HRT Question: I can't swallow pills

[Michelle789]

I'm considering transition and HRT. I know it may be a while before I start HRT, but I'm already freaking out over this.

I have a question about HRT. I was reading on estrogen and testoterone blockers. My understanding is for estrogen I can choose between injections, topical, or patches, or pills.

For spiro it says the only option is a pill, and that in the US we only have spiro as an option for an testoterone blocker.

Major problem: I cannot swallow pills. Normally if I need pills I will crush them up and take with applesauce, if it's a pill that can be mashed. Some can be some can't. If a medication is available in another form other than pills I will take that instead.

So my question is am I screwed since I can't swallow pills? Is there any other alternative to taking spiro or any other alternative for testoterone blockers? Can spiro be mashed and put in applesauce? Keep in mind I live in the USA (California).

[AllieSF]

Hey Michelle, I have a swallowing problem that I thin has been corrected. I had trouble swallowing some bigger pills like calcium and definitely any dry meats, fish and even rice. My problem was caused by acid reflux (GERD). Over the years it has damaged my esophagus sphincter, which made swallowing a lot of different foods very difficult to almost impossible. I also had a chronic cough since high school, which would last up to 3-4 months after a cold and linger around until the next cold. Well, after many doctors' visits and some hard talk, I found someone to treat my malady. I take an reducing medicine (e.g. Nexium, pantaprozole) and my cough has almost disappeared. I have had about seven endoscopies where the Dr. dilates (expands) my sphincter a little bit at a time. After about 8 procedures, I am now almost cough free and can eat and swallow just about anything that I could not before. Talk to your doctor and see what he recommends. I had asked my general practitioner (family doctor) to recommend a good specialist. He did and now after so many yeas of suffering, I am a new person. Try it and you may also be a new person times 2! Good luck.

[mbmeen12]

Can Spiro be mashed and put in applesauce? I would say yes, the liver would react the same i.e. crushed or not crushed. And of course just ask your Pharmacist or prescribing doctor.

[gonegirl]

They will crush OK. Spiro tastes pretty terrible so the applesauce is probably a good idea.

[Aprilrain]

You will want a nuclear flavored applesauce none of that organic stuff! Spiro has the amazing ability to somehow tasty kinda minty and throw up awful at the same time. It's a horse pill too!

[Rachel Smith]

My spiro is a generic and only as big as an asprin.

[Sarah M]

To me Spiro tastes really bad Yuk I just pop a spiro in my mouth an take a drink an swallow works 99 % of the time an sometimes the Spiro will stick to my tongue an not go down an will start to dissolve Yuk Yuk !! Their is a alternative to the Spiro is have the testicles removed !! Try breaking the Spiro in half an putting each piece in some food an try that ...

[LeaP]

Spiro is "good" with food! Meaning you are supposed to take with food anyway. Its bioavailability is almost 100% greater when taken with food AND easier on the liver, which is huge. I would think crushing it would be fine (pun not intended).

http://www.ncbi.nlm.nih.gov/pubmed/3769384

[Jamie M]

don't know if it helps or not but I was extremely surprised at how small my E tablets are, they must only be about 3mm across and 1mm deep, they're tiny and many a time have I dropped them and spent ages looking for where the blasted things rolled off to. if that's still a problem don't panic, I'm sure you won't have been the first. discuss it with your prescribing doctor and see what else they can offer or indeed if they can be crushed.

[Angela Campbell]

The estradiol is easy, just put it under the tongue. Doesn't taste bad and is actually better on your liver that way.

[sandra-leigh]

Spiro has a drop of peppermint oil added to make it more palatable. It tastes bad otherwise. From time to time I split one, and that was bad enough; crushing them would surely be pretty yucky. I was glad to stop them.

The US will not prescribe cypro, but it will prescribe finesteride, which is a DHT blocker, the pills for which are smaller than spiro. If I recall correctly it didn't taste great either, but not as bad as spiro.

See also here (http://www.hypertext.org/ENGLISH/HB.html)

[LeaP]

See also here (http://www.hypertext.org/ENGLISH/HB.html)

Interesting, but a dead end for transsexual hormonal management. These drugs virtually define Spiro as benign by comparison.

[sandra-leigh]

Lupron is what is often used for adolescents to delay puberty. And it is done by injections. An endocrinologist would know what to suggest for anti-androgens for adults.

[Nigella]

Not sure what the score is on the other side of the pond is, but here in the "old country", anti-androgens are available as an injection. I have too many drugs going through my liver and when HRT was discussed, patches were the preferred choice for E and T Blocker was injection.

[Tamara Croft]

OMG, I can't believe what some of you are suggesting... do you have any idea what crushing medication can do to your body if it's not meant to be crushed?? Those of you saying 'oh it should be ok' are NOT pharmacists or doctors and you do not have the qualification to say whether it is ok or can be crushed.

I'm going to give the OP some advice and then I'm locking this thread before more bad advice is given. I work in home care, I deal with medication everyday, I have been trained to understand what crushing medication can do to your body. So, do NOT do anything with medication unless your doctor or pharmacist has specifically stated is ok to do. Doesn't matter what anyone else's doctor etc has said, you get proper advice from a professional, not people on a forum that have no qualifications to do so.