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Choking on Supplements May Be More Common Among Older Adults

FDA doesn't regulate size of these pills and capsules

A person is holding several pill capsules in their hand along with a glass of water

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En español | Choking may be more common among older adults who take dietary supplements than among the general population, recent research indicates.

Using a decade of information that dietary supplement manufacturers must provide to federal government health authorities, researchers found that when age was indicated in reports about swallowing problems, choking was by far the most common complaint related to swallowing (87 percent). And more than three-quarters of victims were 65 or older.

Their findings were publicized in an online research report in Annals of Internal Medicine.


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The Food and Drug Administration (FDA) recommends that generic drug tablets and capsules “not exceed 17 millimeters [about two-thirds of an inch] in a single dimension.” For branded products that already exceed 17 millimeters, the guideline is 22 millimeters, and generics should be no larger than the branded version.

But no such guidelines exist for dietary supplements, which are not under FDA jurisdiction.

According to the research on dietary supplements, “the 10 products most commonly identified in reports of swallowing complications all exceed 17 millimeters in length."

In addition, “most reports of swallowing complications from dietary supplements involve multivitamins or calcium supplements,” with multivitamins “used by up to 35 percent and calcium supplements used by up to 24 percent of older adults."

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