Can You Open Clindamycin Capsules?

There is an overall lack of safety data available regarding opening clindamycin capsules.

Question

Can I open clindamycin capsules and put the power in food?

Asked by taylor On Feb 04, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Feb 05, 2022
Last updated Mar 03, 2022

Key points

  • There is a lack of published data regarding the safety of opening clindamycin capsules and sprinkling the powder on food.
  • The FDA-approved prescribing information for clindamycin capsules does not reference the safety of opening them.
  • Some studies have reported clindamycin powder causing throat irritation.
  • Clindamycin is available in a liquid form (clindamycin suspension 75mg/5mL) and is a good alternative if you cannot swallow the capsules.

Hello and thank you for your question

There is little information available regarding the safety of opening clindamycin capsules, unfortunately, but I can certainly give you some insight on what I found regarding my search for the answer.

First, let's talk about opening capsules in general.

Opening Capsules

Even though it may seem like there is little harm in opening a capsule and taking the contents inside in an alternative way (e.g. sprinkling a powder onto food), this isn't always the case.

Several drugs that come in capsule form are not recommended to be opened, and this is for a few reasons, including:

  • The drug may be 'time-released'
  • The drug could be irritating to the throat/stomach
  • The drug could be an 'antineoplastic'

Opening capsules that contain a drug that is 'time-released' could negatively affect the 'time-release' mechanism, causing the drug to release all at once, instead of over a period of time. This could greatly increase the risk of side effects.

Next, many drugs are known irritants and can cause pain, burning, and swelling in the throat. Most of these drugs are listed by the ISMP (Institute for Safe Medication Practices). Examples include:

  • Temodar
  • Theo-24
  • Topamax
  • Trintellix
  • Minocin

Lastly, many drugs just should not be handled due to their potential toxicity. Antineoplastic drugs (i.e. drugs that treat cancer) certainly fall into this category.

So, the takeaway here is that you shouldn't open capsules without first checking with your doctor or pharmacist if it is safe to do so.

Opening Clindamycin Capsules - Safe?

When it comes to opening capsules, cutting tablets, etc, there are typically a few different resources I'll reference.

First, I'll check the FDA-approved prescribing information for the drug in question, to see if the manufacturer explicitly states whether or not the drug can be opened, crushed, split, etc..

Neither the prescribing information for the branded Cleocin capsules nor the prescribing information for the various generic manufacturers discusses opening capsules, so dead end there.

My next resource is to check known references that discuss administering drugs in alternative ways than intended.

I mentioned the ISMP in the section above, and they have an extensive 'do not crush' list, that includes capsules. Clindamycin isn't contained on this list, however.

Lastly, I look for published studies that discuss the administration of the drug in question.

Now, I did find a few studies that reported several cases in which clindamycin powder from the capsule caused burning and irritation. One such study concluded:

The accidental opening of clindamycin capsules during swallowing can lead to severe laryngotracheitis [larynx/trachea inflammation].
QJM: An International Journal of Medicine, Volume 104, Issue 7, July 2011, Pages 609–611

Other studies reported similar cases, although I really couldn't find too many published reports on the matter.

Overall, there just isn't a lot of information available regarding the safety of opening clindamycin capsules.

Based on the lack of information in the FDA-approved prescribing information, the lack of safety data, and published case studies reporting throat irritation, I wouldn't recommend opening clindamycin capsules.

However, all is not lost if you have swallowing issues. Clindamycin is available as a suspension (clindamycin 75mg/5mL suspension) and I would go that route instead of opening capsules.

Final Words

Thank you again for your question!

References

  • Institute for Safe Medication Practices, ISMP
  • Acute laryngotracheitis after accidental aspiration of clindamycin, Oxford Academic
  • Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs, PubMed
  • Clindamycin-induced esophageal ulcer, PubMed
  • Clindamycin Prescribing Information, AccessFDA

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