Topic hub — 2026-10-22
Does mixing a bitter medicine with food or drink soften its bitterness?
To be clear from the start, this page is about studies that compared how bitter people found the same drug (or the same bitter sample) when it was left in water or alone and when it was mixed with a food, a drink, a swallowing-aid jelly or a dissolving liquid. It is not advice on how to take medicines; effects, absorption and drug interactions are not covered. The bitterness of a medicine is often described as softening when it is mixed with food or drink. So what do studies say that changed only what the same drug was mixed with and had people rate bitterness? This page lines up the included studies, drug by drug and study by study, together with their conditions: the kind and amount of drug, what it was mixed with, and who rated it on what scale. In the included studies there are comparisons where the rating fell below that for water or the drug alone, comparisons where it rose, and comparisons with no significant difference, and the direction differed by drug and study. For this reason no statement is made about a particular food or drink as a whole. Studies that measured palatability, dose taken or aversion, not bitterness intensity, are kept out of the bitterness rows and listed in a separate overview. Many studies show values only in figures or give no sensory test result, so please check the test in each row. Drugs, scales, raters and aggregation differ by study, so values are not compared across studies or turned into ratios. This page then separates what was established within one experiment, what differences between studies might explain, and what this comparison alone cannot separate. Studies comparing foods with each other and studies adding sugar or salt are on the page Does adding sugar or salt suppress bitterness?, and the whole subject of measuring and masking the bitterness of medicines is covered on the page Handling the bitterness of medicines.
On this page (11 sections)
- What this page establishes
- What the included studies allow us to say
- Bitterness ratings at a glance
- Values that are not bitterness intensity
- Conditions and results, study by study
- What was established within an experiment
- Candidate explanations for the differences
- What is not known — what this comparison alone cannot separate
- How studies and rows were counted
- What we looked at
- Read in the encyclopedia
What this page establishes
- That this page lines up results, drug by drug and study by study, from studies in which healthy adults and others held the mixture in the mouth and rated it; that most raters were healthy adults, that drugs, scales and numbers of people differ by study, that compared with water or the drug alone some studies showed a fall, some a rise and some no significant difference, and that the combinations of drug and what it was mixed with are in the table rows.
- That milk and dairy products did not go one way either, and that some studies have no water control or measured aversion, not bitterness.
- That for water temperature the direction was opposite depending on the sample and the people rating it.
- That many studies show values only in figures or give no test result for the comparison.
- That the raters were mostly healthy adults and that the study in children also rated how the dose felt, including bitterness, but the table on this page shows dose taken; that studies from the same lab or hospital are not counted as independent replications; and that no significant difference does not mean the same.
What the included studies allow us to say
- Compared with water (or the drug alone), bitterness ratings went in different directions for different drugs and studies. An example of a fall is clindamycin mixed with condensed milk, brown sugar syrup (kuromitsu) or vanilla ice cream (Takagi 2017), where the approximate median in Fig. 3 was about 62–65 against about 87 for water, significantly lower. Prednisolone powder mixed with an acidic sports drink (Ishizaka 2008) was also significantly lower than water by the mark in the legend. An example of a rise is clarithromycin DS mixed with acidic jellies (pH 3.8 and 3.7) (Tsuji 2006), at 3.0 and 4.0 against 1.0 for the water suspension. An example without a significant difference is azithromycin powder mixed with orange juice (Tanaka 2020), at 65.5 against 67 in the 1st evaluation. [rows: Takagi 2017 Vanilla ice cream vs water; Takagi 2017 Condensed milk vs water; Takagi 2017 Brown sugar syrup (kuromitsu) vs water; Ishizaka 2008 Acidic sports drink (Pocari Sweat) vs water; Tsuji 2006 Swallowing-aid jelly: Paste-type jelly (pH 3.8) vs water suspension (clarithromycin DS); Tsuji 2006 Swallowing-aid jelly: Water jelly, muscat (pH 3.7) vs water suspension (clarithromycin DS); Tanaka 2020 Orange juice vs water (azithromycin powder)]
- Milk and dairy products did not go one way either. Condensed milk was lower than water for clindamycin (Takagi 2017), prednisolone powder (Ishizaka 2008) and a herbal preparation (Kido 2019). By contrast, milk carries no mark in the legend for prednisolone powder, and in the study dissolving zinc and paracetamol dispersible tablets in infant formula milk (Orubu 2022; aversion was measured), only the zinc mannitol-base blend was lower, at p=0.015, while the 2 paracetamol bases had slightly higher numbers and were not significant. [rows: Takagi 2017 Condensed milk vs water; Ishizaka 2008 Condensed milk vs water; Kido 2019 Condensed milk vs water (screening); Ishizaka 2008 Milk vs water; Orubu 2022 Infant formula milk vs water (dispersible tablet, zinc, mannitol base (T2)); Orubu 2022 Infant formula milk vs water (dispersible tablet, paracetamol, lactose base (T1))]
- For water temperature, when the water mixed with bitter-gourd powder (not a drug) was cold or warm, scores were significantly higher than at room temperature in junior high students, and no significant difference was shown in teachers in the test across the 3 conditions (Sugai 2026). A suspension of Aminoleban EN, which the source describes as a nutritional product, was significantly lower at 0–5 °C than at 25–30 °C (Haraguchi 2011). Even for "cold", the direction was opposite depending on the sample and the people rating it. [rows: Sugai 2026 Not a drug sample: Cold water (2–4 °C) vs room-temperature water (23–25 °C) (junior high students); Sugai 2026 Not a drug sample: Warm water (48–50 °C) vs room-temperature water (23–25 °C) (junior high students); Sugai 2026 Not a drug sample: room-temperature, cold and warm water, 3 conditions overall (teachers); Haraguchi 2011 Nutritional product sample: 0–5 °C vs 25–30 °C (Aminoleban EN suspension)]
- Values on palatability or dose taken, not bitterness intensity, are kept separate. For dexamethasone elixir, mean palatability scores between foods ranged from 2.6 at the highest to 0.1 at the lowest, but the elixir alone was not rated (Kawase 2023). In the study comparing with the elixir alone (Yasunaga 2024; the raters were 9 pharmacists in their 30s to 50s), 1 item (honey) was significant, at 2.44 against 1.33. The information sheet for parents reproduced in the source carries a caution not to use honey for infants aged 0. The study of levocetirizine DS with 79 children enrolled and 73 analysed (Sogo 2025) also rated how the dose felt, including bitterness, on 5-step scales, but the table shows dose taken, and no significant difference was shown in dose taken between water and each food. None of the values shown here is a rating of bitterness intensity. [rows: Kawase 2023 Palatability and dose taken: Strawberry jam vs miso soup (mixed 1:1 with the elixir; the elixir alone was not rated); Yasunaga 2024 Palatability and dose taken: Honey vs elixir alone (rated by 9 pharmacists); Sogo 2025 Palatability and dose taken: Vanilla ice cream vs natural water (aged 1 to under 3)]
Bitterness ratings at a glance
Human bitterness ratings only. Drugs, scales and aggregation differ by study, so values are not compared across studies. The two conditions compared are set out in the label as the mixed condition (food, drink, jelly, dissolving liquid, low temperature and so on) before "vs" and the water or drug-alone reference after it. Rows whose reference is not water or the drug alone (the main test with the jelly as reference, milks against each other, foods against each other) say so in the label. The column heading is "Reference compared", and what the reference was is given in each row. The "Direction" column shows which condition was more bitter ("... more bitter"). The direction shows which published value is larger or, when values are only in figures, what the text states or an approximate reading of the figure, and is not necessarily the result of an individual test between the two conditions shown. Whether the difference is significant is shown by the test in the same "Direction / test" column; even in rows with no significant difference, the direction shows which value is larger. Rows with no test result shown are not described as not significant. Values in figures we did not obtain are kept as numerically unverified, and values read approximately from figures we obtained are marked approximate. A tag at the start of each label shows what was mixed: no tag for foods and drinks; "Swallowing-aid jelly" for commercial swallowing-aid jellies; "Dissolving liquid" for liquids that are not foods, such as sodium bicarbonate water; "Not a drug sample" for bitter-gourd powder; and "Nutritional product sample" for Aminoleban EN, which the source describes as a nutritional product. Select a study name to jump to its detailed table under "Conditions and results, study by study"; the note under each row of that detailed table gives the conditions of the test, the significance level and any disagreement between the text and the figures or tables.
Results in which people rated bitterness only. Where each value comes from (a table or a reading from a figure) is shown in its row; scales and methods differ between studies, so compare within a row, not across rows.
| Study | Comparison and condition | Measured as | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Direction / test |
|---|---|---|---|---|---|
| Takagi 2017 | Vanilla ice cream vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | about 65 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Takagi 2017 | Condensed milk vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | about 62 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Takagi 2017 | Brown sugar syrup (kuromitsu) vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | about 65 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Takagi 2017 | Orange juice vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | about 80 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Takagi 2017 | Vegetable juice vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | about 80 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Ishizaka 2008 | Acidic sports drink (Pocari Sweat) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Carbonated lemon drink (C.C. Lemon) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Cola vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Grape-tasting carbonated drink (Fanta) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Orange juice vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Coffee milk vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Condensed milk vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 10 g of jelly or condensed milk | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Chocolate jelly (a Ryukakusan commercial product) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 10 g of jelly or condensed milk | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Strawberry jelly (a Ryukakusan commercial product) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 10 g of jelly or condensed milk | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Ishizaka 2008 | Milk vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of milk | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | Direction not given Test method described; result for this comparison not reported |
| Tanaka 2020 | Vanilla ice cream (Häagen-Dazs) vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | 1.0 (1st) / 3.5 (2nd) | 67 (1st) / 59 (2nd) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Tanaka 2020 | Oolong tea vs water (azithromycin powder) [not significant at the corrected level of 0.01] Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | 22 (1st) / 35.5 (2nd) | 67 (1st) / 59 (2nd) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, not significant |
| Tanaka 2020 | Orange juice vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | 65.5 (1st) / 78.5 (2nd) | 67 (1st) / 59 (2nd) | Depends on the combination Tested, not significant |
| Tanaka 2020 | Sports drink vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | about 70 (1st) / about 55 (2nd) (approximate, from the box medians in Fig. 2) | 67 (1st) / 59 (2nd) | Depends on the combination Tested, not significant |
| Tanaka 2020 | Yogurt vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | about 41 (1st) / about 62 (2nd) (approximate, from the box medians in Fig. 2) | 67 (1st) / 59 (2nd) | Depends on the combination Tested, not significant |
| Inoue 2020 | Prepared soy milk vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 2 | 5 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Inoue 2020 | Prepared soy milk vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 2.5 | 5 | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Yoshida 2019 | Sports drink vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 2.5 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Yoshida 2019 | Orange juice vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 3.0 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Yoshida 2019 | Lactic acid drink vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 2.3 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Yoshida 2019 | Barley tea vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 3.4 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Yoshida 2019 | Simple syrup (8.5% sucrose solution) vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 3.2 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Yoshida 2019 | Sports drink vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 2.0 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Yoshida 2019 | Orange juice vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 1.9 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Yoshida 2019 | Lactic acid drink vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 1.8 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Yoshida 2019 | Barley tea vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 3.0 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | Same published value (not a test of equivalence) No test reported |
| Yoshida 2019 | Simple syrup (8.5% sucrose solution) vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | about 2.3 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Kido 2019 | Condensed milk vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | 2.8 | 4.1 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Vanilla ice cream vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | 2.9 | 4.1 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Chocolate ice cream vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | 3.0 | 4.1 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Peanut cream vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | 2.6 | 4.1 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Nori tsukudani (seaweed simmered in soy sauce) vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | 2.1 | 4.1 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Milk cocoa vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | Figure not obtained, so values unconfirmed | 4.1 | Direction not given Tested, not significant |
| Kido 2019 | Condensed milk vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | about −2.4 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Vanilla ice cream vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | about −2.6 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Chocolate ice cream vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | about −2.7 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Peanut cream vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | about −3.5 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Kido 2019 | Nori tsukudani (seaweed simmered in soy sauce) vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | about −3.1 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Bennett 2012 | Milks with different fat: skim milk, whole milk and half-and-half, 3 conditions overall (no water control) Ibuprofen sodium 2.50% (121.2 mM) dissolved in 10 mL of skim milk (fat 0.12–0.36%), whole milk (3.40–3.42%) or half-and-half (10.58–10.76%), served at 4 °C; 50 people | gLMS (rated 1 time straight after swallowing, higher is stronger; 50 people) | Whole milk and half-and-half: figure not obtained, so values unconfirmed | Skim milk: figure not obtained, so values unconfirmed | Direction not given Tested, not significant |
| Forman 2021 | Foods against each other: chocolate pudding, Ensure and yogurt vs applesauce (no water or unmixed control) The contents of a 34 mg pimavanserin capsule mixed with about 15 mL of applesauce, chocolate pudding, yogurt or vanilla Ensure; 18 people aged 60 or older, 4-way crossover, open label | number answering bitterness was "none to mild" (1–2 points) (a count of people from a 1–5 rating, not a score of bitterness intensity) | chocolate pudding 14/18 people, Ensure 14/18 people, yogurt 8/18 people | applesauce 9/18 people | Depends on the combination No test reported |
| Inoue 2020 | Swallowing-aid jelly: Swallowing-aid jelly (chocolate flavour, for antibiotics) vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 5 | 5 | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Inoue 2020 | Swallowing-aid jelly: Swallowing-aid jelly (chocolate flavour, for antibiotics) vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 4 | 5 | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Kido 2019 | Swallowing-aid jelly: Jelly for powdered drugs (coffee jelly flavour) vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | 3.1 | 4.1 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, not significant |
| Kido 2019 | Swallowing-aid jelly: Jelly for powdered drugs (coffee jelly flavour) vs the drug dissolved in water (check before the main test) Keimeigashinsan S 1 g mixed with 20 mL of water (alone) or 20 g of jelly; a 5-step rating comparing only the jelly and the drug; 16 people | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 16 people; values are approximate, read from the bars in Fig. 3) | about 2.8 (approximate, from Fig. 3) | about 4.2 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Tsuji 2006 | Swallowing-aid jelly: Chocolate-flavour jelly (pH 6.4) vs water suspension (clarithromycin DS) Clarithromycin dry syrup (CAMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | 0.2 | 1.0 | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Tsuji 2006 | Swallowing-aid jelly: Paste-type jelly (pH 3.8) vs water suspension (clarithromycin DS) Clarithromycin dry syrup (CAMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | 3.0 | 1.0 | Mixed or changed condition (given in each row) more bitter Tested; significance reported, but which pair differs is unclear |
| Tsuji 2006 | Swallowing-aid jelly: Water jelly, muscat (pH 3.7) vs water suspension (clarithromycin DS) Clarithromycin dry syrup (CAMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | 4.0 | 1.0 | Mixed or changed condition (given in each row) more bitter Tested; significance reported, but which pair differs is unclear |
