In the UK, medicines often come in some of the following preparations:
The active part of the medicine is combined with a liquid to make it easier to take or better absorbed. A liquid may also be called a ‘mixture’, ‘solution’ or ‘syrup’. Many common liquids are now available without any added colouring or sugar.
The active ingredient is combined with another substance and pressed into a round or oval solid shape. There are different types of tablet. Soluble or dispersible tablets can safely be dissolved in water.
The active part of the medicine is contained inside a plastic shell that dissolves slowly in the stomach. Some capsules can be taken apart so the contents can be mixed with a favourite food. Others need to be swallowed whole so the medicine is not absorbed until the stomach acid breaks down the capsule shell.
Other types of medicine include the following:
These are creams, lotions or ointments that are applied directly onto the skin. They come in tubs, bottles or tubes depending on the type of medicine. The active part of the medicine is mixed with another substance that makes it easy to apply to the skin.
The active part of the medicine is combined with another substance and pressed into a ‘bullet shape’ so it can be inserted into the rectum (back passage). Suppositories must not be swallowed.
The active part of the medicine is released under pressure directly into the lungs. Young children may need to use a ‘spacer’ device to take the medicine properly. Inhalers can be difficult to use at first so your pharmacist will show you how to give them.
There are various types of injection, differing in how and where it is injected. Subcutaneous or SC injections are given just under the surface of the skin. Intramuscular or IM injections are given into a muscle. Intrathecal injections are given into the fluid around the spinal cord. Intravenous or IV injections are given into a vein. Some injections can be given at home but most are given at your doctor’s surgery (GP) or in hospital.
Implants or patches
Some medicines are absorbed by the body through the skin, such as nicotine patches for help in giving up smoking or contraceptive implants.
Buccal or sublingual tablets or liquids
These look similar to normal tablets or liquids but they are not swallowed. Buccal medicines are held in the cheek so that the mouth lining absorbs the active ingredient. Sublingual medicines work in the same way but are put underneath the tongue. Buccal and sublingual medicines tend only to be given in very specific circumstances.
When your doctor is prescribing medicine, remember to ask about the different formats available. If you know from experience that your child prefers tablets to liquids, please tell your doctor. Wherever possible, he or she will prescribe the medicine in a format that makes it easier for your child to take it. You can also discuss this with your pharmacist when you hand in the prescription.
Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.
For children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. In most cases, this is because the manufacturer will recruit adults to clinical trials in the first instance and therefore the initial marketing authorisation (licence) only covers adults and older children.
For new medicines, the manufacturer then has to recruit children and newborns into trials (unless the medicine is not going to be used in children and newborns) and subsequently amend the PIL with the approved information. Older medicines may have been used effectively for many years in children without problems but the manufacturer has not been required to collect data and amend the licence. This does not mean that it is unsafe for children and young people to be prescribed such a medicine ‘off-licence/off-label’. However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.