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!


  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!

    • THIS WORKS GREAT! WE have a family member who is also having difficulty taking this pill (40 mg) due to the taste. It just puts her over the edge. Here is the idea I posed to the doctor. Would there happen to be a gel capsule we could put over the top of the pill and would you advise this? He said, “YES” on both fronts! I hopped on line, did some research and purchased a couple of sizes. The site I found was . We found the size 2 clear gelatin capsules worked great for the 40 mg Stattera. We store the gelatin capsules SEPARATELY from the Strattera until it is time to take the pill. When it is pill time, we take the gel cap apart, pop the Stattera inside the smaller part of the gel cap, then slide the larger half over the top to encapsulate the pill. Then take the pill. There is no awful taste and it goes down easily. AGAIN, do not store the gel caps with the Stattera. they tend to take on the taste of the pills which is what we are trying to prevent. :) I hope you all experience the same fabulous results!!!

      • I am sorry. In my previous posting, I accidentally posted the email address rather than the website for MyHerbar. It is if you are looking to purchase gel capsules for Strattera or any other unpleasant tasting capsule or pill.

    • Try using apple sauce it works well just put the pill on top of the apple sauce on the spoon and then take an extra bite to help take it the reast of the way down

  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!

    • I’m curious, do you think the milk ma also prevent upset stomach? My child refuses to swallow a pill & i’m out of patience. i’ve tried everything but she’s being a drama queen. I’m exhausted just from dealing with it.
      Is your son still taking it?
      Any other advice or suggestions would be great.
      Thank you

    • We used to use whole and 2% milk with choc syrup with the 10 & 25 mg and my 5yo would drink it w/ no problems. Im guessing that the higher the dose the nastier that taste gets? The same week the Dr up’ed her dose to 40mg we found out she is allergic to dairy! Needless to say, almond and coconut milk just don’t cut it. The taste was awful! Shes non verbal (autistic) and I feel terrible that she actually drank it a few days (under duress) before I realized how terrible the taste was. Unfortunately I think we are out of options for Stattera until she can swallow pills. Having tasted it myself, I’m not even going to submit her to trying PB. NOTHING makes that taste go away.

      • I completely agree! The taste is UNREAL and parents need to try it before subjecting their children to it. We tried yogurt and applesauce before trying it ourselves and realizing how HORRID it is. Peanut butter does not cut the taste and we even tried maple syrup in desperation with no luck either. As far as I’m concerned this drug is not an option for kids who can’t swallow pills and the advice of the manufacturer should be followed!

      • So the PB really does work!! I lost my 60mg pills but had some 40g so I decided to take a pill and then cut open another one and sprinkle half on the apple sauce without even thinking. It disgusting and bribing immediately!! I was gargling pop, brushing teeth, tongue, roofof mouth and nothing was helping. It wasn’t until then that I googled starters powder and was scared I did something really stupid. I tried a spoonful of PB out of desperation and it worked. That was close to 5 minutes after swallowing it and I don’t taste it any more at all. We will see how my stomach feels in a bit!

  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!

    • I thought you were not supposed to open the straterra because it’s extended release? I thought the point was to swallow the pill whole and then it releases the medicine over an extended period of time. When you break the pill, does it have the same affect?

      I have an 8 year old as well. We have tried ice cream, pudding, the oraflo cup, nothing works.

      I’m going to try practicing with tic tac’s. I am at a complete loss.

      • I was told DO NOT open the capsule that it can burn the mouth and lining of the stomach by the manufacture and pharmacist today. It is extended release so it could possible depending on how your child digests the medication (Everybody is different on body size and etc.) that it could have dangerous issue’s. The nausea is a problem in the first place and opening the capsule also makes it worse. I am frustrated that this medication comes in only capsule form and that it can’t be compounded either (Into liquid form for children that can’t swallow medications) This is ridiculous. The only options it leaves my child is to either learn to swallow the medication which he won’t after the first time he did and it hurt his chest bad after swallowing it or changing to the next class meds which are stimulants. (Methylin, riddlin etc) which i wanted to stay away from.

      • My research showed it was an Ocular irritant, so do not get into the eyes. It is not ER, XR, or extended release as far as I know!

  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.

