Medications that Cause Swallowing Problems

Here is a list of the medications that can impact swallowing and why this happens:

Dysphagia as a side effect of medication

Medications that affect the smooth and striated muscles of the esophagus which are involved in swallowing may cause dysphagia.

Medications with anticholinergic or antimuscarinic effects.

• Benztropine mesylate (Cogentin); given for movement related effects caused by some psychotropic meds
• Oxybutynin (Ditropan); improves bladder capacity
• Propantheline (Pro-Banthine); inhibits the release of stomach acid
• Tolterodine (Detrol); affects bladder capacity

Medications that cause dry mouth (xerostomia) may interfere with swallowing by impairing the person’s ability to move food.

• ACE Inhibitors; used for high blood pressure – Captopril (Capoten), Lisinopril (Prinivil, Zestril)
• Antiarrythmics; cardiac preparations – Disopyramide (Norpace), Mexiletine (Mexitil), Procainamide (Procan)
• Antiemetics; used for nausea – Meclizine (Antivert), Metoclopramide (Reglan), Prochlorperazine (Compazine)
• Antihistamines and decongestants; used for cold symptoms – Chlorpheniramine (Chlor-Trimeton), Diphenhydramine (Benadryl), Pseudoephedrine (Sudafed)
• Calcium channel blockers; used for chronic chest pain due to angina – Amlodipine (Norvasc)
• Diuretics; given to get rid of excess fluid in body – Ethacrynic adic (Edecrin)
• SSRIs (selective serotonin reuptake inhibitors); anti-depressant medications – Citalopram (Celexa), Fluoxetine (Prozac), Nefazodone (Serzone), Paroxetine (Paxil), Sertraline (Zoloft), Venlafaxine (Effexor)

* see also Antipsychotic/Neuroleptic medication list below

Local anaesthetics such as Novocain which is often used for dental work may temporarily cause a loss of sensation that may affect swallowing before it wears off.

Antipsychotic/ neuroleptic medications given for treatment of psychiatric disorders may affect swallowing as many of them produce dry mouth, and some can cause movement disorders which impact the muscles of the face and tongue that are involved in swallowing.

Antipsychotic/ neuroleptic medications

• Chlorpromazine (Thorazine)
• Olanzapine (Zyprexa)
• Clozapine (Clozaril)
• Quetiapine (Seroquel)
• Fluphenazine (Prolixin)
• Risperidone (Risperdal)
• Haloperidol (Haldol)
• Thioridazine (Mellaril)
• Lithium (Eskalith, Lithobid)
• Thiothizene (Navane)
• Loxapine (Loxitane)
• Trifluoperazine (Stelazine)

Dysphagia as a complication of the therapeutic action of the medication

Medications that depress the Central Nervous System (CNS) can decrease awareness and voluntary muscle control that may affect swallowing.

• Anti-epileptic drugs; for seizures – Carbamazepine (Tegretol) Gabapentin (Neurontin) Phenobarbital, Phenytoin (Dilantin), Valproic acid (Depakote)
• Benzodiazepines; anti-anxiety drugs – Alprazolam (Xanax), Clonazepam (Klonopin), Clorazepate (Tranxene), Diazepam (Valium), Lorazepam (Ativan)
• Narcotics; for pain relief – Codeine (Tylenol #3), Fentanyl (Duragesic), Propozyphene (Darvon, Darvocet)
• Skeletal muscle relaxants; relieves muscle spasms and relaxes muscles – Baclofen (Lioresal), Cyclobenzaprine (Flexeril), Tizanidine (Zanaflex)

Medications that can cause esophageal injury and increase risk

Some medications can cause dysphagia because of injury to the esophagus caused by local irritation. This can happen because the person is in a reclining position shortly after taking the medication, or because an inadequate amount of fluid is taken with the medication. In both instances, the medications remain in the esophagus too long, potentially causing damage and affecting swallowing.

Drugs that may cause esophageal injury

• Acid-containing products – Clindamycin (Cleocin), Doxycycline (Vibramycin), Erythromycin (Ery-tabs, E-mycin), Tetracycline (Sumycin)
• Aspirin – Bayer aspirin and generic brands
  Bisphosphonates; given for osteoporosis – Alendronate (Fosamax)
• Iron-containing products – FeoSol, Feratab, Slow-FE, Fer-Iron etc.
• Methylxanthines; bronchodilator – Theophylline (Theo-Dur, Unidur, Slo-Bid)
• Nonsteroidal anti-inflammatory drugs; relieves pain – Ibuprofen (Advil, Motrin), Naproxen (Aleve, Naprosyn)
• Potassium chloride supplements – K-Dur, K-tabs, Klor-Con, Slow K, etc.
• Vitamin C (ascorbic acid) supplements – Allbee with C Vitamin C tabs, etc.

Other medications such as high dose steroids and chemotherapeutic (anti-cancer) preparations may cause muscle wasting or damage to the esophagus and may suppress the immune system making the person susceptible to infection.