Dosage Forms

Part of Pharmacy and Apothecary

The different physical forms medicines can take — liquid, solid, topical — and when to choose each for maximum effectiveness and patient compliance.

Why This Matters

The same medicinal substance can be prepared as a tea, a pill, a syrup, a salve, or a suppository — and these choices profoundly affect how quickly it works, how well the patient tolerates it, and whether the medicine reaches the target tissue at all. A patient who cannot swallow cannot benefit from a pill. An infection in skin tissue is better reached by a topical salve than an oral preparation. A medicine that tastes intolerably bitter may be abandoned by the patient before the treatment course is complete.

Choosing the right dosage form is clinical decision-making, not mere preference. It requires understanding where in the body the medicine needs to act, how quickly it needs to act, who the patient is and what they can tolerate, and what resources you have available to prepare each form.

Without modern pharmaceutical manufacturing, you are limited to what can be made by hand. This is actually a rich toolkit — historical apothecaries worked with these forms for thousands of years before capsule machines existed. The key is knowing the properties of each form and making informed choices.

Liquid Forms

Infusions are made by steeping plant material in hot water, like tea. They extract water-soluble compounds — flavonoids, some alkaloids, mucilages. Best for: delicate aerial parts (flowers, leaves), water-soluble actives, patients who need easy-to-swallow preparations. Onset is relatively rapid (30-60 minutes). Shelf life without refrigeration: one day.

Decoctions are made by simmering harder plant material — roots, bark, seeds — in water for 15-30 minutes. Extract the same compounds as infusions but more thoroughly from dense tissues. Best for: roots, bark, seeds, tough stems. Shelf life: one day.

Tinctures are alcohol extracts. Alcohol extracts a broader range of compounds than water and preserves them for months to years. Best for: resins, some alkaloids, preparations that need long shelf life. More concentrated than infusions — doses are typically 2-5 mL rather than 100+ mL. Require alcohol production capability.

Syrups are concentrated sugar solutions with medicine dissolved or suspended in them. The sugar provides palatability (critical for children) and some preservative effect. Best for: cough preparations, medicines for children, bitter medicines that need masking.

Expressed juices are fresh plant juices extracted by crushing or pressing. Preserve heat-sensitive compounds that would be destroyed by infusion. Best for: fresh herbs that lose activity when dried or heated. Very short shelf life — use immediately.

Medicated oils are plant materials extracted in vegetable oil. Best for: fat-soluble compounds, topical preparations, medicines applied to skin or taken by mouth when alcohol is unavailable.

Solid Oral Forms

Powders are dried plant material ground to a fine consistency. They can be mixed into food or water, or applied topically. Simple to make — just dry and grind. Best for: medicines that are tolerable tasting, situations where other equipment is unavailable.

Pills are small spheres made from powdered medicine mixed with a binding agent (honey, gum, or moistened bread) and rolled by hand. Traditional pharmacy term — do not confuse with modern tablets. A standard pill weighs about 250 mg and is about 1 cm in diameter. Best for: accurate dosing of potent medicines, medicines that need slow release, patients who cannot tolerate liquids.

Lozenges are hard tablets dissolved slowly in the mouth. Made from a mixture of powdered medicine, sugar, and a gum binder, dried or baked. Best for: throat preparations, cough medicines, medicines where slow oral absorption is desired.

Electuaries are medicines mixed into a thick paste, usually with honey. One of the oldest pharmaceutical forms. The honey provides palatability and preservation, and the thick consistency allows the patient to take precise doses with a spoon. Best for: bitter powders, combination preparations, pediatric use.

Topical Forms

Poultices are fresh or rehydrated plant material applied directly to skin. Moist and warm. They release active compounds directly at the application site and provide physical warmth and moisture that improves circulation. Best for: infections, inflammation, wounds. Active for 1-4 hours, then must be replaced.

Salves and ointments are medicines suspended in a fat base (lard, tallow, plant oils, beeswax). Water-resistant, provide a protective film, and slowly release medicine over hours. Best for: dry skin conditions, slow-release topical treatment, forming a protective barrier over wounds.

Creams are oil-in-water emulsions — lighter than ointments, absorb into skin more readily. Require an emulsifier to form (beeswax acts as a partial emulsifier). Best for: inflamed skin where heavy occlusive treatment is not wanted.

Liniments are liquid preparations for rubbing into the skin. Often oil- or alcohol-based. Best for: muscle pain, joint inflammation, where massage combined with medicine is beneficial.

Compresses are cloths soaked in medicinal liquid and applied to the body. Cold compresses reduce inflammation. Warm compresses improve circulation and draw out infection. Easy to apply and change repeatedly.

Special Routes

Suppositories are solid preparations that melt at body temperature and are inserted rectally or vaginally. They allow medication to reach the body when the patient cannot swallow or is vomiting. Require a melting base — cocoa butter if available, or a lard-beeswax combination. Absorbed directly into bloodstream through the rectal mucosa with relatively fast onset (15-30 minutes).

Eye preparations: Any preparation applied to the eye must be sterile (or as clean as achievable), made with boiled-then-cooled water, and free of particles. Salt water (0.9% — about one-quarter teaspoon salt per 250 mL water) is the safest eyewash. Never apply anything to the eye that has not been prepared specifically for ophthalmic use.

Inhalations: Medicinal vapors can be inhaled by having the patient breathe over a bowl of hot infusion, often with a cloth tent to concentrate the steam. Best for: respiratory infections, congestion. Active compounds in eucalyptus, thyme, and pine act directly on respiratory mucosa.

Choosing the Right Form

Situation	Recommended Form
Acute systemic infection	Oral tincture or decoction
Chronic ongoing treatment	Tincture, syrup, or pills
Child refusing bitter medicine	Syrup or electuary
Patient vomiting	Suppository
Skin wound or infection	Poultice (acute), salve (ongoing)
Muscle or joint pain	Liniment or compress
Throat infection	Lozenge or gargle
Cough, congestion	Syrup or steam inhalation
Rapid emergency absorption needed	Sublingual tincture (under the tongue)

When in doubt, choose the form the patient can most reliably take. The best preparation is the one that actually gets into the patient in the right dose at the right time.