It's best not to open capsules to reduce side effects
Many people get headaches when they see capsule medicines. The shell is sticky, and even after swallowing, it feels like it's stuck in the throat. Therefore, some people peel them open and swallow the powder with water.
Capsule formulations are generally not recommended to be opened, unless the patient has difficulty taking capsule medicines, or the dose exceeds the therapeutic need. Especially for sustained-release capsules and enteric-coated capsules, they must never be opened. The reason these two types of capsule medicines are designed this way is for precise positioning, ensuring the drug is absorbed in specific locations like the small intestine. If opened, the former may reduce its efficacy, while the latter can easily induce drug-induced gastritis.
Many enteric-coated capsules contain drugs that can damage the gastric mucosa. Among them, the most "hostile" to the stomach are non-steroidal anti-inflammatory drugs, such as Fenbid. These drugs can cause damage to gastric mucosal cells, and in severe cases, may lead to peptic ulcers, bleeding, and perforation. Adrenocortical hormone drugs can slow down the renewal speed of gastric mucosal epithelial cells and promote the secretion of gastric acid and pepsin. At the same time, capsule drugs containing digestive enzymes or probiotics must also be swallowed whole.
Relatively speaking, it is more difficult for children and the elderly to take capsules. Therefore, if a capsule is large and truly difficult to swallow, you can consult a pharmacist to see if it can be opened. Generally, for short-term and infrequent use, occasionally opening them is not a big problem. When there is no suitable dosage form for the drug, doctors will also guide patients to dilute the capsule with lactose and take it in divided doses.
To make it easier for patients to take capsules, you might want to follow these four steps. First, drink a glass of 200-300 ml of warm water to swallow it. But do not use hot water or fruit juice to take the medicine. The former will accelerate the dissolution of the capsule, or cause the capsule shell to stick to the throat or esophagus. The latter is acidic, which will dissolve many drugs prematurely, which is not conducive to absorption and may also affect the efficacy of some drugs. Second, take a sip of water before taking the medicine. One is to "review" the swallowing action, and the other is to moisten the throat and esophagus to facilitate the passage of the drug. Third, place the capsule in your mouth, then take another sip of water and swallow. This can prevent the capsule from sticking to the mouth, throat, etc. Capsule medicines for treating osteoporosis, for example, are quite corrosive. If they stick to the esophagus during administration, the released chemicals will burn the esophageal mucosa. Fourth, take another sip of water. The adult esophagus has three narrowings, especially the second one, which will block capsules and other "foreign objects" from passing through. This sip of water can help the drug pass through the narrow area smoothly.