Strattera: “My son can’t swallow the pill”
ByOn my last post, Lori posted a question about the fact that her son cannot swallow the Strattera. It seems to be working after only a few days (which is possible, yes, though not that common for many people), and she wants her son to keep taking it even though he has trouble swallowing the pills.
And all of the information says that the capsule shouldn’t be opened. This includes information from the pharmacies, the product monograph, and I have even checked with the company that manufactures Strattera, Eli Lilly. Not only do they say that the capsule cannot be opened, but they are not allowed to even comment on any possible solutions.
Lori asks: “Is this because of the capsule??”
Here is the situation on opening the capsules of Strattera (atomoxetine).
The fact is that the actual medicine is an irritant.
The main reason to not open the capsule is that having the medication in the mouth, throat, stomach etc. without a capsule will feel like it is ‘burning’ to the person taking it. One of the main side effects of Strattera is nausea, and it can be worse without a capsule as well.
Now, if Strattera is the only medicine working, or the best medicine for your child, what can you do if your child cannot swallow the capsule?
Yelling doesn’t help.
Battles once daily tend to ruin the day.
And if your child tells you that the medicine mixed in water (or milk, or jam, etc) tastes terrible, or burns their mouth, believe them, because it’s true.
An American colleague of mine made a suggestion to me, which has helped many of my patients.
I will share it with you, but please check with your doctor, and realize that this is not an official recommendation, as the pharmacists and Eli Lilly will just flatly tell you not to open the capsule.
Peanut Butter.
That’s right. Putting the contents of the Strattera capsule into a spoonful of peanut butter, and mixing it in, can help your child to get the medicine down. The peanut butter kind of ‘binds’ the medicine, so that it doesn’t irritate the mouth, throat, or stomach.
Now, this doesn’t work for everyone, because some kids are allergic, and others hate peanut butter!
But, if you can, give peanut butter a try.
If this works for you, please post a comment to share your experience.
If it doesn’t work for you, and you have found another solution, please share that as well by posting a comment so that other parents can benefit from your experience.
Before finishing this article, I would like to mention that there are ADHD medicines which do not require a child to swallow a pill.
They are:
- Dexedrine Spansules: These capsules can be openned and sprinkled into apple sauce. (Amphetamine)
- Adderall XR: These capsules can be openned and sprinkled into apple sauce. (Amphetamine)
- Biphentin: This newer methylphenidate (same medicine as ritalin) medicine can be sprinkled as well.
- Daytrana: This is the first methylphenidate (ritalin) patch, and is applied to the skin for most of the day.
- Methylin Solution: This is methylphenidate (ritalin) in a liquid solution.
- Methylin Chewable: This is methylphenidate (ritalin) in a chewable tablet.
When it comes to these medications, unfortunately, many of them are not available outside of the United States.
However, if your child has trouble swallowing the ADHD medicine that is prescribed, hopefully this article helps you to find a solution.
Again, please post a comment to share your experiences – successes or failures, so that other parents can learn from you. Thanks in advance!
Our son has learned to swallow the pills when taken with a spoonful of pudding. We tried other methods, but this seems to work best.
Kathryn & Alex
Thank you for sharing your experience.
You son doesn’t have any burning sensation or bitterness with the strattera in pudding?
Dr. Kenny Handelman
Wow! This post was so long ago. I wish I found it last summer. My son was not able to swallow the Strattera pill. I contacted a compound pharmacist about creating a liquid after seeing that suggestion on several sites. They said they had tried before but the bitterness was too strong. And then of course the reality of the expense of changing the Strattera form. So we decided to try other “sprinkle” friendly medication. All year we have tried almost all stimulants on your list but not getting the best effect. He was calmer but very flat. So now we are back to Strattera. I did save tons of the empty capsules from his other medications for us to practice swallowing with. Still not successful but will keep practicing. However, in the meantime…we are using the peanut butter mixing method. Still in the first week of the process but he is taking it. There is an after taste that is bitter but he said no burning or upset tummy. The next day I tried a taste and yep, once the peanut butter goes down then you have a bitter taste. So I added a little bit of cooled melted chocolate chips. That worked better but definitely need to have a flavored drink handy to wash the after taste. And we give it to him before bed so he goes straight to brushing his teeth which might help with the after taste. But so far he has had no complaints of irritation. I am just monitoring to see if this Strattera will even be helpful to him. But we are still going to practice with the empty capsules. I am just surprised that this original post was from 2005 and there hasn’t been any new way of administering Strattera. At least more Children Friendly. Why can’t the powder be trapped in little bead form?
