A new study designed to describe and compare lubricants which can be purchased in different countries to make tablets and capsules easier to swallow, using an International Standard for assessment of texture, found that whilst many products were potentially suitable for dysphagia, some may not be.1 Some were deemed to be very runny whereas other had very high viscosity which led the authors to suggest that they may be unsuitable if a texture required for a safe swallow was expected to be within the international range. These lubricants are frequently designed for people who just don’t like swallowing tablets or capsules and in such cases it is the individual patient preference which is most important.
The methods suggest that the lubricants were not actually tested with tablets or capsules within them, which is how they are expected to be used and this may affect the results. Furthermore, as with all of these products, their physical effect on the active ingredients in the medicines themselves are usually not tested. With some evidence that even the simplest of ingredients surrounding a tablet or capsule can potentially affect how well they are absorbed,2 whenever such products are used it is important that the patient is monitored to make sure that effectiveness is not changed.
1. Malouh MA, Cichero JAY, Manrique YJ, Crino L, Lau ETL, Nissen LM, Steadman KJ. Are Medication Swallowing Lubricants Suitable for Use in Dysphagia? Consistency, Viscosity, Texture, and Application of the International Dysphagia Diet Standardization Initiative (IDDSI) Framework. Pharmaceutics. 2020 Sep 28;12(10):924. doi: 10.3390/pharmaceutics12100924. PMID: 32998301; PMCID: PMC7601516.
2. Wright DJ, Potter JF, Clark A, Blyth A, Maskrey V, Mencarelli G, Wicks SO, Craig DQM. Administration of aspirin tablets using a novel gel-based swallowing aid: an open-label randomised controlled cross-over trial. BMJ Innov. 2019 Oct;5(4):113-119. doi: 10.1136/bmjinnov-2018-000293. Epub 2019 Jul 4. PMID: 32038883; PMCID: PMC6979441.
written by by Prof David Wright