| Tsuji 2006 | Swallowing-aid jelly: Chocolate-flavour jelly (pH 6.4) vs water suspension (azithromycin fine granules) Azithromycin fine granules (AZMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | 0 | 0.4 | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Tsuji 2006 | Swallowing-aid jelly: Paste-type jelly (pH 3.8) vs water suspension (azithromycin fine granules) Azithromycin fine granules (AZMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | 2.0 | 0.4 | Mixed or changed condition (given in each row) more bitter Tested; significance reported, but which pair differs is unclear |
| Tsuji 2006 | Swallowing-aid jelly: Water jelly, muscat (pH 3.7) vs water suspension (azithromycin fine granules) Azithromycin fine granules (AZMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | 2.2 | 0.4 | Mixed or changed condition (given in each row) more bitter Tested; significance reported, but which pair differs is unclear |
| Yoshida 2010 | Swallowing-aid jelly: Strawberry–chocolate jelly vs water Orengedokuto extract granules 1 g mixed for 30 s with water (control) or 20 mL of jelly; commercial Ryukakusan jellies | bitterness score (mean on 5 steps against quinine standards, higher is more bitter; 6 people; values are approximate, read from Fig. 3; the source gives mean ± SEM) | about 1.6 (approximate, from Fig. 3) | about 3.4 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Yoshida 2010 | Swallowing-aid jelly: Chocolate jelly vs water Orengedokuto extract granules 1 g mixed for 30 s with water (control) or 20 mL of jelly; commercial Ryukakusan jellies | bitterness score (mean on 5 steps against quinine standards, higher is more bitter; 6 people; values are approximate, read from Fig. 3; the source gives mean ± SEM) | about 1.9 (approximate, from Fig. 3) | about 3.4 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Yoshida 2010 | Swallowing-aid jelly: Coffee, peach, lemon, grape and strawberry jellies (5 kinds) vs water Orengedokuto extract granules 1 g mixed for 30 s with water (control) or 20 mL of jelly; commercial Ryukakusan jellies | bitterness score (mean on 5 steps against quinine standards, higher is more bitter; 6 people; values are approximate, read from Fig. 3; the source gives mean ± SEM) | about 2.3–2.6 (approximate, from Fig. 3; the range over 5 kinds) | about 3.4 (approximate, from Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Inoue 2020 | Dissolving liquid: Alkaline ionised water vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 5 | 5 | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Inoue 2020 | Dissolving liquid: Hot-spring water vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 5 | 5 | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Inoue 2020 | Dissolving liquid: Sodium bicarbonate water vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 2 | 5 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Inoue 2020 | Dissolving liquid: Alkaline ionised water vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 5 | 5 | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Inoue 2020 | Dissolving liquid: Hot-spring water vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 4 | 5 | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Inoue 2020 | Dissolving liquid: Sodium bicarbonate water vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | 2.5 | 5 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Sugai 2026 | Not a drug sample: chocolate syrup, nori tsukudani, miso soup, condensed milk, sweet bean paste, unsalted butter and cream (7 foods) vs room-temperature water (junior high students) Bitter-gourd powder 1.0 g (a model of a bitter food, not a drug) mixed with room-temperature water (control) or 10 mL or 10 g of a food; not blinded, same order for all; 40 junior high students | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Figure not obtained, so values unconfirmed | 8 [8–9] (room-temperature water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Sugai 2026 | Not a drug sample: Lemon juice (diluted 1:1 with water) and plain yogurt vs room-temperature water (junior high students) Bitter-gourd powder 1.0 g (a model of a bitter food, not a drug) mixed with room-temperature water (control) or 10 mL or 10 g of a food; not blinded, same order for all; 40 junior high students | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Figure not obtained, so values unconfirmed | 8 [8–9] (room-temperature water) | Direction not given Tested, not significant |
| Sugai 2026 | Not a drug sample: All 9 foods (the 7 above plus lemon juice and plain yogurt) vs room-temperature water (teachers) Bitter-gourd powder 1.0 g (a model of a bitter food, not a drug) mixed with room-temperature water (control) or 10 mL or 10 g of a food; not blinded, same order for all; 23 teachers | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Figure not obtained, so values unconfirmed | 6 [5–7] (room-temperature water) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Sugai 2026 | Not a drug sample: Cold water (2–4 °C) vs room-temperature water (23–25 °C) (junior high students) Bitter-gourd powder 1.0 g mixed into 10 mL of mineral water, with the water at room temperature (23–25 °C), cold (2–4 °C) or warm (48–50 °C); not blinded; 40 junior high students | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Figure not obtained, so values unconfirmed | 8 [8–9] (room-temperature water) | Mixed or changed condition (given in each row) more bitter Tested, significant |
| Sugai 2026 | Not a drug sample: Warm water (48–50 °C) vs room-temperature water (23–25 °C) (junior high students) Bitter-gourd powder 1.0 g mixed into 10 mL of mineral water, with the water at room temperature (23–25 °C), cold (2–4 °C) or warm (48–50 °C); not blinded; 40 junior high students | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Figure not obtained, so values unconfirmed | 8 [8–9] (room-temperature water) | Mixed or changed condition (given in each row) more bitter Tested, significant |
| Sugai 2026 | Not a drug sample: room-temperature, cold and warm water, 3 conditions overall (teachers) Bitter-gourd powder 1.0 g mixed into 10 mL of mineral water, with the water at room temperature (23–25 °C), cold (2–4 °C) or warm (48–50 °C); not blinded; 23 teachers | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Cold and warm water: figure not obtained, so values unconfirmed | 6 [5–7] (room-temperature water) | Direction not given Tested, not significant |
| Haraguchi 2011 | Nutritional product sample: 0–5 °C vs 25–30 °C (Aminoleban EN suspension) Aminoleban EN (the source describes it as a nutritional product for liver failure) 50 g suspended in 180 mL of water; no flavoured powder, only the temperature changed, 0–5 °C and 25–30 °C | τ (quinine-equivalent scale, higher is more bitter; 4–12 people; values are approximate, read from the bars in Fig. 1; the source gives mean ± SEM) | about 2.35 (approximate, from Fig. 1) | about 2.85 (approximate, from Fig. 1) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Haraguchi 2011 | Nutritional product sample: Apple, fruit, plum and pineapple flavoured powders (4 kinds) vs no flavoured powder (Aminoleban EN) Aminoleban EN (the source describes it as a nutritional product for liver failure) 50 g suspended in 180 mL of water; at 25–30 °C, with 3% flavoured powder added | τ (quinine-equivalent scale, higher is more bitter; 4–12 people; values are approximate, read from the bars in Fig. 1; the source gives mean ± SEM) | about 1.7–2.15 (approximate, from Fig. 1; the range over 4 kinds) | about 2.85 (approximate, from Fig. 1; no flavoured powder) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Haraguchi 2011 | Nutritional product sample: Coffee flavoured powder vs no flavoured powder (Aminoleban EN) Aminoleban EN (the source describes it as a nutritional product for liver failure) 50 g suspended in 180 mL of water; at 25–30 °C, with 3% flavoured powder added | τ (quinine-equivalent scale, higher is more bitter; 4–12 people; values are approximate, read from the bars in Fig. 1; the source gives mean ± SEM) | about 2.45 (approximate, from Fig. 1) | about 2.85 (approximate, from Fig. 1; no flavoured powder) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Haraguchi 2011 | Nutritional product sample: Green tea flavoured powder vs no flavoured powder (Aminoleban EN) Aminoleban EN (the source describes it as a nutritional product for liver failure) 50 g suspended in 180 mL of water; at 25–30 °C, with 3% flavoured powder added | τ (quinine-equivalent scale, higher is more bitter; 4–12 people; values are approximate, read from the bars in Fig. 1; the source gives mean ± SEM) | about 2.8 (approximate, from Fig. 1) | about 2.85 (approximate, from Fig. 1; no flavoured powder) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, not significant |
Values that are not bitterness intensity
Rows measuring palatability, dose taken or aversion are set out separately from the bitterness rows. These are not scores of bitterness intensity and cannot be compared on the same scale as the bitterness rows. Palatability and aversion scores also reflect tastes other than bitterness, smell and mouthfeel, and dose taken is the proportion of the dose that children managed to take. The rows set out here are a selection, paired where possible with the bitterness rows of each study, and not all of them (for studies with no bitterness rows in the table a representative row was chosen). Some studies did not rate the elixir alone and some have few people per item, so these rows are not used for the comparison in this question and are shown as a record.
Results on palatability, aversion and dose taken only (not bitterness intensity). Where each value comes from (a table or a reading from a figure) is shown in its row; scales and methods differ between studies, so compare within a row, not across rows.
| Study | Comparison and condition | Measured as | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Direction / test |
|---|---|---|---|---|---|
| Orubu 2022 | Infant formula milk vs water (dispersible tablet, zinc, mannitol base (T2)) Powder blend of a dispersible tablet containing zinc (as the source puts it, a theoretical concentration of 2 mg/mL of active ingredient; the blend contains zinc sulfate heptahydrate), dissolved in water (control) or 10 mL of infant formula milk | aversion VAS 0–100 (water used for calibration set at 0, higher is more aversive; 20 people; the source gives mean (SD); not a score of bitterness intensity) | 43.95 | 60.15 | Reference compared (mostly water or the drug alone; given in each row) higher Tested, significant |
| Orubu 2022 | Infant formula milk vs water (dispersible tablet, zinc, lactose base (T1)) Powder blend of a dispersible tablet containing zinc (as the source puts it, a theoretical concentration of 2 mg/mL of active ingredient; the blend contains zinc sulfate heptahydrate), dissolved in water (control) or 10 mL of infant formula milk | aversion VAS 0–100 (water used for calibration set at 0, higher is more aversive; 20 people; the source gives mean (SD); not a score of bitterness intensity) | 48.60 | 56.75 | Reference compared (mostly water or the drug alone; given in each row) higher Tested, not significant |
| Orubu 2022 | Infant formula milk vs water (dispersible tablet, paracetamol, lactose base (T1)) Powder blend of a dispersible tablet containing paracetamol (12 mg/mL), dissolved in water (control) or 10 mL of infant formula milk | aversion VAS 0–100 (water used for calibration set at 0, higher is more aversive; 20 people; the source gives mean (SD); not a score of bitterness intensity) | 77.90 | 73.70 | Mixed or changed condition (given in each row) higher Tested, not significant |
| Orubu 2022 | Infant formula milk vs water (dispersible tablet, paracetamol, mannitol base (T2)) Powder blend of a dispersible tablet containing paracetamol (12 mg/mL), dissolved in water (control) or 10 mL of infant formula milk | aversion VAS 0–100 (water used for calibration set at 0, higher is more aversive; 20 people; the source gives mean (SD); not a score of bitterness intensity) | 81.20 | 72.70 | Mixed or changed condition (given in each row) higher Tested, not significant |
| Tanaka 2020 | Palatability and dose taken: Vanilla ice cream vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | overall palatability VAS 0–100 mm median (higher is easier to take; not a score of bitterness intensity; 16 people; 1st then 2nd evaluation) | 78.5 (1st) / 83.5 (2nd) | 23.5 (1st) / 36 (2nd) | Mixed or changed condition (given in each row) higher Tested, significant |
| Tanaka 2020 | Palatability and dose taken: Barley tea vs water (carbocisteine DS) Carbocisteine DS 50% (1 g sachet, 500 mg) mixed with water (control) or 5 mL of barley tea; randomised crossover, 16 people | overall palatability VAS 0–100 mm median (higher is easier to take; not a score of bitterness intensity; 16 people; 1st then 2nd evaluation) | 38.5 (1st) / 37 (2nd) | 63.5 (1st) / 53 (2nd) | Reference compared (mostly water or the drug alone; given in each row) higher Tested, only some pairs significant |
| Tanaka 2020 | Palatability and dose taken: Yogurt vs water (carbocisteine DS) Carbocisteine DS 50% (1 g sachet, 500 mg) mixed with water (control) or 5 g of yogurt; randomised crossover, 16 people | overall palatability VAS 0–100 mm median (higher is easier to take; not a score of bitterness intensity; 16 people; 1st then 2nd evaluation) | 76 (1st) / 68 (2nd) | 63.5 (1st) / 53 (2nd) | Mixed or changed condition (given in each row) higher Tested, not significant |
| Inoue 2020 | Palatability and dose taken: Sodium bicarbonate water vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder | palatability on 5 steps, median (1 = bad … 5 = good; higher is easier to take; 12 people; not a score of bitterness intensity) | 4 | 1 | Mixed or changed condition (given in each row) higher Tested, significant |
| Inoue 2020 | Palatability and dose taken: Prepared soy milk vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder | palatability on 5 steps, median (1 = bad … 5 = good; higher is easier to take; 12 people; not a score of bitterness intensity) | 4 | 1 | Mixed or changed condition (given in each row) higher Tested, significant |
| Inoue 2020 | Palatability and dose taken: Prepared soy milk vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder | palatability on 5 steps, median (1 = bad … 5 = good; higher is easier to take; 12 people; not a score of bitterness intensity) | 3.5 | 2 | Mixed or changed condition (given in each row) higher Tested, significant |
| Kawase 2023 | Palatability and dose taken: Strawberry jam vs miso soup (mixed 1:1 with the elixir; the elixir alone was not rated) Dexamethasone elixir (0.01%) mixed 1:1 with each of 20 foods; 10 staff rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 10 people; not a score of bitterness intensity) | 2.6 | 0.1 | Mixed or changed condition (given in each row) higher Tested, significant |
| Yasunaga 2024 | Palatability and dose taken: Honey vs elixir alone (rated by 9 pharmacists) Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 2.44 | 1.33 | Mixed or changed condition (given in each row) higher Tested, significant |
| Yasunaga 2024 | Palatability and dose taken: Chocolate sauce vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 2.44 | 1.33 | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Yasunaga 2024 | Palatability and dose taken: Aquarius vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 2.11 | 1.33 | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Yasunaga 2024 | Palatability and dose taken: Diluted 2-fold with water vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 1.89 | 1.33 | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Yasunaga 2024 | Palatability and dose taken: Undiluted Calpis vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 1.78 | 1.33 | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Yasunaga 2024 | Palatability and dose taken: Barley tea and green tea (the same value for both) vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 1.67 | 1.33 | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Yasunaga 2024 | Palatability and dose taken: Diluted 1.5-fold with water vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 1.56 | 1.33 | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Yasunaga 2024 | Palatability and dose taken: Bread vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 1.33 | 1.33 | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Yasunaga 2024 | Palatability and dose taken: Chilled (24 h) vs elixir alone Dexamethasone elixir alone chilled for 24 h in a household refrigerator, compared with the elixir alone not chilled (not mixed with any food or drink); 9 pharmacists rated individually | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | 1.11 | 1.33 | Reference compared (mostly water or the drug alone; given in each row) higher Test method described; result for this comparison not reported |
| Sogo 2025 | Palatability and dose taken: Vanilla ice cream vs natural water (aged 1 to under 3) Levocetirizine DS 0.5% mixed with water or 15 mL of a food or drink, with instructions to take it within 5 min of mixing, for 3 days; 1 item per child; aged 1 to under 3 (35 in the analysis) | dose taken (%) (calculated from 3 days with "all taken" as 100, "about half" as 50 and "almost none" as 0; higher means a larger proportion taken; children; not a score of bitterness intensity) | 100 (text) | in the 80s (text) | Mixed or changed condition (given in each row) higher Tested, not significant |
| Sogo 2025 | Palatability and dose taken: Yogurt vs natural water (aged 3 to under 7) Levocetirizine DS 0.5% mixed with water or 15 mL of a food or drink, with instructions to take it within 5 min of mixing, for 3 days; 1 item per child; aged 3 to under 7 (19 in the analysis) | dose taken (%) (calculated from 3 days with "all taken" as 100, "about half" as 50 and "almost none" as 0; higher means a larger proportion taken; children; not a score of bitterness intensity) | about 55 (approximate, from Fig. 2C; the text says "low") | 100 (text) | Reference compared (mostly water or the drug alone; given in each row) higher Tested, not significant |
| Sogo 2025 | Palatability and dose taken: Barley tea vs natural water (aged 6 months to under 1 year) Levocetirizine DS 0.5% mixed with water or 15 mL of a drink, with instructions to take it within 5 min of mixing, for 3 days; 1 item per child; aged 6 months to under 1 year (19 in the analysis) | dose taken (%) (calculated from 3 days with "all taken" as 100, "about half" as 50 and "almost none" as 0; higher means a larger proportion taken; children; not a score of bitterness intensity) | about 80 (approximate, from Fig. 2A) | about 93 (approximate, from Fig. 2A; the text says natural water was highest, followed by orange juice, apple juice and barley tea) | Reference compared (mostly water or the drug alone; given in each row) higher Tested, not significant |
Conditions and results, study by study
For each study, the drug and amount, what it was mixed with, how samples were served and who rated them, and the results. Each row is one study × one measured result, so different comparisons in the same study are separate rows. Under each row we give where it is in the paper and whether it can be used to judge whether, for the same drug (or the same bitter sample), changing only what it is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive, with the reason. Where other conditions changed together (bitterness after mixing in a co-administered drug, a reference that is not water), the reason says so. Nothing is left blank: "not given", "not read" and "not applicable" are kept apart, and values from figures we did not obtain are marked as such. Where the text and the figures or tables of a study disagree, the disagreement is kept.
