If you find pills hard to swallow you should consider taking the medication as a patch, in liquid form or through an inhaler, before attempting to crush them. Crushing pills and swallowing them can lead to severe side-effects, and even death, says a group of experts who have formulated a new guideline.

Many pills have special coatings on them to regulate their rate of release when they enter the body. Crushing them can change the rate of release and lead to temporary overdose.

Pills which are taken just once a day often have a special coating which makes the release into the body slow and constant during the 24-hour period. Crushing could give the patient too much at first, and then nothing for the second half of the day.

Over half of all elderly people find it difficult to swallow pills and tablets. In fact, the majority of tablets in care homes are crushed by the nursing staff.

Here are examples of some complications:

— Tamoxifen must never be crushed. Whoever is doing the crushing could be inhaling the drug. If that person is pregnant this could be extremely harmful. Tamoxifen is used for treating breast-cancer.

— Morphine. If this is crushed the patient has a high risk of having an overdose (it will be released into the body too quickly).

— Nifedipine. If crushed, the patient is at much higher risk of stroke or heart attack. Some other side-effects associated with crushing include headaches and dizziness. Nifedipine is used for the treatment of angina and hypertension (high blood pressure).

Amazingly, say the researchers, patients, carers and relatives are frequently told to crush the pills by doctors and nurses. If a doctor or nurse tells people to crush their medication, he/she could be liable.

Richard Griffith, Lecturer, Healthcare Law, University of Wales, one of the team members who formulated the new guideline, said “A healthcare professional who advises that a tablet is crushed or a capsule opened to assist with swallowing difficulties should proceed with caution. Any resulting harm could render the person legally liable due to negligence. Improved communication between prescriber and patient could significantly reduce these problems, and dramatically improve patient care.”

It is vital that doctors find out first whether the patient has trouble swallowing pills before handing out the prescription. Most medications that exist as pills or tablets can also be available in liquid form, patches, through inhalers or as suppositories.

The study was carried out by Rosemont Pharmaceuticals Limited, makers of liquid medications. Dr. David Wright, University of East Anglia, UK, and team created the new guidelines.

— Click here to download the new guideline (PDF)

Written by: Christian Nordqvist
Editor: Medical News Today