What to Do When You (or Your Child) Can't Swallow ADHD Medication

You doctor prescribes your child (or you) a medication for ADHD and when you get the pharmacy you realize it is a pill and it isn't going to go down easily.  Don't panic, there are a few different things you can do if you need to take medication for your ADHD and you can't swallow pills.

First of all, DON'T crush it.  While it probably is ok to take some ADHD medications crushed, some depend on the pill capsule or coating to regulate the rate at which the medicine is released into the body.  Too much ADHD medication at one time can make you psychotic, or even kill you, so don't take a chance and crush your medication unless the pharmacist says it's ok.  Even when the pharmacist says it is ok, most medications are so bitter that it is very hard to take them crushed even with something like chocolate sauce.  An adult could manage, but a child probably would put up a fight, so it is best to find a better solution.

Try a different formulation.   There are many different medicines available for ADHD and some of them are in the form of suspensions/liquids (Ritalin, Adderall, Quillivant XR, Dyanavel XR), sprinkles (Focalin XR, Aptensio XR, Vyvanse), chewables (Quillichew ER), or patch (Daytrana).   This gives you and your doctor a lot of choices for treatment if swallowing a pill is a problem for you.  Unforunately, many of these medications are new and may require a higher copay or may not be covered at all by insurance.

Try to learn to swallow a pill.  There are a few ways to do this.

• Applesauce/pudding.  Start with something small, like a small fish oil capsule (Fisol, for example), or mini M and M's (contain coloring).  Put the practice pill in a spoonful of the applesauce, or something of a similar soft consistenc( pudding, jelly, ice cream, jello) feed the person learning to swallow pills the entire spoonful of of sauce with pill.  When the person swallows the sauce, the pill also goes down.
• Double swallow.  Take a sip of water, then place the pill in the mouth.  Take another sip of water.  While swallowing the water, turn your head to the side.  The pill should go down without having to tip your head back.
• Use a device.  There are several pill swallowing cups and sprays marketed online for people who have sensitive gag reflexes.
• Some people just don't do well with using a liquid to swallow a pill, and so it is often a good idea to just try dry if the whole taking a sip and swallowing doesn't work for you.

Most people who are unable to swallow their ADHD medication at first eventually find a solution.  If you are new to medication, the best bet is to try a nonpill formulation, provided that your insurance covers it.  But if you are an adult, it may be a good time to try to learn to swallow a pill since you know you will eventually need medication for other conditions and this will give you daily practice.

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