Takagi 2017 sensory only
電子味覚システムとヒト官能試験によるクリンダマイシンの苦味抑制飲食物の探索 (Identification of Foods Masking Clindamycin Bitterness Using an Electronic Gustatory Screening System Followed by Organoleptic Examination). 医療薬学 (Japanese Journal of Pharmaceutical Health Care and Sciences) 43(9):492-501 — doi:10.5649/jjphcs.43.492
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (methods, results, discussion, Figs 3 and 4; Fig. 3 checked as an image) Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- The whole contents of a 150 mg Dalacin capsule (clindamycin) dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); 4 of 21 candidates chosen with an electronic gustatory system (condensed milk, brown sugar syrup (kuromitsu), orange juice, vegetable juice) plus vanilla ice cream, which is used with children's medicines, went to the human sensory test
- Processing and cooking
- Not applicable (simply mixed); randomised crossover with the order of samples reversed between 2 groups
- How it was served or eaten
- 3 mL held in the mouth for 10 s and spat out; after rinsing, remembered bitterness rated on a 100 mm VAS (0 = not bitter at all, 100 = extremely bitter); 15 min between samples; the serving temperature of the ice cream is not given in the parts read
- Who rated, on what scale
- 30 healthy adults (10 men, 20 women, aged 22–26); Kruskal-Wallis test; Fig. 3 shows medians and quartiles
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Vanilla ice cream vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | about 65 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. Kruskal-Wallis test (the method of multiple comparison is not stated); *** in Fig. 3 means P<0.001 (against water, per the legend); no pairwise p value in the text. People scoring under 50 on the VAS: 2 for water against 8 (of 30). The text's "distributions differ significantly (χ²=16.32, P<0.001)" does not match, since with 5 degrees of freedom P is about 0.006, so it is not used Where: Results section 2 (text) and Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug (clindamycin) in the same amount was mixed with water and with the food or drink, rated by the same 30 people in a randomised crossover, with a test; values are approximate readings from a figure | |||||
| Bitterness intensity (sensory) | Condensed milk vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | about 62 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. Kruskal-Wallis test (the method of multiple comparison is not stated); *** in Fig. 3 means P<0.001 (against water, per the legend); no pairwise p value in the text. People scoring under 50 on the VAS: 2 for water against 9 (of 30). The text's "distributions differ significantly (χ²=16.32, P<0.001)" does not match, since with 5 degrees of freedom P is about 0.006, so it is not used Where: Results section 2 (text) and Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug (clindamycin) in the same amount was mixed with water and with the food or drink, rated by the same 30 people in a randomised crossover, with a test; values are approximate readings from a figure | |||||
| Bitterness intensity (sensory) | Brown sugar syrup (kuromitsu) vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | about 65 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. Kruskal-Wallis test (the method of multiple comparison is not stated); *** in Fig. 3 means P<0.001 (against water, per the legend); no pairwise p value in the text. People scoring under 50 on the VAS: 2 for water against 9 (of 30). The text's "distributions differ significantly (χ²=16.32, P<0.001)" does not match, since with 5 degrees of freedom P is about 0.006, so it is not used Where: Results section 2 (text) and Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug (clindamycin) in the same amount was mixed with water and with the food or drink, rated by the same 30 people in a randomised crossover, with a test; values are approximate readings from a figure | |||||
| Bitterness intensity (sensory) | Orange juice vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | about 80 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Direction shows which approximate value read from the figure is larger (the difference is about 7, close to the reading error of about 5). No significance mark in Fig. 3. The text gives no pairwise p value, and since no test result is shown this is not described as "not significant" Where: Results section 2 (text) and Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The comparison is under the same conditions, but no test result is shown for this pair (no mark in the figure, no pairwise p); the direction is from approximate readings of the figure, and the difference is close to the reading error | |||||
| Bitterness intensity (sensory) | Vegetable juice vs water Clindamycin 150 mg dissolved or suspended in 3 mL of water (mineral water) or a food or drink (50 mg/mL); randomised crossover | about 80 (approximate, from Fig. 3) | about 87 (approximate, from Fig. 3) | VAS 0–100 mm median (higher is more bitter; 30 people; values are approximate, read from the box medians in Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Direction shows which approximate value read from the figure is larger (the difference is about 7, close to the reading error of about 5). No significance mark in Fig. 3. The text gives no pairwise p value, and since no test result is shown this is not described as "not significant" Where: Results section 2 (text) and Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The comparison is under the same conditions, but no test result is shown for this pair (no mark in the figure, no pairwise p); the direction is from approximate readings of the figure, and the difference is close to the reading error | |||||
Tsuji 2006 sensory only
Evaluation of Bitterness Suppression of Macrolide Dry Syrups by Jellies. Chem Pharm Bull 54(3):310-314 — doi:10.1248/cpb.54.310
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (experimental, results and discussion, Fig. 2, Table 1); figures not viewed; some authors are affiliated with the jelly maker (Ryukakusan) Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- Clarithromycin dry syrup (CAMD) or azithromycin fine granules (AZMD), 0.2 g each; 3 commercial swallowing-aid jellies (chocolate flavour pH 6.4, paste type pH 3.8, water jelly muscat pH 3.7)
- Processing and cooking
- Mixed with 10 mL of jelly (water as control) with a spoon for 30 s
- How it was served or eaten
- 2 mL held in the mouth for 5 s ("immediate bitterness") and "after-bitterness" after spitting out and rinsing with water, rated
- Who rated, on what scale
- Well-trained healthy adults (5 or 6; the Fig. 2 legend says 5); scored against quinine hydrochloride standards (0.01–1.00 mM = 0–4); the methods name the Mann-Whitney U test
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Swallowing-aid jelly: Chocolate-flavour jelly (pH 6.4) vs water suspension (clarithromycin DS) Clarithromycin dry syrup (CAMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | 0.2 | 1.0 | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The abstract says the mixture with the neutral chocolate jelly was less bitter than the water suspension (without saying "significantly"). The methods name the Mann-Whitney U test, but no result (p value) for this comparison is in the text. No test result is shown, so this is not described as "not significant". At jelly to CAMD ratios of 25, 50 and 77, the immediate bitterness was 0.7, 0.2 and 0 (other conditions). Fig. 2 is a scatter plot against the taste sensor prediction and carries no test marks Where: Results and discussion (bitterness suppression), Fig. 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with water and with the jelly and rated by the same 5 or 6 people (the figure legend says 5), but no test result (p value) is shown for this comparison | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Paste-type jelly (pH 3.8) vs water suspension (clarithromycin DS) Clarithromycin dry syrup (CAMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | 3.0 | 1.0 | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | Mixed or changed condition (given in each row) more bitter Tested; significance reported, but which pair differs is unclear |
| Direction shows which published value is larger. The abstract says the bitterness of mixtures with acidic jellies was significantly greater than that of the water suspensions (the methods name the Mann-Whitney U test). The pairwise p value for each drug and jelly is not in the text. CAM concentrations in the HPLC extracts were reported to be higher for the acidic jellies than for the water suspension (P<0.01; values in the source); the authors relate this to jelly pH and release of the drug, but this is a candidate explanation for bitterness in the mouth, and this page does not cover how the drug works or moves in the body. Fig. 2 is a scatter plot against the taste sensor prediction and carries no test marks Where: Results and discussion (bitterness suppression), Fig. 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with water and with the jelly and rated by the same 5 or 6 people (the figure legend says 5); the abstract says significant, but no pairwise p value is shown for each drug and jelly | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Water jelly, muscat (pH 3.7) vs water suspension (clarithromycin DS) Clarithromycin dry syrup (CAMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | 4.0 | 1.0 | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | Mixed or changed condition (given in each row) more bitter Tested; significance reported, but which pair differs is unclear |
| Direction shows which published value is larger. The abstract says the bitterness of mixtures with acidic jellies was significantly greater than that of the water suspensions (the methods name the Mann-Whitney U test). The pairwise p value for each drug and jelly is not in the text. CAM concentrations in the HPLC extracts were reported to be higher for the acidic jellies than for the water suspension (P<0.01; values in the source); the authors relate this to jelly pH and release of the drug, but this is a candidate explanation for bitterness in the mouth, and this page does not cover how the drug works or moves in the body. Fig. 2 is a scatter plot against the taste sensor prediction and carries no test marks Where: Results and discussion (bitterness suppression), Fig. 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with water and with the jelly and rated by the same 5 or 6 people (the figure legend says 5); the abstract says significant, but no pairwise p value is shown for each drug and jelly | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Chocolate-flavour jelly (pH 6.4) vs water suspension (azithromycin fine granules) Azithromycin fine granules (AZMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | 0 | 0.4 | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The abstract says the mixture with the neutral chocolate jelly was less bitter than the water suspension (without saying "significantly"). The methods name the Mann-Whitney U test, but no result (p value) for this comparison is in the text. No test result is shown, so this is not described as "not significant". Fig. 2 is a scatter plot against the taste sensor prediction and carries no test marks Where: Results and discussion (bitterness suppression), Fig. 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with water and with the jelly and rated by the same 5 or 6 people (the figure legend says 5), but no test result (p value) is shown for this comparison | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Paste-type jelly (pH 3.8) vs water suspension (azithromycin fine granules) Azithromycin fine granules (AZMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | 2.0 | 0.4 | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | Mixed or changed condition (given in each row) more bitter Tested; significance reported, but which pair differs is unclear |
| Direction shows which published value is larger. The abstract says the bitterness of mixtures with acidic jellies was significantly greater than that of the water suspensions (the methods name the Mann-Whitney U test). The pairwise p value for each drug and jelly is not in the text. The authors relate the difference in bitterness to jelly pH and release of the drug, but this was not checked for this row. Fig. 2 is a scatter plot against the taste sensor prediction and carries no test marks Where: Results and discussion (bitterness suppression), Fig. 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with water and with the jelly and rated by the same 5 or 6 people (the figure legend says 5); the abstract says significant, but no pairwise p value is shown for each drug and jelly | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Water jelly, muscat (pH 3.7) vs water suspension (azithromycin fine granules) Azithromycin fine granules (AZMD) 0.2 g mixed with a spoon for 30 s with 10 mL of jelly (water as control) | 2.2 | 0.4 | score of 0–4 against quinine standards (higher is more bitter; immediate bitterness in the mouth; 5 or 6 people, the Fig. 2 legend says 5) | Mixed or changed condition (given in each row) more bitter Tested; significance reported, but which pair differs is unclear |
| Direction shows which published value is larger. The abstract says the bitterness of mixtures with acidic jellies was significantly greater than that of the water suspensions (the methods name the Mann-Whitney U test). The pairwise p value for each drug and jelly is not in the text. The authors relate the difference in bitterness to jelly pH and release of the drug, but this was not checked for this row. Fig. 2 is a scatter plot against the taste sensor prediction and carries no test marks Where: Results and discussion (bitterness suppression), Fig. 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with water and with the jelly and rated by the same 5 or 6 people (the figure legend says 5); the abstract says significant, but no pairwise p value is shown for each drug and jelly | |||||
Ishizaka 2008 sensory only
Suppression of Bitterness and Improvement of Palatability of Commercial Prednisolone Powder. Chem Pharm Bull 56(10):1395-1399 — doi:10.1248/cpb.56.1395
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (experimental, results and discussion, Fig. 6 as an image and its legend); the values of the points in Fig. 6 cannot be read, so only the marks in the legend were used Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- 0.5 g of prednisolone powder 1% (Takeda) mixed with 12.5 mL of water or a drink, or 10 g of jelly or condensed milk; drinks were an acidic sports drink, a carbonated lemon drink, cola, a grape-tasting carbonated drink, orange juice, coffee milk and milk; the 2 jellies (chocolate, strawberry) were commercial products of Ryukakusan; the mixtures with added simple syrup are not in the table
- Processing and cooking
- Mixed for 30 s (stirrer bar or glass rod)
- How it was served or eaten
- The methods say volunteers tasted 2 mL of a sample suspended in water and that all samples were kept in the mouth for 15 s; whether the samples mixed with jelly or condensed milk used the same amount is not stated
- Who rated, on what scale
- 8 healthy adult volunteers; bitterness scored against quinine standards (0–4, τ); palatability by a separate SD method; Mann-Whitney U test against the water suspension; values are mean ± SE
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Acidic sports drink (Pocari Sweat) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is * (p<0.05). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Carbonated lemon drink (C.C. Lemon) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is * (p<0.05). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Cola vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is * (p<0.05). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Grape-tasting carbonated drink (Fanta) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is * (p<0.05). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Orange juice vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is ** (p<0.005). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Coffee milk vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of the drink | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is * (p<0.05). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Condensed milk vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 10 g of jelly or condensed milk | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is ** (p<0.005). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Chocolate jelly (a Ryukakusan commercial product) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 10 g of jelly or condensed milk | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is * (p<0.05). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Strawberry jelly (a Ryukakusan commercial product) vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 10 g of jelly or condensed milk | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (bitterness fell below that of water for every drink and food except milk). The mark in the legend is * (p<0.05). Mann-Whitney U test against the water suspension. The point values cannot be read. The discussion says bitterness did not fall below the threshold with any drink or food. Palatability (SD method) is a separate value and not this row Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the drink or food, rated by the same 8 people, with a test mark in the legend; the point values cannot be read in Fig. 6 | |||||
| Bitterness intensity (sensory) | Milk vs water Prednisolone powder 1% 0.5 g mixed for 30 s with water (control) or 12.5 mL of milk | a point in Fig. 6 but its value cannot be read (only the mark in the legend was checked) | 3.5 (text; the value for water) | bitterness intensity τ (0–4 score against quinine standards, higher is more bitter; 8 people; the source gives mean ± SE) | Direction not given Test method described; result for this comparison not reported |
| The legend of Fig. 6 gives milk no mark, and the text says milk had a negligible effect on bitterness. No test result is shown, so this is not described as "not significant", and no direction is read. Palatability worsened with milk (a separate value, not this row) Where: Results and discussion, Fig. 6 (legend) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The comparison is under the same conditions, but no test result is shown for milk (no mark in the legend); no direction is read either | |||||
Tanaka 2020 bitterness + palatability
Combining Powder Formulations of Drugs with Food and Beverages to Improve Palatability. Biol Pharm Bull 43(12):1954-1959 — doi:10.1248/bpb.b20-00491
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (methods, results and discussion, Figs 2 and 3, Table 1; Figs 2 and 3 checked as images); the bitterness of carbocisteine DS is not a row because the median for water was 0 and differences cannot show Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- Azithromycin powder 10% (1 g sachet, 100 mg) mixed with 5 mL of water (natural water), oolong tea, orange juice or a sports drink, or 5 g of yogurt or vanilla ice cream; barley tea was added for carbocisteine DS 50% (1 g sachet, 500 mg)
- Processing and cooking
- Not applicable (simply mixed); randomised crossover
- How it was served or eaten
- Rated while holding the mixture in the mouth for 30 s ("first evaluation") and again 30 s after spitting it out ("second evaluation"), then rinsed with water; 100 mm VAS
- Who rated, on what scale
- 16 healthy adults (23.0 ± 2.6 years); medians; Wilcoxon signed-rank tests against water with Bonferroni correction, significance at p<0.01 (0.05/5); the note to Table 1 says paired t-test, which disagrees with the methods
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Vanilla ice cream (Häagen-Dazs) vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | 1.0 (1st) / 3.5 (2nd) | 67 (1st) / 59 (2nd) | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, significance at p<0.01 after Bonferroni correction (0.05/5). The p values against water are 0.0006 for the 1st and 0.0024 for the 2nd evaluation (Fig. 2). The text says it fell significantly compared with water. Values are as given in the text Where: Results and discussion, Fig. 2 (a and c) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food or drink, rated by the same 16 people in a randomised crossover, with a test (corrected level 0.01) | |||||
| Bitterness intensity (sensory) | Oolong tea vs water (azithromycin powder) [not significant at the corrected level of 0.01] Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | 22 (1st) / 35.5 (2nd) | 67 (1st) / 59 (2nd) | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, not significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, significance at p<0.01 after Bonferroni correction (0.05/5). The p values against water are 0.0199 for the 1st and 0.1336 for the 2nd evaluation (Fig. 2). The p for the 1st evaluation is below 0.05 but does not reach the corrected level of 0.01. The text says it fell, but by the test neither evaluation is significant (which does not mean the same). Values are as given in the text Where: Results and discussion, Fig. 2 (a and c) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food or drink, rated by the same 16 people in a randomised crossover, with a test (corrected level 0.01) | |||||
| Bitterness intensity (sensory) | Orange juice vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | 65.5 (1st) / 78.5 (2nd) | 67 (1st) / 59 (2nd) | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | Depends on the combination Tested, not significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, significance at p<0.01 after Bonferroni correction (0.05/5). The p values against water are 0.5694 for the 1st and 0.0841 for the 2nd evaluation (Fig. 2). In the 1st evaluation water is slightly higher and in the second the mixture is higher. The text says it rose with orange juice, but the 1st evaluation is 65.5 against 67 (a small difference) and the second has p=0.0841, short of the level (which does not mean the same). Values are as given in the text Where: Results and discussion, Fig. 2 (a and c) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food or drink, rated by the same 16 people in a randomised crossover, with a test (corrected level 0.01) | |||||
| Bitterness intensity (sensory) | Sports drink vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | about 70 (1st) / about 55 (2nd) (approximate, from the box medians in Fig. 2) | 67 (1st) / 59 (2nd) | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | Depends on the combination Tested, not significant |
