Many medications taken by mouth come in either liquid or pill form. If a child has been prescribed pills but cannot swallow them, they can sometimes be split in half or crushed to make them easier to swallow. But some medications only come in capsule form. Many people, especially children and the elderly find it difficult to swallow capsules. Or in the case of small children, the dose within the capsule is too large. In this case, the contents of the capsule need to be removed and taken with an approved food or drink or mixed with water using a dissolve-and-dose device to create a solution in order to give the correct dose. But this can be a difficult and messy process.
A capsule shredder is an adapter caregivers can add to a dissolve-and-dose device. It crushes medication capsules and mixes the contents within a closed system. This reduces the risk of contamination or spillage of the medication.
How to use a capsule shredder
The capsule shredder has two parts. The first part, the adaptor body, contains a capsule-shaped hole where the capsule is placed. The second part, the adaptor cap, screws onto it to allow the capsule to be shredded.
The dissolve-and-dose device also has two parts, a blue screw top with a removable pop-top cap and a tube for the liquid.
Preparing the dose
You will need to mix the contents of the entire capsule with water first and give only a specific amount to your child.
To mix and give a capsule, you will need:
- a clean surface
- your child’s medication
- an empty cup
- a dissolve-and-dose device to mix and hold the solution
- a capsule shredding device
- water (amount will be specified by your health-care provider)
- an oral syringe to give the dose
- an old medicine bottle with a child-safe lid to dispose of any unused medication
- gloves
Always prepare the medication right before your child will take it.
Before you begin, wash your hands with soap and water.
Connect the blue screw top from the dissolve-and-dose device to the capsule shredder adaptor cap.
Use the oral syringe to fill the dissolve-and-dose tube with the amount of water specified by your health-care provider. Screw the adapter body from the capsule shredder onto the tube and place it in the empty cup.
Next put on the gloves and open the medicine bottle and remove a capsule. Put the lid back on the bottle as soon as possible.
Place the capsule into the rectangular hole. It should fit easily. Do not place it in vertically. If you have placed the capsule vertically, do not pull the capsule out in case it comes apart, and do not turn the liquid-filled device upside down, as this will spill some of the liquid. Instead, unscrew the adapter body from the tube of liquid (you can place this into the empty cup to keep it from spilling) and turn the adapter upside down to let the capsule fall out.
Once the capsule is lying in the hole, screw the capsule shredder adapter cap on clockwise onto the adapter body.
Use the adapter cap to shred the capsule by twisting it clockwise. You will hear a grinding sound. The contents of the capsule will fall into the water and dissolve. Make sure the capsule shredder adapter cap is still screwed on properly and then gently rock the device back and forth to help the medication dissolve. Let it sit for several minutes to allow the capsule contents to dissolve fully. Do not leave the medication and equipment unattended while you wait.
While waiting, make sure the plunger of the oral syringe is pushed all the way in. Once the solution is ready, use it right away. You may see bits of the capsule floating in the liquid, this is OK, they will not fit into the syringe.
Open the pop-top on the blue cap of the dissolve-and-dose device and place the tip of the oral syringe into the blue cap.
Lift the dissolve-and-dose device until it is upright over the oral syringe. Withdraw the appropriate dose using the oral syringe. Your health-care provider will tell you how much solution to give to your child.
Give the medicine to your child right away. Never prepare and store the dose ahead of time. Your child may drink more water after taking their medication. Your child’s health-care provider will tell you if your child may take any other drinks or food right away after the dose.
Speak to your child’s health-care provider if your child is having trouble taking their medication.
If there is any solution left over in the dissolve-and-dose device, do not keep it. Instead, pour it into the old medicine bottle and store it there until you can dispose of it safely. Pieces of the capsule may also be left in the capsule shredder. Also dispose of these pieces in your medicine bottle. When the bottle is full, you can take it to your local pharmacy to dispose of it properly.
Once you are all finished, wash your hands.
Cleaning the capsule shredding device
You may wash and reuse some of your supplies. But take care not to rinse them in the kitchen sink over other dishes or utensils. If you are reusing an item, rinse it with warm soapy water and let it air dry. Clean the sink after washing your supplies. After cleaning, check to make sure the spike in the capsule shredder adapter cap is not broken or chipped. If it is, please get a new one.
Remember to always store your medications and their supplies 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. Return the medication and supplies to the locked box after each use. Do not keep any medication in your purse, knapsack or diaper bag.
For more information on these tips, speak to your health-care provider.
Production and maintenance of this article was made possible by a grant provided by the Black Opportunities Fund. SickKids is grateful for the generous support of our corporate partners but does not endorse specific products or services, nor receive any editorial direction from its sponsors.