manIt’s hard to believe that another summer has come and gone and September has come to an end too.
Before I delve into October’s topic I want to remind everyone that Flu shots will be available soon. Obtaining your shot at the pharmacy is a simple and convenient option for Ontarians 5 years of age and older. The Universal Influenza Program is a government funded program allowing you to get a flu shot at your local pharmacy with no cost to yourself. Our pharmacy will be offering several clinics during the month of November and you are encouraged to sign up for a time convenient for you. We also take walk-ins any day but there may be a slightly longer wait time.
Throughout my day in the pharmacy I answer many questions. Often these questions are about specific medications, both prescription and non-prescription or OTC (Over the counter). I also field queries about pharmacy procedures, drug plans, diseases and medication administration. Sometimes potential problems are revealed in discussion with patients or their caregivers. Over the next several months I will be discussing some of these.
“My mom is having trouble swallowing.”
This simple statement prompts me to ask about “mom’s” medication. When swallowing is an issue it is important to ask your pharmacist whether it is ok to crush, chew or break up your medication. It is not always appropriate to tamper with medications when swallowing is a problem. For example, controlled release, extended release, sustained release and timed-release products are formulated so that the medication is released slowly over time. When you crush these medications all of the medication is released quickly which can be dangerous. Enteric-coated medications are made so that they don’t dissolve in the acid environment of the stomach but wait to dissolve until they reach the intestines. This is often used to protect the stomach from the medication. Crushing enteric coated tablets will negate this protective effect.
Sometimes there are alternative dosage forms available such as liquids or chewable or quick-dissolve tablets which could be used instead of tampering with tablets.
Sometimes there are capsules available that can be opened and sprinkled on foods such as applesauce or pudding.
Some extended release medications are scored and can be broken in half.
Sometimes there are alternative dosage forms such as patches or suppositories that could be prescribed.
Sometimes a compounding pharmacy can prepare an alternative dosage form for you.
Sometimes it is necessary to find an alternative drug that does the same job but can be crushed.
Whether you have a temporary problem such as a severe sore throat or chronic swallowing issue, it is important to ask before you crush, chew or otherwise alter a dosage form.

Nancy Wiechenthal is a pharmacist and co-owner of North Hastings Family Pharmacy in Bancroft, Ontario. Her opinions expressed in the Apsley Backroads are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice.