up until that moment.

Luckily, the fish oil was not an actual necessary medication, so we gave up after some very frustrating and unhappy attempts. I still don't know if she could actually swallow a pill if she had to. These techniques might come in handy.
posted by briank at 8:19 AM on November 12, 2014

Wow, what pills did you guys all have to swallow as kids? All the medicine I ever had to take was either liquid or some godawful chewable thing. I would have SO preferred pills. I remember the first time I accidentally swallowed gum, I thought it was the coolest thing ever. I started swallowing gum every chance I got, until somebody told me about how it was going to stay in my guts for 10 years, and I figured I really ought to pace myself before I get all backed up with gum for the next decade. Then I remember being jealous of adults, when I learned that they got to swallow their vitamins and medicines whole. I could not wait to get to the age cutoff for Childrens' Tylenol so I could start taking the non-chewable kind. I don't know why my parents didn't just tell me I could swallow the chewable medicine. I would have been the happiest sick kid ever.
posted by gueneverey at 8:38 AM on November 12, 2014 [1 favorite]

Funny - I have no recollection of how I came up with my method of taking pills, but I basically take a huge swallow of water and then tilt my head back, still holding the water in my throat. Then I open my mouth, throw the pills into the chamber of water toward the back of my throat, and swallow. I take five pills in the morning every day and I can do all five at once, without ever feeling a thing.

My 13 year old stepdaughter was really resistant about taking pills for the longest time, until her mom came up with the idea of paying her $20 if she swallowed the pill instead of having to grind it up. She learned really quickly with that incentive!
posted by Neely O'Hara at 8:54 AM on November 12, 2014

I didn't really learn to swallow pills until I was bring prepped for oral surgery as a young adult and was faced with three pills and a half-filled Dixie cup of water. The nurse just shook her head when I asked for more water.

Luckily, a gentleman in the same ward was a retired pharmacist and gave me two recommendations:
1) Place pills under the tongue before swallowing water
2) Tilt your head forward for capsules
posted by invokeuse at 9:13 AM on November 12, 2014

My daughter had to learn how to swallow pills when she was barely 7, after she was diagnosed with fructose malabsorption disorder. She's completely intolerant of high fructose corn syrup and sugar alcohols, and for a long time we had to keep her total sucrose consumption under 5mg a day, from all sources. Most children's liquid medicines are sweetened with HFCS or sorbitol, and the ones that are sweetened with sucrose usually have 4-5mg of sucrose per dose, not great when you're looking at amoxicillin 4x daily. On top of that, she has to take a multivitamin daily, since she can't really eat fruits or vegetables, and the only one available without ingredients she doesn't tolerate is a capsule.

We started by putting the pill on top of a spoonful of peanut butter, then chasing it with a glass of milk. After about a week she could take them with just water, and now she can dry-swallow them, at least little ones like advil or benadryl. (For some reason, once we cleared up her gut inflammation, her lifetime trouble with ear infections also stopped, so we haven't had to do antibiotics in a while.) So maybe try the peanut butter / milk thing, if you're having trouble.
posted by KathrynT at 9:27 AM on November 12, 2014

I like to throw my head back and shake my neck and torso like a pelican consuming a terrified fish

I had an elderly aunt who did this. She was otherwise a quiet and ladylike person. When she pulled the fancy pillbox out of her handbag my sister and I would hold our breaths and make fists to keep from laughing aloud. It was very dramatic and suspenseful--would she get them all swallowed? The sight of her wattles shaking over her pearls as she wrestled those pills down is still vivid.
posted by kinnakeet at 9:49 AM on November 12, 2014 [3 favorites]

I didn't manage to find a way to swallow pills until I was 30. Tilt your head back, tilt your head forward, water before, water after, water both before and after -- none of it worked. When I had to take HUGE antibiotic pills after surgery when I was 18, I would sit in front of the TV with a pill and a paring knife and a meat tenderizer and a carton of orange juice (to mask the taste), and I would cut that pill up into about 64 tiny chips, and take a giant swig of OJ with each and every one. I watched a lot of TV that week.

