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

There are no suitable licensed formulations of pantoprazole or rabeprazole. Other PPIs are available in suitable formulations and may be prefered.

Omeprazole: licensed options

Omeprazole capsules

Contain enteric-coated pellets and are licensed to be opened and the contents mixed with water, fruit juice or apple sauce. The pellets must not be crushed or chewed. The capsules can also be sucked and the pellets swallowed with water. See the relevant SPC for details.

The capsules are also licensed to be sucked and the pellets swallowed with water. This option may not be suitable for patients unable to control their swallow.

Omeprazole dispersible tablets (Losec MUPS, Mezzopram)

Contain enteric-coated pellets and are licensed to be broken and dispersed in a spoonful of water or mixed with fruit juice or apple sauce. Do not use milk or carbonated water. The pellets must not be crushed or chewed. See the relevant SPC for details.

Omeprazole oral suspension 20mg/5ml

Available as a licensed product. Provided as powder to be reconstituted with water before dispensing. Once reconstituted, it has an expiry of 28 days and requires fridge storage.

Omeprazole oral solution 10mg/15ml and 20mg/15ml unit dose

Available as licensed products, these single-dose formulations can be taken directly from the bottle. Each is provided as two solutions that must be mixed together before administration. See the relevant SPC for details. The concentration makes these better suited to child rather than adult doses.

Lansoprazole: licensed options

Lansoprazole capsules

Contain granules and can be opened for oral administration. Some brands are licensed for the capsule contents to be mixed with a small amount of water or fruit juice, or sprinkled onto a small amount of soft food. The granules must not be crushed or chewed. Check the relevant SPC for details.

Lansoprazole absorption is reduced by food; this is unlikely to be clinically relevant when given with a small amount of soft food. If lansoprazole is to be given with meals, monitor for effect and adjust the dose if necessary, or consider switching to a different PPI.

Lansoprazole orodispersible tablets

Can be placed on the tongue and gently sucked; they rapidly disperse in saliva, releasing gastroresistant microgranules to be swallowed, with or without additional water. The microgranules must not be crushed or chewed. Orodispersible tablets may not be suitable for patients unable to control their swallow.

Lansoprazole orodispersible tablets can also be dispersed in water and given via an oral syringe. The microgranules must not be crushed or chewed. See the relevant SPC for details.

Esomeprazole: licensed options

Esomeprazole tablets

Licensed to be dispersed in water (not carbonated water or other liquid) before administration. See the relevant SPC for details.

Esomeprazole capsules

Licensed to be dispersed in water (not carbonated water or other liquid) before administration. See the relevant SPC for details.

Esomeprazole granules for oral suspension

Licensed to be dispersed in water before administration. The suspension will thicken on standing. The granules must not be chewed or crushed. See the relevant SPC for details.

Licensed products used ‘off-label’

In view of the licensed options available, it is unlikely a licensed product would need to be used in an unlicensed way.

Special-order products

In view of the licensed products available, special-order preparations are unlikely to be required.

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