Hi, just an update with the peanut butter and strattera. We have tried the peanut butter and spreadable honey in a little mini sandwich with dinner. No complaints or any other side effects I have read about. No burning, no upset tummy, and definitely no vomiting. And he said he can’t even taste the medicine.
i put the capsule into a fruit smoothie in the morning. strawberries, blueberries, orange juice and ice. so far no complaints.
i also do hot chocolate at night. its kroger brand dutch hot chocolate – so it is pretty strong. i’m not happy about sugar at night, and am still looking for a better option – i am going to try the peanut butter this week!
everything else bombed. it is really a strong and horrible tasting medication!
thank you for the information and the ideas
My son just chews a mouthful (of anything), sticks the pill in the middle, and swallows it. It works just like the peanut butter in making a bolus that is normal food-consistency so that the capsule-shape doesn’t get caught in the back of the mouth. Works beautifully!
My 5 year old son started on Straterra a couple of weeks ago and we battled every day to get the whole capsule into him using peanut butter, honey, marshmallows none of this worked for us. For the past three days we have been emptying the capsule into a cup of strawberry flavoured milk and he has drunk it easily not noticing that the Straterra is in it, long may that continue.
I take strattera, and my son, who is 8, has just started taking it. It floats. If you lift your head and swollow, it will not go down. I tell my son to drink a little to get his mouth wet, put the pill in his mouth, take a mouthful of juice, look down, and swollow. That way the pill goes down first. If you try to swollow it with your head up, it really doesn’t work. Hope this helps!
We were having such a problem with my son being able to swallow Strattera so we were sprinkling it in hot sauce, because that seemed to be the only thing that would hide the nasty taste. One day we decided to just drop the whole capsule in his drink and it worked! The drink washed it down and we haven’t had any issues since.
My 8 year old son just started taking Stratera and we were concerned about him learning to swallow a pill. We had him practice swallowing tic tacs with a sip of chocolate milk. Fortunately, it became a positive challenge for him. We then said can you swallow 2 tic tacs with whatever he was drinking, through a straw, which helps. Even my younger son wanted to try the tic tac challenge. now they can both swallow 3 tic tacs with no water. After that, the Stratera was a breeze! Hope it helps.
I take a small amount of OJ and sprinkle my sons meds in it. Its not the best tasting but he will wake it. Have tried almost everything else and he can tell the pill is still there.
We are new strattera users in Melbourne, Australia. I have a 7 year old son who will not swallow pill whole.
Our best success has been mixing it in a medicine cup with a single mouthful of ribena (a sweet blackcurrant juice mix). We tried it in a spoon of chocolate sauce and scored it 10/10 for disgustingness.
he described it as ” f…ing disgusting and so bad I think I will pewk and do diarreoh. I hope I never have to take it again with chocolate sauce”
With Ribena blackcurrant juice he scores it 6/10 for disgustingness. Apple juice is 8/10.So Ribena WINS!!! Followed by a ribena chaser.
