How to Make Tablets Easier to Swallow: Top Tips for Formulators & Manufacturers

Difficulty swallowing tablets and capsules, also known as pill dysphagia, affects a significant percentage of the population. Reports estimate between 10–40% struggle swallowing tablets and capsules, especially larger ones (Source).

Key Takeaways

• Difficulty swallowing tablets is a global issue that directly impacts patient adherence, consumer confidence, and brand loyalty.
  
• Tablet swallowability is influenced by controllable design factors, including size, shape, and coating.
• Film coatings improve swallowability by reducing friction, preventing sticking, and masking unpleasant taste and odor.
• Patient‑centric tablet design, informed by real‑world feedback and market insight, supports better acceptance across pediatric, geriatric, and polypharmacy populations.
• Designing tablets that are easier to swallow delivers both clinical and commercial value by reducing non‑adherence risk and strengthening product differentiation.

Why Swallowability Matters

What Factors Cause Swallowability Issues?

Patients may struggle to swallow tablets and capsules for a variety of reasons, often involving a combination of physical, psychological, and formulation-related factors.

• Physiological and medical factors may arise due to ageing or conditions such as Parkinson’s disease, dementia, multiple sclerosis, and head and neck cancers. These can lead to swallowing dysfunction (dysphagia) or reduced saliva production, both of which make swallowing solid dosage forms more difficult.
  
  
• Psychological and perceptual barriers include fear of choking, a heightened gag reflex, or learned avoidance behaviours, where repeated negative experiences cause patients to delay doses or discontinue medication altogether.
  
  
• Tablet and capsule design factors also play a role, including the size and shape of the dosage form, whether a tablet is coated or uncoated, and the type of capsule used (for example, soft gel versus hard gelatin).
  
  
• Population-specific challenges are particularly evident among older adults, children, and patients taking multiple medications, all of whom may face an increased swallowing burden.

Consequences of Swallowing Difficulties

As a result of swallowing difficulties, patients may delay doses, modify their medication by crushing tablets, or avoid taking it altogether. This non‑adherence is associated with poorer treatment outcomes and increased healthcare utilisation and costs. For over‑the‑counter (OTC) medicines and dietary supplements, these challenges can also translate into reduced consumer confidence, a negative brand experience, and ultimately lost sales due to discontinued or inconsistent use.

Tablet Design Strategies to Improve Swallowability

Swallowability is influenced by multiple design attributes. While patient physiology and perception play an important role, the physical design of the dosage form itself is a critical and controllable factor. When developing tablets and capsules, manufacturers should consider four key design elements:

Size and Shape

Tablet size and shape are among the most influential determinants of swallowability. Larger tablets are more likely to trigger gag reflexes, create anxiety, or become lodged in the throat or oesophagus, while poorly designed shapes can increase friction during swallowing.

• Smaller, elongated, or rounded tablets are generally perceived as easier to swallow than large, flat, or sharply edged forms. Oval shaped tablets tend to move more smoothly through the mouth and oesophagus compared to round or angular designs.
  
  
• Design considerations may include controlling maximum dimensions, optimising aspect ratio, and incorporating break lines or score marks where appropriate to support dose flexibility without compromising swallowability.
  
  
• Regulatory guidance increasingly recognises the role of size and shape in patient adherence, encouraging manufacturers to consider swallowability as part of patient‑centric product design, particularly for chronic therapies and vulnerable populations.

Thoughtful optimization of size and shape early in development can significantly reduce adherence challenges.

Coating Choice

Tablet coatings play a central role in improving swallowability by addressing both mechanical and sensory challenges.

Taste masking is another critical benefit of coatings, as bitterness or unpleasant API flavours can provoke aversion or gag reflexes before swallowing even occurs.

Selecting the right coating system allows manufacturers to enhance patient experience without compromising stability or release performance. For a deeper overview of coating technologies and their functional benefits visit our article What Types of Coatings Are Used in the Pharma Industry.

Color and Branding Opportunities

Color is often viewed as a branding element, but it can also influence swallowability and patient perception. It is recommended to conduct patient or consumer preference studies as color preferences vary according to age, gender and geographic market.

Consistent and distinctive color choices can support brand recognition, help differentiate strengths or formulations, and reduce confusion for patients managing multiple medications. For OTC medicines and dietary supplements in particular, color plays an important role in shaping consumer expectations, reinforcing brand identity, and contributing to a positive overall product experience when combined with appropriate coatings and surface finishes.

Flavor and Aroma Masking

Sensory perception begins before swallowing, and taste and smell can strongly influence whether a patient is willing to take a tablet or capsule at all.

• Unpleasant tastes or odours, particularly from bitter APIs, can trigger immediate aversion, gag reflexes, or learned avoidance behaviours.
  
