how to swallow pills bigger than a pea: a primer for people like us

December 25, 2013 § 1 Comment



UPDATE 2016: ice cream. ice cream is the best throat lube in town. thick and sticky enough to coat even the biggest pills, tasty enough to mask any pill odors or flavors that might make swallowing additionally difficult. it’s the only thing i use anymore.


i’ve developed osteoporosis in my mid-30s from a lifetime of underweight caused by mental intensity of various kinds. not eating has been the go-to compulsive ritual historically triggered by decades of otherwise unmanaged anxiety, and it’s had profound consequences for my bone density. i was informed by a traditional doctor recently that i should take one of the osteoporosis drugs they market for older women – boniva or fosamax or similar. i didn’t want to do this as the drugs have not been tested on or evaluated for effectiveness in pre-menopausal women, yet have some gnarly side effects (remember phossy jaw, from 19th century working conditions in match factories? hell naw). so i visited a naturopath for a second opinion.

she ran a test that measured my bone metabolism (which is the ratio of bone building to bone destroying chemicals, which gives a better picture of where your bones are at than the DEXA scan normally used) and then prescribed a shit ton of bone building nutritional supplements, and also brain supplements to treat the underlying anxiety/depression issues. which is all cool in that i have an alternative to the boniva stuff but also presents its own challenge, in that i am a terrible pill swallower. terrible. and i’m now supposed to take about 15-20 pills a day. it doesn’t help that my anxiety and depression has historically manifested as issues around swallowing, eating, and vomiting–fears of things entering and exiting my stomach. but as i am now trying to heal the physical results of this underlying mental history, it’s a challenge i’m determined to deal with.

one of the upsides is that i’ve compiled a short list of unlikely tips for others in my boat. so, here are some pill swallowing tips for those who have a hard time swallowing pills:


–for pills you take in the morning: use morning mocos as lubricant. hock it up and use it for your largest pills. it really works!

–you can also coat your pills in honey or syrup and swallow

–if you take pills after you brush your teeth, your spit will naturally be thicker and more mocos-like. drinking something citrusy (orange juice, lemonade) also makes mucosal saliva.

–if you can, it helps to swallow pills when you are hungry. conversely, avoid taking pills when you’re full. one of the better times for me actually is toward the end of a meal, when i’m not quite done yet and still a little hungry.


–there is a zone in the throat where a pill at the back of the tongue will trip gag reflex, and a point past that zone at which it won’t. so, tip head back to let pill (coated with honey or mocos) slide past that zone. let gravity do the work!

–when you right your head up again, stick your tongue out ala gene simmons, which guides pill down even further. when you’re ready to swallow, pill should be so far down that it doesn’t trip your panic button.


–one way to do this: when ready to swallow, tip head *forward/down,* which naturally opens you up

–alternately, pull the back of the throat away from pill, either by jutting your jaw forward or…flexing your esophagus. i don’t know how else to put it. the sensation internally is similar to when you yawn, if that helps. as you flex, visualize the back wall of your throat pulling away from the pill so that it’s no longer touching. no touching, no gagging!


use these tips alone or in combination. overall, using a lubricant is key, at least at first until you master the other steps. it does seem to me that some big pharma company would have stumbled on the idea of marketing artificial mucus, to improve drug compliance in swallow-averse crazies like myself…sorta like KY for your mouth.

until that day, tho…may these tips be helpful.


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