Medication Administration Through Enteral Feeding Tubes

Nancy Toedter Williams, Pharm.D., BCPS, BCNSP

Disclosures

Am J Health Syst Pharm. 2008;65(24):2347-2357. 

In This Article

Medication Administration Timing

To reduce drug–nutrient interactions, it is important to consider timing of drug delivery in relation to EN. This is affected by both the frequency of medication administration and the enteral feeding delivery method. Once-daily drug dosing and intermittent or bolus feedings are easier to work with than multiple-daily drug dosing and continuous feeding regimens. When administering medications with continuous feedings, the EN may need to be interrupted repeatedly, depending on the frequency of the medication regimen. It may be necessary to adjust the feeding rate to compensate for the time EN was held for drug delivery so the patient still receives the desired amount of protein and calories.[13]

Some medications should be taken on an empty stomach. A variety of recommendations have been proposed to improve drug absorption with continuous enteral feedings. Gilbar[12] suggested that EN be stopped 30 minutes before administering the drug to allow gastric emptying. After the medication is given, EN may be restarted 30 minutes later, thus allowing time for drug absorption to occur before the feedings resume. This practice is only applicable for gastric feeding and not small bowel access because enteral feedings are not retained in the duodenum or jejunum. Gora et al.[9] recommended stopping the continuous feedings just 15 minutes before drug delivery. For optimal absorption, it may be necessary to hold feedings for an hour before and two hours after medication administration.[10] For patients receiving intermittent or bolus gastric feedings, medications may be easily administered between feedings.

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