Safe handling of hazardous medicines at home: Mixing capsules with liquid or food

If your child is taking an entire capsule and the contents need to be mixed with liquid or food, follow these instructions.

If your child is taking only a portion of the capsule, see the information on Safe Handling of hazardous medicines at home: Giving capsule solutions.

What is hazardous medicine?

Hazardous medicines are used to treat a variety of medical conditions. For example, chemotherapy is used to treat cancer, and immunosuppressants are used to prevent organ rejection after a transplant.

Hazardous medicine can damage healthy cells. Anyone handling hazardous medicine should keep themselves protected.

Although the risk of harm from handling hazardous medicine is small, it is a good idea to avoid exposure. This includes not tasting your child’s medicine. If you are pregnant or breastfeeding, it is best to avoid contact with hazardous medicine. If possible have someone else prepare and give your child their capsules.

Preparing the space

You will need to gather certain supplies and take careful steps when setting up your work area. Your child’s healthcare provider will help you make a list of the supplies you will need. You can buy these materials at a grocery or drug store.

To handle your child’s hazardous medicine at home, choose an uncluttered counter or table away from windows, fans, vents, areas where you prepare food, and where children and pets play.

If you are preparing your child's medicine by mixing the contents of the capsule with liquid or food, a gown, mask and gloves offer protection. Other supplies will include:

• paper towels or a disposable, absorbent plastic-backed mat — to contain any spills
• a large, clear plastic bag — to contain the work area and for waste disposal
• a medicine cup — to hold the food or liquid
• tweezers — to pick up the medicine
  
• a spoon or an oral syringe — to give the medicine
• room-temperature food or drink — to mix with the medicine. Your child’s health-care provider will tell you which foods or liquids can be mixed with your child’s medicine
• your child’s medicine

Giving your child the capsules mixed with liquid or food

Always prepare the medicine right before your child will take it. Never prepare and store the dose ahead of time.

Before mixing the contents of the capsule with liquid or food:

• Wash your hands with soap and water.
• Put on your gloves, gown and mask.
• Place paper towels or a disposable, absorbent plastic-backed mat over your work surface.

You are now ready to handle your child’s medicine.

Giving the medicine

1. Put the food or liquid you will use to mix the contents of the capsule with into the medicine cup. Keep extra food or liquid on hand in case you need to add more.
2. Open the medicine bottle and use tweezers to remove the required number of capsules. Place the capsules onto the covered work surface and put the lid back on the medicine bottle.
3. To minimize the amount of medicine that gets into the air, you will prepare the dose inside the plastic bag. Put the capsule(s), spoon or oral syringe, and the medicine cup filled with food or liquid into the clear plastic bag.

4. 

   With your hands inside the bag, tap the capsule to loosen its contents. While holding the capsule upright, remove the top half.

5. Empty the contents of the capsule into the medicine cup with room temperature food or liquid. If needed, pinch the capsule ends to loosen the medicine. Make sure both capsule ends are empty. Repeat this procedure if your child needs to take more than one capsule at a time.

6. 

   While keeping the medicine cup inside the plastic bag, use the spoon to mix the contents from the capsule with the food that is in the cup. If there is liquid in the cup, you can use the oral syringe to mix in the contents of the capsule. The medicine may not dissolve completely.

7. If you have prepared the medicine using food, you can use the spoon to scoop up the food mixture and allow your child to eat the mixed amount.
8. If you have prepared the medicine in liquid, your child can take the dose directly from the medicine cup.
9. Or, draw up the liquid from the cup using the oral syringe. Place the oral syringe into your child’s mouth and slowly push the plunger to release the medicine. If any medicine is left in the oral syringe, draw up more water, gently rock the syringe back and forth and give the medicine to your child.
10. When you are done, place the empty capsule pieces in a plastic bag or bottle clearly marked for disposal.

Speak to your health-care provider if your child is having trouble taking the medicine.

While preparing your child’s medicine, please remember:

• Use the tweezers and oral syringe to give the hazardous medicine only. Do not use them for other medicines.

Clean-up and storage of hazardous medicines

Hazardous medicines should be handled safely. It is important to carefully handle the clean up of the supplies and work area, and to dispose of wastes properly.

Remember these key tips for safe handling of hazardous medicines at home.

• If possible, avoid contact with hazardous medicines if you are pregnant or breastfeeding.
• You and your child should wash your hands before and after handling hazardous medicines.
• Wear gloves when handling hazardous medicine tablets, capsules or liquids.
• Properly clean, dispose of or store the equipment and hazardous medicine.

All disposable items that have been in contact with hazardous medicines, such as used paper towels and gloves, must go into a designated plastic waste bag or container. Contact the Household Hazardous Waste Depot in your neighbourhood to see if they will accept the waste bags or containers. If such a service does not exist in your area, ask a member of your child's healthcare team about other options.

You may wash and reuse some of your supplies, but do not rinse them in the kitchen sink over other dishes or utensils. If you are reusing an item, such as the medicine cup, rinse it with warm soapy water and allow it to air dry. Clean the sink after washing your supplies.

Always store hazardous medicines away from children and pets. If stored at room temperature, place them in a locked box, away from moisture and direct sunlight, and in a cool, dry place. If the medicine needs refrigeration, place it in a separate container at the back of the fridge. Return the medicine to the locked box or fridge after each use. Do not keep any medicine in your purse, knapsack or diaper bag.

Take special precautions with your child's waste (vomit, urine and stool) while they are taking hazardous medicine

While your child is taking hazardous medicine, some of the drug is broken down and removed from the body through urine and stool. It may also appear in vomit. It is important that you protect yourself and others from hazardous medicine in your child's urine, stool or vomit by following these guidelines:

• When changing your child’s diaper, wear disposable gloves and place diapers in a sealed plastic bag before disposal.
• If your child is toilet trained, have your child close the lid, to avoid splashes, and flush twice after using the toilet. Always make sure they wash their hands afterwards.
• Have supplies ready in case you need to quickly clean up any accident. You need a paper towel, soap and water, disposable gloves, and a disposable container, such as an empty ice cream container.
• Use a plastic mattress cover to protect the mattress from accidents.
• Keep a plastic container close by in case of vomiting. If you use the container, empty the contents into the toilet and wash with warm soapy water.
• Wear disposable gloves when you are handling any bodily wastes, such as changing soiled sheets or cleaning up vomit.
• Wash soiled clothes or sheets separately from other laundry. If they cannot be washed right away, place them in a sealed plastic bag and set it aside.
• Once you are all finished, wash your hands.