A Tough Pill to Swallow…Literally!

It’s cold and flu season again…and sinus infection, bronchitis, pneumonia season, etc….and what does all this mean?

Pills. Tablets. Capsules. Caplets. Gel caps.

Oh my.

In 1 study of adults in the U.S., 40% reported difficulty swallowing pills while having no trouble swallowing food or liquids. Common complaints among the non-pill-swallowers included a feeling of having the pill lodged in their throat, fear of gagging, or a bad taste in their mouth.

image credit: http://www.telegraph.co.uk/science/science-news/9783724/

While some people have a legitimate inability to swallow (that is not unique to pills) termed dysphagia, in the majority of the population, fear is the biggest factor, and particularly the fear of gagging.

However, here may be some new tools to add to your pill-taking toolbox. A recent study in the Annals of Family Medicine including both people who do and do not have difficulty swallowing pills has found two options to help get the medicine down. Next time you have to swallow large, dense tablets (think about some of those giant vitamin tablets, or antibiotics!), try using thePop Bottle Method“.

  • With this method, use a squeezable plastic bottle full of water.
  • Place the tablet on your tongue,
  • Make a tight seal with your lips on the water bottle
  • Suck in water as you tilt your head back.

The force of the water should carry the tablet with it right on down the throat.

What if the issue isn’t a large tablet but is a capsule that just won’t go down the hatch?

image credit: http://www.lovethispic.com/image/42520/candy-capsules

Try the Lean Forward Technique, a trick appreciated by almost 90% of the participants in the pill-swallowing study. The idea underlying this technique is that the pill should be lighter than the liquid swallowed with it.

How to do the Lean Forward technique?

  • Place the capsule on the tongue,
  • Take a sip of liquid,
  • Lean the head forward while swallowing.

Other options are to take only 1 tablet or capsule at a time and try taking the pill with a cold (not hot!) beverage. Warm beverages make pills dissolve more quickly, whereas cold beverages often will help the tablet or capsule remain intact for the time it will take you to swallow it. (This also cuts down on the unpleasant taste of a half-dissolved tablet!).

Still having trouble? Check out this NPR Shots post complete with videos of both the Pop Bottle and Lean Forward techniques and this WSJ post about getting over the “fear factor” of swallowing pills.

Finally, don’t hesitate to let your health care provider know that you have difficulty swallowing pills. Ask if liquid or chewable formulas may be available and could be prescribed instead. Also, remember that some medications should not be crushed or chewed; some are made specifically to dissolve very slowly in the stomach/gastrointestinal tract and crushing/chewing may make them less effective or even dangerous. To be safe, check with your pharmacist or prescriber before you crush or chew any medicine.

So, here’s hoping that you remain healthy all season long. However, if you find yourself with a prescription for tablets or capsules, hopefully these tips and tricks can help!

Here’s to your health, and here’s to getting the medicine down!

Top 4 Sources for Diabetes Support at UNC

Having diabetes (a condition in which blood sugar regulation is impaired) in college can be like having two full-time jobs – the first is being a student, and the second is managing blood sugars. It can be a tricky and overwhelming balancing act at times, but knowing where to turn for help can help lighten the load.


There are many resources available at UNC for students with diabetes and their supporters, and

#1 – UNC Campus Health Services is a great place to start (find directions to CHS here). With a diabetes team including a doctor, a nutritionist, a pharmacist/Certified Diabetes Educator (CDE) and the counseling and mental health professionals at Counseling and Psychological Services (CAPS), Campus Health offers a range of services to help keep UNC’s students and post-docs with diabetes healthy, happy, and thriving.

#2 – There’s also a full-service Campus Health Pharmacy right on campus in the basement of Campus Health, with a wide range of prescription diabetes supplies, as well as the Healthy Heels Shoppe, stocked with over-the-counter medicines, supplies, and healthy snacks. In addition, if you have the Student Blue, RA/TA, or Post-Doc Blue Cross/Blue Shield insurance plans, the copays on your prescriptions will be lower at Campus Health Pharmacy than anywhere else, and you even have the option to charge them to your student account. Don’t worry if you have private insurance though – the pharmacy accepts hundreds of plans from across the country.

