Safe Handling of Chemotherapy and Hazardous Drugs at Home
Some hazardous medicines (including oral chemotherapy) can be given at home. But it is important to follow safety instructions for handling and storing hazardous drugs.
All hazardous drugs brought into the home are a potential risk to patients, caregivers, and household members. Medicines can sometimes be absorbed through the skin or breathed in through the lungs. Family members can also be exposed to hazardous drugs through food or drinks or by touching everyday surfaces in the home.
Women who are pregnant or breastfeeding should avoid all contact with hazardous drugs.
Safety reminders for hazardous drugs
Simple steps can protect patients, family members, and caregivers from harm.
Read medicine labels and follow dosing instructions carefully.
Wash hands before and after handling hazardous medicines.
Wear gloves, mask, and other safety gear as instructed.
Thoroughly clean surfaces and wash items that come in contact with the medicine.
Keep medicine away from food, drinks, or items used by household members.
Store medicines securely away from children, pets, and food.
Dispose of medicines and contaminated items properly.
Educate all caregivers and household members about medicine safety.
How to handle hazardous medicines
Always follow your care team’s instructions for handling and giving medicines. Take care to avoid contact with your skin or eyes, and do not breathe in hazardous medicines. General safety tips include:
Wash hands and clean surfaces before and after handling hazardous medicines.
Wear recommended protective gear (gloves, mask, and/or glasses) as instructed.
When giving pills, pour them into a small cup instead of your hand before giving them to the patient.
Use the provided syringes, droppers, or applicators. Never reuse them unless directed by your provider.
Do not crush, break, or chew chemotherapy tablets or capsules unless instructed by your pharmacist or care team.
Avoid preparing food, drinks, or formula in the same area where hazardous medicines are handled.
Gloves
Gloves help protect caregivers from absorbing medicines through the skin. Gloves should be worn anytime a hazardous drug is handled by someone other than the patient. Patients do not need to wear gloves when taking their medication.
Wear disposable nitrile gloves. Do not use latex gloves.
Do not wear gloves that are torn or punctured.
After handling medicine, remove gloves by turning them inside out. Throw them away. Do not reuse them.
After removing gloves, wash hands thoroughly with warm, soapy water.
If patients do not wear gloves, they should still wash their hands before and after handling medicine to prevent spreading powder from tablets or capsules.
Face masks
Wear a mask only if directed to do so by your doctor or pharmacist. Disposable masks protect caregivers from breathing in hazardous drugs. Masks may be needed if crushing or splitting tablets.
Eye protection
Safety goggles or glasses can protect the eyes, especially when handling liquid medicines. If there is a possibility of spilling or squirting of the medication, eye protection is needed.
How to cut or crush hazardous medicines
Do not cut, crush, or break hazardous medicines unless you have been told to do so. This can release hazardous particles into the air.
Follow the instructions for the specific medicine. Some tablets (such as mercaptopurine) may need to be split using a tablet cutter. Some gel caps (such as isotretinoin) may need to be cut using scissors.
If using tablet cutters, scissors, or tablet crushers for hazardous medicines, do not use these products for any other medications or uses.
Prepare the medicine on a high surface, such as a table or counter. Make sure the area is clean and free of clutter.
Do not cut or crush hazardous medicines near ceiling fans or vents. This will prevent blowing of the medication.
Cover the work surface with disposable plastic before cutting or crushing hazardous medicines. This will protect the surface from spills and make it easier to clean.
Clean the work surface thoroughly.
How to clean up spills from hazardous medicines
Block off the spill area.
Keep children and pets away.
Put 2 pairs of gloves to clean it up.
For liquid spills, use paper towels to soak up the liquid. Start at the outside of the spill and work inward. Place the paper towels into a plastic bag and seal before throwing away.
Clean the area 3 times with a home cleaning product. This is to make sure that no medicine is left on the surface.
Rinse the area with water.
Remove contaminated clothes, place them in a plastic bag, and seal. Wash these clothes separately as soon as possible. Wash a second time before using again. Always wash contaminated items separately from other laundry.
If the hazardous medicine gets in your eyes: Rinse your eyes right away with cool running water for at least 15 minutes. Contact your health care provider for further instructions.
If the hazardous medicine gets on skin: Rinse the area well with clean water. Then wash with soap and water for 10 minutes. If you notice redness or irritation, contact your health care provider.
How to handle body fluids
For 48 hours after your child takes hazardous medicines, all of their body fluids can contain the drug. Be sure to ask for gloves to take home with you from the hospital if needed.
Follow these safety guidelines until 48 hours have passed:
Wear gloves and protective clothing when handling your child’s vomit, blood, urine (pee), or stool (poop).
Wear gloves when handling your child’s soiled laundry or linens.
Wear a face shield or goggles if there is a risk of splashing of body fluids.
Wear gloves and a face shield when changing your child’s diaper. You can put used diapers in your regular trash, but try to limit your exposure to them.
Males should sit to use the toilet.
Lower the toilet lid when flushing the toilet.
If any of your child’s body fluids touch your skin, wash your skin well with soap and water.
If any of your child’s body fluids get in your eyes, flush with water for 15 minutes while holding the eyelid open. Then, call your personal health care provider and explain what has happened.
Chemotherapy and other hazardous drugs can be a serious safety risk for household members. Take steps to prevent contamination and accidental use. Dispose of contaminated items and unused medicines properly to prevent harm to the environment and risk to others.
Safe storage of hazardous drugs
Be sure you know any special storage instructions for the medicine.
Keep medicines in a secure location. Store medicines in a locked cabinet or box, out of reach of children, pets, or household members.
Store medicines in a cool, dry place away from sunlight, heat, or moisture.
Keep medicines in their original containers with their labels intact.
Apply warning labels on hazardous medicines so they can be easily identified.
Keep hazardous medicines away from household items and separate from non-hazardous medicines.
When transporting hazardous medicines, keep them in their original, labeled container inside a sealed plastic bag or separate container. Avoid storing them in vehicles for long periods or exposing them to heat.
Safe disposal of hazardous drugs
Read the package insert that comes with the medicine for specific disposal instructions.
Do not flush or pour down drains. Never put hazardous medicines into toilets or sinks. This can contaminate water systems.
Place unused medicines in a sealed container and dispose of them as instructed.
Use Drug Take-Back Programs. Many pharmacies and hospitals offer a take-back service for medications.
Safe storage and disposal of medicines protects patients, caregivers, and family members. Learn how to store and get rid of unused or expired medicines safely.