| Wilcoxon signed-rank test, significance at p<0.01 after Bonferroni correction (0.05/5). The p values against water are 0.2239 for the 1st and 0.2774 for the 2nd evaluation (Fig. 2). The values are not in the text and are approximate readings of the figure: the mixed condition is larger in the 1st evaluation and water in the 2nd, so the direction is opposite (both differences are small and close to the reading error). No significant difference does not mean the same Where: Results and discussion, Fig. 2 (a and c) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food or drink, rated by the same 16 people in a randomised crossover, with a test (corrected level 0.01) | |||||
| Bitterness intensity (sensory) | Yogurt vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | about 41 (1st) / about 62 (2nd) (approximate, from the box medians in Fig. 2) | 67 (1st) / 59 (2nd) | bitterness VAS 0–100 mm median (higher is more bitter; 16 people; 1st then 2nd evaluation) | Depends on the combination Tested, not significant |
| Wilcoxon signed-rank test, significance at p<0.01 after Bonferroni correction (0.05/5). The p values against water are 0.4850 for the 1st and 0.4776 for the 2nd evaluation (Fig. 2). In the 1st evaluation about 41 against 67 (p=0.4850, values approximate from the figure) and in the 2nd about 62 against 59 (p=0.4776), so the direction reverses. The values are not in the text. No significant difference does not mean the same Where: Results and discussion, Fig. 2 (a and c) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food or drink, rated by the same 16 people in a randomised crossover, with a test (corrected level 0.01) | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Vanilla ice cream vs water (azithromycin powder) Azithromycin powder 10% (1 g sachet, 100 mg) mixed with water (control) or with 5 mL of a drink or 5 g of a food; randomised crossover, 16 people | 78.5 (1st) / 83.5 (2nd) | 23.5 (1st) / 36 (2nd) | overall palatability VAS 0–100 mm median (higher is easier to take; not a score of bitterness intensity; 16 people; 1st then 2nd evaluation) | Mixed or changed condition (given in each row) higher Tested, significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, significance at p<0.01 after Bonferroni correction (0.05/5). The p values against water are 0.0006 for the 1st and 0.0015 for the 2nd evaluation (Fig. 2). This is overall palatability, separate from the bitterness rows Where: Results and discussion (overall palatability), Fig. 2 (b and d) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Barley tea vs water (carbocisteine DS) Carbocisteine DS 50% (1 g sachet, 500 mg) mixed with water (control) or 5 mL of barley tea; randomised crossover, 16 people | 38.5 (1st) / 37 (2nd) | 63.5 (1st) / 53 (2nd) | overall palatability VAS 0–100 mm median (higher is easier to take; not a score of bitterness intensity; 16 people; 1st then 2nd evaluation) | Reference compared (mostly water or the drug alone; given in each row) higher Tested, only some pairs significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, corrected level p<0.01. The p values against water are 0.0114 for the 1st evaluation (not reaching the level) and 0.0076 for the 2nd (reaching it) (Fig. 3b and d). This is overall palatability, separate from the bitterness rows Where: Results and discussion (overall palatability), Fig. 3 (b and d) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Yogurt vs water (carbocisteine DS) Carbocisteine DS 50% (1 g sachet, 500 mg) mixed with water (control) or 5 g of yogurt; randomised crossover, 16 people | 76 (1st) / 68 (2nd) | 63.5 (1st) / 53 (2nd) | overall palatability VAS 0–100 mm median (higher is easier to take; not a score of bitterness intensity; 16 people; 1st then 2nd evaluation) | Mixed or changed condition (given in each row) higher Tested, not significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, corrected level p<0.01. The p values against water are 0.0534 for the 1st and 0.0113 for the 2nd evaluation, neither reaching the level (Fig. 3b and d). The text and abstract say yogurt raised palatability, but by the test this level is not met. This is overall palatability, separate from the bitterness rows Where: Results and discussion (overall palatability), Fig. 3 (b and d) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question; shown separately | |||||
Inoue 2020 bitterness + palatability
各種溶解液でマクロライド系抗菌散剤溶解後にカルボシステインドライシロップ混合を行うことによる服薬改善の検討 (Improvement of medication when carbocisteine dry syrup is mixed with macrolide antibacterial powder dissolved in various dissolution solutions). 日本小児臨床薬理学会雑誌 33(1):80-85 — doi:10.69325/jdpt.33.1_80
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (methods, results, Tables 1–3, the Fig. 1 legend); the overall VAS in Fig. 1 was read from the legend only Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- Clarithromycin DS 10% (CAM, 1.5 g) or azithromycin fine granules 10% (AZM, 2.0 g) dissolved in a liquid, then carbocisteine DS 50% (0.4 g) mixed in (10 mL of liquid per 1 g of total powder, 25 g for the swallowing-aid jelly); the liquids were tap water (control), alkaline ionised water, hot-spring water, sodium bicarbonate water (1 g), prepared soy milk and a swallowing-aid jelly (chocolate flavour, for antibiotics)
- Processing and cooking
- Dissolved first, then mixed with carbocisteine (pH also measured); this bitterness arises from mixing the co-administered drug, which the authors attribute to carbocisteine being acidic and dissolving the macrolide coating
- How it was served or eaten
- Within 60 s of mixing, 5 mL held in the mouth for 10 s, spat out and rated
- Who rated, on what scale
- 12 healthy non-smoking adults in their 20s working in healthcare (7 men, 5 women); 5-step ratings (bitterness: 1 = weak … 5 = strong; palatability: 1 = bad … 5 = good), medians; Steel-Dwass test against tap water (* p<0.05, ** p<0.01)
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Prepared soy milk vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 2 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. Marked **. Where: Results section 2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Prepared soy milk vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 2.5 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. The median is 2.5, the same as for sodium bicarbonate water, but only that row carries a mark and the soy milk row does not (this must not be read as a difference between them). This pair carries no mark in the table, and the text gives no result of a bitterness test for this pair (not described as "not significant"). Where: Results section 2, Table 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Swallowing-aid jelly (chocolate flavour, for antibiotics) vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 5 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. The published medians are equal (5 vs 5); this is not a test showing that the bitterness was equivalent. This pair carries no mark in the table, and the text gives no result of a bitterness test for this pair (not described as "not significant"). Where: Results section 2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Swallowing-aid jelly (chocolate flavour, for antibiotics) vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 4 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. This pair carries no mark in the table, and the text gives no result of a bitterness test for this pair (not described as "not significant"). Where: Results section 2, Table 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Dissolving liquid: Alkaline ionised water vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 5 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. The published medians are equal (5 vs 5); this is not a test showing that the bitterness was equivalent. This pair carries no mark in the table, and the text gives no result of a bitterness test for this pair (not described as "not significant"). Where: Results section 2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The liquid is not a food (sodium bicarbonate water, alkaline ionised water, hot-spring water), so this is separate from comparisons of mixing with food. Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Dissolving liquid: Hot-spring water vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 5 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. The published medians are equal (5 vs 5); this is not a test showing that the bitterness was equivalent. This pair carries no mark in the table, and the text gives no result of a bitterness test for this pair (not described as "not significant"). Where: Results section 2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The liquid is not a food (sodium bicarbonate water, alkaline ionised water, hot-spring water), so this is separate from comparisons of mixing with food. Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Dissolving liquid: Sodium bicarbonate water vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 2 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. Marked **. Where: Results section 2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The liquid is not a food (sodium bicarbonate water, alkaline ionised water, hot-spring water), so this is separate from comparisons of mixing with food. Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Dissolving liquid: Alkaline ionised water vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 5 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. The published medians are equal (5 vs 5); this is not a test showing that the bitterness was equivalent. This pair carries no mark in the table, and the text gives no result of a bitterness test for this pair (not described as "not significant"). Where: Results section 2, Table 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The liquid is not a food (sodium bicarbonate water, alkaline ionised water, hot-spring water), so this is separate from comparisons of mixing with food. Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Dissolving liquid: Hot-spring water vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 4 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. This pair carries no mark in the table, and the text gives no result of a bitterness test for this pair (not described as "not significant"). Where: Results section 2, Table 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The liquid is not a food (sodium bicarbonate water, alkaline ionised water, hot-spring water), so this is separate from comparisons of mixing with food. Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Bitterness intensity (sensory) | Dissolving liquid: Sodium bicarbonate water vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder (25 g for the swallowing-aid jelly) | 2.5 | 5 | bitterness on 5 steps, median (1 = weak … 5 = strong; 12 people; interquartile ranges are in the source tables) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. This bitterness is that of the mixture made by dissolving the drug in the liquid and then mixing in carbocisteine (bitterness that arises from mixing the co-administered drug). Compared with dissolving in tap water by the Steel-Dwass test; the marks in the table are * for p<0.05 and ** for p<0.01. Marked *. Where: Results section 2, Table 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The liquid is not a food (sodium bicarbonate water, alkaline ionised water, hot-spring water), so this is separate from comparisons of mixing with food. Only the dissolving liquid was changed, but what was measured is the bitterness after mixing in carbocisteine (bitterness that arises from mixing the co-administered drug), a different condition from mixing 1 drug with food. The test is Steel-Dwass | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Sodium bicarbonate water vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder | 4 | 1 | palatability on 5 steps, median (1 = bad … 5 = good; higher is easier to take; 12 people; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Tested, significant |
| Direction shows which published value is larger. Compared with dissolving in tap water by the Steel-Dwass test; the mark in the table is ** (* is p<0.05 and ** is p<0.01). This is a palatability value, separate from the bitterness rows Where: Results section 2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Prepared soy milk vs tap water (clarithromycin) Clarithromycin DS 10% (1.5 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder | 4 | 1 | palatability on 5 steps, median (1 = bad … 5 = good; higher is easier to take; 12 people; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Tested, significant |
| Direction shows which published value is larger. Compared with dissolving in tap water by the Steel-Dwass test; the mark in the table is ** (* is p<0.05 and ** is p<0.01). This is a palatability value, separate from the bitterness rows Where: Results section 2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Prepared soy milk vs tap water (azithromycin) Azithromycin fine granules 10% (2.0 g) dissolved in the liquid, then carbocisteine DS 50% (0.4 g) mixed in; 10 mL of liquid per 1 g of total powder | 3.5 | 2 | palatability on 5 steps, median (1 = bad … 5 = good; higher is easier to take; 12 people; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Tested, significant |
| Direction shows which published value is larger. Compared with dissolving in tap water by the Steel-Dwass test; the mark in the table is * (* is p<0.05 and ** is p<0.01). This is a palatability value, separate from the bitterness rows Where: Results section 2, Table 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question; shown separately | |||||
Yoshida 2019 sensory only
Bitterness-Masking Effects of Different Beverages on Zopiclone and Eszopiclone Tablets. Chem Pharm Bull 67(5):404-409 — doi:10.1248/cpb.c18-00502
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (experimental, results and discussion, Figs 5–7 as images); the human ratings exist only in Fig. 5, as approximate point readings Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- 1 tablet of zopiclone or eszopiclone suspended in 40 mL of water or a drink; drinks were barley tea, a sports drink, a lactic acid drink, orange juice and simple syrup (8.5% sucrose solution)
- Processing and cooking
- Not applicable (simply suspended)
- How it was served or eaten
- 2 mL held in the mouth for 5 s and bitterness scored; at least 20 min between samples with thorough gargling
- Who rated, on what scale
- 5 healthy women (30 ± 9 years); quinine hydrochloride standards 1–4 (equivalent concentration method); the statistics are Tukey (taste sensor values) and Spearman (correlation), and no pairwise test of the human ratings is described
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Sports drink vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 2.5 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger. No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Orange juice vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 3.0 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger. No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Lactic acid drink vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 2.3 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger. No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Barley tea vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 3.4 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger (the difference is under 0.5 and falls within the SD error bars, which show variation between people and are separate from the reading error). No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Simple syrup (8.5% sucrose solution) vs water (zopiclone) 1 tablet of zopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 3.2 (approximate, from Fig. 5) | about 3.8 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger. No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Sports drink vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 2.0 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger. No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Orange juice vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 1.9 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger. No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Lactic acid drink vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 1.8 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger. No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Barley tea vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 3.0 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Same published value (not a test of equivalence) No test reported |
| The approximate readings from the figure are the same (about 3.0). There is no test of the human ratings, so this does not show that the bitterness was equivalent (the SD error bars are also wide). No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
| Bitterness intensity (sensory) | Simple syrup (8.5% sucrose solution) vs water (eszopiclone) 1 tablet of eszopiclone suspended in water (control) or 40 mL of the drink; 5 women | about 2.3 (approximate, from Fig. 5) | about 3.0 (approximate, from Fig. 5) | mean score of 0–4 against quinine standards (higher is more bitter; 5 people; approximate readings of the points in Fig. 5 within about 0.2; the error bars are SD and wide) | Reference compared (mostly water or the drug alone; given in each row) more bitter No test reported |
| Direction shows which approximate value read from the figure is larger. No pairwise test of the human ratings is described (Tukey is for the taste sensor values; Spearman is for the correlation r=0.93 between the sensor estimates and the human ratings). Values are approximate readings of the points in Fig. 5 Where: Results and discussion, Fig. 5 (the points for the human ratings) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was suspended in water and in the drink and rated by the same 5 people, but there is no test of the human ratings, and the values are approximate readings with wide error bars | |||||
Yoshida 2010 sensory only
Bitterness Suppression of the Kampo Medicine 'Orengedokuto' Using Flavoured Jellies. Chem Pharm Bull 58(4):449-453 — doi:10.1248/cpb.58.449
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (experimental, results and discussion, Figs 3–5 as images); the figure legends (3A sweetness, 5A bitterness and so on) are swapped relative to the axis titles, so the axis titles were followed (the top-left panel of Fig. 3 is bitterness) Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- 1 g of Orengedokuto extract granules mixed with 20 mL of water (control) or jelly; 7 commercial jellies of Ryukakusan (chocolate, strawberry, peach, grape, strawberry–chocolate, coffee, lemon)
- Processing and cooking
- Mixed uniformly with a spoon for 30 s
- How it was served or eaten
- 2 mL held in the mouth for 10 s, then gargled
- Who rated, on what scale
- 6 well-trained healthy volunteers; bitterness scored on 5 steps against quinine standards; Dunnett test against the control; figures show mean ± SEM
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Swallowing-aid jelly: Strawberry–chocolate jelly vs water Orengedokuto extract granules 1 g mixed for 30 s with water (control) or 20 mL of jelly; commercial Ryukakusan jellies | about 1.6 (approximate, from Fig. 3) | about 3.4 (approximate, from Fig. 3) | bitterness score (mean on 5 steps against quinine standards, higher is more bitter; 6 people; values are approximate, read from Fig. 3; the source gives mean ± SEM) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. Dunnett test against the control; the mark in Fig. 3 is ** (p<0.01). The abstract says bitterness was significantly lower than the control with chocolate-type jellies (the results section writes "higher", read as a misprint; the figure shows water higher) Where: Results and discussion (bitterness and astringency), Fig. 3 (top-left panel) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the jelly, rated by the same 6 people, with Dunnett test marks; values are approximate readings from Fig. 3 | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Chocolate jelly vs water Orengedokuto extract granules 1 g mixed for 30 s with water (control) or 20 mL of jelly; commercial Ryukakusan jellies | about 1.9 (approximate, from Fig. 3) | about 3.4 (approximate, from Fig. 3) | bitterness score (mean on 5 steps against quinine standards, higher is more bitter; 6 people; values are approximate, read from Fig. 3; the source gives mean ± SEM) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. Dunnett test; the mark in Fig. 3 is * (p<0.05). The text says "chocolate or strawberry–chocolate p<0.01", which disagrees with the mark in the figure (* for chocolate); the disagreement is kept Where: Results and discussion (bitterness and astringency), Fig. 3 (top-left panel) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the jelly, rated by the same 6 people, with Dunnett test marks; values are approximate readings from Fig. 3 | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Coffee, peach, lemon, grape and strawberry jellies (5 kinds) vs water Orengedokuto extract granules 1 g mixed for 30 s with water (control) or 20 mL of jelly; commercial Ryukakusan jellies | about 2.3–2.6 (approximate, from Fig. 3; the range over 5 kinds) | about 3.4 (approximate, from Fig. 3) | bitterness score (mean on 5 steps against quinine standards, higher is more bitter; 6 people; values are approximate, read from Fig. 3; the source gives mean ± SEM) | Reference compared (mostly water or the drug alone; given in each row) more bitter Test method described; result for this comparison not reported |
| Direction shows which approximate value read from the figure is larger. In Fig. 3 only strawberry–chocolate and chocolate carry significance marks and these 5 kinds carry none. The Dunnett test is described, but no result for these 5 kinds is in the text, and this is not described as "not significant" Where: Results and discussion (bitterness and astringency), Fig. 3 (top-left panel) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The comparison is under the same conditions, but no test result is shown for these 5 kinds (no marks in the figure); the values are approximate readings from Fig. 3, as a range over the 5 kinds | |||||
Kido 2019 sensory only
食品による生薬製剤のマスキング効果. 日本食品化学学会誌 26(1):68-76 — doi:10.18891/jjfcs.26.1_68
- How deeply checked
- Checked in full text — Full text via J-STAGE (Results, Table 1, Figs 1–4) Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-21.
