How To Give Medicine Through a Feeding Tube

A feeding tube is a soft, flexible tube through which medicine, water, and liquid food can be given. A person may have a feeding tube if she or he has trouble swallowing or cannot have food, liquid, or medicine by mouth.

Here is the information about how to give medicine through a feeding tube. A health care provider may also give you more specific instructions. If you have problems or questions, contact a health care provider.

Supplies needed:

• 60 mL catheter-tip syringe(s).
• Medicine(s).
• Pill crusher, if the medicine is in tablet form.
• Small, clean medicine cup(s), one for each medicine that you will be giving.
• Purified water, at room temperature. Purify drinking water by boiling it:
  • Boil water for 1 minute or longer. Keep a lid over the water while it boils.
  • Allow the water to cool to room temperature before you use it.
• Sterile water, at room temperature (if you will not be using purified water). Use this if:
  • The person has a weak immune system and his or her body has difficulty protecting itself from infections (is immunocompromised).
  • You are unsure about the amount of chemical contaminants in purified water or drinking water.

How to prepare the medicine

If the medicine cannot be given with the tube feeding, stop the feeding. Before you go on to the following steps, wait the amount of time that the person’s health care provider has directed (hold time). You may need to wait 60 minutes or up to 2 hours, depending on whether the person needs to take medicine on an empty stomach.

1. Raise (elevate) the person’s head so it is above the level of his or her stomach. Do this with pillows or by raising the head of the bed.
2. Wash your hands with soap and water.
3. Check the placement of the tube as directed.
4. Prepare the medicine that will go into the tube:
   1. If the medicine is a liquid, mix it in a clean medicine cup with 30 mL of water, or with the amount of water recommended by the health care provider.
   1. If the medicine is in tablet form, use a pill-crushing device to make it into a fine powder. In a medicine cup, mix the powder with 30 mL of water. Mix well. Make sure there are no large pieces of medicine because they may block the tube.
   1. If the medicine is a capsule that contains dry pellets and the health care provider has told you to open it, open the capsule and empty it into 30 mL of water in a medicine cup.
   1. If the medicine is a capsule that contains liquid (gelcap), use it in one of these ways:
      1. Poke a small hole in the gelcap, then empty its liquid into 30 mL of warm water in a medicine cup, or as directed.
      1. Dissolve the unopened gelcap in warm water in a medicine cup, or as directed.
   1. Do not crush or use extended-release, long-acting, or delayed-release medicines with any type of feeding tube. Those may deliver too much medicine at one time.

How to flush the tube

Always rinse out (flush) the tube before and after giving medicine. Follow these steps to make sure the tube is clear:

1. Push the plunger all the way into a new, clean syringe to empty it. Doing this will set the syringe to zero (empty).
2. Put the tip of the syringe into the purified or sterile water. While the syringe is in the water, pull back on the syringe plunger until the water level on the syringe barrel is 15 mL.
3. Before removing the cap or connecting the syringe, close the tube by using a clamp (clamping)or bending (kinking) the tube.
4. Connect the syringe to the tube, then open the tube by removing the clamp (unclamping) or straightening (unkinking) the tube.
5. Slowly push 15 mL of water from the syringe into the tube to flush the tube.

How to give the medicine through the feeding tube

1. Pull back the syringe plunger to bring (draw up) the medicine-and-water mixture into the syringe. Never mix medicines.
2. Close (clamp or kink) the tube.
3. Disconnect the syringe that you used to rinse out (flush) the tube, then connect the medicine-and-water mixture syringe to the tube.
4. Open (unclamp or unkink) the tube.
5. Slowly push the medicine-and-water mixture into the tube.
6. Close (clamp or kink) the tube.
7. Disconnect the syringe from the tube.
8. Put the tip of the syringe into the purified or sterile water. While the syringe is in the water, pull back on the syringe plunger until the water level on the syringe barrel is 30 mL.
9. Connect the syringe to the tube, then open (unclamp or unkink) the tube.
10. Slowly push the water from the syringe into the tube to flushthe tube. Always flush the tube before and after giving medicine.
11. Close (clamp or kink) the tube, then disconnect the syringe from the tube.
12. Put the cap on the tube.

General tips

• Use liquid medicines when possible.
• Give the medicine only as directed. Do not mix medicines together.
  • If giving only one dose of medicine, flush the tube with water after giving the medicine.
  • If giving more than one dose of medicine, give each medicine separately. Flush the tube between different medicines and after the last dose of medicine.
  • Use a new, clean syringe for each medicine.
• If a tube feeding will be continued after the medicine, but the medicine cannot be given with the feeding:
  • Wait 30–60 minutes after giving medicine. Then give the feeding.
  • When appropriate, reconnect the feeding bag set or the gravity drip tubing set to the tube.
• If a tube feeding will not be continued after the medicine:
  • Put the cap on the tube.
  • Put the person in a comfortable position, but keep his or her head raised for one hour after you have given the medicine.
• Always clamp the tube before you remove the cap or before you disconnect a syringe.

Contact a health care provider if:

• You are not sure what types of medicines to give.
• The length of tube from the insertion site to the tube gets longer.

Get help right away if:

• The feeding tube gets clogged, falls out, or does not work.
• The skin area around the tube is red, swollen, warm to the touch, or tender.
• There is more drainage than normal coming from around the tube.
• The drainage from the tube has a bad smell.
• The person who is getting the feeding has any of these problems:
  • Fever.
  • Shortness of breath or difficulty breathing.
  • Vomiting or nausea.
  • Constipation or diarrhea.
  • Pain or tenderness in the abdomen, or abdominal bloating (distension).

Summary

• A person may have a feeding tube if she or he has trouble swallowing or cannot have food, liquid, or medicine by mouth.
• This sheet gives you information about how to give medicine through a feeding tube. A health care provider may also give you more specific instructions.
• Before and after giving medicine through the tube, slowly push water through a syringe into the tube to rinse out (flush) the tube. Always flush the tube between different medicines and after the last dose of medicine.
• If you have problems or questions, contact a health care provider.