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A friend of mine told me some time ago that it actually can be dangerous to take pills (the process of taking it), which to me seemed like a pretty bold statement -- swallowing a pill doesn't seem to be that hard.

The idea was that if you are not careful enough and for example start coughing while taking the pill and then try to swallow it again, the pill could end up in your lungs and cause all kinds of nasty things. I don't really know a lot about medicine and therefore I was a bit surprised at first (this didn't seem to be that far fetched at all). Upon thinking a bit about it and googling I really couldn't find anything useful. A lot of articles talk about swallowing things you shouldn't (battery, etc.) and what to do then, but I really didn't find anything understandable about inhaling a pill.

So can this happen? Would you know that it happend? And is there an upper limit of how big the pill can be (I imagine that inhaling a pill of 2mm x 2mm x 2mm is a lot easier, if possible, than a 1cm x 5mm x 5mm or something the like). If it can happen, what are you supposed to do if it happens?

PS. Let's, for the sake of argument, assume that you are not a child or a extremely old person (or any other kind of group of people that could have problems with swallowing).

A related article that discusses the issue:

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  • This can happen, but the natural body reflex would be to cough it out before it gets to the lungs. Nuts, seeds and other small items have been inhaled by some people.
    – Chris Rogers
    Dec 1 '18 at 9:42
  • many people find swallowing pills difficult. That you don't find it hard is not really relevant.
    – Kate Gregory
    Dec 1 '18 at 22:45
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It is possible to aspirate (inhale into the respiratory system) a pill and it is more common than you might think (PubMed):

It is estimated that roughly 7% of all foreign bodies aspirated in the airways are medicinal pills.

The length of the vocal cords (the bottleneck of the upper respiratory system) in adults is about 20 mm (PubMed), so this is probably the largest size of the aspirated object.

Upper respiratory tract infection (sinusitis, laryngitis, pharyngitis), dry mouth or a strong gag reflex may increase the risk of pill aspiration.

The aspirated pill usually get stuck in some bronchus and can cause localized inflammation, or, sometimes, aspiration pneumonia, any of which can be quite serious. The pill can be found and removed by bronchoscopy; rarely, a surgery is required.

An aspirated iron pill, for example, can cause a quite severe injury followed by chronic problems (PubMed).

The first aid for aspiration of foreign bodies includes several strong blows on the back, which may or may not help to expel the pill.

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    Back slaps would be fine but the choking rescue procedure (Heimlich maneuver) is not recommended when the windpipe is partially blocked.
    – Chris Rogers
    Dec 1 '18 at 9:46
  • Agreed that pills aren't likely to block the airway, so why does your answer recommend the Heimlich for an aspirated pill? The Heimlich should only be employed in case of complete airway obstruction.
    – Carey Gregory ♦
    Dec 1 '18 at 16:19
  • OK, I removed Heimlich maneuver - it is probably ineffective in partial obstruction.
    – Jan
    Dec 1 '18 at 16:35
  • Worse than ineffective -- it's potentially harmful.
    – Carey Gregory ♦
    Dec 1 '18 at 17:12

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