- Samples
- 1 g of a herbal powder (mainly zedoary) mixed with 20 mL water (control) or 20 mL / 20 g of a food; 30 foods (condensed milk, ice cream, peanut cream, nori tsukudani, miso soup and others)
- Processing and cooking
- Not applicable (simply mixed)
- How it was served or eaten
- 1 spoonful held 5 s and swallowed, then rinsed; ice cream kept cold, others at room temperature
- Who rated, on what scale
- There are 3 tests. Screening: 20 of 25 students and staff analysed (excluding 2 presumed to perceive little bitterness and 3 with missing data); 30 foods compared with the herbal preparation in water on a 1–5 bitterness scale with quinine standards. Confirmation in Fig. 3: the jelly for powdered drugs compared with the herbal preparation alone on the same 5-step scale (16 people). Main test (Fig. 4): 20 people selected from 39 by a five-taste identification test rated the jelly and 5 foods on a 9-point scale from −4 to +4 with the herbal preparation alone as 0, repeated 3 times. Tests were Wilcoxon signed-rank tests with Bonferroni correction (two-sided; some one-sided results are also given)
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Condensed milk vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | 2.8 | 4.1 | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, two-sided with Bonferroni correction, p<0.05 (foods the text names as significant). The individual marks in Fig. 1A were not viewed. The same study's food comparison also appears as kd-food on the sugar and salt page (the study record is shared) Where: Results and discussion 1 (screening), Fig. 1A For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food, rated by the same 20 people, with a test after Bonferroni correction (part of a 30-food screening) | |||||
| Bitterness intensity (sensory) | Vanilla ice cream vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | 2.9 | 4.1 | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, two-sided with Bonferroni correction, p<0.05 (foods the text names as significant). The individual marks in Fig. 1A were not viewed. The same study's food comparison also appears as kd-food on the sugar and salt page (the study record is shared) Where: Results and discussion 1 (screening), Fig. 1A For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food, rated by the same 20 people, with a test after Bonferroni correction (part of a 30-food screening) | |||||
| Bitterness intensity (sensory) | Chocolate ice cream vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | 3.0 | 4.1 | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, two-sided with Bonferroni correction, p<0.05 (foods the text names as significant). The individual marks in Fig. 1A were not viewed. The same study's food comparison also appears as kd-food on the sugar and salt page (the study record is shared) Where: Results and discussion 1 (screening), Fig. 1A For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food, rated by the same 20 people, with a test after Bonferroni correction (part of a 30-food screening) | |||||
| Bitterness intensity (sensory) | Peanut cream vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | 2.6 | 4.1 | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, two-sided with Bonferroni correction, p<0.05 (foods the text names as significant). The individual marks in Fig. 1A were not viewed. The same study's food comparison also appears as kd-food on the sugar and salt page (the study record is shared) Where: Results and discussion 1 (screening), Fig. 1A For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food, rated by the same 20 people, with a test after Bonferroni correction (part of a 30-food screening) | |||||
| Bitterness intensity (sensory) | Nori tsukudani (seaweed simmered in soy sauce) vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | 2.1 | 4.1 | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which published value is larger. Wilcoxon signed-rank test, two-sided with Bonferroni correction, p<0.05 (foods the text names as significant). The individual marks in Fig. 1A were not viewed. The same study's food comparison also appears as kd-food on the sugar and salt page (the study record is shared) Where: Results and discussion 1 (screening), Fig. 1A For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the food, rated by the same 20 people, with a test after Bonferroni correction (part of a 30-food screening) | |||||
| Bitterness intensity (sensory) | Milk cocoa vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | Figure not obtained, so values unconfirmed | 4.1 | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | Direction not given Tested, not significant |
| The text says cocoa is said to mask bitterness, but in the screening test no significant bitterness-suppressing effect was found for milk cocoa. The value and the pairwise p value are not in the text, only in Fig. 1A. No direction is read. No significant difference does not mean the same Where: Results and discussion 1 (screening), Fig. 1A For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The comparison is under the same conditions and the text says it is not significant, but the value and the pairwise p are not in the text (only in Fig. 1A), and no direction is read | |||||
| Bitterness intensity (sensory) | Condensed milk vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | about −2.4 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. * in Fig. 4 is for the comparison with the swallowing-aid jelly (two-sided; * is p<0.05 and ** is p<0.01). The text says all 5 suppressed bitterness significantly more than the jelly. The per-food values are approximate readings. This is not the comparison with the drug dissolved in water (0) Where: Results and discussion 2 (main test), Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with the food and with the jelly and compared, but the reference is the jelly, not water, on a relative rating with the drug dissolved in water as 0; values are approximate readings from Fig. 4 | |||||
| Bitterness intensity (sensory) | Vanilla ice cream vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | about −2.6 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. * in Fig. 4 is for the comparison with the swallowing-aid jelly (two-sided; * is p<0.05 and ** is p<0.01). The text says all 5 suppressed bitterness significantly more than the jelly. The per-food values are approximate readings. This is not the comparison with the drug dissolved in water (0) Where: Results and discussion 2 (main test), Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with the food and with the jelly and compared, but the reference is the jelly, not water, on a relative rating with the drug dissolved in water as 0; values are approximate readings from Fig. 4 | |||||
| Bitterness intensity (sensory) | Chocolate ice cream vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | about −2.7 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. * in Fig. 4 is for the comparison with the swallowing-aid jelly (two-sided; * is p<0.05 and ** is p<0.01). The text says all 5 suppressed bitterness significantly more than the jelly. The per-food values are approximate readings. This is not the comparison with the drug dissolved in water (0) Where: Results and discussion 2 (main test), Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with the food and with the jelly and compared, but the reference is the jelly, not water, on a relative rating with the drug dissolved in water as 0; values are approximate readings from Fig. 4 | |||||
| Bitterness intensity (sensory) | Peanut cream vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | about −3.5 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. ** in Fig. 4 is for the comparison with the swallowing-aid jelly (two-sided; * is p<0.05 and ** is p<0.01). The text says all 5 suppressed bitterness significantly more than the jelly. The per-food values are approximate readings. This is not the comparison with the drug dissolved in water (0) Where: Results and discussion 2 (main test), Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with the food and with the jelly and compared, but the reference is the jelly, not water, on a relative rating with the drug dissolved in water as 0; values are approximate readings from Fig. 4 | |||||
| Bitterness intensity (sensory) | Nori tsukudani (seaweed simmered in soy sauce) vs swallowing-aid jelly (main test; the reference is the jelly, not water) Keimeigashinsan S 1 g mixed with 20 g (or 20 mL) of the food or with jelly; main test (6 items); repeated 3 times | about −3.1 (approximate, from Fig. 4) | about −1.4 (approximate, from Fig. 4; the swallowing-aid jelly) | mean on a 9-step rating (the drug dissolved in water as 0; −4 = no bitterness … +4 = far more bitter than the drug); 20 people; values are approximate, read from the bars in Fig. 4 | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. ** in Fig. 4 is for the comparison with the swallowing-aid jelly (two-sided; * is p<0.05 and ** is p<0.01). The text says all 5 suppressed bitterness significantly more than the jelly. The per-food values are approximate readings. This is not the comparison with the drug dissolved in water (0) Where: Results and discussion 2 (main test), Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The same drug in the same amount was mixed with the food and with the jelly and compared, but the reference is the jelly, not water, on a relative rating with the drug dissolved in water as 0; values are approximate readings from Fig. 4 | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Jelly for powdered drugs (coffee jelly flavour) vs water (screening) Keimeigashinsan S (a commercial gastrointestinal medicine based on zedoary) 1 g mixed with 20 mL of water (control) or 20 mL or 20 g of a food; screening test (30 foods); of 25 panellists, 2 judged to perceive bitterness weakly (scoring 1 or 2 for the drug alone) and 3 with missing data were excluded from the analysis | 3.1 | 4.1 | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 20 people; the source gives mean ± SD) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, not significant |
| Direction shows which published value is larger. Not significant by the two-sided test (after Bonferroni correction) and significant only by the one-sided test shown for reference (p<0.05). No significant difference does not mean the same. The same jelly is also covered in the main-test row (kd-jelly-m) Where: Results and discussion 1 (screening), Fig. 1A For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — The comparison is under the same conditions, but it is not significant by the two-sided test and significant only by the one-sided test (for reference) | |||||
| Bitterness intensity (sensory) | Swallowing-aid jelly: Jelly for powdered drugs (coffee jelly flavour) vs the drug dissolved in water (check before the main test) Keimeigashinsan S 1 g mixed with 20 mL of water (alone) or 20 g of jelly; a 5-step rating comparing only the jelly and the drug; 16 people | about 2.8 (approximate, from Fig. 3) | about 4.2 (approximate, from Fig. 3) | mean bitterness on a 1–5 scale (1 = none … 5 = strong; 16 people; values are approximate, read from the bars in Fig. 3) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. ** in Fig. 3 means p<0.01 (two-sided). The text says the jelly suppressed bitterness significantly compared with the drug alone. After this check, 6 items including the jelly went to the main test on a 9-step scale Where: Results and discussion 2 (main test), Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Usable — The same drug in the same amount was mixed with water and with the jelly, rated by the same 16 people, with a two-sided test; values are approximate readings from Fig. 3 | |||||
Haraguchi 2011 sensory only
Synergistic Effects of Sour Taste and Low Temperature in Suppressing the Bitterness of Aminoleban EN. Chem Pharm Bull 59(5):536-540 — doi:10.1248/cpb.59.536
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (experimental, results and discussion, Tables 1–3, figure legends); Fig. 1 checked as an image (approximate bars and marks); other figures such as Fig. 3 not viewed Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- 50 g of Aminoleban EN (described in the source as a nutritional product for liver failure, containing branched-chain amino acids) suspended in 180 mL of water (the "50 mg" in the methods is read as a misprint and the 50 g of the introduction was used); some samples had 3% of a flavoured powder (coffee, green tea, apple, fruit, plum, pineapple); temperatures were 0–5 °C and 25–30 °C
- Processing and cooking
- Not applicable (simply suspended)
- How it was served or eaten
- 2 mL held in the mouth for 5 s and spat out; scored on the τ scale (quinine-equivalent scale)
- Who rated, on what scale
- 4–12 healthy women (26 ± 4 years); Scheffé test after one-way ANOVA for 3 or more groups, Mann-Whitney U test for 2 groups; figures show mean ± SEM
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Nutritional product sample: 0–5 °C vs 25–30 °C (Aminoleban EN suspension) Aminoleban EN (the source describes it as a nutritional product for liver failure) 50 g suspended in 180 mL of water; no flavoured powder, only the temperature changed, 0–5 °C and 25–30 °C | about 2.35 (approximate, from Fig. 1) | about 2.85 (approximate, from Fig. 1) | τ (quinine-equivalent scale, higher is more bitter; 4–12 people; values are approximate, read from the bars in Fig. 1; the source gives mean ± SEM) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. The text says it was significantly lower at 0–5 °C than at 25–30 °C. Mann-Whitney U test; †† in Fig. 1 is p<0.01. Also with flavoured powders, the 6 groups were lower at 0–5 °C, marked † (p<0.05). In the same study the BCAA solution concentration at which half the people called it bitter was τ 2.42 at 0–5 °C, 2.08 at 25–30 °C and 2.02 at 45–50 °C (a separate measurement) Where: Results and discussion (flavoured powders; temperature), Fig. 1 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — A suspension of Aminoleban EN, which the source describes as a nutritional product; only the temperature was changed; the values are approximate readings of the bars in Fig. 1, and it is treated separately as a nutritional product sample, as the source calls it | |||||
| Bitterness intensity (sensory) | Nutritional product sample: Apple, fruit, plum and pineapple flavoured powders (4 kinds) vs no flavoured powder (Aminoleban EN) Aminoleban EN (the source describes it as a nutritional product for liver failure) 50 g suspended in 180 mL of water; at 25–30 °C, with 3% flavoured powder added | about 1.7–2.15 (approximate, from Fig. 1; the range over 4 kinds) | about 2.85 (approximate, from Fig. 1; no flavoured powder) | τ (quinine-equivalent scale, higher is more bitter; 4–12 people; values are approximate, read from the bars in Fig. 1; the source gives mean ± SEM) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. The marks in Fig. 1 are * p<0.05 (fruit), ** p<0.01 (apple, plum) and *** p<0.001 (pineapple), by the Scheffé test. This added the accompanying flavoured powders (with strong sweetness and sourness), not a food Where: Results and discussion (flavoured powders; temperature), Fig. 1 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — A suspension of Aminoleban EN, which the source describes as a nutritional product; an accompanying flavoured powder (not a food) was added; the values are approximate readings of the bars in Fig. 1, and it is treated separately as a nutritional product sample, as the source calls it | |||||
| Bitterness intensity (sensory) | Nutritional product sample: Coffee flavoured powder vs no flavoured powder (Aminoleban EN) Aminoleban EN (the source describes it as a nutritional product for liver failure) 50 g suspended in 180 mL of water; at 25–30 °C, with 3% flavoured powder added | about 2.45 (approximate, from Fig. 1) | about 2.85 (approximate, from Fig. 1; no flavoured powder) | τ (quinine-equivalent scale, higher is more bitter; 4–12 people; values are approximate, read from the bars in Fig. 1; the source gives mean ± SEM) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction shows which approximate value read from the figure is larger. The mark in Fig. 1 is * (p<0.05), by the Scheffé test. The text says every flavoured powder except green tea lowered bitterness significantly, and the marks in the figure include coffee. The sentence in the Fig. 1 legend names only 4 as lowering it and does not include coffee Where: Results and discussion (flavoured powders; temperature), Fig. 1 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — A suspension of Aminoleban EN, which the source describes as a nutritional product; an accompanying flavoured powder (not a food) was added; the values are approximate readings of the bars in Fig. 1, and it is treated separately as a nutritional product sample, as the source calls it | |||||
| Bitterness intensity (sensory) | Nutritional product sample: Green tea flavoured powder vs no flavoured powder (Aminoleban EN) Aminoleban EN (the source describes it as a nutritional product for liver failure) 50 g suspended in 180 mL of water; at 25–30 °C, with 3% flavoured powder added | about 2.8 (approximate, from Fig. 1) | about 2.85 (approximate, from Fig. 1; no flavoured powder) | τ (quinine-equivalent scale, higher is more bitter; 4–12 people; values are approximate, read from the bars in Fig. 1; the source gives mean ± SEM) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, not significant |
| No mark in Fig. 1, and the text says only the green tea flavoured powder did not significantly lower bitterness (the authors attribute this to the bitterness of green tea itself). Direction shows which approximate value read from the figure is larger (the difference is about 0.05, close to the reading error). No significant difference does not mean the same Where: Results and discussion (flavoured powders; temperature), Fig. 1 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — A suspension of Aminoleban EN, which the source describes as a nutritional product; an accompanying flavoured powder (not a food) was added; the values are approximate readings of the bars in Fig. 1, and it is treated separately as a nutritional product sample, as the source calls it | |||||
Sugai 2026 sensory only
服薬アドヒアランス向上を目的とした中学生の食品による苦味マスキング官能評価 (Sensory Evaluation of Food-Based Bitterness Masking in Junior High School Students Aimed at Improving Medication Adherence). 医療薬学 (Japanese Journal of Pharmaceutical Health Care and Sciences) 52(7):403-414 — doi:10.5649/jjphcs.52.403
- How deeply checked
- Checked in full text — Full text via J-STAGE (Results, Table 1, Figs 3 and 5); values per food only in figures, which were not viewed Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-21.
- Samples
- 1.0 g bitter-gourd powder mixed with room-temperature water (control) or 10 mL / 10 g of a food; 9 foods (chocolate syrup, condensed milk, sweet bean paste, nori tsukudani, miso soup, lemon juice, plain yogurt, cream, unsalted butter)
- Processing and cooking
- Not applicable (simply mixed)
- How it was served or eaten
- About 1 mL or 1 g held 5 s, normally spat out; same order for all, not blinded
- Who rated, on what scale
- 40 junior-high students and 23 teachers; bitterness on an 11-point 0–10 scale; Friedman test, Wilcoxon signed-rank tests with Holm correction
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Not a drug sample: chocolate syrup, nori tsukudani, miso soup, condensed milk, sweet bean paste, unsalted butter and cream (7 foods) vs room-temperature water (junior high students) Bitter-gourd powder 1.0 g (a model of a bitter food, not a drug) mixed with room-temperature water (control) or 10 mL or 10 g of a food; not blinded, same order for all; 40 junior high students | Figure not obtained, so values unconfirmed | 8 [8–9] (room-temperature water) | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (all 7 foods significantly lower than room-temperature water, P<0.001 after Holm correction). Wilcoxon signed-rank tests with Holm correction (against room-temperature water). The values are in figures and the box values were not read. The same study's food comparison also appears as sg-food on the sugar and salt page (the study record is shared) Where: Results section 5 (foods), Fig. 5 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — A model bitter food (bitter-gourd powder; not a drug) was mixed with water and with foods and compared; not blinded and in the same order for all; the values are in figures and were not read | |||||
| Bitterness intensity (sensory) | Not a drug sample: Lemon juice (diluted 1:1 with water) and plain yogurt vs room-temperature water (junior high students) Bitter-gourd powder 1.0 g (a model of a bitter food, not a drug) mixed with room-temperature water (control) or 10 mL or 10 g of a food; not blinded, same order for all; 40 junior high students | Figure not obtained, so values unconfirmed | 8 [8–9] (room-temperature water) | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Direction not given Tested, not significant |
| The text says no significant difference was found for these 2 foods in junior high students. The values are in a figure and no direction is read. No significant difference does not mean the same. Wilcoxon signed-rank tests with Holm correction (against room-temperature water). The values are in figures and the box values were not read. The same study's food comparison also appears as sg-food on the sugar and salt page (the study record is shared) Where: Results section 5 (foods), Fig. 5 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — A model bitter food (bitter-gourd powder; not a drug) was mixed with water and with foods and compared; not blinded and in the same order for all; the values are in figures and were not read | |||||
| Bitterness intensity (sensory) | Not a drug sample: All 9 foods (the 7 above plus lemon juice and plain yogurt) vs room-temperature water (teachers) Bitter-gourd powder 1.0 g (a model of a bitter food, not a drug) mixed with room-temperature water (control) or 10 mL or 10 g of a food; not blinded, same order for all; 23 teachers | Figure not obtained, so values unconfirmed | 6 [5–7] (room-temperature water) | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Reference compared (mostly water or the drug alone; given in each row) more bitter Tested, significant |
| Direction follows the text (all 9 foods significantly lower than room-temperature water, P<0.05 after Holm correction). Wilcoxon signed-rank tests with Holm correction (against room-temperature water). The values are in figures and the box values were not read. The same study's food comparison also appears as sg-food on the sugar and salt page (the study record is shared) Where: Results section 5 (foods), Fig. 5 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — A model bitter food (bitter-gourd powder; not a drug) was mixed with water and with foods and compared; not blinded and in the same order for all; the values are in figures and were not read | |||||
| Bitterness intensity (sensory) | Not a drug sample: Cold water (2–4 °C) vs room-temperature water (23–25 °C) (junior high students) Bitter-gourd powder 1.0 g mixed into 10 mL of mineral water, with the water at room temperature (23–25 °C), cold (2–4 °C) or warm (48–50 °C); not blinded; 40 junior high students | Figure not obtained, so values unconfirmed | 8 [8–9] (room-temperature water) | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Mixed or changed condition (given in each row) more bitter Tested, significant |
| Direction follows the text (both cold and warm water significantly higher than room-temperature water; Friedman test then Wilcoxon signed-rank tests, P<0.01 after Holm correction). No significant difference between cold and warm. The values are in Fig. 3A and were not read. This temperature comparison is not on the sugar and salt page and was newly made for this question Where: Results section 3 (temperature), Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — Only the temperature of the water mixed with the model bitter food (bitter-gourd powder; not a drug) was changed; not blinded and in the same order for all; the values are in a figure and were not read | |||||
