Safe handling of hazardous medicines at home: Giving capsule solutions

If your child is taking only a portion of the capsule, you will need to mix it with water first and give only a specific amount to your child.

If your child is taking the entire capsule and the contents need to be mixed with liquid or food, see the information on Safe Handling of hazardous medicines at home: Mixing capsules with liquid or food.

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 health-care 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 dissolving the contents of a capsule, 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 dissolve-and-dose device — to mix and hold the solution
• a medicine cup – to hold the water used to dissolve the capsules
• tweezers — to pick up the medicine
• an oral syringe — to give the medicine
• 10 mL of room-temperature water
• a labelled container to place any unused mixed medicine
• your child’s medicine

Giving your child the capsule solution

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

Before preparing your child's medicine:

• 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. Pour 10 mL of room-temperature water into a small medicine cup.
2. To prepare the syringe, remove the cap and push the plunger all the way in.
3. Open the medicine bottle and use tweezers to remove the capsule. Place the capsule onto the covered work surface. Put the lid back on the medicine bottle.
4. To minimize the amount of medicine that gets into the air, you will prepare the dose inside the plastic bag. Put the capsule, oral syringe, medicine cup filled with water, and the dissolve-and-dose device inside the clear plastic bag.
5. With your hands inside the bag, unscrew the lid of the dissolve-and-dose device.



6. Tap the capsule to loosen its contents. While holding the capsule upright, remove the top half. Empty the contents of the capsule into the dissolve-and-dose device. If needed, pinch the capsule ends to loosen the medicine. Make sure both halves of the capsule are empty.
7. Pour the 10 mL of room-temperature water from the medicine cup into the dissolve-and-dose device. Only mix the medicine with room temperature water.
8. Screw the cap back onto the device, making sure the top is secure. Then, gently rock the device back and forth. Leave it to sit for several minutes to allow the capsule contents to dissolve fully. Do not leave the medicine and equipment unattended while you wait.
9. Once the solution is ready, use it right away. Pop the cap off the dissolve-and-dose device and place the oral syringe into the cap nozzle. Carefully lift the dissolve-and-dose until it is upright over the oral syringe. This will help release any air bubbles. Draw and measure the appropriate dose using the oral syringe. Your health-care provider will tell you how much solution to give your child.
10. Place the syringe into your child’s mouth, and slowly push the plunger to release the liquid and medicine solution. 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 afterwards.

If there is solution left over in the dissolve-and-dose device, do not keep it. Instead, pour it into a bottle and store it there until you can dispose of it safely. Make sure you label the bottle "hazardous for disposal". When the bottle is full, you can take it to your local pharmacy to dispose of properly.

Speak to your child’s health-care provider if your child is having trouble taking their medicine.

While preparing your child’s medicine, please remember:

• Use the tweezers, dissolve ‘n dose device 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 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 health-care 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.