Swallow OR Chew ?

Have you ever encounter a situation whereby your tablet or capsule is too big to swallow?

Could we simply chew the tablet before swallowing it into our gut ?

The answer is yes and no.

Let's break it down. 

For certain medicines, it is ok for us to break it into pieces before swallowing them. This class of drugs are usually fast acting or rapid acting medicines, in which the time the tablet/capsule break down do not matter.

1. Chewable tablets

These medicines are meant to be broken down into pieces by the teeth and then swallow them.

Eg. Vitamin C, antacids (eg Gaviscon tablets, Maalox tablets) 

2. Orodispersible tablet

These tablets will dissolve once you put into your mouth. This rapid dissolution formulation is designed for some antipsychotic drugs to ensure patient compliance. it is also designed for rapid response, for example, orodispersible ondansetron (used for nausea or vomiting) disperse quickly in the mouth and then could be swallowed down and exhibit its effect.

3. Sublingual tablet 

These tablets are designed to be placed under the tongue and allow it to be absorbed into the blood for rapid therapeutic action. Eg nitroglycerin tablet or glyceryl trinitrate to be used sublingually for angina attacks.

However, we need to be cautious as some medicines are meant to be swallow whole. The formulation of the tablet/capsule is designed to release the medicine (active ingredient) slowly into your body. This kind of drugs come under sustained release, modified release or prolonged release medicines.

In this case, if we break or chew the tablet/capsule, the medicines will be released in a large amount into the body at once. It may hurt our body as the dose get too high suddenly (overdose). Consequently, you are more likely to experience the side effects of the medicines.

When it comes to the issue where the patient have swallow difficulty, other alternatives should be attempted. Can it be made extemporaneously into suspension ? Can it be administerd via nasogastric route? Any other administration routes can be used ?

Hence, it is always a good idea to ask your doctor or pharmacist before taking the medicines.


I came across with a customer, complaining to me about the side effects she experienced from her antihypertensive medicines. After asking her a few questions, she told me:

"The tablet is way to big for me to swallow, I take it by chewing it into pieces before swallowing it. The taste of the medicine is terrible though."

I found out that her medicine is a modified-release tablet, which should be swallow whole.



Often, the doctor or pharmacist would have told you the way you take the medicines. However, just in case they forget, do Ask them.