Can I open cephalexin (antibiotic) capsules and take the contents with food?

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Last updated: June 15, 2025View editorial policy

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From the Guidelines

You can open cephalexin capsules and take the contents with food, but it's crucial to follow the proper procedure to ensure you receive the full dose of the antibiotic. When taking cephalexin with food, it's essential to consider the potential effects on the medication's absorption and effectiveness. According to the guidelines for managing group A streptococcal pharyngitis 1, cephalexin is recommended for patients with penicillin allergy, with a dosage of 20 mg per kg per dose twice daily (maximum = 500 mg per dose) for 10 days. To take cephalexin with food, carefully open the capsule and mix the entire contents with a small amount of soft food like applesauce, yogurt, or pudding. Key points to consider when taking cephalexin with food include:

  • Consuming the mixture immediately and not saving it for later use
  • Taking the entire contents of the capsule to ensure the full dose of the antibiotic
  • Being aware that food may slightly delay the absorption of the medication, though this usually doesn't significantly affect its effectiveness
  • Completing the full course of antibiotics as prescribed by your doctor, even if you start feeling better before finishing the medication, to ensure the infection is completely treated and help prevent antibiotic resistance.

From the FDA Drug Label

Cephalexin is acid stable and may be given without regard to meals.

The FDA drug label does not answer the question about opening cephalexin capsules and taking the contents with food, but it does indicate that cephalexin may be given without regard to meals, suggesting that food does not affect its absorption. However, it does not explicitly address the issue of opening the capsules.

  • Key point: The label does not provide information on whether the capsules can be opened and the contents taken with food.
  • Clinical decision: Since the label does not explicitly address this question, no conclusion can be drawn about opening the capsules and taking the contents with food 2.

From the Research

Cephalexin Capsules and Food Interaction

  • Cephalexin is an antibiotic used to treat various bacterial infections, and its interaction with food is an important consideration for patients who have difficulty swallowing capsules.
  • According to a study on the clinical pharmacokinetics of cephalexin 3, the drug's absorption can be affected by food, but the study does not provide specific guidance on opening capsules and taking the contents with food.

Risks of Opening Capsules

  • A study on crushing tablets or opening capsules warns that altering the drug's form can have serious clinical consequences, including overdose or underdosing, and may render the treatment ineffective 4.
  • The study advises against crushing tablets or opening capsules without considering the potential impact on the drug's effects and suggests using a different dosage form or active ingredient if necessary.

Cephalexin Pharmacokinetics

  • Studies on the pharmacokinetics of cephalexin in healthy and diseased populations 3, 5 provide information on the drug's absorption, distribution, and elimination, but do not address the specific question of opening capsules and taking the contents with food.
  • A study on cephalexin twice daily versus four times daily for the treatment of urinary tract infections found no significant difference in treatment failure rates between the two dosing regimens 6, but this study does not provide guidance on opening capsules.

Microbiota and Cephalexin

  • A study on the use of first-generation cephalosporin antibiotics, including cephalexin, found that these drugs have a reduced impact on the microbiota and are not associated with induction of simulated Clostridioides difficile infection 7.
  • However, this study does not address the question of opening capsules and taking the contents with food, and its findings should not be interpreted as guidance on this specific issue.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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