Children younger than five years old are generally unable to safely swallow solid capsules and tablets larger than 10 mm.1 Although oral liquid medicines can be prescribed, these have some disadvantages over solid medicines. Substances or excipients that solubilize the active ingredient or ensure microbial stability are included in oral liquids and these may be harmful to young children.2 Liquid medicines tend to be more expensive than solid medicines and this make them less accessible to patients who pay for medicines out-of-pocket. Another problem is that liquid medicines are less chemically stable than solid medicines and require refrigeration in hot climates to guarantee their quality and efficacy. In countries where liquid formulations are not available, caregivers may manipulate solid medicines to make them easier to swallow, thus jeopardizing the quality, safety and efficacy of the medicine. These issues are a concern in global efforts to improve access to age-appropriate essential medicines for young children, especially in low- and middle-income countries.3
a School of Pharmacy, University College London, 29–39 Brunswick Square, WC1N 1AX, London, England.
Publication: Bulletin of the World Health Organization; Type: Perspectives Article ID: BLT.16.171967