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"Let people know diluting pills is easy"

About: Cancer Services / IV & Oral SACT Treatment (Chemotherapy)

(as the patient),

My cancer treatment involves taking five oral chemotherapy pills twice a day. So ten in total. 

When I said I struggle to swallow pills but will happily crunch, chew or dilute them if possible, the oncologist and the information available didn’t seem to make clear this was an option. When I eventually found out diluting them was an option, my anxiety about taking the medication went away. 

The pharmacy instructions I got said dilute in 200ml of lukewarm water. First time I tried it didn’t dilute them much so I tried bashing them with a spoon. I eventually found the accurate information online that Lukewarm is 40 degrees C and it take 15 minutes for them to dilute properly. This works well. 

So it would be much better to provide every one with the detailed information that you can try swallowing the pills whole, or if you don’t like that here is an alternative diluting method: put them all in 200ml of lukewarm water (40C) for 15 minutes then drink. Down the hatch easy peazy. 

When I mentioned this to a few people, most agreed swallowing pills whole is something they don’t like but are not aware there is an alternative and would prefer a liquid form. 

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Responses

Response from Nicola McKee, Lead Nurse, Specialist Services, NHS Tayside 4 months ago
Nicola McKee
Lead Nurse, Specialist Services,
NHS Tayside

I work as a Lead nurse within the Triumvirate structure for Specialist Services. I provided Leadership and Professional Nursing support to the following teams: Renal, Oncology, Haematology, Neurosciences (which include Neurology, Neurosurgery and all linked specialities), Genetics, Advanced Intervention Service and Pain Service in addition to this I also provide Professional support to the Radiology Nursing service and Stracthro Regional Treatment Centre.

Submitted on 27/01/2025 at 10:35
Published on Care Opinion at 10:35


picture of Nicola McKee

Dear Donald1,

Thank you for taking the time to share your feedback. I am pleased to hear you are able to take your medication in an easier way. I have shared your post with our Lead Pharmacist for Oncology and Haematology (Katherine Cowie) and she has offered the following advice;

We would advise all patients that they should swallow anti-cancer tablets or capsules whole. Please don’t chew them. There are numerous different oral anti-cancer medicines and some will need an intact coating or capsule in order to work properly. If you have any issues swallowing your medication please discuss with your specialist team. Never crush tablets or open capsules unless your doctor, nurse or pharmacist tells you to. There are several specialist pharmacist that work within the Oncology department and they will happily explain the options for your particular treatment.

I hope that you find this helpful and would encourage you to speak with a member of our team to gain support and guidance as to which tablets can and can't be dissolved to ensure your treatment is not compromised.

Best wishes

Nicola McKee, Lead Nurse, Specialist Services

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Update posted by Donald1 (the patient)

Thanks for your response. Now I am worried I have compromised my care. I assumed the effectiveness of dissolving capecitabine was the same as swallowing whole. I asked and was given instructions on how to dissolve them. My feedback was based on the instructions were incomplete ie the best temperature and duration before they are completely dissolved.

If taking tablets whole is vital then some help to overcome my probably phobic fear of choking on them would be helpful.

Response from Nicola McKee, Lead Nurse, Specialist Services, NHS Tayside 4 months ago
Nicola McKee
Lead Nurse, Specialist Services,
NHS Tayside

I work as a Lead nurse within the Triumvirate structure for Specialist Services. I provided Leadership and Professional Nursing support to the following teams: Renal, Oncology, Haematology, Neurosciences (which include Neurology, Neurosurgery and all linked specialities), Genetics, Advanced Intervention Service and Pain Service in addition to this I also provide Professional support to the Radiology Nursing service and Stracthro Regional Treatment Centre.

Submitted on 27/01/2025 at 12:17
Published on Care Opinion at 12:17


picture of Nicola McKee

Dear Donald1

I'm sorry, It was not my intention to cause alarm. There are a number of anti-cancer medications and we wanted to ensure you were receiving the correct advice. I am advised that Capecitabine is one of the medications that can be dispersed in water and therefore would be just as effective. I take on board your feedback in relation to the instructions you were given being incomplete and can see the usefulness of what you have shared, so thank you for doing so, I will ensure this is shared with our Pharmacy and Nursing teams.

If you would like to discuss this further or would like support with any other medication, please share your contact details with our Patient Experience Team who will be happy to forward them to us:

Staffnet Patient Experience

Email: TAY.feedback@nhs.scot

Freephone: 0800 027 5507

Extension: 35507

Best wishes

Nicola McKee

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