    • Hi I know it’s 2 yrs later but was yr son taking strattera at the time and did u break the capsule and mix it with the Nutella many thanks

  5. The PB is a great idea! Thank you so much. We tried it tonight and our daughter finally took a straterra. Praying the trend continues. We have taken stimulants in the past (tried: focalin, Ritalin, adderall) and had negative side effects (trichotrillomania-pulling out hair)…as soon as we stopped the meds the hair pulling stopped. It was unfortunate bc the stimulants really helped her behavior at school…but the s/e just weren’t tolerable. Just thought I’d mention it incase anyone else has battled that issue. Good luck to all! God bless!

    • My son had the same side effects along with low mood and aggressive behaviour. We have now been given Stratterra but he won’t / can’t swallow the capsule. I’ll be trying the chocolate milk, Nutella or peanut butter tricks over the next few days to see what happens. Thank you!

      • We are having the same issues over here with swallowing the capsule. One trick I’m working on is sprinkling it on toast and trying different toppings, cinnamon and sugar, peanut butter, jelly, to see what works. My daughter has given herself so much anxiety over just taking it that it has become ridiculous all by itself. She just turned 10 and as much as I want to give her some control and not trick her if she doesn’t know it is there there is no anxiety and she is much more calm and feels better. And we are working on swallowing pills. I’m starting with mini marshmallows. Then we are moving on to tic tacs in the mini marshmallows so hopefully one day it can be any kind of pill in a mini marshmallow and it won’t be a problem. And I’m teaching my other daughter right along with her just in case. Good luck to everyone out there.

      • I just ordered an Oralflo cup for people who have a hard time taking/swallowing pills as my son’s doctor is about to put him on Startera. I’m hoping he will find it easy to use and be proud of himself the first time he uses it.

        • Kelly,

          Thank you so very much for this information. I will give this a try. My son is non-verbal and we cocktail all of his meds. His doctor wants him to try this since but he can’t swallow pills, we will give this a try. We have not tried the peanut butter option either, but I’m willing to try. I’m just scared of the side-effects that my occur. I will have to keep a look out on him to ensure he is able to tolerate it. Wish me luck as I will need it.

  6. My son has just been diagnosed with ADHD and he too was not able to swall a Strattera pill. My husband called the Company that manufactures these pills and they suggested we dilute the complete pill in either apple, cranberry or grape juice until the entire pill is completed disolved and then drink it. You have to continuessly stir the drink to help it dilute which could take about an hour (also only add about 1/4 cup of juice). After 3 days of this my son has never complained of any irritation in his throat or stomache. My husband also called the pharmasict and they said as long as he’s not having any reaction thn it’s o.k

  7. We make tablet powder and mix it in milo or cocoa powder then my 6 years old son eat it with spone have no problem.please try it

  8. My son has a hard time taking capsules and we found that gatorade helps mask some of the taste but not enough to help him get it down quick. He does not like peanut butter or soft ice cream and we have tried yogurt and apple sauce. His dad and I don’t know what else to do or use to help him out. Any suggestions are appreciated.

  9. My son has tried several add meds and the side effects were brutal the most severe was the emotional upset we started statera and he seems to be doing much better except the stomach ache and nauseous so I took the pills and put them in applesauce it worked but he still tastes the med. I am going to try the peanut butter do I mix it in it ?

  10. HELP… I need advice on what to do if my son won’t swallow the Strattera 10mg capsule. He took it yesterday and cried forever saying it hurt his chest. The capsule they say can not be broken up because its extended and my pharmacy told me not too do it.. How can i get this medication down without hurting him throat/chest.

  11. I came upon this thread because I just burned my mouth on Strattera powder.
    I am trying out the Strattera and I have significantly INCREASED brain fog and sleepiness on 65mg. I am usually very sensitive to any medicines so I thought I might try half the capsule and see how it works.
    I poured half the capsule’s powder under my tongue, took a swig of warm tea, and about 30 seconds afterward it felt like I had burned under my tongue with scalding water.
    The burn lasted about 10 minutes and now my under my tongue is beginning to numb.
    Every medicine I’ve come across that has said not to open the capsule was bogus. So I did not heed the warning. Would be great if they explained WHY, I guess for stubborn DIY-ers like dumb old me!!

  12. Hi

    My son (13) just started on Strattera a month ago. He was diagnosed with ADD in 4th grade and after his first year in middle school ift was clear that he could not rely on his intellegence and abitity to learn quickly to get by. He does not have the hyperactivity. I was wonder if this drug is more effective for ADHD or ADD?

  13. My daughter has been taking stratagem for a month. She takes 25mg, I give it to her in a tablespoon of chocolate caramel peanut butter ice cream. I carefully mix it with a kabob scewere and make sure it’s absorbed really well. It seems to be fine.

