Quick takeaways Struggling to get tablets down is common and nothing to be embarrassed about. A few changes in posture and technique help many people, and a pharmacist can often suggest another form.
If tablets or capsules seem to stick in your throat, you are far from alone. Most people can learn to swallow pills more easily with a few changes: sit or stand upright, take a sip of water first, use the head position that suits the type of pill, and wash it down with a good mouthful of water, or soft food if the leaflet allows. If none of that helps, a pharmacist can often suggest a different form of the same medicine.
The tips below are general. Never crush, split or open a medicine without checking first, because some are designed to release slowly or to pass through the stomach intact.
Why pills can feel hard to swallow
- The gag reflex. A solid object at the back of the tongue can set it off, especially when you are tense.
- Anticipation. Worrying about choking tightens the throat muscles, which makes swallowing harder, and the worry grows each time.
- A dry mouth. Some conditions and medicines reduce saliva.
- Size and shape. Large, rough or oddly shaped tablets are harder than small coated ones.
- Medical causes. Trouble swallowing food and drink as well as pills, known as dysphagia, is a different matter and needs checking by a doctor.
Two techniques worth trying
The lean-forward method for capsules
Capsules are light and tend to float. Place the capsule on your tongue, take a medium sip of water without swallowing, then tip your chin slightly down towards your chest and swallow. As you lean forward, the capsule floats towards the back of the mouth.
The bottle method for tablets
Tablets are heavier and sink. Put the tablet on your tongue, seal your lips tightly around the neck of a flexible plastic water bottle, and drink with a sucking motion, keeping your lips closed around it. The suction helps carry the tablet down with the water. Tilting your head right back is usually unnecessary and can make swallowing harder.
More tips that help
- Sit or stand upright, and stay upright for a while afterwards, as many leaflets advise.
- Take a sip of water before the pill to wet the mouth and throat.
- Place the pill in the middle of the tongue rather than at the very back.
- Drink a full glass of water with it, unless you have been told to limit fluids.
- Try a cold drink or sucking a small ice chip first if your gag reflex is strong.
- Take one pill at a time instead of a handful.
- If the patient leaflet says it is suitable, put the pill in a spoonful of something soft, such as yoghurt or apple purée, and swallow without chewing.
- Ask at the pharmacy about swallowing gels and pill cups, which coat or guide tablets, and whether they suit your medicine.
Practising without medicine
Some people build confidence by practising with small sweets of gradually increasing size, using the same technique each time. Children are often taught this way, always with an adult watching. Practise when you feel relaxed, not when you urgently need a dose, and stop if anything feels uncomfortable.
Can I crush or split my tablets?
| Type of medicine | Usually safe to crush or split? | Why |
|---|---|---|
| Plain tablet with a score line | Sometimes; check first | The line may be for splitting, or only for decoration |
| Modified-release (often marked SR, XL, MR or CR) | No, unless told otherwise | Crushing can release the whole dose at once |
| Enteric-coated | No, unless told otherwise | The coating protects the stomach or the medicine |
| Capsules | Ask first | Some can be opened, many cannot |
Markings vary, so the label and leaflet are your best guide. Our guide to reading a prescription label shows where to find the medicine's full name and form.
Ask about other forms
Many medicines come in more than one form: liquids, dispersible tablets, tablets that melt on the tongue, smaller tablets, patches, sprays or chewables. A pharmacist can check what exists and whether a switch is possible, although changing the form may need a new prescription. Sometimes another manufacturer's version is smaller or differently coated; our explainer on generic and brand-name medicines covers why tablets from different makers can look different while containing the same active ingredient.
Pharmacies increasingly advertise services such as medicine reviews on screens near the counter, as our piece on digital signage in pharmacies describes. If you have not seen one offered, ask; a review is a good moment to raise swallowing problems.
When to get help
- If a tablet feels stuck, stay upright and sip more water. If the feeling does not pass, or you have chest pain, contact a doctor.
- If you are choking or cannot breathe, call your emergency number straight away.
- If swallowing food or drink has become difficult or painful, or you often cough when eating, talk to your doctor, as this needs proper assessment.
- If fear of swallowing is stopping you from taking medicines you need, say so. Doctors and pharmacists hear this often, and anxiety around swallowing can ease with support from a GP or a talking therapist.
Once swallowing feels easier, the next hurdle is often remembering every dose; our guide to medication reminder apps covers that.
One thing first
A guide, not a verdict
Our pages are good for understanding a topic and for writing down the questions you want to ask. They cannot tell you what is happening in your own mouth, lungs or body.
If anything here seems to clash with what your dentist, pharmacist or doctor has told you, their advice comes first.
The writers at Inside Schizophrenia
The topic map
Before you use this site. Everyday reading only. Your dentist, pharmacist or doctor knows your own situation.