Amoxicillin Capsules Can Be Opened and Given with Food
Yes, amoxicillin capsules can be opened and the contents mixed with food to facilitate administration. This is explicitly supported by the FDA drug label for amoxicillin 1.
Administration Recommendations
Opening Capsules
- Amoxicillin capsules can be opened and the contents mixed with food for patients who have difficulty swallowing
- This is particularly useful for:
- Children who cannot swallow capsules
- Adults with swallowing difficulties
- Patients with feeding tubes
Food Considerations
- The FDA label specifically recommends taking amoxicillin at the start of a meal to minimize gastrointestinal intolerance 1
- Mixing with food does not significantly compromise the effectiveness of amoxicillin
- Unlike some antibiotics where food significantly impairs absorption, amoxicillin remains effective when taken with food
Important Precautions
Appropriate Foods for Mixing
- Mix with a small amount of soft food (e.g., applesauce, yogurt, pudding)
- Ensure the entire mixture is consumed immediately after preparation
- Do not mix with hot foods or beverages as heat may degrade the medication
Administration Timing
- The entire mixture should be consumed immediately after preparation
- Do not prepare doses in advance as this may affect stability
Special Considerations
When NOT to Open Capsules
While amoxicillin capsules can be opened, it's important to note that this practice is not universal for all medications. Some medications should never be crushed or opened, including:
- Extended-release formulations
- Enteric-coated tablets
- Medications with irritant properties
- Medications that are carcinogenic, teratogenic, or allergenic 2
Potential Impact on Absorption
- Some studies suggest dose-dependent absorption of amoxicillin 3, but this is not clinically significant at standard dosing when taken with food
- Similar to findings with flucloxacillin (another penicillin), taking amoxicillin with food may slightly reduce peak concentration but doesn't compromise effective plasma concentrations in most circumstances 4
Clinical Implications
Improved Compliance
- Opening capsules and mixing with food can improve medication adherence
- This is particularly important for completing the full course of antibiotics
- As noted in research, good compliance and completion of the entire treatment course is more important than whether the medication is taken on an empty stomach 5
Reduced Side Effects
- Taking amoxicillin with food can reduce gastrointestinal side effects
- This may further improve compliance with the full treatment course
In conclusion, amoxicillin capsules can be safely opened and mixed with food, which may improve both tolerability and compliance with the prescribed regimen. This practice is supported by the FDA drug label and contemporary pharmacokinetic understanding.