My son swallows the pill and chases it with a large marshmallow. He doesn’t have trouble with any other pills, just the strattera capsule which he reports goes down sideways and gets stuck. The marshmallow pushes it down when it gets stuck and is a minor reward when it doesn’t.
hello!
my 8 year old daughter just started on Strattera. i really hope it works for her.
we have been opening and mixing it in a teaspoon of peanut butter the last 2 days. this morning she had the peanut butter spread on an eggo waffle.
my question is…will the medicine be as effective? i mean, does sitting in a teaspoon of peanut butter dilute it in any way?
of course, the goal is to eventually swallow the capsule!
if anyone can answer my question that would be swell!
The peanut butter solution worked great until we got to 25mg. Seemed there was too much for it to be blended into peanut butter enough so that it didn’t taste bad. Rather, I my son didn’t want to eat about 1/4-1/3 cup of peanut butter every morning – and I don’t blame him.
We’ve just switched to chewable Methylin – but it’s a stimulant, so we’ll just see how it goes.
I have a lot of my young patients that need pills for whatever reason learn to swallow them with the use of a straw. I have them take a sip of water from the straw and then place the pill as far back as possible and then another drink from the straw. The straw creates a unidirectional flow of water that aids swallowing the pill rather than turbulent flow experienced just drinking from a glass without a straw. Good luck!!
Great tip, Dr. Patterson. Thanks for the suggestion. I will try that out as well!
My 7 year old son started taking Strattera about three weeks ago. I read this blog and it has changed his life. I have to be careful not to spill the powder, but once I mix it around he takes it like a pro and swallows it down with a big gulp of milk. He hasn’t complained of any bad taste or burning. He’s just happy to be taking something that will help him be able to focus and get through his day. He’s even playing soccer with the kids at school. Before, group activities were a complete disaster. Now he’s just a regular kid, not the one all the other kids have to avoid because they don’t know what he’s going to do next. It is expensive, but worth it. I was never in favor of medication before, but I have to say, I have been converted.
My son’s pediatrician and I are planning on trying to get my son on Strattera this summer after trying it when he was 7 and he just couldn’t swallow the pill. In fact, it got stuck in his throat and he freaked out and would never try it again. After a lot of discussions and several different stimulant medications, she seems to think Strattera would be a good match for him (of course we won’t know until we try, but summer is a perfect time for that.) I am glad I found this site, because I have never heard of the tip Dr. Patterson gave. All my research has been on how to disguise the bitter taste. Will certainly be giving this a try!
hello! nancy back again. my daughter is now swallowing the strattera capsule after practicing with tic-tacs. also our OT suggested having a big cold drink of water with it and tipping the head back..it helped a lot and i am now glad i don’t have to mix it with peanut butter.
when we went up to 40mg, however, it made her very sick to her stomach. we now do two doses a day at 25mg with meals. its better.
i think it is working but it is subtle. also she still complains of nausea and headache sometimes.
good luck to everyone!
We get strattera in liquid form through our compounding pharmacy. When my son takes it we make sure we have a toothbrush ready and he quickly brushes to get any taste out of his mouth. I recently learned that strattera now is available in a transdermal gel so I will be contacting my pharmacy. My son is also on tenex and zoloft. I have all of these compounded. Hope this helps.
I have been giving Strattera to my son for a few days now. I just sprinkle it on a spoonful of yogurt, then cover it up with a little more yogurt and he swallows it down no problem. I just give him something to drink (juice) right afterward.
try a little olive or safflower oil oil on the capsule. it reduces the stickiness and the capsule slides right down.
FOR THE SAFETY OF YOUR CHILD DONT OPEN THE CAPSULES..THIS CAUSES SEVEAR LIVER DAMAGE..TO YOUR CHILD.I DID IT FOR 1 WEEK WITH PUDDING AND MY SON 6 YEARS ENDED UP IN THE EMERGENCIE ROOM WITH LEVEL ONE LIVER DAMAGE IT COULD KILL YOUR CHILD,,DONT OPEN THE STRATTERA CAPSULES PLEASE CHECK WITH YOUR DOCTOR..
