Medicines and tube feeding

A feeding tube is used if you are unable to eat, or if you have an illness that makes it hard to swallow food or drinks. Having a feeding tube means that if you normally take your medicines by mouth, you may need to take them through your feeding tube.

What types of medicines are used with a feeding tube?

Liquids

Liquid medicines that are usually taken by mouth can usually be taken in a feeding tube. If you are unsure whether your medicine is available in a liquid, ask your pharmacist. Some liquid medicines are very thick and you may need to mix them with water before putting them down the tube. This should be done just before giving the dose.

Tablets

If your medicine comes in tablets only, ask your pharmacist whether your tablets can be crushed before you take them using a feeding tube. Only certain tablets can be given this way.

  • Immediate release tablets: These are ‘ordinary’ tablets. Sometimes they are sugar or film coated. Some of these tablets will disperse (dissolve or break down) if left in water.
  • Soluble tablets: These tablets dissolve completely to leave a clear or coloured solution.
  • Dispersible tablets: These tablets break down to a fine powder when put in water.
  • Special release: These tablets may be called slow release, modified release or enteric coated. They usually have the letters XL, LA, SR, MR, EC or CR in the name. These should NOT be crushed and are not suitable for use through a feeding tube.

Capsules

If your medicine comes in capsules only, ask your pharmacist whether your capsules can be opened and dispersed in water before taking them.
Most capsules have a gelatin shell with loose powder inside that can be mixed with water. Some contain granules and others are soft capsules filled with liquid. 

Some capsules are special release, and have coated beads inside. These may be called slow release, modified release or enteric coated and usually have the letters XL, LA, SR, MR, EC or CR in the name. These should NOT be crushed and are not suitable for use through a feeding tube.

Tips for taking your medicine with a feeding tube

While you are in hospital, you will be given instructions on what to do when you get home, such as these:

  • Check the placement of your feeding tube the way you were shown in hospital.
  • Be sure to use the correct port on the feeding tube for your medicines.
  • Prepare each medicine the way you were shown in the hospital. 
  • Don't try to put whole pills in the tube – they may get stuck.
  • Measure the prescribed amount of liquid medicine, or crush pills and dissolve the powder in water or liquid as shown in hospital. 
  • Take each medicine by itself, in the following order:
    • liquid medicines first
    • medicines that need to be dissolved second
    • thick medicines last.
  • Don’t mix medicines with feeding formula unless your healthcare provider says it’s okay to do this.
  • Wait before restarting your tube feeding. Some medicines don’t work when mixed with the feeding formula.
  • Ask your healthcare provider how long you should wait to start feeding after taking medicines.
  • Flush your tube before, between and after giving medicines so the tube doesn't get clogged.
  • Keep your tube clamped in between feedings.

Tell all your healthcare providers that you take medicines through your tube. Also ask your pharmacist whether your medicine comes as a patch (to put on your skin), a suppository (to be inserted into your bottom) or an inhaled (breathed in) version. This might be easier than taking it in a feeding tube.

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following: 
  • coughing
  • trouble breathing during feeding, flushing, or giving medicine
  • nausea or vomiting
  • bloated or tight stomach
  • runny poos (diarrhoea) that last more than 3 loose stools
  • difficulty passing poos (constipation) lasting more than 48 hours
  • sudden weight loss or gain 
  • fever
  • tube that can’t be unclogged
  • tube that falls out or if you have difficulty telling if the tube is in the right place
  • tube that is cracked or breaking down
  • bloody or coffee-coloured drainage through the tube
  • red, warm or tender skin around the tube
  • sudden increase or decrease in the amount of drainage through the tube

References

  1. Preventing errors when administering drugs via an enteral feeding tube Institute for Safe Medicines Practices, 2010
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 26 Jun 2020