How I take nystatin

Because of a swallowing problem that I have, I can’t swallow pills, even using the standard techniques people use. Nystatin was one of the few medications that is (1) extremely bitter, (2) I didn’t happen to get compounded (I think it’s covered by insurance if you just get the normal tablets, but otherwise I’d have to pay a bunch of money out of pocket), and (3) comes in tablet (rather than liquid, etc) form. I was told by my doctor that I could crush it. Since I’m going to have to swallow 150 of these tablets, I decided it was worth spending a bit of effort figuring out how I can minimize the annoyance of having to take something so bitter.¹ Here’s the routine I’ve settled on:

1. Get a small piece of plastic wrap. Fold it in two. Stick the tablet between. So there should be two layers above and two layers below the tablet. Now take the back of a knife or some other sturdy object and gently smash the tablet until it turns into powder. The plastic wrap can be reused several times.
2. Carefully transfer the powder into a small drinking glass. I recommend one with as small a base as you can manage, because otherwise you’ll need to add more water probably (higher area = more possible spots the nystatin powder can stick to, so more water needed to flush it).
3. Add a tiny bit of water. Less than you think. Swirl the glass a bunch until the nystatin melts into the water.
4. Peel a mandarin orange. Get a few pieces ready so you can immediately grab them when needed.
5. Now swirl the glass and drink the bitter water. Add more water if needed, but be careful not to add too much (or else you’ll have more work to do to swallow it – remember, I am assuming some sort of swallowing disorder here because otherwise you can just swallow the tablet whole!).
6. Once you’re done drinking it, start eating the mandarin. I picked mandarin because bitter + citrus = grape fruit. My brain seems to not find it weird. I’ve tried eating other things after the nystatin and my brain does not like those other things being bitter. By the time you’re done with the mandarin, all the nystatin should have gone down your throat and you shouldn’t taste anything bitter.