Strattera: “My son can’t swallow the pill”

On 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!


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Comments

  1. We had to give up on the Strattera and have been using the Daytrana Patch for awhile now. It has been working well. I really wanted the Strattera to work because I wanted to avoid using a simulant. But we used the peanut butter method for awhile. Those that are posting opening it and have the kids take it WITHOUT some kind of “coating or binding” food, I don’t think you have read why it is encapsulated. And the post from the elementary school opening and giving it with powdered fun dip is a little concerning. How can a school administer medication for ADHD without following manufacturers directions?

    From what I understand about Strattera, you build up to the level or dosage a little at a time. And that may take about six months, and THEN, that may result in an effective or non-effective result. So over those six months, you may or may not be taking the right course. And because the medication is an irritant, it can cause stomach irritation. For us, using opened medication in peanut butter, I noticed my son’s voice began to be a little hoarse. Could have been a number of things. But because we were trying the Strattera, I attributed it to his throat being irritated by the medication as he ate it.

    Obviously, if there is some new reactions you should contact your doctor. But if Ivory’s son “tastes” the pill, then the powder is out. He must be chewing it or it dissolves a bit before going down. And then, maybe that is upsetting his stomach.

    Really, has any of you tried to taste it first? It tastes terrible. And we have been through this for awhile. My original posts were in 2009! I can’t believe it has been that long but it is nice to get updates on other families experiences.

    Good luck to all!

  2. I emptied a capsule into my child’s chocolate milk this morning and he never knew it was in there. He used to complain about the taste and he has also mentioned a burning feeling from it before. I’m guessing it had dissolved before it was in his stomach. So far there have not been a complaint over the chocolate milk. I will keep it updated!

  3. My 8 yo son will not learn to swallow pills, so we open the Stratterra capsules and use our “cocktail” I created that works for us. His doctor said only applesauce, ice cream and something else (I forgot) can be mixed with it, so I use a dollup of vanilla ice cream on a spoon. I let it soften, the sprinkle 2-10mg capsules on top gently. Then I add a dollup of Chocolate Syrup, and gently mix with the point of a sharp knife. It’s a tricky science, as you have to mix the powder on the spoon without knocking the powder out. Hence, the pointy knife end gives me ultimate control. Then, I add the 3rd-10 mg pill to this and re-mix. The chocolate helps mask the HORRIBLE taste of this medicine. I know, I tried some! My son will only chase it with apple juice, and I must give him a marshmallow immediately following the swallowing to get that taste out of his mouth. Lastly, we do it right after dinner as we found out the hard way that with all that apple juice drinking he does to chase the medicine, he will wet the bed every single time if this medicine ritual is performed too close to bedtime.

    Our social and dinner plans are dictated by his Stratterra dosing as traveling with ice cream and chocolate syrup is not easy! It’s time to get those Tic Tacs and teach him to swallow a pill! Our friend suggested having him practice swallowing Tic Tacs as they are small and not harmful!

  4. I just wanted to say thank-you! My son was taking his dose in pudding and complained each day about how bad it tasted. One day he refused to take it any more – even the thought of the pudding was making him nauseous. Since he doesn’t like peanut butter we tried Nutella and it worked. He has taken his medicine this way for weeks now without complaint and says he hardly tastes the medicine. It’s easier and cleaner to prepare on the spoon as well compared with dosing in pudding.

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