CDN_logo_web_cWhether you’re an incoming student with diabetes concerned about managing blood sugars away from home, an established student looking to connect with others who know what it’s like to have diabetes, or even if you have a friend or loved one with diabetes in college who you want to support, another excellent resource is #3 – the UNC diabetes advocacy and support group, Heels and Hearts. The group is a chapter of the national College Diabetes Network and meets monthly to talk about tips for general self-care for students with diabetes, learn about new technology available for people with diabetes (PWD), socialize with others who know what “bolus” means, and come together for community service opportunities like the JDRF One Walk in Raleigh in October. Like Heels and Hearts on Facebook!

Looking for more ways to connect?

#4 – Take a look around the broader diabetes community – check out the local Triangle JDRF chapter and the Raleigh Tour de Cure sites for starters, and don’t forget the other campus resources that pertain to diabetes, like Carolina Dining Services, where you can find nutritional info (and carb counts!) for food served on campus and Campus Rec, where you can learn about opportunities to stay active and healthy.

Diabetes can sometimes feel like an isolating condition. However, there are some other excellent online resources, communities, and forums for PWD, including Students with Diabetestudiabetes (part of the diabetes hands foundation), typeonenation (part of the Juvenile Diabetes Research Foundation or JDRF), DiabetesSisters (a community for women with diabetes), diabetesmine.com, glu (an active online community of people with type 1 diabetes) six until me (an honest blog about life with type 1 diabetes), Your Diabetes May Vary (a blog about life with type 2 diabetes), diaTribe (the latest in research and technology updates!) Diabetes Social Media Advocacyasweetlife.org, insulindependence (community for active PWD), and the American Diabetes Association.

So, connect, ask for support, and make this year at UNC a year to thrive!


ERMAHGERD!! Extrer drergs!! (What to do with all those random extra pills you no longer need!)

Did you know that keeping those extra pain pills (or those antibiotics you ended up being allergic to, or those birth control pills you switched off of months ago) lying around isn’t exactly ideal? There are actually quite a few safety hazards related to unwanted/extra pharmaceuticals: drug abuse, poisoning, overdose, environmental problems…Plus you will likely want to clear out your medicine cabinet sooner or later, and may wonder the best way to dispose of these meds.

Ritalin (Photo credit: Wikipedia)

Here are some tips for safely ridding yourself of those pesky extra pills:

› DON’T FLUSH unless they are on this list from the FDA:

Swimming Fish





› Trash ’em? OK…BUT

  • First, make any leftover pills as unappealing as possible – shake them out of the bottle and mix them with gross trash like rotting food, old wet coffee grounds, and/or dirty kitty litter.
  • Be sure they are not in a trash receptacle that is accessible to kids, pets, or
    wildlife to avoid unintentional poisoning. Even something as simple as a few iron pills can be fatal to small children if accidentally ingested.
  • Protect yourself: remove any and all identifying info from the bottle – this includes anything with the patient’s name, phone number, address, etc. – prior to recycling it (if possible) or throwing it away.

Look who got stuck in the garbage can...

›  Best bet? Bring them to your pharmacy for proper disposal (Call them first – not all pharmacies have the ability to take back your old prescription/non-prescription meds).

  • Sometimes the pharmacy will want the label left on, and sometimes they will have you tear the label off before dropping them off.  To be on the safe side, leave all labels on until/unless you’re told otherwise.
  • You can bring them to Campus Health Pharmacy any time during business hours.
  • *Due to DEA regulations, Campus Health Pharmacy is unable to accept controlled substances – however, look for specific events throughout the year for take-back of these items!*

› Bestest bet? Don’t forget community “drug take back” events!

  • Keep an eye out for these events, which are often sponsored by the local police department, hospital, or pharmacy.  These offer great opportunities to gather up all those old tubes, bottles, vials, jars, and boxes of meds you don’t need any longer and get rid of them all for good.
  • See disposemymeds for an easy way to find these events in your neck of the woods.
  • Come find Campus Health during the move-out events around campus at the end of the spring semesters – we’ll be here to collect up any meds you find under that 3 month old pile of dirty laundry you finally had to pick up in order to pack.

Now, go forth and clean out that medicine cabinet! And stay tuned for more medication safety tips…

Oregon Drug Take Back Event - Sept. 2010