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Oral medications

Many different medications are taken orally. While some active ingredients already enter the bloodstream through the oral mucosa (the mucous membranes lining the inside of the mouth), for most others this does not happen until they reach the stomach or bowel. Some active ingredients – for example, certain laxatives or contrast agents – are not meant to enter the bloodstream at all. So that medications reach their intended goal in the body, they are offered in different dosage forms. The choice of dosage form depends not only on the physical and chemical properties of the drug. It is also important where, when and for how long a medication should have an effect, and whether it is being taken by a child or an adult, for example.

We have put together a list of the most important dosage forms of oral medications. You can find more detailed information about the correct use of medicines for longer periods of time here.

Tablets

Tablets are available in many different shapes and sizes. They are easy to produce and keep a long time. One or more active ingredients are combined with so-called excipients (carrier substances that help hold the tablet together) and then pressed into tablet form.

Tablets without coating: Tablets are made of powder or granulate pressed tightly together. If they are not given a coating, they have a rough surface. It is important to take tablets with water to avoid them getting stuck in your throat and so that there is enough liquid in your stomach to allow the tablet to dissolve.
Coated tablets (sugar-coated or film-coated tablets): Tablets can be covered with a layer to protect against dampness and bacteria, for example. Coated tablets are smooth and often shiny, and have different colors. They go down easier when you swallow and are tasteless. The layer material and thickness determines whether you have sugar-coated or film-coated tablets. Sugar-coated tablets are usually round or oval in shape; film-coated tablets only have a thin coating. When tablets contain active ingredients that have to be protected from the acid in the stomach they are coated with a protective layer that is resistant to gastric acids. Then the active ingredients are not released until they reach the small intestine. Coated tablets should not be crushed, because this will cause them to lose the coating’s protection.
Fizzy tablets: Fizzy tablets are dissolved in a glass of water and then drunk. They are well suited for people who have difficulty swallowing and can have a faster effect than tablets, because the medication arrives in the stomach already dissolved.
Chewable tablets and lozenges: They contain active ingredients intended to have an effect in the throat, for example for a sore throat, or that can be absorbed by the oral mucosa. These tablets are either chewed or sucked on.
Sublingual tablets (from the Latin sub, meaning “under”, and lingua, meaning “tongue”): These tablets are dissolved under the tongue, and the active ingredient is absorbed directly by the oral mucosa.

Capsules and chewable capsules

Capsules have a shell – usually made of gelatin – containing the medication in powder, granulate or liquid form. The shell dissolves in the stomach or bowel and then releases the active ingredient. The advantage of capsules: The drug – for example, a powder – is easier to dose. Capsules are long-lasting and tasteless, and sensitive active ingredients can be contained well in capsules. There are also chewable capsules that you bite into so that the active ingredient can be absorbed by the oral mucosa.

Time-release tablets and capsules

Time-release tablets and capsules, sometimes also called sustained-release, are made so that they release their active ingredients only gradually. A time-release-tablet may contain an entire day’s worth of active ingredients, and then release them evenly over the course of the day. This has the advantage that often only one tablet per day is needed and not several.

Powders and granulates

Some drugs are available in powder or granulate form. They are usually dissolved in water to be taken. These include some antibiotics for children (dry syrup), and also vitamin C powder.

Teas

Teas are mixtures of dried plant material that are put into hot water to release the active ingredients. There are also instant teas that contain plant extracts or essential oils.

Drops

In drops either the liquid itself is the active ingredient of the medicine or it has been dissolved in liquid, usually in water or a mixture of water and alcohol. Dosages are given in numbers of drops.

Liquid medications and syrups

In liquid medications one or more active ingredients are usually dissolved or suspended in water. The liquid itself may also be the active ingredient. These medications usually come with a measuring cup for getting the right dose. People who have problems swallowing tablets often turn to medications. Thicker solutions of sugar that contain medicine are called syrups. Medications intended for children are often available as syrup because it tastes better than less sweet medications.

Author: German Institute for Quality and Efficiency in Health Care (IQWiG)