Giving oral medicines and supplements to children

A 6 year old boy undergoing treatment for acute myelogenous leukaemia is discharged from hospital to continue treatment from home. He is unable to swallow tablets or capsules and so must use compounded liquid formulations, some of which have only seven day stability. His family live in a remote area, two hours’ drive to the nearest compounding pharmacy. They bring a cooler every week when they drive to obtain medication refills because the medications must be refrigerated at all times. The medications are unpalatable, and his parents are spending up to three hours three times a day, every day, trying to give him his medication.

Giving medications to children who cannot yet swallow tablets or capsules (hereafter referred to collectively as “pills”) is a common problem without a universal solution. Frequently, parents, clinicians, and pharmacists attempt to crush tablets, empty capsules into food, search for alternative dosage forms, or find a different medicine altogether. Unfortunately, finding alternative formulations that children will accept can be challenging. Oral liquid formulations are sometimes a viable solution, but many oral liquid preparations are not commercially available, can be difficult to measure and dose correctly, or may …