How to Give Medicines Through a Feeding Tube

Some medicines can be given through your child’s feeding tube. Check with your health care team before giving any medicine.

Before you start, make sure you know:

• How to use the feeding tube
• How to prepare the medicine
• Dose of medicine and when it should be given
• How the medicine should be given in relation to feedings

Some medicines should not be given through a feeding tube. These include medicines that are:

• Meant to go under the tongue (sublingual)
• Enteric-coated (special coating to protect from stomach acid)
• Long-acting or time-released
• Meant to be taken whole

Supplies needed

• Medicine or medicines
• Water (use purified or sterile water if instructed, do not use well water)
• Pill crusher if the medicine is in tablet or pill form
• Medicine cup, 1 for each medicine if needed
• ENFit medicine bottle adapter for each liquid, if needed
• ENFit medicine syringe for each medicine
• EnFit syringe (10-12 mL) for flushing
• Button extension set (if needed)

Prepare your work area

1. Gather your supplies.
2. Clean your work surface.
3. Clean your hands with soap and water or use an alcohol-based hand sanitizer to prevent infection.

Prepare the medicine

Always follow the instructions from your pharmacist or care team:

• Use liquid medicine when possible.
• Some medicines are too thick to give through a feeding tube safely. If the medicine looks thick, add some water until it is a thin, watery liquid.
• If the medicine is a tablet, crush it to a fine powder using a pill crusher. Know how many tablets make up your dose of medicine.
• If the medicine is a capsule, open the correct number of capsules.
• Pour the powder from the pill or capsule into a small amount of water (1-2 mL) in a medicine cup and let it dissolve.
• Put each medicine into its own cup or ENFit syringe. Do not put more than 1 medicine in a cup or syringe. 

If your child is getting feedings, stop the feeding.

If a medicine must be taken on an empty stomach, stop the feeding at least 30 minutes before giving the medicine. Wait 30 minutes after giving the medicine to start feeding again.

To give medicines through a feeding tube:

1. Clamp the tube.
2. Draw up 10mL of water into the ENFit flushing syringe.
3. Attach the flushing syringe to the end of the feeding tube or extension set. If your child has a G-tube, most medicines go into the medicine port (M-port). Ask your care team if you are not sure.
4. Unclamp the tube.
5. Flush the tube with water. Clamp the tube and unscrew the flushing syringe.
6. Draw up medicine into a clean ENFit medicine syringe. Make sure all the liquid is drawn up into the syringe. Use a separate syringe for each medicine.
7. Screw the medicine syringe into the medicine port.
8. Unclamp the extension tubing.
9. Give the medicine using the attached syringe. Unclamp and give the medicine as instructed.
10. Flush the feeding tube with a small amount of water after each medicine.

If you are giving more than 1 medicine:

• Give each medicine by itself and repeat steps 5 to 11.
• Flush the tube between each medicine. You may need to refill your flush syringe if you give more than 1 medicine.
• After you give all the medicines, flush the tube with the recommended amount of water using the flushing syringe you used before.

After you have given all medicines:

Clamp the tube or start the feeding again if your child is getting continuous feeding. If your child has a button device, disconnect the extension tubing.

If you paused the feeding pump, unclamp the extension tubing and restart the pump. 

Reminders for giving medicines through a feeding tube

• Give each medicine by itself. Do not mix any medicine with formula or with another medicine.
• Do not open a capsule and dissolve medicine until you check with your doctor, pharmacist, or nurse.
• Do not give coated pills or extended-release or long-acting medicines through a feeding tube.
• Flush the feeding tube before and after giving the medicine.
• Always close or clamp the tube before removing the cap or disconnecting a syringe.
• Do not force water or medicine through the tubing.

When to call your care team

Contact your care team if:

• You have questions about the feeding tube, medicines, or when to give medicines in relation to feeds.
• The feeding tube will not flush, the medicine leaks out, or the feeding tube comes out.
• You notice symptoms or side effects after your child gets a medicine.
• Call 911 if your child has symptoms of a severe allergic reaction to a medicine such as:
  • Extensive skin reactions, such as rashes covering large amounts of the body, blistering, or peeling of the skin
  • Pale or blue skin
  • Swelling of the mouth, tongue, lips, throat, or eyes
  • Coughing, wheezing, shortness of breath, or trouble breathing
  • Trouble swallowing
  • Low blood pressure (feeling faint or dizzy)
  • Fast or weak heart rate
  • Confusion, decreased alertness, or loss of consciousness  

Questions to ask your care team

• Which medicines can be given through their feeding tube?
• How do I prepare each medicine before giving it through a tube?
• Do I need to pause or adjust feeds when giving a medicine?
• What is the dose and timing of each medicine?
• What should I do if the tube clogs or I have problems giving the medicine?
• What problems should I watch for?
• When should I contact my child’s doctor or care team?

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