  
• Layered coating systems, functional barriers, and targeted flavour‑masking strategies can help isolate the API from the taste buds during administration.
  
  
• Flavouring approaches, where appropriate, may further improve palatability and acceptance, particularly for OTC products and dietary supplements where consumer experience directly influences brand loyalty.

Effective flavour and aroma masking supports a more positive first impression and reduces the likelihood of delayed or skipped doses.

Manufacturing Considerations

Adjustments in Formulation to Optimize Swallowability.

When tablet size becomes a barrier to patient acceptability—typically for tablets weighing more than 1 g—formulators can explore adjustments to the core formulation to help reduce overall tablet mass without compromising performance. One effective strategy is the use of multifunctional excipients, which can fulfil multiple roles within the formulation. For example, partially pregelatinized starches such as Starch 1500 can act simultaneously as a filler, binder, and disintegrant. By replacing several single‑function excipients with one multifunctional option, it is often possible to simplify the formulation and reduce tablet weight, resulting in a smaller, more manageable dosage form that is easier for patients to swallow.

In addition to core formulation changes, the application of a tablet coating can significantly enhance swallowability. Film coatings provide a smoother, glossier surface that reduces friction in the mouth and oesophagus, making tablets easier to swallow compared to uncoated cores.

Collaborative Product Development With Patients

To optimize dosage forms for patient acceptability, a collaborative development approach that integrates patient feedback, market research, and robust in‑process testing is recommended. Early engagement with patients and caregivers helps identify real‑world challenges related to mouthfeel, taste, and tablet size, ensuring that formulation decisions are guided by user experience rather than technical considerations alone. Market research further supports this process by highlighting population‑specific needs, regional preferences, and competitive benchmarks. These activities enable formulators and manufacturers to design dosage forms that are not only technically robust, but also aligned with patient expectations, ultimately supporting adherence and successful product adoption.

 “When companies involve patients and consumers in development, they create medicines that are truly accepted. It’s about more than choosing attractive colours—it’s about designing with real people in mind.” 

Charlotte Miller - Global Marketing Communications Manager

Regulatory Guidance

Regulatory agencies such as the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) are increasingly emphasising the need for accessible, patient‑friendly oral dosage forms. Their guidance (FDA & EMA) encourages manufacturers to consider factors such as tablet and capsule size, shape, coating, and overall ease of swallowing as part of quality‑by‑design and patient safety principles. This regulatory focus mirrors growing market demand for paediatric, geriatric, and dysphagia‑friendly medicines, where conventional tablets may present adherence challenges.

Benefits of Tablet Coatings for Patient Experience

Tablet coatings aren’t just for stability; they can improve mouthfeel and other properties that make it easier to swallow. By optimising tablet size and shape, leveraging proven coating technologies, and addressing sensory experience from the first interaction, manufacturers can remove a critical barrier to adherence and acceptance. When these design choices are informed by patient insight and aligned with regulatory expectations, they do more than improve usability—they strengthen brand reputation, reduce non‑adherence risk, and support long‑term commercial success. In an increasingly competitive market, designing tablets that are easier to swallow is not just good science; it’s a clear strategic advantage.

Colorcon has many years of experience supporting the pharmaceutical and nutraceutical industry with tablet design. Tools like photo-realistic images and 3D printed tablet models can help development and marketing teams visualize options and aid market research studies. Contact Colorcon for more information.

Further Reading:

• What Are The Benefits of Film Coating?

• Dare To Be Different - Article in Medicine Maker Magazine

• Pharmaceutical Tablet Design - Top 4 Factors to Consider

• What Types of Coatings of Coatings Are Used in the Pharma Industry?

• Pharmaceutical Formulations for Older Patients (Pages 97-128)
  
  

Frequently Asked Questions

• Are coated tablets really easier to swallow than uncoated?
  Yes, many studies have proven that coated tablets are easier to swallow than uncoated tablets. Read about our study. 
  
  
• Is it safe for patients to split tablets?
  Some tablets can be split but patients should check with their healthcare providers first. Medications that are labelled controlled or delayed release shouldn’t be broken as the medication won’t work effectively.
   
• What coating materials are best for swallowability?
  Any film coating is better than no film coating but coatings like Opadry EZ improve slip when wet, thereby improving swallowability. 
  
  
• How does tablet size/shape affect patient preference?
  Large tablets are often difficult to swallow. Even small modifications to tablet dimensions can improve size perception and rounding tablet edges can reduce the risk of tablet sticking in the esophagus. 
  
  
• Are there standards/guidance for “easy swallow” tablets?
  Regulatory guidance has been issued by regulatory authorities like the FDA and EMA. Guidance’s can be found here: FDA guidance & EMA guidance.