The most common way people take medications is orally (by mouth). Depending on what your doctor has prescribed, your oral medication can be swallowed, chewed or placed under your tongue to dissolve.
Medications that you swallow travel from your stomach or intestine into your bloodstream and then are carried to all parts of your body. This is known as absorption. The speed with which this occurs depends on several factors:
- The type of medication you are taking – e.g. liquid or tablet
- Whether you take your medication with food, after food or on an empty stomach
- The ability of your medication to pass into your bloodstream – some medications have a special coating and dissolve slowly in your stomach
- How your medication reacts with the acid conditions in your stomach
- Whether your medication interacts with other medications you are taking at the same time
If a quick effect is desired, your doctor may prescribe a medication that will dissolve in your mouth and rapidly enter your bloodstream.
Types of Oral Medications
Tablets and Capsules
In general, you should take tablets and capsules with water. For example, taking certain pills, such as Lipitor (Atorvastatin) and Viagra (Sildenafil), with grapefruit juice can cause potentially dangerous side effects. Additionally, milk can block the absorption of some antibiotics, such as Cipro (Ciprofloxacin).
Your healthcare provider or pharmacist will tell you if you should take your medication on an empty stomach or before or after eating. This is very important since food in your stomach and intestine can interfere with your medication dissolving and passing into your bloodstream. Make sure to follow the directions on your prescription very carefully.
Additionally, do not break, crush, or chew any capsule or tablet before swallowing. Many medications are long-acting or have a special coating and are intended to be swallowed whole. If you are not sure, ask your pharmacist.
If you have trouble swallowing your medication, tell your doctor and pharmacist. They may be able to provide you with a liquid form of the medication or a pill that is smaller and easier to swallow.
Liquid medications are good for children and adults (especially older adults) who are not able to swallow tablets or capsules. Many liquid medications, including both prescription drugs and over-the-counter drugs, are made for children and are flavored to mask the taste of the medication.
Before measuring the proper dose of liquid medication, make sure to shake the bottle as some of the medication may have “settled” at the bottom.
Most often, you will be told to measure the medication using a teaspoon. To a doctor and pharmacist, this means 5 ml (milliliters) of medication. Many household teaspoons are different sizes and hold more or less than 5 ml. Therefore, you might get too much or too little medication on your spoon.
Measure your liquid medication carefully! Ask your pharmacist for a spoon, medicine cup, medicine dropper, or a syringe without a needle meant specifically for measuring medications. Your pharmacist can show you how to properly use these. Many over-the-counter liquid medications come with a small medicine cup attached to the top of the bottle.
If the medication has been prescribed for an infant or young child, make sure to speak with your pediatrician about the proper dosage, or amount, of liquid medication for your child.
Sublingual and Buccal Medications
Certain medications are placed under the tongue (sublingual) or between the teeth and the cheek (buccal). These medications are absorbed quickly into the bloodstream through the lining of the mouth and are used to relieve symptoms almost immediately.
Some examples of sublingual medications are Nitrostat and other nitroglycerin preparations used to treat angina (chest pain) and Suboxone (bupronorphine with naloxone) used to treat addiction to heroin and narcotic painkillers.
Other Forms of Oral Medications
Although most oral medications are swallowed, some are released in the mouth by chewing, dissolving slowly or melting on the tongue. Many of these medications are sold over-the-counter.
Chewable tablets should be chewed until they have dissolved completely. They are not meant to be swallowed. Examples of chewable tablets include Tylenol Chewable and many brands of children’s vitamins.
Chewing gum medications have a minimum time that they must be chewed to assure that the entire amount of drug has been released, often up to 30 minutes. Examples of medicated chewing gums include Nicorette Gum (nicotine) and Aspergum (aspirin).
Lozenges are meant to be “sucked” on like hard candy and allowed to dissolve slowly in your mouth. They should not be swallowed. Examples of medicated lozenges include Commit (nicotine) and Cepacol (benzocaine).
Softchew® medications are meant to melt in your mouth or to be chewed. Examples of Softchew® medications are Triaminic Softchew Cold and Allergy Medication (chlorpheniramine and pseudoephedrine) and Rolaids Soft Chew (calcium carbonate).
A quick tip from Dr. Mike: Always read the instructions carefully and take your medications as recommended. If you have any doubts or concerns, contact your doctor or pharmacist.