Yes, do not break the pill, as even inhaling the dust is dangerous. I have been on it for 13 years, and I have a history of HORRIBLE dysphagia. My palate does not even lift to protect my airway when I am bad. I find that taking them immediately upon wakening, one at a time if necessary and turning my head to one side to help facilitate swallowing works almost without fail. In the evening I usually take my dose at a time when I've not just finished eating or talking a lot (rested.)

Now once I was in the hospital and the hospital pharmacy sent me down 250 mg caps, and they were considerably smaller. Of course you have to take twice as many. Also, all generics are not created equally. One brand of generic is very rough and chalky and much more difficult to swallow. Accord brand generic works best for me--nice and smooth.

I think with a bit of practice, you will get the hang of it. If you feel like you are choking, don't try to be ladylike--just do what you need to get it either up or down--you can wipe up the mess later!

Good luck.