Can Cephalexin Capsules Be Opened and Given via Gastric Tube?
Yes, cephalexin capsules can be opened and the contents administered via a gastric tube, as cephalexin is absorbed in the upper intestine (not the stomach) and does not require an intact capsule for proper absorption.
Pharmacokinetic Rationale
- Cephalexin is not absorbed from the stomach but is totally and rapidly absorbed in the upper intestine, making it suitable for administration via gastric tubes 1
- The drug's absorption occurs high in the intestinal tract and does not disturb lower bowel flora, which supports its administration as opened capsule contents 1
- Cephalexin reaches therapeutic levels in serum and tissues when absorbed from the gastrointestinal tract, regardless of capsule integrity 2
Administration Technique via Gastric Tube
- Flush the tube with at least 30 mL of water before, between, and after medication administration to prevent tube occlusion 3
- Administer medications individually through the tube—never mix multiple drugs together 3
- Confirm the tube tip location is in the stomach, as cephalexin absorption occurs primarily in the proximal small bowel 3
- Dissolve the capsule contents in water before administration to ensure complete delivery and prevent tube blockage 4, 5
Important Clinical Considerations
- Clinical judgment from the entire care team (physicians, pharmacists, nurses) is necessary when developing a plan for administering altered medications via feeding tubes 4
- Cephalexin's stability and chemical configuration make it suitable for this route of administration 1
- The drug maintains its efficacy when delivered via gastric access devices, provided proper technique is followed 5
Common Pitfalls to Avoid
- Do not administer distal to the stomach (e.g., directly into duodenum or jejunum) without confirming absorption characteristics, as this may alter drug availability 3
- Avoid mixing cephalexin with enteral feeding formulas simultaneously, as drug-nutrient interactions could theoretically occur 5
- Ensure adequate flushing to prevent tube occlusion, which is a common complication with medication administration via gastric access devices 3, 5
Dosing Adjustments
- Patients with creatinine clearance less than 30 mL/min require dosage reduction proportional to reduced renal function 1
- Children may need higher doses per kilogram than adults due to greater body water turnover 1
- Standard adult dosing of 250-500 mg achieves urinary concentrations of 500-1000 micrograms/mL, many times greater than minimum inhibitory concentrations for typical pathogens 1