Clear Answers to Your Medication Questions So You Can Take Your Medicine Safely

Making The Medicine Go Down

Hi Dr Louise- I am an RPh and my mother is receiving KCl 10Meq liquid which she has refused to take any more. Having tried it in all the usual flavoring vehicles i.e apple sauce etc I convince her Doc to try Micro K capsules. I believe the KCl is micro encapsulelated. Will be starting it tomorrow, mixing with apple sauce, maybe bananas, or ice cream. Do you have any other ideas what can be used for flavors etc.

This is a struggle for an 88 year old cancer patient, with a pace maker who expects me to make this stuff palatable.

Thanks-
Mark B. RPh

Thanks for your question, Mark.

There are two things going on here that I’ve learned from doing taste tests on liquid antibiotics for my family medicine residents. When it comes to making the medicine go down, there’s TASTE and then there’s TEXTURE. Either one or both can be the “yuk” factor that makes your patient balk at swallowing their medicine. The nastiest tasting liquid antibiotic we have recorded was Biaxin®, which was not only bitter but left this incredibly nasty grittiness in your mouth. One taste of that and we all understood why parents were calling us to complain that their kid refused to take another dose!

Although potassium chloride (KCl) liquid isn’t gritty, it IS a salt. And let’s face it, salt tastes, well, SALTY. And KCL liquid tastes really, really salty. And really salty things can be nauseating, not only on the way down but afterward, sitting in your stomach. Taking the potassium with food helps with the nausea.

Years ago we used to dispense potassium chloride as an effervescent tablet or in little packets that you would add to a glass of water or juice at home right before taking it. Most people found that tomato juice, orange juice or pineapple juice disguised the saltiness the best.

You mentioned using Micro-K®. That’s a capsule filled with little beads that you can either swallow whole or open up and mix with food. That’s much better than the liquid. My personal favorite over the years has been K-Dur® tablets. K-Dur® is a white pressed tablet made up of little crystalline micro-beads that has an iridescent look to it. I find K-Dur® much easier to disguise than using the Micro-K®  beads because once a K-Dur® tablet hits liquid it “melts” into bland tasting mush with just a little bit of grittiness. I’ve actually tasted it to make sure. Again, when it comes to palatability of liquid medicine, I find that it’s all about taste and texture.

What flavors would I suggest? Hmmm… Years ago we had a problem disguising activated charcoal for kids on our Pediatric Unit. The best result we found with that age group was mixing the gritty charcoal bits with straight Hershey’s® syrup and using a “chaser” of 7-Up to get the gritty stuff down. The syrup’s thickness helped ease the grittiness of the charcoal, and kids like chocolate.

These days it’s easier to buy flavorings than ever, because instead of just unsweetened Kool-Aid® powder, you can buy Crystal Light®, Mio® and other products that flavor water. And now there’s Hershey’s® Syrup available in chocolate, caramel and other flavors. It helps hides grittiness because of its thick texture.

What does your mom like? Is her main objection TASTE or TEXTURE? Would she be willing to try a “chaser” of another food or drink to help rinse out her mouth?

Thanks for the question, and best of luck.

Dr. Louise

P.S. Anyone have any other ideas for Mark?

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  • ABOUT DR. LOUISE

    Dr. Achey graduated from Washington State University’s school of pharmacy in 1979, and completed her Doctor of Pharmacy from Idaho State University in 1994.

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