For those who might still be having trouble with pills (esp. trying to take with water), I learned it similarly to Blue Jello Elf's solution. I thought to myself "Look, you can swallow giant chunks of potato and meat and fruit and stuff so long as you've been chewing on it; what's the actual problem here." It seemed that I couldn't get past the "No, this is something solid that I have not chewed and I will choke and die" reaction. So now when I take pills, I put food in my mouth and chew it, then pop the pill behind the food in my mouth, and then swallow the food. Works every time, even on massive horse-pill-type pills.

You have to choose the food well -- can't be too crunchy because then there isn't enough "chewed food" in your mouth to swallow, and can't be too liquid-ish like yogurt for the same reason. I find soft fruits like grapes and peaches work, all bread products, meat, etc.

I almost look forward to being prescribed pills once in a while, because it's something I couldn't do for a long time, and now I've conquered it!
posted by tzikeh at 10:49 AM on November 12, 2014 [1 favorite]

As someone who takes oodles of pills every night, I don't get what the big deal i-

Ohhhhhh, they go in your mouth?

this explains so much
posted by mikurski at 11:16 AM on November 12, 2014 [1 favorite]

I'm crap at doing many things, but by yiminy, I can take all size pills, from itty bitty to horse-size. Thanks to my ability to take said pills, I can be less crap at doing things.

Works out well.
posted by BlueHorse at 12:11 PM on November 12, 2014 [1 favorite]

I should probably clarify that I didn't intend to make fun of people who have difficulty swallowing pills -- it's like I've suddenly noticed half of the buildings in downtown are painted bright yellow with green curse words, or that half of the population walks backwards because they've always walked backwards and I simply never noticed before.
posted by aramaic at 12:12 PM on November 12, 2014

Pills go under the tongue. Then the water. Swish a couple times to unstick them. Then swallow.

Dry swallowing can be done but only a single pill at a time. And only when I've got a headache. The lesser of two evils and all.
posted by zinon at 2:22 PM on November 12, 2014

I never had major trouble with pills, but my gradually-increasing quota of vitamins over the years has helped me learn to swallow bigger and bigger ones. Now that I can swallow fish-oil capsules with no problem, I think I can handle just about anything.

I'm just glad I don't have to take the potassium supplements we give in the hospital. Not only are they gigantic, they start melting into a sticky glop the minute they touch any saliva. If you don't get it down quick with your first gulp of water, it sticks and is nearly impossible to wash down, no matter how much you drink.

I wonder if people on dialysis would have any good tips. A lot of times they're restricted on how much fluids they are allowed to drink, plus they often need tons of pills. I've seen a person swallow 15+ pills in one gulp with only the tiniest sip of water, and act like it was no big thing. (Dear patient who can swallow pills, you are a busy nurse's dream come true. Dear patient who needs 3 oz fluid after every single one of your 20 scheduled pills, you are... not a dream come true, let's put it that way. But I don't want you to choke, so we will spend the half hour if that's what we have to do.)
posted by vytae at 2:24 PM on November 12, 2014

I wonder if people on dialysis would have any good tips.

My dad was on dialysis for 7-8 years. He'd pour about an inch of water into one of those child-sized juice glasses and gulp down all his pills in one quick swig. (He'd always keep one of those tiny cups by the sink.) Nurses loooooved him. Good pills and easy veins.

I was swallowing 4-5 pills dry at a time until, um, well, um, yesterday when I saw that comment about esophageal erosion. I'm going to stop doing that now.
posted by mochapickle at 2:50 PM on November 12, 2014

Blackanvil: "But does anyone know how to get a cat to swallow a pill, instead of biting the hand that feeds it and then horking up the pill afterwards if you manage to get it down in the first place?"

Tell your vet that your cat is unpillable and you want it as a transdermal gel. Then you go to the nearest compounding pharmacy and they make your cat's medicine as a gel you rub on the cat's ear-skin, and give you a couple dozen finger-condoms so you don't medicate yourself. If you raise a big enough stink almost all cat pills can be made transdermal!
posted by Eyebrows McGee at 4:45 PM on November 12, 2014 [3 favorites]

I was put on ADHD meds as a kid that required taking two pills three times a day (the eventual switch to daily dexedrine spansules was amazing) and I just learned to dry-swallow because it was less hassle than finding a drinking fountain every few hours. I had no idea it was such a thing for a lot of people.
posted by Pope Guilty at 7:51 PM on November 12, 2014

I was pretty blase about swallowing pills until I ended up with an esophageal ulcer this past winter.

