Using our advice

Please see Medicines suitable for adults with swallowing difficulties

The choice of medicine formulation should be made on an individual basis, taking account of patient factors. Follow our stepwise guide Choosing formulations of medicines for adults with swallowing difficulties

Licensed medicines in suitable formulations

Enalapril 5mg/5ml oral solution

Available as a licensed product. It has a 30-day expiry once opened and requires fridge storage.

Ramipril 2.5mg/5ml oral solution

Available as a licensed product. It has a one-month expiry once opened and requires fridge storage.

Lisinopril 5mg/5ml oral solution

Available as a licensed product. It has a 30-day expiry once opened and does not require fridge storage.

Captopril 5mg/5ml and 25mg/5ml oral solutions

Available as licensed products. They have an expiry of 21 or 28 days after opening (depending on manufacturer) and do not require fridge storage.

Captopril is not usually suitable for once daily administration.

Licensed medicines used ‘off-label’

Enalapril, lisinopril and ramipril tablets

Can be crushed and/or dispersed in water or crushed and given with soft food.

Perindopril erbumine (perindopril tert-butylamine) tablets

Can be crushed and mixed with water or given with soft food. Perindopril absorption might be reduced by food but this may not be clinically relevant; give the medicine the same way each day, monitor for effect and adjust the dose if necessary.

Ramipril capsules

Can be opened and the contents placed directly in the mouth, on a piece of bread or given with soft food. The capsule contents taste unpleasant.

Captopril tablets

Can be crushed and/or dispersed in water or crushed and given with soft food.

Captopril is not usually suitable for once daily administration.

Special-order medicines

In view of the licensed preparations available, special-order products may not be required.

The following are listed in Part VIIIB of the Drug Tariff:

Enalapril

10mg/5ml, 5mg/5ml and 1.25mg/5ml oral suspensions; 5mg/5ml oral solution

Lisinopril

20mg/5ml oral solution; 20mg/5ml oral suspension

Perindopril erbumine

4mg/5ml oral solution; 4mg/5ml oral suspension

Ramipril

10mg/5ml oral suspension

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