| Bitterness intensity (sensory) | Not a drug sample: Warm water (48–50 °C) vs room-temperature water (23–25 °C) (junior high students) Bitter-gourd powder 1.0 g mixed into 10 mL of mineral water, with the water at room temperature (23–25 °C), cold (2–4 °C) or warm (48–50 °C); not blinded; 40 junior high students | Figure not obtained, so values unconfirmed | 8 [8–9] (room-temperature water) | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Mixed or changed condition (given in each row) more bitter Tested, significant |
| Direction follows the text (both cold and warm water significantly higher than room-temperature water; Friedman test then Wilcoxon signed-rank tests, P<0.01 after Holm correction). No significant difference between cold and warm. The values are in Fig. 3A and were not read. This temperature comparison is not on the sugar and salt page and was newly made for this question Where: Results section 3 (temperature), Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — Only the temperature of the water mixed with the model bitter food (bitter-gourd powder; not a drug) was changed; not blinded and in the same order for all; the values are in a figure and were not read | |||||
| Bitterness intensity (sensory) | Not a drug sample: room-temperature, cold and warm water, 3 conditions overall (teachers) Bitter-gourd powder 1.0 g mixed into 10 mL of mineral water, with the water at room temperature (23–25 °C), cold (2–4 °C) or warm (48–50 °C); not blinded; 23 teachers | Cold and warm water: figure not obtained, so values unconfirmed | 6 [5–7] (room-temperature water) | NRS 0–10 (higher is more bitter) median (the source gives median [interquartile range]) | Direction not given Tested, not significant |
| The text says no significant difference in bitterness scores by temperature was found in teachers (Friedman test across the 3 conditions). Pairwise tests of cold vs room-temperature and warm vs room-temperature water were run only when the overall test was significant, and no result is shown for teachers. The values for cold and warm water are in Fig. 3B and were not read. No significant difference does not mean the same Where: Results section 3 (temperature), Fig. 3 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — Only the temperature of the water mixed with the model bitter food (bitter-gourd powder; not a drug) was changed; not blinded and in the same order for all; the values are in a figure and were not read | |||||
Orubu 2022 aversion
Evaluating the Taste Masking Ability of Two Novel Dispersible Tablet Platforms Containing Zinc Sulfate and Paracetamol Reconstituted in a Breast Milk Substitute. Pharmaceutics 14(2):420 — doi:10.3390/pharmaceutics14020420
- How deeply checked
- Checked in full text — Full text via Europe PMC (methods, results, Tables 1 and 2); Figs 1–3 not viewed Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- Powder blends of dispersible tablets (lactose base T1, mannitol base T2) containing zinc (as the source puts it, a theoretical concentration of 2 mg/mL of active ingredient after reconstitution; the blend contains zinc sulfate heptahydrate) or paracetamol (12 mg/mL), dissolved in 10 mL of water or infant formula milk (Aptamil 1); the sample weight is 300 mg in the Table 1 caption and 330 mg in the methods text, which disagree within the paper
- Processing and cooking
- Shaken for 10 s until homogeneous
- How it was served or eaten
- Swirl and spit (5 s, spat out); 9 samples per day over 2 days, 10 min apart; blinded
- Who rated, on what scale
- 20 young healthy adults (aged 18–40, students at University College London); "aversion" rated on a 10 cm VAS as 0–100 (water used for calibration set at 0); water and milk compared by Wilcoxon signed-rank test; no correction for multiple comparisons is described in the parts read
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Aversion (sensory rating; not bitterness intensity) | Infant formula milk vs water (dispersible tablet, zinc, mannitol base (T2)) Powder blend of a dispersible tablet containing zinc (as the source puts it, a theoretical concentration of 2 mg/mL of active ingredient; the blend contains zinc sulfate heptahydrate), dissolved in water (control) or 10 mL of infant formula milk | 43.95 | 60.15 | aversion VAS 0–100 (water used for calibration set at 0, higher is more aversive; 20 people; the source gives mean (SD); not a score of bitterness intensity) | Reference compared (mostly water or the drug alone; given in each row) higher Tested, significant |
| Direction shows which published value is larger. The text gives p=0.02 and the table 0.015. p=0.015. Wilcoxon signed-rank test (water against milk). No correction for multiple comparisons is described in the parts read for the 4 comparisons, and only one, the zinc mannitol-base blend, has p below 0.05. What was measured is aversion, not bitterness (placebos scored under 50, "not aversive") Where: Results section 3.2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — The same base and drug were dissolved in water and in milk and rated by the same 20 people, but what was measured is aversion, not bitterness intensity, so this is not used for the comparison in this question and is recorded as a comparison of aversion | |||||
| Aversion (sensory rating; not bitterness intensity) | Infant formula milk vs water (dispersible tablet, zinc, lactose base (T1)) Powder blend of a dispersible tablet containing zinc (as the source puts it, a theoretical concentration of 2 mg/mL of active ingredient; the blend contains zinc sulfate heptahydrate), dissolved in water (control) or 10 mL of infant formula milk | 48.60 | 56.75 | aversion VAS 0–100 (water used for calibration set at 0, higher is more aversive; 20 people; the source gives mean (SD); not a score of bitterness intensity) | Reference compared (mostly water or the drug alone; given in each row) higher Tested, not significant |
| Direction shows which published value is larger. p=0.263. Wilcoxon signed-rank test (water against milk). No correction for multiple comparisons is described in the parts read for the 4 comparisons, and only one, the zinc mannitol-base blend, has p below 0.05. What was measured is aversion, not bitterness (placebos scored under 50, "not aversive") Where: Results section 3.2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — The same base and drug were dissolved in water and in milk and rated by the same 20 people, but what was measured is aversion, not bitterness intensity, so this is not used for the comparison in this question and is recorded as a comparison of aversion | |||||
| Aversion (sensory rating; not bitterness intensity) | Infant formula milk vs water (dispersible tablet, paracetamol, lactose base (T1)) Powder blend of a dispersible tablet containing paracetamol (12 mg/mL), dissolved in water (control) or 10 mL of infant formula milk | 77.90 | 73.70 | aversion VAS 0–100 (water used for calibration set at 0, higher is more aversive; 20 people; the source gives mean (SD); not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Tested, not significant |
| Direction shows which published value is larger. The numbers are slightly higher with milk. p=0.344. Wilcoxon signed-rank test (water against milk). No correction for multiple comparisons is described in the parts read for the 4 comparisons, and only one, the zinc mannitol-base blend, has p below 0.05. What was measured is aversion, not bitterness (placebos scored under 50, "not aversive") Where: Results section 3.2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — The same base and drug were dissolved in water and in milk and rated by the same 20 people, but what was measured is aversion, not bitterness intensity, so this is not used for the comparison in this question and is recorded as a comparison of aversion | |||||
| Aversion (sensory rating; not bitterness intensity) | Infant formula milk vs water (dispersible tablet, paracetamol, mannitol base (T2)) Powder blend of a dispersible tablet containing paracetamol (12 mg/mL), dissolved in water (control) or 10 mL of infant formula milk | 81.20 | 72.70 | aversion VAS 0–100 (water used for calibration set at 0, higher is more aversive; 20 people; the source gives mean (SD); not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Tested, not significant |
| Direction shows which published value is larger. The numbers are slightly higher with milk. p=0.121. Wilcoxon signed-rank test (water against milk). No correction for multiple comparisons is described in the parts read for the 4 comparisons, and only one, the zinc mannitol-base blend, has p below 0.05. What was measured is aversion, not bitterness (placebos scored under 50, "not aversive") Where: Results section 3.2, Table 2 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — The same base and drug were dissolved in water and in milk and rated by the same 20 people, but what was measured is aversion, not bitterness intensity, so this is not used for the comparison in this question and is recorded as a comparison of aversion | |||||
Bennett 2012 sensory only
Using milk fat to reduce the irritation and bitter taste of ibuprofen. Chemosens Percept 5(3-4):231-236 — doi:10.1007/s12078-012-9128-6
- How deeply checked
- Checked in full text — Full text of the PMC author manuscript (methods, results and discussion, Table 1); Fig. 1 not viewed Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- Ibuprofen sodium 2.50% (121.2 mM) dissolved in 10 mL of skim milk (fat 0.12–0.36%), whole milk (3.40–3.42%) or half-and-half (10.58–10.76%); served at 4 °C; a water control was deliberately not included because it would look and taste different
- Processing and cooking
- Not applicable (simply dissolved)
- How it was served or eaten
- 10 mL placed in the mouth, head tilted back and held at the back of the throat for 5 s, then swallowed in 2 stages; "throat irritation" and "bitterness" rated once on a gLMS straight after swallowing; a dummy warm-up sample (quinine in whole milk) first, then 3 test samples in random order
- Who rated, on what scale
- 50 healthy non-smoking adults (13 men, aged 18–45); gLMS; repeated-measures ANOVA (fat level and sample position); planned pairwise comparisons by unadjusted t tests
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Bitterness intensity (sensory) | Milks with different fat: skim milk, whole milk and half-and-half, 3 conditions overall (no water control) Ibuprofen sodium 2.50% (121.2 mM) dissolved in 10 mL of skim milk (fat 0.12–0.36%), whole milk (3.40–3.42%) or half-and-half (10.58–10.76%), served at 4 °C; 50 people | Whole milk and half-and-half: figure not obtained, so values unconfirmed | Skim milk: figure not obtained, so values unconfirmed | gLMS (rated 1 time straight after swallowing, higher is stronger; 50 people) | Direction not given Tested, not significant |
| The overall effect of fat level across the 3 conditions is not significant (repeated-measures ANOVA F(2,96)=1.58, p=0.21). No result of a pairwise bitterness test, such as half-and-half vs skim milk, is reported. The values are only in Fig. 1B. The effect of sample position is significant (F(2,96)=3.71, p=0.028; the last sample was lower than the second to last, p=0.007). The amount of ibuprofen in the aqueous phase differed with fat (F(2,6)=5.0, p=0.05; whole milk lower than skim milk and half-and-half, p=0.03), and the authors write that partitioning into fat does not explain this. Throat irritation is a separate item (half-and-half lower than skim milk, p=0.027) and not this row. With no water control this does not answer whether mixing with milk lowers bitterness. No significant difference does not mean the same Where: Results and discussion (bitterness ratings), Fig. 1B (figure not obtained), Table 1 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Limited — Only the fat of the milk was changed for the same drug, but there is no water control, so this is not a comparison of mixing or not mixing with milk; the values are only in Fig. 1B | |||||
Forman 2021 sensory only
Palatability and Swallowability of Pimavanserin When Mixed with Selected Food Vehicles: An Exploratory Open-Label Crossover Study. Geriatrics 6(2):61 — doi:10.3390/geriatrics6020061
- How deeply checked
- Checked in full text — Full text via Europe PMC (methods, results text); Figs 2 and 3 not viewed Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- The contents of a 34 mg pimavanserin capsule mixed with about 15 mL of applesauce, chocolate pudding, yogurt or vanilla Ensure; there is no unmixed control and no water control
- Processing and cooking
- Not applicable (simply mixed); 4-way Latin square crossover, open label
- How it was served or eaten
- Taken and rated; bitterness on a 1–5 scale (1 = none, 5 = extreme), with 1–2 counted as "favourable"
- Who rated, on what scale
- 18 healthy adults aged 60 or older (mean 65.2 years, 9 women; 2 in part 1a and 16 in part 2); exploratory, descriptive only, with no test
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Number answering "no or slight bitterness" (sensory; more means more people found it not bitter; not an intensity score) | Foods against each other: chocolate pudding, Ensure and yogurt vs applesauce (no water or unmixed control) The contents of a 34 mg pimavanserin capsule mixed with about 15 mL of applesauce, chocolate pudding, yogurt or vanilla Ensure; 18 people aged 60 or older, 4-way crossover, open label | chocolate pudding 14/18 people, Ensure 14/18 people, yogurt 8/18 people | applesauce 9/18 people | number answering bitterness was "none to mild" (1–2 points) (a count of people from a 1–5 rating, not a score of bitterness intensity) | Depends on the combination No test reported |
| No test reported (exploratory, descriptive only). The direction is from the numbers of people: more for chocolate pudding and Ensure than for applesauce, fewer for yogurt. People answering "none to mild" bitterness: 14 (78%) for chocolate pudding and Ensure, 9 (50%) for applesauce and 8 (44%) for yogurt. This is a description of foods against each other with no comparison with water or the unmixed drug, so it does not answer whether mixing softens bitterness. Overall taste is a separate rating Where: Results section 3.4.1 (text), Fig. 3C For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — A description of foods against each other, with no comparison with water or the unmixed drug and no test; not used for the comparison in this question and shown as a record | |||||
Kawase 2023 palatability
デカドロンⓇエリキシルの服薬コンプライアンス向上に関する検討 (A study on improving medication compliance with DECADRON Ⓡ elixir). 日本小児臨床薬理学会雑誌 36(1):82-86 — doi:10.69325/jdpt.36.1_82
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (subjects and methods, results, discussion); Fig. 1 is garbled and cannot be read, so the values in the text were used Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- Dexamethasone elixir (Decadron 0.01%) mixed 1:1 with each of 20 foods; for liquids 1–2 drops on a teaspoon with a dropper, for solids 1 teaspoonful
- Processing and cooking
- Not applicable (simply mixed)
- How it was served or eaten
- Tasted one person at a time and palatability scored 0–3 (3 = very easy to take, 2 = flavour remains but easy to take, 1 = somewhat hard, 0 = hard)
- Who rated, on what scale
- 10 staff of Hiroshima City Funairi Citizens Hospital (1 in their 20s, 3 in their 30s, 4 in their 40s, 2 in their 50s); means; Kruskal-Wallis test with Steel-Dwass multiple comparisons; the elixir alone was not rated
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Strawberry jam vs miso soup (mixed 1:1 with the elixir; the elixir alone was not rated) Dexamethasone elixir (0.01%) mixed 1:1 with each of 20 foods; 10 staff rated one at a time | 2.6 | 0.1 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 10 people; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Tested, significant |
| Direction shows which published value is larger. Kruskal-Wallis test, then Steel-Dwass comparisons between foods. The differences between strawberry jam or peach nectar and miso soup are p<0.01 and the other pairs (matcha latte, apple juice, corn soup and others) are p<0.05. The elixir alone was not rated, and the authors write that they could not compare whether mixing improved it. The values are the highest (2.6) and lowest (0.1) of the 20 foods Where: Results, Fig. 1 (values in the text) For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, and there is no control of the elixir alone; shown separately | |||||
Yasunaga 2024 palatability
デカドロンⓇエリキシルの服薬コンプライアンス向上に関する検討（第2報）―小児における服薬に関するアンケート結果と官能検査― (A study on improving medication compliance with DECADRONⓇ elixir （part2）： results of questionnaire on medication in children and taste test). 日本小児臨床薬理学会雑誌 37(1):55-61 — doi:10.69325/jdpt.37.1_55
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (subjects and methods, results, discussion, Fig. 4); the questionnaire answers of 32 children are not rows Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- Dexamethasone elixir alone and 10 other samples in all 11: chilled (24 h in a household refrigerator), diluted 1.5-fold with water, diluted 2-fold with water, bread, barley tea, green tea, undiluted Calpis, Aquarius, chocolate sauce and honey; mixed 1:1 with the foods and drinks (water in other ratios too)
- Processing and cooking
- Not applicable (simply mixed); only the chilled sample was cooled
- How it was served or eaten
- 1–2 drops of liquid on a teaspoon with a dropper or 1 teaspoonful of solid held in the mouth and swallowed; palatability scored 0–3 (as in Kawase 2023); the authors count 2 or more as "easy to take"
- Who rated, on what scale
- 9 pharmacists of Hiroshima City Funairi Citizens Hospital (3 each in their 30s, 40s and 50s); means; Kruskal-Wallis test (p=0.020451), Steel multiple comparisons against the elixir alone (p<0.05)
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Honey vs elixir alone (rated by 9 pharmacists) Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | 2.44 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Tested, significant |
| Direction shows which published value is larger. Kruskal-Wallis test (p=0.020451), then Steel comparisons against the elixir alone: 1 item was significant (this honey) at p<0.05 (* in Fig. 4). The raters were 9 pharmacists in their 30s to 50s, not children. Separately, the information sheet for parents reproduced in the source carries a caution that honey is only for ages 1 and over and is not to be used for infants aged 0 (this is the source's statement, not the age of the people tested). This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Chocolate sauce vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | 2.44 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The Steel method (against the elixir alone) is described, but only 1 item is shown as significant against the elixir alone in the text and Fig. 4, and no result for this comparison is shown (not described as "not significant"). This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Aquarius vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | 2.11 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The Steel method (against the elixir alone) is described, but only 1 item is shown as significant against the elixir alone in the text and Fig. 4, and no result for this comparison is shown (not described as "not significant"). This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Diluted 2-fold with water vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | 1.89 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The Steel method (against the elixir alone) is described, but only 1 item is shown as significant against the elixir alone in the text and Fig. 4, and no result for this comparison is shown (not described as "not significant"). This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Undiluted Calpis vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | 1.78 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The Steel method (against the elixir alone) is described, but only 1 item is shown as significant against the elixir alone in the text and Fig. 4, and no result for this comparison is shown (not described as "not significant"). This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Barley tea and green tea (the same value for both) vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | 1.67 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The Steel method (against the elixir alone) is described, but only 1 item is shown as significant against the elixir alone in the text and Fig. 4, and no result for this comparison is shown (not described as "not significant"). This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Diluted 1.5-fold with water vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | 1.56 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The Steel method (against the elixir alone) is described, but only 1 item is shown as significant against the elixir alone in the text and Fig. 4, and no result for this comparison is shown (not described as "not significant"). This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Bread vs elixir alone Dexamethasone elixir mixed 1:1 with foods and drinks (water in other ratios too); 9 pharmacists rated one at a time | 1.33 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Same published value (not a test of equivalence) Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The Steel method (against the elixir alone) is described, but only 1 item is shown as significant against the elixir alone in the text and Fig. 4, and no result for this comparison is shown (not described as "not significant"). The published means are equal (1.33); this is not a test showing that palatability was equivalent. This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
| Palatability (sensory rating; not bitterness intensity) | Palatability and dose taken: Chilled (24 h) vs elixir alone Dexamethasone elixir alone chilled for 24 h in a household refrigerator, compared with the elixir alone not chilled (not mixed with any food or drink); 9 pharmacists rated individually | 1.11 | 1.33 | mean palatability 0–3 (3 = very easy to take; higher is easier to take; 9 people; the authors count 2 or more as "easy to take"; not a score of bitterness intensity) | Reference compared (mostly water or the drug alone; given in each row) higher Test method described; result for this comparison not reported |
| Direction shows which published value is larger. The Steel method (against the elixir alone) is described, but only 1 item is shown as significant against the elixir alone in the text and Fig. 4, and no result for this comparison is shown (not described as "not significant"). This is a palatability value, separate from the bitterness rows Where: Results section 2, Fig. 4 For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is palatability, not bitterness intensity, so this is not used for the comparison in this question, although it compares against the drug alone; shown separately | |||||
Sogo 2025 dose taken
小児患者における嗜好品混合によるレボセチリジン塩酸塩ドライシロップの飲みやすさ探索試験 (An exploratory study on the palatability of levocetirizine hydrochloride dry syrup mixed with flavored vehicles in pediatric patients). 日本小児臨床薬理学会雑誌 38(1):88-95 — doi:10.69325/jdpt.38.1_88
- How deeply checked
- Checked in full text — Full text via the J-STAGE PDF (subjects and methods, results, Table 1, Fig. 2 as an image); the radar charts of how the dose felt in Fig. 3 give neither values nor tests that can be read; the year in print is 2025 Checked by: LLM (one extracted, another checked against the source; no human check), 2026-10-22.
