The objective of the present study is to identify, through integrative review, whether form adaptations farmacêuticas orais sólidas quando administrados por sondas enterais e estomias podem comprometer a segurança e eficácia terapêutica e qual o perfil de uso dessas adaptações na prática clínica. A literature search was conducted between August and September 2024 in the LILACS, Medline, SCIELO, and Scopus databases. A total of 148 records were identified, with 17 studies included in the final integrative review. Biopharmaceutical clinical trials and cross-sectional pharmacoepidemiological studies were included. We evaluated biopharmaceutical aspects: solubility, stability, adsorption, and obstruction of enteral tubes and ostomies, adaptation methods, and the prevalence of this practice in different healthcare settings and populations. Adaptations of solid oral medications are common practices in various settings and populations. Crushing, opening capsules and dividing tablets must be properly evaluated by healthcare professionals in order to avoid loss of the physical and chemical stability of the medication, its clinical efficacy, which may lead to an increase in adverse effects or toxicity. Because adaptations of solid dosage forms are a globally applied practice, instruments such as the creation of flowcharts and clear and detailed institutional protocols that guide which medications can be crushed, dispersed, or use an alternative solvent to water must be developed, and physicians, nurses, pharmacists, and caregivers must be trained.