Crushed No More? Whole Tablets Safe in Stroke Dysphagia

KREMS, Austria - Oct. 28, 2025 - PRLog -- For decades, stroke patients with swallowing difficulties have routinely received crushed tablets to reduce the risk of aspiration. New clinical data now challenge this practice. A study using endoscopic swallowing diagnostics in patients with poststroke dysphagia has shown that whole tablets, when administered with a soft bolus such as applesauce, are often swallowed safely — without signs of penetration or aspiration. In contrast, crushed forms left significantly more residue in the pharynx, potentially impairing drug absorption and increasing the risk of complications. The research, coordinated by the Karl Landsteiner University of Health Sciences (KL Krems), calls into question the default use of crushed tablets and points to the need for updated clinical guidelines. A more differentiated approach could reduce medication errors and improve the safety of pharmaceutical treatment in stroke care.

Poststroke dysphagia is one of the most frequent and serious complications following a stroke, affecting up to 75% of patients. It increases the likelihood of pneumonia, malnutrition, and delays in recovery. While international guidelines recommend standardized screening to detect swallowing impairments, they offer little guidance on how to handle oral medications—especially solid tablets and capsules. In everyday practice, tablets are often crushed or altered without first assessing the patient's ability to swallow. To address this lack of evidence, the Division of Neurology at University Hospital Tulln (a teaching and research centre of KL Krems) coordinated a systematic investigation using fiberoptic endoscopy to evaluate the actual safety of tablet intake.

Scientific Contact

PhDr. Michaela Trapl-Grundschober, MSc

Division of Neurology at University Hospital Tulln

Karl Landsteiner University of Health Sciences

Dr.-Karl-Dorrek-Straße 30

3500 Krems / Austria

T +43 2272/9004-13310

E neurologie@tulln.lknoe.at

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