- Samples
- Levocetirizine hydrochloride DS 0.5% (strawberry-milk flavour, generic) mixed with 15 mL of a drink or food, with instructions to take it within 5 min of mixing; 4 items for ages 6 months to under 1 year (natural water, barley tea, orange juice, apple juice) and 10 items from age 1 (adding a sports drink, milk, chocolate ice cream, vanilla ice cream, jelly, yogurt); each child was assigned 1 item by lottery
- Processing and cooking
- Not applicable (simply mixed)
- How it was served or eaten
- Parents filled in a medication check sheet for 3 days; dose taken was calculated with "all taken" as 100%, "about half" as 50% and "almost none" as 0%; how the dose felt (sweetness, bitterness, aftertaste, ease of dissolving, ease of taking, the parent's view of the child) on 5-step face scales
- Who rated, on what scale
- 79 children (21 aged 6 months to under 1 year, 58 aged 1 or older); the analysis without dropouts covers 73 in all (19 aged 6 months to under 1 year, 35 aged 1 to under 3 and 19 aged 3 to under 7); dose taken was compared with water by Scheffé's test; the number per item is not in the text
| Measured | Comparison and condition | Mixed or changed condition (given in each row) | Reference compared (mostly water or the drug alone; given in each row) | Unit | Direction / test |
|---|---|---|---|---|---|
| Dose taken (proportion taken; not bitterness intensity) | Palatability and dose taken: Vanilla ice cream vs natural water (aged 1 to under 3) Levocetirizine DS 0.5% mixed with water or 15 mL of a food or drink, with instructions to take it within 5 min of mixing, for 3 days; 1 item per child; aged 1 to under 3 (35 in the analysis) | 100 (text) | in the 80s (text) | dose taken (%) (calculated from 3 days with "all taken" as 100, "about half" as 50 and "almost none" as 0; higher means a larger proportion taken; children; not a score of bitterness intensity) | Mixed or changed condition (given in each row) higher Tested, not significant |
| Direction shows which published value is larger. The text gives vanilla ice cream at 100% and natural water, milk and yogurt in the 80s. No significant difference was seen between water and the 9 items in this age group (p=0.81). Dose taken with water and with each food or drink was compared within each age group by Scheffé's test (the text writes NS). The number per item is not in the text and is small (the authors note this as a limit). This row is 1 item per age group, picked as the highest or lowest the text names among those compared with water (not all items are shown). This compares within an age group, not across groups. How the dose felt (5-step face scales including bitterness) is in the radar charts of Fig. 3, whose values and tests cannot be read Where: Results section 2 (dose taken), Fig. 2B For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is dose taken, not bitterness intensity, and the number per item is small; not used for the comparison in this question; shown separately | |||||
| Dose taken (proportion taken; not bitterness intensity) | Palatability and dose taken: Yogurt vs natural water (aged 3 to under 7) Levocetirizine DS 0.5% mixed with water or 15 mL of a food or drink, with instructions to take it within 5 min of mixing, for 3 days; 1 item per child; aged 3 to under 7 (19 in the analysis) | about 55 (approximate, from Fig. 2C; the text says "low") | 100 (text) | dose taken (%) (calculated from 3 days with "all taken" as 100, "about half" as 50 and "almost none" as 0; higher means a larger proportion taken; children; not a score of bitterness intensity) | Reference compared (mostly water or the drug alone; given in each row) higher Tested, not significant |
| Direction shows which approximate value read from the figure is larger. The text gives natural water, barley tea, orange juice, milk and vanilla ice cream at 100% and says the sports drink, apple juice and yogurt were low. No significant difference was seen between water and the 9 items in this age group (p=0.12). Dose taken with water and with each food or drink was compared within each age group by Scheffé's test (the text writes NS). The number per item is not in the text and is small (the authors note this as a limit). This row is 1 item per age group, picked as the highest or lowest the text names among those compared with water (not all items are shown). This compares within an age group, not across groups. How the dose felt (5-step face scales including bitterness) is in the radar charts of Fig. 3, whose values and tests cannot be read Where: Results section 2 (dose taken), Fig. 2C For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is dose taken, not bitterness intensity, and the number per item is small; not used for the comparison in this question; shown separately | |||||
| Dose taken (proportion taken; not bitterness intensity) | Palatability and dose taken: Barley tea vs natural water (aged 6 months to under 1 year) Levocetirizine DS 0.5% mixed with water or 15 mL of a drink, with instructions to take it within 5 min of mixing, for 3 days; 1 item per child; aged 6 months to under 1 year (19 in the analysis) | about 80 (approximate, from Fig. 2A) | about 93 (approximate, from Fig. 2A; the text says natural water was highest, followed by orange juice, apple juice and barley tea) | dose taken (%) (calculated from 3 days with "all taken" as 100, "about half" as 50 and "almost none" as 0; higher means a larger proportion taken; children; not a score of bitterness intensity) | Reference compared (mostly water or the drug alone; given in each row) higher Tested, not significant |
| Direction shows which approximate value read from the figure is larger. No significant difference was seen between water and the 3 items in this age group (p=0.63). Dose taken with water and with each food or drink was compared within each age group by Scheffé's test (the text writes NS). The number per item is not in the text and is small (the authors note this as a limit). This row is 1 item per age group, picked as the highest or lowest the text names among those compared with water (not all items are shown). This compares within an age group, not across groups. How the dose felt (5-step face scales including bitterness) is in the radar charts of Fig. 3, whose values and tests cannot be read Where: Results section 2 (dose taken), Fig. 2A For whether changing only what the same drug (or the same bitter sample) is mixed with (food, drink, jelly, dissolving liquid, dilution) or its temperature changes the intensity of bitterness people perceive: Not usable — What was measured is dose taken, not bitterness intensity, and the number per item is small; not used for the comparison in this question; shown separately | |||||
What was established within an experiment
Only results observed in comparisons within one study. Results with no test shown are stated as such.
- For mixtures of clarithromycin DS and carbocisteine DS, using sodium bicarbonate water or prepared soy milk as the dissolving liquid gave a bitterness median of 2 against 5 for tap water, which was significant (mark **, Inoue 2020). The swallowing-aid jelly, alkaline ionised water and hot-spring water had a median of 5, the same value as tap water (no mark in the table, and no test result is given for these pairs). For azithromycin, sodium bicarbonate water was 2.5 (mark *); soy milk also has the same median of 2.5 but no mark (no test result is given for this pair), so no difference is read. This bitterness is that after mixing in the co-administered drug, a different condition from mixing 1 drug with food. [rows: Inoue 2020 Dissolving liquid: Sodium bicarbonate water vs tap water (clarithromycin); Inoue 2020 Prepared soy milk vs tap water (clarithromycin); Inoue 2020 Swallowing-aid jelly: Swallowing-aid jelly (chocolate flavour, for antibiotics) vs tap water (clarithromycin); Inoue 2020 Dissolving liquid: Alkaline ionised water vs tap water (clarithromycin); Inoue 2020 Dissolving liquid: Sodium bicarbonate water vs tap water (azithromycin); Inoue 2020 Prepared soy milk vs tap water (azithromycin)]
- When azithromycin powder was mixed with vanilla ice cream, the median bitterness VAS was 1.0 against 67 for water in the 1st evaluation, significant at the corrected level (p=0.0006, Tanaka 2020). Oolong tea was 22 with p=0.0199 and orange juice 65.5 with p=0.5694, neither reaching this level. Overall palatability was measured separately in the same study, at 78.5 against 23.5 for the ice cream. [rows: Tanaka 2020 Vanilla ice cream (Häagen-Dazs) vs water (azithromycin powder); Tanaka 2020 Oolong tea vs water (azithromycin powder) [not significant at the corrected level of 0.01]; Tanaka 2020 Orange juice vs water (azithromycin powder); Tanaka 2020 Palatability and dose taken: Vanilla ice cream vs water (azithromycin powder)]
- For the herbal preparation (Keimeigashinsan S), in the screening condensed milk at 2.8, vanilla ice cream at 2.9, chocolate ice cream at 3.0, peanut cream at 2.6 and nori tsukudani at 2.1 were significantly lower than 4.1 for water (Kido 2019). The jelly for powdered drugs, at 3.1, was not significant by the two-sided test (significant only by the one-sided test). In the main test, these 5 foods were significantly lower than the jelly, at approximately −2.4 to −3.5 against about −1.4 for the jelly (the reference is the jelly, not water). The text says milk cocoa showed no significant suppressing effect. [rows: Kido 2019 Condensed milk vs water (screening); Kido 2019 Vanilla ice cream vs water (screening); Kido 2019 Chocolate ice cream vs water (screening); Kido 2019 Peanut cream vs water (screening); Kido 2019 Nori tsukudani (seaweed simmered in soy sauce) vs water (screening); Kido 2019 Swallowing-aid jelly: Jelly for powdered drugs (coffee jelly flavour) vs water (screening); Kido 2019 Condensed milk vs swallowing-aid jelly (main test; the reference is the jelly, not water); Kido 2019 Peanut cream vs swallowing-aid jelly (main test; the reference is the jelly, not water); Kido 2019 Milk cocoa vs water (screening)]
- For Orengedokuto, of the 7 jellies only strawberry–chocolate (**) and chocolate (*) carry significance marks in Fig. 3, at approximately 1.6 and 1.9 against about 3.4 for water (Yoshida 2010). The other 5 carry no marks and no test result is shown for them. The abstract says "lower" and the results section "higher", the opposite; the figure shows water higher, and the results section is read as a misprint. [rows: Yoshida 2010 Swallowing-aid jelly: Strawberry–chocolate jelly vs water; Yoshida 2010 Swallowing-aid jelly: Chocolate jelly vs water; Yoshida 2010 Swallowing-aid jelly: Coffee, peach, lemon, grape and strawberry jellies (5 kinds) vs water]
- In the comparison dissolving ibuprofen in milks with different fat (Bennett 2012), the overall effect of fat level on bitterness across the 3 conditions (skim milk, whole milk, half-and-half) was not significant (F(2,96)=1.58, p=0.21). No result of a pairwise bitterness test is reported. The effect of sample position was significant (p=0.028). With no water control, this is not a comparison of mixing or not mixing with milk. In the comparison dissolving paracetamol and zinc dispersible tablets in water and infant formula milk (Orubu 2022), only 1 of the 4 comparisons had p below 0.05 (p=0.015), no correction is described in the parts read, and what was measured was aversion, not bitterness. [rows: Bennett 2012 Milks with different fat: skim milk, whole milk and half-and-half, 3 conditions overall (no water control); Orubu 2022 Infant formula milk vs water (dispersible tablet, zinc, mannitol base (T2)); Orubu 2022 Infant formula milk vs water (dispersible tablet, zinc, lactose base (T1)); Orubu 2022 Infant formula milk vs water (dispersible tablet, paracetamol, lactose base (T1)); Orubu 2022 Infant formula milk vs water (dispersible tablet, paracetamol, mannitol base (T2))]
- With bitter-gourd powder (not a drug), 7 foods (chocolate syrup, nori tsukudani, miso soup, condensed milk, sweet bean paste, unsalted butter and cream) were significantly lower than room-temperature water in junior high students (P<0.001), and no significant difference was shown for lemon juice and plain yogurt. In teachers all 9 were significantly lower (P<0.05, Sugai 2026). The test was not blinded and the order was the same for all. [rows: Sugai 2026 Not a drug sample: chocolate syrup, nori tsukudani, miso soup, condensed milk, sweet bean paste, unsalted butter and cream (7 foods) vs room-temperature water (junior high students); Sugai 2026 Not a drug sample: Lemon juice (diluted 1:1 with water) and plain yogurt vs room-temperature water (junior high students); Sugai 2026 Not a drug sample: All 9 foods (the 7 above plus lemon juice and plain yogurt) vs room-temperature water (teachers)]
- Disagreements between text or abstract and figures or tables were found in several studies. Tanaka 2020 says bitterness rose with orange juice, but the p values against water were 0.5694 and 0.0841. Yoshida 2010 gives p<0.01 for chocolate, but the mark in the figure is *. The P for the χ² in Takagi 2017 also does not match when calculated from the degrees of freedom. This table takes the values of figures, tables and tests, and the disagreements are kept in the row notes. [rows: Tanaka 2020 Orange juice vs water (azithromycin powder); Yoshida 2010 Swallowing-aid jelly: Chocolate jelly vs water; Takagi 2017 Vanilla ice cream vs water]
Candidate explanations for the differences
Conditions that differ between studies and could explain the differences in results, and the authors' interpretations. Several conditions differ at once, so which one mattered is unknown. These are candidates, not causes.