Christine,
While I don’t know the specifics of what happened to your child, there is a warning about liver toxicity to Strattera, though it is extremely rare. There have been no deaths related to strattera, and to my knowledge, there is no difference if the pill is opened or taken whole. I’m sorry to hear what happened to your son.
My son hated taking all kinds of liquid medicine, so I started working with him on taking a pill form instead. We started with a small candy, something that tasted good. He tried to swallow with water, but he could not get it down. When he got frustrated we just stopped and tried another day. Next we tried with yogurt. He put the candy in his mouth and then took a spoonful of yogurt. We started with just a half of smartie candy and then tried larger candies as he got better. Now he has it down and always takes his strattera pill with a spoonful of yogurt, pudding or applesauce. Not having to take an awful tasting liquid medicine of any kind is great!
My 5 y.o has been taking Strattera for a month now, he too can’t swallow the capsule. So glad I read the post about the peanut butter because nothing else was working. Since the increase to 25mg he’s noticed the bitter taste so we have a frozen yogurt chaser now which seems to work. Are most kids taking it at night or in the morning? We’ve just started noticing a difference in his behaviour, much less impulsive and calmer, which is surprising at this time of year. Waiting to see how it goes once he’s back in school where the stimulation is much higher, trying not to get our hopes up too much….
We started with swallowing mini M & Ms then went on to orange Tic Tacs. That was fine with Ritalin, but with the Biphentin capsules we practiced with a straw. It is impossible to not swallow while drinking with a straw. We had no problems.
My son’s psychiatrist recommends banana! He says chewing some banana, putting the pill in your mouth then taking a swig of something has worked wonders for his patients who have trouble with pills!!! I’ve also heard a pharmacist recommend having a child chew and swallow a piece of gum first – to get the feel of how to swallow a pill. Unfortunately our son refuses to even TRY the “banana trick!” Bt maybe the TicTacs!!! Will be trying peanut butter tonight or milkshakes!!! Chocolate milk, pudding, mouse, yogurt and vanilla frosting have all been a huge BUST!!!
One year later! Strattera is working well. My daughter takes a 25mg tablet with breakfast and a 40mg tablet at dinner. She is 9 (will be 10 in August).
Getting your child to swallow a pill will be a helpful breakthrough! Again, try tic-tacs!
She still occasionally gets a little stomachache if she does not have a full tummy with her Strattera but other than that the side effects eventually went away!
Good Luck Everyone!
My wife and I are at a complete loss here. Please help!!
Our son was diagnosed with ADHD with additional anxiety/gross motor skills issues (can’t recall the exact terminology)… We were prescribed Straterra by his Psychiatrist starting with 2wks of 18mg, 2 weeks of 25mg then 2 weeks of 40mg. He is 7 and cannot swallow the capsule – his anxieties do not help in the matter either. We’ve tried placing the pill in peanut butter – he gags and vomits. We’ve tried the drinking from a straw and that speeds up the disintegration of the capsule – it doesn’t work. He is getting frustrated with himself and extremely worked up – it has been an unbelievably taxing experience for all of us.
In trying to find a solution, we came across this blog and tried the opening of the capsule and mixing with peanut butter in a small sandwich – that worked! He could taste the powder a bit but it was manageable. No issues with a sore stomach, etc. We’ve also mixed it in with breakfast-to-go chocolate drinks which works okay too.
Problem we’ve run into most recently is that we have double checked with his therapist and psychologist to ensure this was an okay path to take. We’ve been told that by opening the capsule and mixing it by either methods we’ve found success with, we effectively decrease the potency of the medication by 40%.
Not sure if this is scare tactics to get us to somehow magically convince our son to take the pill or if this is based on science and research… if you could provide us any additional perspective.
Thanks so much!!
Terry,
As far as I know, the only research done says that strattera has to be swallowed whole. I am not aware of any studies which show that by opening the capsule that the efficacy is reduced by 40%.
But – even if they are right… What else can you do? Just do your best, monitor your child’s response, and if the dose needs to be raised, you can do that…
Good luck.
