Crushing tablets to make them easier to swallow can be deadly, experts have warned.
An estimated one in five people in the UK suffer from swallowing difficulties, known by the medical term dysphagia.
They are forced to find new ways to take their medication, including crushing tablets, cutting them in half, or taking granules from inside capsules.
But these actions can alter the way medicines work and may cause ‘serious’ side effects, Shamir Patel, pharmacist and founder at online pharmacy Chemist-4-U.com, warns.
He said tablets and pills often have special coatings that slowly release medication into the body.
Shamir said: “Medicines with a modified release contain drugs which should be released gradually over a period of time, say 12 to 24 hours.
“If they are crushed the whole dose can be released in five to 10 minutes. This can undoubtedly lead to serious side effects which in some cases could prove fatal.”
Tablets with a special coating that prevent them being dissolved in the stomach should also only be swallowed whole.
Shamir explained: “These tablets may be coated to stop the medicine from irritating the stomach. If the coating is taken away it could cause indigestion or ulcers.
“They might also be there to make the tablet taste better.”
An estimated one in five people in the UK have trouble swallowing medication, and some 60% of older people are also estimated to suffer from swallowing difficulties.
Shamir said: “Before anyone considers crushing or chopping a tablet in half it’s really important to speak to a pharmacist to check that it is safe to do so.
“Some tablets are designed in such a way that they should only to taken whole.
“You can’t tell which tablets have a special coating just by looking at them, making it vital you seek advice from your doctor or pharmacist.”
Care should also be taken with hormone, steroid, antibiotic or chemotherapy medicines.
If these tablets are crushed then the medicine can go into the air as dust particles, and can cause side effects for the person crushing the tablets or anyone else nearby.
Shamir recommends using swallowing aid which can ease the passage of medicines down the throat, such as Med-Easy. A lightly viscous liquid, it can be given to children over two years of age, providing they can swallow independently.
He said: “Such liquids wrap themselves around the medication which means that rather than resting on the tongue, the tablet is suspended in the formula and therefore free to flow down the oesophagus with ease.
“It is chemically passive, therefore compatible to take with almost any medication.”
One mum has spoken of desperately battling with getting her daughter to take solid dose medication, before trying a liquid swallowing aid.
Darcie Defty, nine, from South Shields, hated the thought of swallowing a tablet.
Her mum Helen said: “We used to hide a tablet in a soft sweet and squash it to try and trick her into taking it.
“I think it was the idea of swallowing something - a foreign body going down her throat. She wouldn’t swallow it or she’d keep it in her mouth, then she wouldn’t like the taste and spit it out - so it was defeating the point.
But Med-Easy solved the problem.
“It was so easy. I can see how it can work for people of any age,” she said.
Mixing medications with certain foods can create a whole host of problems, too.
Certain antibiotics mixed in calcium rich foods like yoghurt can clash with medication and stop them working properly.
"Dairy products or other foods that are high in calcium can reduce absorption and therefore decrease the effectiveness of some antibiotics," explains Shamir.
"It is recommended these medications are taken two hours before or six hours after eating foods high in calcium."
People should also avoid grapefruit if they are taking medication including atorvastatin, simvastatin and warfarin.
And tyramine, which is found in cheese, dried fruit and meat which has been smoked should also be avoided by those taking medications used to treat depression such as tranylcypromine and linezolid.
Shamir added: “Unless the patient information leaflet states it’s safe to crush your tablets or open your capsules, or mix with food, then don’t.”