- In studies mixing basic macrolide drugs with acidic jellies or drinks, a rise in bitterness is reported, and the authors attribute it to the polymer coating dissolving more easily in acid (Tsuji 2006, Tanaka 2020, Inoue 2020). Tsuji and colleagues report CAM concentrations in the jelly extracts that were higher for the acidic jellies than for the water suspension (values in the source). This is, however, a candidate explanation for bitterness in the mouth, and this page does not cover how the drug works or moves in the body. It is also an explanation for macrolide drugs, and whether it accounts for the direction in other drugs was not checked in this table. [rows: Tsuji 2006 Swallowing-aid jelly: Paste-type jelly (pH 3.8) vs water suspension (clarithromycin DS); Tsuji 2006 Swallowing-aid jelly: Water jelly, muscat (pH 3.7) vs water suspension (clarithromycin DS); Tanaka 2020 Orange juice vs water (azithromycin powder); Inoue 2020 Swallowing-aid jelly: Swallowing-aid jelly (chocolate flavour, for antibiotics) vs tap water (clarithromycin)]
- The authors name strong taste, sweetness and viscosity as candidate reasons, since many of the foods in the lowered group are strong-tasting, sweet or viscous (Kido 2019, Kawase 2023; the values for Kawase are mean palatability, not bitterness scores). Kido and colleagues think the foods coat the herbal powder and keep it from spreading in the mouth. However, sweetness, viscosity, fat, temperature and salt differ together between foods, and which mattered cannot be separated. The study showing a negative correlation between bitterness and sweetness scores (Yoshida 2010) is also a correlation among mean values, not a causal one. [rows: Kido 2019 Condensed milk vs water (screening); Kido 2019 Peanut cream vs swallowing-aid jelly (main test; the reference is the jelly, not water); Kawase 2023 Palatability and dose taken: Strawberry jam vs miso soup (mixed 1:1 with the elixir; the elixir alone was not rated); Yoshida 2010 Swallowing-aid jelly: Strawberry–chocolate jelly vs water]
- The effect of low temperature went opposite ways across studies. The authors raise the possibility that coldness lowered bitterness in the ice cream study (Tanaka 2020), and Aminoleban EN was significantly lower at 0–5 °C (Haraguchi 2011). By contrast, cold water mixed with bitter-gourd powder was significantly higher than room-temperature water in junior high students (Sugai 2026), and the chilled dexamethasone elixir had a lower mean than the elixir alone (Yasunaga 2024; mean palatability, not a bitterness score). Samples, temperatures and raters differ, so this cannot be stated as an effect of temperature alone. [rows: Tanaka 2020 Vanilla ice cream (Häagen-Dazs) vs water (azithromycin powder); Haraguchi 2011 Nutritional product sample: 0–5 °C vs 25–30 °C (Aminoleban EN suspension); Sugai 2026 Not a drug sample: Cold water (2–4 °C) vs room-temperature water (23–25 °C) (junior high students); Yasunaga 2024 Palatability and dose taken: Chilled (24 h) vs elixir alone]
- Across studies the scales (quinine-standard 0–4 scores, VAS, 5-step ratings, gLMS, aversion VAS), amounts mixed, ways of serving the samples and numbers of raters (4–50 people) differ. These may contribute to the differences in results, but this was not checked in this table. The 5 studies from Mukogawa Women's University share a corresponding author and the 2 from Funairi Citizens Hospital come from the same hospital, so they are not counted as independent replications. [rows: Tsuji 2006 Swallowing-aid jelly: Paste-type jelly (pH 3.8) vs water suspension (clarithromycin DS); Takagi 2017 Vanilla ice cream vs water; Bennett 2012 Milks with different fat: skim milk, whole milk and half-and-half, 3 conditions overall (no water control); Orubu 2022 Infant formula milk vs water (dispersible tablet, zinc, mannitol base (T2)); Kawase 2023 Palatability and dose taken: Strawberry jam vs miso soup (mixed 1:1 with the elixir; the elixir alone was not rated)]
What is not known — what this comparison alone cannot separate
- Even for the same food or drink, taste, sweetness, sourness, viscosity, fat, temperature, pH and amount mixed differ together, so which property changed the bitterness cannot be separated by this comparison alone. The dissolving liquids (sodium bicarbonate water, alkaline ionised water, hot-spring water) are not foods and involve mixing in a second drug after dissolving, so they are not counted together with comparisons of mixing with food. [rows: Inoue 2020 Dissolving liquid: Sodium bicarbonate water vs tap water (clarithromycin); Inoue 2020 Dissolving liquid: Hot-spring water vs tap water (clarithromycin); Tanaka 2020 Vanilla ice cream (Häagen-Dazs) vs water (azithromycin powder); Kido 2019 Nori tsukudani (seaweed simmered in soy sauce) vs swallowing-aid jelly (main test; the reference is the jelly, not water)]
- Some studies have no water or drug-alone control. Milks with different fat (Bennett 2012), 4 foods against each other (Forman 2021) and 20 foods against each other (Kawase 2023) do not answer whether mixing softens bitterness. The main test of Kido 2019 also used the jelly, not water, as the reference. [rows: Bennett 2012 Milks with different fat: skim milk, whole milk and half-and-half, 3 conditions overall (no water control); Forman 2021 Foods against each other: chocolate pudding, Ensure and yogurt vs applesauce (no water or unmixed control); Kawase 2023 Palatability and dose taken: Strawberry jam vs miso soup (mixed 1:1 with the elixir; the elixir alone was not rated); Kido 2019 Condensed milk vs swallowing-aid jelly (main test; the reference is the jelly, not water)]
- The only study in children was Sogo 2025 (79 children enrolled and 73 analysed), which also rated how the dose felt, including bitterness, on 5-step scales; the table shows dose taken. Junior high students were the 40 in Sugai 2026, with a sample that was not a drug. The rest were healthy adults (4–50 people), and whether the results apply to how people who actually take the drug perceive it cannot be separated by this comparison alone. The researchers write that taste sensitivity differs by age and individual, but its size was not checked in this table. [rows: Sogo 2025 Palatability and dose taken: Vanilla ice cream vs natural water (aged 1 to under 3); Sugai 2026 Not a drug sample: chocolate syrup, nori tsukudani, miso soup, condensed milk, sweet bean paste, unsalted butter and cream (7 foods) vs room-temperature water (junior high students); Takagi 2017 Vanilla ice cream vs water; Bennett 2012 Milks with different fat: skim milk, whole milk and half-and-half, 3 conditions overall (no water control)]
- No significant difference does not mean the bitterness was the same. Possible reasons include few people (many studies have 5–8), no pairwise p values being shown, and a strict corrected level. Comparisons for which no test result is shown (orange juice in Takagi 2017, milk in Ishizaka 2008, the 5 kinds in Yoshida 2010) are not described as "not significant". [rows: Takagi 2017 Orange juice vs water; Ishizaka 2008 Milk vs water; Yoshida 2010 Swallowing-aid jelly: Coffee, peach, lemon, grape and strawberry jellies (5 kinds) vs water; Tanaka 2020 Oolong tea vs water (azithromycin powder) [not significant at the corrected level of 0.01]]
- Because the direction differs by drug and study, no general statement such as "mixing this food softens bitterness" or "acidic drinks increase bitterness" can be made. What this page shows is what was shown (or not shown) for each drug and study, under those conditions and for those people. [rows: Tsuji 2006 Swallowing-aid jelly: Paste-type jelly (pH 3.8) vs water suspension (clarithromycin DS); Ishizaka 2008 Acidic sports drink (Pocari Sweat) vs water; Takagi 2017 Vanilla ice cream vs water; Tanaka 2020 Orange juice vs water (azithromycin powder)]
How studies and rows were counted
The number of evidence rows is not the number of studies. Table rows, ledger evidence rows, papers and research groups are counted separately. Studies from the laboratory of the same corresponding author at Mukogawa Women's University, and studies from the pharmacy department of Hiroshima City Funairi Citizens Hospital, are each counted as one research group. The corresponding author at the University of Shizuoka is a different person from the one at Mukogawa Women's University, so that study is a separate group. The studies shared with the sugar and salt page (Kido et al. and Sugai et al.) use the same study records and are not counted again as new evidence. The number of studies that "have results on people's bitterness ratings in this table" below does not include Sogo et al., who also rated how the dose felt, including bitterness, but whose rows in this table show only dose taken. The number of research groups shown in the table below is the number of categories in the ledger, not the number of independent replications; co-authors and affiliations overlap across some studies, so it does not guarantee independence.
- Sources in the table: 16, of which 12 have results on people's bitterness ratings in this table; for the others, only results on something else (palatability, aversion and dose taken) are shown, or they are used only for context.
- Rows in the table (study × measured result): 97. Rows on perceived bitterness: 74.
- Evidence rows in the lab's ledger these rows rest on: 0. One paper can supply several rows. Rows without a ledger evidence row come from other tables of the same papers, or from sources newly read for this question.
- Research groups among the studies with bitterness results in this table, as grouped in the ledger: 8 (reports from the same lab count as 1; co-authors and affiliations can overlap, so this is not a count of independent replications).
What we looked at
The sources examined for this question and why each was included or excluded. We searched J-STAGE for Japanese- and English-language studies (including the Japanese Journal of Pharmaceutical Health Care and Sciences, the Journal of the Japan Society of Developmental and Therapeutics and the Chemical and Pharmaceutical Bulletin) and Europe PMC for English-language studies, combining terms for medicine bitterness, what the medicine is mixed with, and palatability, and added the sources already in the lab's ledger. Results from electronic tongues and taste sensors alone, formulation work (jellification, coating, microcapsules), studies adding compounds such as sugar or salt, studies changing only the order of mixing or eating, and questionnaires of what parents reported were not made rows in the table. Studies whose full text is paywalled and of which only the abstract was read were not made rows either, because their values and tests were not checked. The search described here is a record, not a claim that nothing was missed.
| Source | Decision | Why |
|---|---|---|
| 電子味覚システムとヒト官能試験によるクリンダマイシンの苦味抑制飲食物の探索 (Identification of Foods Masking Clindamycin Bitterness Using an Electronic Gustatory Screening System Followed by Organoleptic Examination) (2017) doi | Included in the table | Bitterness with water and 5 foods and drinks compared by 30 healthy adults; electronic gustatory values are not rows; read in full |
| Evaluation of Bitterness Suppression of Macrolide Dry Syrups by Jellies (2006) doi | Included in the table | Mixtures with 3 swallowing-aid jellies compared with the water suspension; taste sensor values are not rows; read in full |
| Suppression of Bitterness and Improvement of Palatability of Commercial Prednisolone Powder (2008) doi | Included in the table | Bitterness with water, drinks and foods compared; the simple syrup mixtures and palatability (SD method) are not rows; read in full |
| Combining Powder Formulations of Drugs with Food and Beverages to Improve Palatability (2020) doi | Included in the table | Bitterness and overall palatability of azithromycin powder compared with water; the bitterness of carbocisteine DS is not a row because the median for water was 0; read in full |
| 各種溶解液でマクロライド系抗菌散剤溶解後にカルボシステインドライシロップ混合を行うことによる服薬改善の検討 (Improvement of medication when carbocisteine dry syrup is mixed with macrolide antibacterial powder dissolved in various dissolution solutions) (2020) doi | Included in the table | Bitterness and palatability of mixtures with different dissolving liquids compared with tap water; the rows state that this includes liquids that are not foods and bitterness after mixing in the co-administered drug; read in full |
| Bitterness-Masking Effects of Different Beverages on Zopiclone and Eszopiclone Tablets (2019) doi | Included in the table | Human ratings with water and 5 drinks compared; values are approximate readings of the points in Fig. 5 and there is no test of the human ratings; taste sensor values are not rows; read in full |
| Bitterness Suppression of the Kampo Medicine 'Orengedokuto' Using Flavoured Jellies (2010) doi | Included in the table | Bitterness with water and 7 jellies compared; values are approximate readings from Fig. 3; astringency and other items are not rows; read in full |
| Synergistic Effects of Sour Taste and Low Temperature in Suppressing the Bitterness of Aminoleban EN (2011) doi | Included in the table | Temperature and flavoured powders compared for Aminoleban EN, which the source describes as a nutritional product; values are approximate readings of the bars in Fig. 1; the measurements on BCAA solutions alone are not rows; read in full |
| Evaluating the Taste Masking Ability of Two Novel Dispersible Tablet Platforms Containing Zinc Sulfate and Paracetamol Reconstituted in a Breast Milk Substitute (2022) doi | Included in the table | Aversion with water and with infant formula milk compared; the rows state that aversion, not bitterness intensity, was measured; read in full |
| Using milk fat to reduce the irritation and bitter taste of ibuprofen (2012) doi | Included in the table | Bitterness in milks with different fat compared; the row states that there is no water control; throat irritation is a separate item and not a row; read in full |
| Palatability and Swallowability of Pimavanserin When Mixed with Selected Food Vehicles: An Exploratory Open-Label Crossover Study (2021) doi | Included in the table | Descriptive bitterness for 4 vehicles (3 foods and a nutritional drink); there is no test and no water or unmixed control, so it is not used for the comparison and is shown as a record; read in full |
| デカドロンⓇエリキシルの服薬コンプライアンス向上に関する検討 (A study on improving medication compliance with DECADRON Ⓡ elixir) (2023) doi | Included in the table | Palatability compared across 20 foods; the elixir alone was not rated and palatability, not bitterness, was measured, so it is shown separately; read in full |
| デカドロンⓇエリキシルの服薬コンプライアンス向上に関する検討（第2報）―小児における服薬に関するアンケート結果と官能検査― (A study on improving medication compliance with DECADRONⓇ elixir （part2）： results of questionnaire on medication in children and taste test) (2024) doi | Included in the table | Palatability compared between the elixir alone and 10 other samples; palatability, not bitterness, was measured, so it is shown separately; the children's questionnaire is not a row; read in full |
| 小児患者における嗜好品混合によるレボセチリジン塩酸塩ドライシロップの飲みやすさ探索試験 (An exploratory study on the palatability of levocetirizine hydrochloride dry syrup mixed with flavored vehicles in pediatric patients) (2025) doi | Included in the table | Dose taken in children compared; how the dose felt, including bitterness, was also rated on 5-step scales, but the table shows dose taken, which is not a bitterness-intensity row, so it is shown separately; Fig. 3 on how the dose felt gives neither values nor tests that can be read; read in full |
| 食品による生薬製剤のマスキング効果 (2019) doi | Included in the table | A 30-food screening and a 6-item main test; the same study as kd-food on the sugar and salt page (sugar-salt-suppression), whose page is not changed, and here rows are split by food; read in full |
| 服薬アドヒアランス向上を目的とした中学生の食品による苦味マスキング官能評価 (Sensory Evaluation of Food-Based Bitterness Masking in Junior High School Students Aimed at Improving Medication Adherence) (2026) doi | Included in the table | Nine foods and water temperature; the same study as sg-food on the sugar and salt page, whose page is not changed, and the water-temperature rows were newly made for this question; read in full |
| "A spoonful of sugar helps the medicine go down": bitter masking by sucrose among children and adults (2015) doi | Read as context (not in the table) | A study adding sucrose to solutions, not a comparison of mixing with food, so not a row; see the row on the sugar and salt page (abstract read this time; the ledger records an earlier full-text check) |
| クラリスロマイシンドライシロップ製剤の酸性スポーツ飲料併用時およびムコダイン DS 併用時の苦味予測 (2010) doi | Excluded | The human ratings compare 12 preparations with each other, and no human-rating pair comparing the same preparation with water and with the sports drink is in the text (the water rating is on the taste sensor side); checked in the J-STAGE PDF |
| The Suppression of Enhanced Bitterness Intensity of Macrolide Dry Syrup Mixed with an Acidic Powder (2007) doi | Excluded | Human values (n=9) exist, but what is compared is how things are mixed (order of taking, wrapping in or mixing with jelly), not the dissolving liquid or kind of food; there is no pair comparing clarithromycin DS with water and with each food or drink; checked in the J-STAGE PDF |
| Ability of Food/Drink to Reduce the Bitterness Intensity of Topiramate as Determined by Taste Sensor Analysis (2016) doi | Excluded | Taste sensor measurement only, with no human ratings; checked in the J-STAGE PDF |
| The Effect of Various Substances on the Suppression of the Bitterness of Quinine–Human Gustatory Sensation, Binding, and Taste Sensor Studies (2002) doi | Excluded | A study adding compounds (sucrose, aspartame, NaCl and others) to quinine, not foods; within the scope of the sugar and salt page; checked in the J-STAGE PDF |
| Influence of Swallowing Aids on the Adsorption and Palatability of Kremezin (2011) doi | Excluded | Compares an activated-charcoal adsorbent (Kremezin) with 3 swallowing aids and water. The 14 SD-method items (odour, good or bad taste, roughness, aftertaste and others) include no bitterness item, and there is no bitterness rating or test, so it is not a row as a comparison of a bitter drug's bitterness. Even where only palatability was measured, studies mixing a drug whose bitterness is the problem with food and measuring palatability, dose taken or aversion (Kawase, Yasunaga, Sogo, Orubu) are shown separately. Checked in the J-STAGE PDF |
| SD 法による小児用抗菌薬の服用性評価 (2008) doi | Excluded | A study comparing 7 pediatric antibacterial formulations with each other by the SD method (15 items), with no pair of the same drug mixed with water and with a food (a comparison of formulations); checked in the abstract of the J-STAGE PDF |
| 小児用抗菌薬の服用性に関する研究 −懸濁・分散性および苦味強度の評価を中心として− (2008) doi | Excluded | A study comparing suspension and dispersion capabilities and bitterness intensity of 7 formulations and also mixtures of oseltamivir with 4 antibiotic formulations, with no pair of the same drug mixed with water and with a food (formulation comparison and co-administration); checked in the abstract of the J-STAGE PDF |
| クラリスロマイシンドライシロップと各種カルボシステイン製剤併用時の苦味強度における先発医薬品と後発医薬品間の違い (2008) doi | Excluded | A study of the bitterness of clarithromycin DS taken together with carbocisteine preparations, comparing branded and generic products (6 healthy men), not a comparison of mixing with food (co-administration); checked in the abstract of the J-STAGE PDF |
| アセトアミノフェン小児用ドライシロップ剤の味覚評価（苦味マスキングに関する評価 第 1 報） (2008) | Excluded | By its title an evaluation of taste among dry syrup products, not a comparison of mixing with food (formulation comparison); the text layer of the J-STAGE PDF is garbled and only the title and authors could be checked, so the body was not read |
| 入院中の患児に対する 2 種類の服薬補助食品の有用性に関する調査 (2019) doi | Excluded | A questionnaire of caregivers and nurses of hospitalised children, not a comparison in which people rated taste (questionnaire); checked in the abstract of the J-STAGE PDF |
| スルファメトキサゾール・トリメトプリム合剤の服用性に関するアンケート調査 (2019) | Excluded | A questionnaire of 107 pharmacists on the acceptability of ST combination products, not a comparison in which people rated taste (questionnaire); checked in the summary of the J-STAGE PDF |
| 小児を志向したST配合錠のゼリー化：苦味マスキングと製剤特性 (2025) doi | Read as context (not in the table) | A formulation study (jellification). The single comparison of suspension and a 150-fold dilution (a dilution chosen in advance as one that is barely bitter) is not a comparison of mixing with food, so it is not a row; checked in the J-STAGE PDF |
| Stability, Dose Uniformity, and Palatability of Three Counterterrorism Drugs—Human Subject and Electronic Tongue Studies (2005) doi | Full text not reachable | A human volunteer study mixing doxycycline, ciprofloxacin and potassium iodide with household foods and drinks, but the full text is paywalled and only the abstract was read; values and tests were not checked |
| Prior administration of chocolate improves the palatability of bitter drugs: The Choc‐with‐Med study (2021) doi | Full text not reachable | A design in which chocolate is eaten first, not a comparison of mixing the drug with food; the full text is paywalled and only the abstract was read |
| Palatability of Crushed Over-the-Counter Medications (2021) doi | Full text not reachable | A study on mixing with applesauce, but the full text is paywalled and only the abstract was read; values and tests were not checked |
| Ingredients to Mask the Aversive Taste of Medicines: Lessons from the Pharmaceutical and Food Industries and Home Remedies Adopted by Caregivers (2026) doi | Excluded | A review, not a primary study; its reference list was used to look for primary studies, but it is not a row; checked in the Europe PMC full text (CC BY 4.0) |
Read in the encyclopedia
- Does adding sugar or salt suppress bitterness? — studies comparing foods with each other and studies adding sugar or salt
- Handling the bitterness of medicines — the whole subject of measuring and masking the bitterness of medicines
- Palatability (medicinal product) — the idea of acceptability that combines taste, smell and mouthfeel
Source ledger
Each study's source can be reached from its section above. All of the lab's sources are listed in the source ledger.
How to cite this page
Aoki, M. (NIGAMI LAB) (2026). Does mixing a medicine with food soften its bitterness?. https://nigamilab.com/en/topics/drug-masking-foods-bitterness/
Each claim card has a stable anchor (#clm-…). The dataset is CC BY 4.0; see the data page. Dataset DOI: 10.5281/zenodo.22739101