The addition of cotton balls in pill bottles isn't random. Can you guess their original purpose?
This Is the Real Reason There’s Cotton in Pill Bottles
Updated on Apr. 24, 2025
I love the cotton in pill bottles. It’s like finding a toy in the cereal box—that little puff is so soft and fun to make shapes out of! Sometimes I use it to give my cat a powdered wig like an 18th-century French aristocrat. (Aristocat?) But why is there cotton in pill bottles in the first place? In all my years of taking medications and supplements, I’ve never been quite sure. Hygiene? Packing? Maybe it really is to make wigs for cats?
“Historically, the cotton ball served an important purpose,” says Thomas So, a pharmacist and senior manager of the Consumer Drug Information Group at First Databank. “Today you don’t see them as much, but they still have good uses.”
But what are those uses? I asked So to help me unravel the (cotton) threads of this question. Read on to find out the real answer for the white fluff in those orange pill bottles and over-the-counter medications.
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What’s the history of cotton in pill bottles?
This interesting fact dates back to the early 1900s, back when the local pharmacist probably wore a bow tie, used words like tonic and dispensed meds with zero warning labels. In this era before mass production and standardized pharmaceutical packaging, pills were made in small batches and hand-packed by pharmacists. These pills were fragile little things—often made with pressed powders that had the structural integrity of a stale cookie. To keep them from turning into crumbled dreams before they even made it home, pharmacists began stuffing cotton into the bottle’s neck, So says.
Bayer was the first to use the cotton balls, and other companies quickly followed suit. By the 1950s, the cotton ball was a standard in pill packaging. They were a mainstay up to the 1980s, even though by this point pill production had advanced to the point where the cotton wasn’t necessary. But consumers expected it to be there, so it stayed.
Then came the Tylenol tampering crisis in 1982, which led to tamper-evident seals, foil covers, childproof caps … and a growing realization that maybe that cotton ball wasn’t doing all that much anymore. The FDA doesn’t require it, so over the next few decades, it was mostly phased out in favor of those more secure packaging options. Cotton balls also have a major downside: It turns out that cotton can backfire, as it can absorb humidity from the environment, making the pills damp. All this, along with concerns about sustainability and waste, means the once-essential fluff is no longer common.
What purpose does the cotton serve?
OK, so now we’re in the modern age, with medication packaging secure enough to survive a dropkick. So why is that cotton still lurking in some bottles like a pharmaceutical ghost?
Cushioning
“The main reason drug manufacturers placed a cotton ball in pill bottles was to keep the pills in place during shipping, to prevent the pills from being knocked around and potentially breaking,” So explains. Some manufacturers today still use the cotton for this purpose.
Security
While it’s not as secure as a tamper-evident seal, the cotton ball can also serve as an indicator that a bottle has been tampered with. As So notes, “a missing or disturbed cotton ball would indicate that the bottle had been previously opened.”
Moisture control (sometimes)
Cotton balls’ ability to absorb moisture can be beneficial if it’s sealed in the bottle by the manufacturer, soaking up sneaky humidity during shipping. But, So explains, once the bottle is open, the cotton becomes a tiny traitor. “This moisture can lead to breaking down the pills in the bottle, decreasing their effectiveness,” he says.
According to the National Institutes of Health, keeping the cotton in the bottle is a common medication mistake, and you should yank out that puffball ASAP. Otherwise, you risk it pulling moisture into the bottle and turning your pills into sad little sponges.
Consumer expectations
Let’s be honest—some of this is just tradition. Cotton has been in pill bottles since your great-grandma had a headache. People expect it. It’s like the parsley on your plate at a fancy restaurant. No one really needs it, but if it doesn’t show up, you feel a little ripped off.
Are there any alternatives to cotton balls in pill bottles?
Oh, absolutely. Drug companies have made great strides in medication packaging. Here are a few alternatives for the cotton balls, according to So.
Desiccant packs
You know those little “DO NOT EAT” silica gel packets that come in shoe boxes and beef jerky? They can hang out in pill bottles too. “They come as packets or plastic cylinders, protecting the pills from moisture and acting as cushions in the bottle during shipping,” So says.
Blister packs
This type of packaging gives each pill its own private VIP suite—complete with walls, padding, climate control and zero chance of roommate drama (or collisions). So explains that “this protects the individual pills from damage and moisture.”
Nothing
Many pills today are coated, pressurized, and generally engineered to survive the apocalypse, so they don’t need any extra padding, cotton or otherwise, So says.
About the expert
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Sources:
- Thomas So, PharmD, pharmacist and senior manager of the Consumer Drug Information Group at First Databank; email interview, April 22, 2025
- Wall Street Journal: “Bayer Decided They Don’t Need Cotton Anymore, Despite Ritual”
