How to put medicines down an enteral feed tube

Patients that have difficulty swallowing will often have an enteral feeding tube to ensure adequate nutrition. This tube can also be a useful way to get medicines into the body but it must be done very carefully, and only when your doctor has advised you to do so.

The safest way to put medicines down a feeding tube is to use liquid medicines. However, in rare circumstances this may not be possible so instead, your doctor may recommend that you disperse/crush a tablet or open a capsule. If you have to do this, it is important to follow recommended guidelines, to ensure the full dose of medicine is received, but also that the feeding tube is not damaged in any way. If you ever feel ensure about putting a medicine down a feeding tube, or have another other questions or concerns you should speak to your doctor or pharmacist.

If a medicine needs to be given via a feeding tube, you should follow these instructions:

• Switch the feed off if it is still running
• Flush the tube with a adequate amount of water, your doctor will tell you how much and what type of water to use
• Prepare the medicine for administration as instructed by your doctor, you should prepare one medicine at a timeunless told otherwise by your doctor
• Give the medicine down the feeding tube using a syringe
• Draw up 10mL of water into the same syringe and flush this down the feeding tube
• Repeat these steps for any other medicines that need to be administered
• Once you have administered all of the medicines you need to do a final tube flushing, your doctor will tell you how much water to use for this
• Recommence the feed if necessary. However, some medicines may not mix well with the feed or may not work if there is food in the stomach, so you may need to leave some time before recommencing the feed. Your doctor will advise you if any of your medicines need special care such as this but if in any doubt, seek additional advice.

For the tube flushing you should use a 50mL syringe. Ask your prescriber to supply you with at least one for this purpose.

Some medicines interact so much with feeds that the feed has to be stopped for at least 2 hours before and 2 hours afterthe medicine is given. If you are told to do this then it is really important that you follow this instruction otherwise the medicine will not work.