You put the pill in the spout where it is suspended by a plastic grid. Fill the cup with liquid (~ 100ml) , then drink from the cup, and the pill is washed down down your throat as you gulp. For people who have difficulty swallowing pills. You need to have a normal swallow reflex and be able to gulp the liquid. The person I bought it for sips his liquids and holds them in his mouth for a few seconds before swallowing, so didn't work for us. It is in excellent condition.