Tips and Techniques for Pill Swallowing

There are many different methods and techniques to acquire the pill swallowing skill and no one method is recommended over another one. You will need to use trial and error. See what works for you and experiment with other methods. In all likelihood, you will find the technique that works for your individual needs. Before starting, check that your swallowing reflex is automatic and comfortable by swallowing an average-sized mouthful of water without having any spill out from the mouth. If you are able to do this without any coughing, gagging, or vomiting, proceed with trials of some of the most common methods:

Shaping Procedure

Shaping is a behavior modification term which means to learn how to do a difficult task by breaking the task down into the simplest task and then increasing the difficulty as you have success. In the case of pill-swallowing, you start with very small candy ‘pills’ and then move to larger ones as you master the technique. Although some of the best non-medication substances to use for practice are cake decorations and candies, experts advise not to refer to these fake ‘pills’ as candy during practice, since swallowing real candy rarely triggers anxiety and you may not transfer the skill to real medication if you believe you are practicing on candy. In addition, most people typically chew candy and medicine should usually NOT be chewed.

  1. Purchase a series of increasingly larger sized cake decorations, such as round candy balls called “mixed decors”, and candies to be used in the teaching technique, each larger than the next. Cake decorations come in many colors, but consider using only the white decorations, so that they look like medications.
  2. You may want someone else to demonstrate the technique to you.)
  3. Start by swallowing just water.
  4. Next, select the smallest cake decoration, such as the mixed decors (balls).
  5. Place the smallest “pill” on the tongue. Placement may need to be modified based on size, form, and degree of gag reflex. Most should be placed in the middle of the tongue as shown.
  6. Take a big sip of water from a cup.
  7. Keep your head level or, alternately, tip your head back.
  8. You should swallow the water and the “pill”.
  9. Finally, you should have another sip of water to keep the “pill” moving.
  10. If the “pill” doesn’t go down with the first swallow, keep drinking. More than likely, it will probably wash down with the next gulp of water.
  11. Allow as many trials as needed for success as long as your frustration has not become excessive.
  12. If you struggle through each try, go back to just swallowing water and calmly try again another time.
  13. When you have mastered swallowing the first size for a few trials, move on to the next size. Gradually increase the size of the candy—oblong sprinkles used for cake decoration; round, silver cake decoration; round, candy--approx. 1/8- to - inch in diameter; capsule-shaped candy, such as Tic-Tacs, and Mini-M&M’s.
  14. If you are unsuccessful twice with the next size, go back to the previous size before ending the lesson. This guarantees that you will finish the practice session on a high note.
  15. Sessions should last no more than 10-15 minutes, depending on your tolerance level. Subsequent sessions should start with the last size you were successful with before progressing to the next size. You may be able to progress through all the sizes in one session but it is also reasonable to expect it could take anywhere up to 5 or 6 more sessions before the skill is mastered.
  16. When you can reliably swallow the Tic-Tacs or M&Ms, you can try swallowing an actual pill. And remember, practice in order to sustain this new skill.
  17. You may want to track your progress through the different sized pills. Click here for a sample chart.

Using Solids or Liquids

Techniques with Liquids

Techniques with Soft Food Caution: You should consult your health care provider about any possible interactions between the medication and the type of soft foods you are using. Monitor the amount of food being used. Consuming too much of the soft food at one time could lead to choking.

More Tips and Techniques

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