I couldn't get diagnosed--it was missed by several different doctors--and there was an issue with my referral that took three months to clear up. Then one day I was in so much pain that I could no longer eat solid foods and I ran up to the top floor of the library, hunted down the quietest women's restroom, and called the doctor's office in tears to insist that they get me an appointment with the closest GI and it was an emergency goddammit.

The GI, when I saw him two miserable days later, ended up having me go under general anesthesia for an upper endoscopy. An upper endoscopy is a huge pain in the er, throat and the ulcers weren't too fun either.

All this because I didn't swallow my doxycycline with enough water. Don't let doxycycline-induced esophageal ulcers happen to you. Swallow your damn pills correctly.

Side note: I had a lovely chat with my dermatologist on Monday and we agreed that medication bottles which say 'don't take with food' are particularly unhelpful. In many cases (obvs check with your pharm/doc first) it's completely ok and even preferable to take your meds with food. Also water--lots of water. Don't learn my lesson the hard way.
posted by librarylis at 8:24 PM on November 12, 2014

I have many friends who are unable to swallow pills, and I find that unfathomable. I generally find pill-swallowing something as instinctual as holding one's breath.

I take several pills a day (daily meds + supplements), some of which are pretty huge. I think my record is a handful of nine assorted pills and capsules in one go. Everything goes under the tongue, some water, gulp. I can do dry swallowing, but prefer not to unless really necessary (e.g. on the road and have cramps, no water nearby).
posted by Alnedra at 9:22 PM on November 12, 2014

I generally find pill-swallowing something as instinctual as holding one's breath.

By which you mean that your entire body and nervous system has evolved to avoid this as much as possible and even the most primitive part of your brain spends virtually all its effort guarding against this?

Yes, then, I would agree. As instinctual as holding my breath.
posted by If only I had a penguin... at 9:28 PM on November 12, 2014 [2 favorites]

I guess an ask mefi would be more appropriate, but there was one thing I was hoping to get from these links that I didn't... How do you deal with pills that are really just not the right shape for swallowing? Like way too large and also possessed of sharp corners? We use a throat spray that is supposed to coat your throat and make it easier but only kind-of works. The scientist from the study talks about that sort of problem as being the fault of pharma companies, but I think they probably did it because they try to give the pills distinctive all appearances to keep you from mixing them up.
posted by Made of Star Stuff at 3:44 AM on November 13, 2014

I just tried the bottle method twice today. DID NOT WORK. I have a notoriously awful gag reflex and shoving a solid object THAT FAR BACK is flipping me out on all levels. I think I'm gonna choke to death. Solid hard objects should not be going back there, because ain't nobody around to give me a Heimlich most of the time. I can only get it about halfway back and then it's a no-go or vomit central.

My parents were always asses about it, they'd be all, "Your grandfather" (who I never met) "just swallowed pills dry and whole!" Which was super helpful. And pretty much every doctor or dentist I've ever seen that had to prescribe me pills has not believed me when I said I had issues with that. To which I want to say, "you want me to demonstrate and have me THROW UP IN YOUR LAP trying?"

The closest I got to anyone believing me was when I had my wisdom teeth out, I told the guy I couldn't swallow Vicodin horse pills and he said, "no problem, you can chew those." Nope, the pharmacist made it very clear that I. could. not. I was lucky that I didn't have much pain and ended up not taking anything, because if I had genuinely needed them I would have been up shit creek. I hope I never need surgery. Chewing the pills is so much easier even if they taste awful (and Aleve is the worst, I gagged that up on a street corner).
posted by jenfullmoon at 10:34 AM on November 13, 2014

We use a throat spray that is supposed to coat your throat and make it easier but only kind-of works.

But why not liquid?
posted by lokta at 7:11 AM on November 14, 2014