Struggle to swallow your paracetamol? You might find a different type of medication is much better suited to you and your symptoms. Keen to know which is the best medication for you? We break down the difference between pills, caplets, capsules, liquids, syrups, suppositories and more. Here’s everything you need to know.
When it comes to taking medication, the majority of us take either tablets or liquid orally (by mouth). Depending on what your GP has prescribed you, generally speaking, you’ll take an oral tablet that can either be swallowed, chewed, or placed under your tongue to dissolve. But of course medication also comes in liquid form too, and — not to make things too complicated — but there are also suppositories to throw into the mix too.
So what’s the best medication for you, and which one is most effective? Here’s everything you need to know about taking tablets, liquids and suppositories.
Oral medication
Medications that you swallow are designed to travel from your stomach or intestine to be absorbed into your bloodstream. Once the medication has been absorbed, it’s then carried to targeted parts of your body.
But there are a number of things that can affect the way your body absorbs this medication, and the speed of absorption — how quickly it takes to absorb into your bloodstream. These can include:
- what type of medication you’re taking (e.g. liquid or tablet)
- whether you take your medication with food, after food, or on an empty stomach
- how quickly the medication takes to pass into your bloodstream (some medications have a special coating which are designed to dissolve slowly in your stomach)
- what other medications you are taking — this can interact and affect the speed to which your body absorbs your medication
- the acid conditions in your stomach — this acidic environment can interfere with the drug's potency
Tablets/pills and capsules
Tablets, or pills, are the most common type of oral medication. They’re made by compressing one or more powdered ingredients to form a hard, solid, smooth-coated pill that should be swallowed whole. Once ingested, the pill then breaks down in the digestive tract and is absorbed into your bloodstream to essentially do its job: whether that’s pain relief, vitamin supplements, antibiotics, probiotics — the list goes on.
In some cases, tablets contain additives that hold the pill together to improve the taste, texture or appearance, and there are some pills that have a special coating that prevents them from breaking down in the stomach. This coating helps ensure that the tablet will only dissolve after entering the small intestine.They also come in different shapes and sizes; they can be round, oblong or disc-shaped. Oblong pills are known as caplets, which tend to make them easier to swallow. And there are chewable dissolving tablets that break down in your saliva. These are designed for people who find it difficult to swallow pills and tablets.
All of these pills, tablets and caplets work in the same way: you swallow it, your stomach then breaks it down, and it finally “metabolises” and passes through the liver to enter the bloodstream so it can get to work on specific areas of your body.
Capsules work in the same way to pills and tablets, but the medication is enclosed in an outer shell. Your stomach breaks down the outer shell, then your body metabolises the capsule in the same way it would a tablet.
Capsules are usually either hard-shelled (the inside is filled with dry medication in powder or pellet form) or soft-gel capsules, also known as liquid gels. Liquid capsules contain gelatin or a similar substance, to make them easier and quicker to digest — once digested, the active ingredients are quickly released and absorbed into the bloodstream.
So what’s better, a tablet or capsule?
The main difference between the two, is that a capsule tends to be much more fast acting than a tablet, because they break down in your stomach much quicker. They also have a higher bioavailability, which means that more of the drug is likely to enter your bloodstream, making them more effective than tablets. But that also means they come with a more expensive price tag. They tend to taste a lot better too — for anyone who finds pills a little tricky to swallow!
Pills and tablets on the other hand, are more affordable than capsules, and they tend to have a longer shelf life. A single tablet can accommodate a higher dose of an active ingredient than a single capsule, so often you can take 1 tablet for it to work effectively. Tablets are however, more likely to cause stomach irritation, and they can take longer to break down in your stomach.
What about liquid medication?
Liquid medication is usually prescribed for anyone who struggles to swallow tablets or capsules (particularly children and older adults). These can come in various forms including liquids, solutions, syrups and mixtures. They’re usually infused with sweeteners and flavourings to make them taste a lot nicer than a tablet would, and are administered in teaspoon-sized doses, or around 5ml. Although you should always follow the instructions on the packing or from your health provider.
Liquid extracts are actually much easier to digest than tablets, and they have higher absorption rates. Unlike pills, the body doesn’t need to break down a liquid extract, which means your body absorbs more medicinal properties at a much faster rate. In fact, it can take as little 4 minutes to assimilate into your body compared to tablets, which can take 20-30 minutes to break down before the body can even start to absorb them.
What about suppositories?
Suppositories are prescribed when other forms of medication are not able to be used, such as oral medication.
They are usually small, round, oval or cone-shaped, and are inserted into a specific area of the body, to then dissolve and either treat the localised area, or absorb into the bloodstream and travel to other parts of the body. They work in the same way to pills and liquid medication, but they are not administered via the mouth.
There are three types of suppositories:
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rectal suppositories — inserted into the rectum or anus to treat conditions such as constipation, fever, haemorrhoids, pain, nausea and mental health conditions including anxiety, schizophrenia or bipolar disorder
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vaginal suppositories — inserted into the vagina to treat bacterial or fungal infections and vaginal dryness
- urethral suppositories — inserted into the urethra and used to treat men who suffer with erectile dysfunction
Why use suppositories?
A wide range of medications are available in suppository form, and are usually prescribed to patients who have specific health conditions which means they are unable to take oral medication. These can include:
- people who suffer with seizures
- people who have difficult swallowing medication
- if you are vomiting and unable to keep pills or liquids down
- if your digestive tract is blocked — this can stop your body from absorbing the medication
- the medication tastes too bad to take by mouth
- if your gut breaks the medication down too quickly
- if the gastrointestinal tract destroys the medication
Generally speaking, suppositories are best advised for people who are unable to digest or swallow oral medication, as they do not cause nausea or vomiting due to gastric irritation, like some oral medications can do.
They also tend to target specific sites of action and are absorbed by the body much quicker — once inserted, they dissolve and melt, allowing rapid absorption through the mucous membranes, which then delivers directly into body cavities. So they essentially get to work on a specific local area of the body much faster than a pill would.
Suppositories also achieve total bioavailability, which means more of the drug gets into your bloodstream than it would with oral dosage forms.
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