  14. I usually open up the pill and empty out the capsule in some orange juice (sunny delight) and have’nt heard her complaint about it! :) (Doctor told me it was ok). Hope this helps :)

  15. My DD can swallow pills but hates the taste of the capsule itself. I found softening some airheads candy and coating the capsules works like a charm. I am able to coat a couple weeks’ worth with one piece of candy and store them in the fridge so they don’t stick together. Laffy taffy works too but is softer so it sticks together even in the fridge.

  16. My 7 year old won’t swallow pills either. My doctor told us that the Strattera powder is caustic and will burn the inside of your mouth unless you completely encapsulate that powder in fat. We started by mixing the powder into chocolate ice cream. We could get it into my son – although it was a struggle. It did taste absolutely awful, and it was ruining ice cream for him. :-(

    Tonight I made a great discovery, if your child likes mustard, it almost completely masks that awful spicy chemical flavor! Mustard doesn’t have the fat required to coat the drug. So, I mixed the powder into butter and then made my son a butter and mustard sandwich. Add meat as desired; My kid just likes mustard sandwiches. I think would work with a hotdog too! Anyway, I didn’t tell him it was in there, and he scarfed it down with no problems! I did taste the sandwich and can confirm that if I didn’t know it was in there, I would assume it was maybe just a bit stronger of a mustard. Just don’t forget to mix the drug in BUTTER, then just use the mustard to mask the flavor. If you use just mustard alone it could burn!

    I appreciate the comments about chocolate milk. I will try that when he isn’t in the mood for mustard!

  17. My daughter takes liquid Strattera the compound pharmacy puts a orange flavor in it which is still extremely better. The pharmacist suggested taking it with grape juice or orange juice which she does on top of I make coffee and she takes it with the juice and my coffee with some cinnamon in it I put a little extra cream in it for her. The last time she took it she said she couldn’t taste it with the cinnamon and the coffee the two bitterness taste kill each other off

    • Jen,

      Is there a liquid form of Strattera now? My son’s doctor just prescribed it this month but only in the pill form. If this is the case, I will see if this could be an option for me since he can’t swallow pills.

      Thanks in advance.

    • My son just started Strattera a month or two ago and he couldn’t stay it in pudding. His doctor suggested taking it to a compound pharmacy to make the liquid. He hated that too, but it’s easier. I finally started hiding it in grape juice that he doesn’t complain much. HOWEVER, my insurance (UHC) doesn’t pay for compounding and it’s something like $114 for a 14 day supply. So I’m beyond frustrated that we finally found a solution but it’s cost prohibitive.

  18. Please be careful! My stepdaughter is nonverbal and has a G-tube. She is unable to swallow a pill. The doctor prescribed it and we were dissolving it in water and administering it through the G-tube. Just under a month later she started having awful abdominal pain and GI symptoms. About 20 to 40 minutes after drinking a bottle, she would start screaming and crying biting herself and other people. The Strattera was tearing up the lining of her stomach! Also the skin all around the side of the G-tube became irritated terribly from the contents leaking a little bit. I called Eli Lilly and they wouldn’t tell me exactly why other than it’s an irritant but said absolutely not to open it. We had great success with her on the Strattera and are now getting ready to try something new.

  19. My child was on Vyvanse for the longest time and we would open the capsule and add it to her drink whatever she was drinking it seem to work but then we had to switch her doctors and they put her on this Atomoxetine well we tried putting it in soda it seems to work but it still has a bad bitter taste do she plugs her nose and she can’t taste it but it doesn’t affect her stomach or anything and we try the peanut butter and the peanut butter works wonders she’ll drink the content and then she’ll get like one or two scoops of peanut butter and it seems to be working and I’ll keep you all updated after all it is her first day of being on it so we’ll see what happens.

  20. The peanut butter trick worked for a month. Not anymore!! That’s fro a child that loved peanut butter not anymore. Good luck with that!!

  21. Myself and my children are all of ADHD medication (because guess what? it has genetic ties) and we all have had incredible success when we found what works for us.

  22. We put it in a carnation instant breakfast shake. My son prefers chocolate but will use vanilla or strawberry sometimes. We put the powder in the cup and then open the capsule and mix with the powder and then add the milk and mix well. He says he can’t taste it and it keeps the tummy upset away.

  23. After months of fighting with my 8 yr old yo take his Straterra everyday, the pb has worked! Hallelujah for this suggestion!

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