Thank you so much! My son is 4 and recently diagnosed with ADHD and anxiety, while we managed to get him to swallow it the first few days, he has a strong gag reflex and started gagging and throwing up when trying to swallow the pill. Calls to both his pediatrician and phychiatrist yielded very little help. It burned his mouth with pudding. Then I found this. The peanut butter worked wonderfully. We topped it off with a little graped jelly at his request. This week he was upped to 25mg and while he’s still taking it, he’s started gagging again because apparently the higher dose tastes much stronger and makes the peanut butter “taste bad.” I’ve tried adding some brown sugar, some powdered sugar, etc. but that doesn’t seem to help much. I came back to read through the comments and I think we may try a small sandwich tomorrow and see how that works for him. We’re definately seeing some improvements already but it still might not be a high enough dose. Thankfully there have been no side effects yet either and he’s seemed to retain his unique personality. Thanks so much for the help this has provided so far for us.
My 8 year old cannot swallow pills. First we put it in chocolate milk then in regular milk sometimes in juice sometimes in cereal. It all works treaty for a few weeks then he doesn’t like the taste. He won’t eat peanut butter so that method is out of the question. Any other suggestions?
You should all be ashamed for putting a kid not even in his teen years on any adhd pills what is this country coming to. So reliant on a quick fix! Be a parent and show some discipline.
you should be ashamed of yourself for judging a bunch of people you don’t know about a situation that you haven’t witnessed. must be nice up there on your high horse jerk. i have fought for years to keep my son off medication. but, when your child is coming home with straight f’s on his report card, you do something about it. my son is smart but he can’t pay attention. if you could spend ten minutes trying to have a conversation with my son then you would agree. i have never seen anything like it and it isn’t because he isn’t disciplined well. and when he takes the medicine it works and actually helps him. sorry, but i want to try to help my son get a good education and make good grades so he can make something of himself one day instead of failing or barely squeaking by and only being able to find a job flipping burgers. kids with straight f’s don’t get accepted into college. if i waited until my son was a teenager to put him on a medicine then it would be too late. thanks for your thoughts about my life and problems though. now go catch a clue.
Mr. Right couldnt be more wrong. ADHD is not something you can ‘discipline’ out of a kid. My husband and I have done everything by the books and chose to not medicate for a year, but his social skills were terrible and he was so frustrated! We worked with therapy and abided by all the diciplining rules. Times outs, spanking, taking away important things of his, rewarding good behavior, everything you see on nanny 911. I am angered that you posted such a cruel comment. In fact, it is known that those children who have not been properly treated with their malfunctioning neurotransmitters, will be the children who learn to self medicate their problem with things more appalling than your stupid quick fix comment. Educate yourself you idiot!
What an idiot you are Mr. Right! Cruel is what you are to parents that have a child or in my case twins who suffer from ADHD. I myself have ADHD. I fought giving medicine to treat ADHD, wanted to try all alternatives first. When they suffer in school, grades, social situations, it kills you as their parent and destroys their self esteem at such an early age. I continue behavior therapy, psychologist, diet specific foods to help ADHD, and medication. Medication that is needed for a real disease! You are a true donkey Mr. right!
We started our son today on vyvense today because the capsel can be opened and mixed in water with no worries about effectiveness. Drank it down in no time. It’s is very expense and our insurance will not cover it. But some do. Right now it is worth it to us as we have had horrible issues getting any meds into him
Ti Mr. Right: You must not have a child with ADHD, it does not only take discipline to help a child with ADHD. And ADHD medication is not a quick fix.
One trick I learned with the capsules like strattera that float was to bend at the waist after you have the water in your mouth and swallow. This allows the capsule to float to the back of the mouth instead of the front by your teeth when you look up to swallow. My son can swallow the pill just fine this way. Hope that helps!
Would never have thought of this. I will have to try myself & then w/ my son. Thank you for posting.
