Which capsules can be opened

This is why they are usually presented in packaging material such as aluminum strip packing, or foil. The foil protects the hard-shelled capsule from moisture. Soft gelatin capsules have soft, globular, gelatin shells somewhat thicker than that of hard gelatin capsules. The gelation is plasticized by the addition of glycerin and other elements to create the softshell.

It also may contain a preservative to prevent any fungal growth. Potato starch is the main ingredient of the transparent, smooth, flexible film, which can be shaped, filled, and packaged just like gelatin. It is safe to swallow capsule covers. They may need to be swallowed whole because:. According to The Orlando Clinical Research center, it takes approximately 30 minutes for a capsule to dissolve in the body.

In general, it typically takes approximately 30 minutes for most medications to dissolve. When a medication is coated in a special coating — which may help protect the drug from stomach acids — it may take longer to reach the bloodstream.

For example, aspirin may dissolve in a matter of minutes, while gelcaps may take much longer, due to their gel coating. When medications move through the human body, they encounter and are processed by different organs before finally being released into the bloodstream. While this process may sound straightforward, different drugs dissolve at different rates, different formulas, and dosages breakdown differently — and each persons body metabolizes medication in their own unique speed and way.

We hope this article has been helpful to you. View all Recommendations. Irritant; Note: chewed, crushed, or sucked tablets may cause oropharyngeal ulceration. Slow-release; Note: chewed, cut, or crushed tablets may cause oropharyngeal irritation.

Sublingual form g ; Note: chewing or swallowing may result in lower bioavailability. Note: chewing or swallowing may result in lower peak concentrations and bioavailability. Note: tablet should be swallowed whole and not crushed; tablet may be dispersed in water. Note: breaking, chewing, or emptying contents of the capsule can result in increased exposure. Note: see package insert for administration instructions via an oral syringe of NG tube. Note: women who are, or may become, pregnant, should not handle crushed or broken tablets.

Note: an oral powder is available, see prescribing information for administration instructions. Note: combining multiple tablets or portions of tablets may lead to an overdose of entacapone. Only when these tablets or capsules move from the stomach to the small intestine will the coating dissolve, allowing release of the active ingredients. In addition, many drugs in tablet or capsule form are designed to release their active ingredients even more slowly, over a period of 12 to 24 hours as the tablets or granules from the capsule pass through the small intestine.

This sustained-release also called controlled-release, long-acting and extended-release design provides the convenience of once- or twice-daily dosing and minimizes the variation in the amount of drug in the blood over the course of a day. This design can improve patient compliance and drug effectiveness while decreasing the risk of adverse effects. Crushing a tablet, opening a capsule or chewing either of these can circumvent many of the protective design features intended to control when and where a drug is released in the digestive tract.

Depending on the drug, this can result in overdosing, underdosing or direct toxic injury to the lining of the mouth, stomach or intestines.

The Prescrire International review highlighted examples of each of these potentially dangerous circumstances for several commonly used drugs. For some drugs, crushing, chewing or opening a tablet or capsule before swallowing can cause the rapid absorption of a large amount of the drug, potentially resulting in an overdose.

Digoxin is approved by the Food and Drug Administration FDA to treat heart failure and to slow the heart rate in patients who develop atrial fibrillation, a common abnormal heart rhythm characterized by an irregular and often rapid heart rate. According to the authors of the Prescrire International review, crushing digoxin tablets before swallowing may increase the risk of other dangerous abnormal heart rhythms.

Likewise, the authors noted that opening capsules containing the oral anticoagulant dabigatran PRADAXA will increase the amount of drug that is absorbed, exposing the patient to a greater risk of serious bleeding.

Sustained-release drugs also should not be crushed or chewed before swallowing because doing so will cause the dangerously rapid absorption of a large dose that was intended to be released slowly over many hours. See text box, below , for stories of patients who have been seriously harmed or killed after ingesting tablets that were chewed or crushed.

Here are just a few examples published in the medical literature of patients who have been injured or have died after ingesting a sustained-release drug that was chewed or crushed:. In contrast to the prior examples, for some drugs, crushing tablets, opening capsules or chewing either of these before ingestion can result in patients receiving an insufficient dose of the active ingredient. This occurs commonly with medications that have an enteric coating, designed to protect the active ingredient from being destroyed as the tablet or capsule passes through the stomach.

The authors of the Prescrire International review referenced a case of a year-old man who had severe heartburn. He was diagnosed with severe gastroesophageal reflux disease.

His doctor prescribed the proton pump inhibitor omeprazole twice daily. The omeprazole tablets were crushed before being administered via a tube placed in his stomach. Crushing the tablets likely compromised the integrity of their coating, allowing the stomach acid to inactivate the omeprazole, thus rendering the drug ineffective. Omeprazole also is available over the counter OTC. Finally, the authors of the Prescrire International review reported that some medications have a coating that is intended to prevent the active ingredients from causing ulcers and tissue injury in the mouth, stomach or intestines.

Skip to content Share Icon. Facebook Logo. Link Icon. Cohen, R. Published May 29, Extended Release.