If this thread is still up and running: I’ve taken strattera for a while and i’ve tried the peanut butter method. (I’m 18 now) Now, i’ll say I take two 25mg daily and the taste is just…vulgar! Even with peanut butter. I haven’t tried swallowing it whole for a while, it’s difficult for some reason. So if anyone has found better ways of mixing in the powder, please, do tell!
My 9 year old daughter has just been recently diagnosed with ADD. I myself have a hard time with understanding ADD I think because there are so many that are miss diagnosed and that there unfortunately are some parents that just want to medicate there children. I am most diffidently not one of these parents we have struggled with her for years, this year she has started having problems in school so my husband and I knew it was time to figure out something. With that all said she has been put on Strattera and like most kids she will not swallow it at all. We have tried everything but opening it because it says not to (I tend to follow directions lol) But is there any other way that we can get her to take it?? We are practicing on swallowing things we have been using mini m&m’s and we are getting some phantom pills for her to practice with. I’m not sure if this will work and it is so stressful for all of us trying to get her to take this one little pill. I could really us some help if somebody is willing to help us out.
Thank you a thousand times over for all of the ideas and feedback! Our 4 year old was recently prescribed Strattera. He took it the first day with a swallow of apple juice and a smile… some sort of “big boy right of passage” I suppose, because for days subsequent it has been impossible for him to take it. He would either spit it into the cup, or swallow around it and hold it on his tongue, all eventually leading to the pill dissolving. We tried covering it on two separate occasions in spoonfulls chocolate sauce and ice cream. As soon as he detects the pill he spits it out. We have tried everything we could think of because of the strict warning on the label and from the pharmacist about not opening the capsule. Out of sheer desperation I was searching the web for an answer as to what makes in contents harmful if ultimately they are able to be ingested. I came across this site, and I sat and read every comment aloud with my husband (he had some choice words for “Mr Right”!). We are going to try the peanut butter method tomorrow. I will report back on how things go. I guess I just wanted to say how wonderful it is to know there are other people out there who share similar frustrations and are coming together to help each other out.
Jeanine – how did it go? Did it work?
You need to find a pharmacy that will compound it into a liquid for you. Luckily, we found one in our city. Even though they don’t recommend opening it they can as long as its compounded correctly. Search for a pharmacy in your city with this link…
http://www.iacprx.org/site/PageServer?pagename=home_page
hi all
doctor prescribed to my 4,5 years old son strattera 10 mg ,my child cant swallow capsule ,the other problem is that lilly says do not open the capsule,i dont know which way will work
So very frustrating trying to coax a already stressed, high anxiety 6yr old to swallow the capsule. A boy that can inhale any kind of food within seconds but, refuses to try and swallow the capsule. I opened mixed w/ strong juice, Nasty! Tried a sip myself to confirm his declaration. Tried putting capsule in applesauce requesting him to swallow straight down & take a quick drink right after. He searches out the capsule, no matter what I put it in. He dislikes peanut butter. I am now down 3 pills wasted. I’m very happy that this blog is here to know I am not alone. Going to try the tic tac and m&m suggestion.
Both my twin boys’ were diagnosed with having ADHD by our Pediatric Neurologist 2 years ago. I felt it was too early to treat with medications at the early age of 4. Almost 2yrs later we are now in the process of the medication roller coaster trial and error. My one son was first put on Focalin XR, we gave the meds a long trial period. I hate the rebound, he hates the emotional state, and his anxiety at times was unbearable. He has now been switched to Strattera, today has been a nightmare because I cannot get him to swallow the capsule. My other son, today is his first day ever on meds, he has been prescribed Adderrall XR, the same as me, his Mom, I refused to try Focalin XR. The journal process of tracking mood, attitude, focus, activity, everything starts to today for all of us. Hoping for a brighter future for all.
Strattera better to give my 6yr old in the morning or at bed. Anyone have experience with giving the medication at different times and which ended up being the best, morning vs. night?