Patient education: Hazardous medicine safety at home (The Basics)

Overview — This article has general information about hazardous medicines, including:

●How to handle these medicines at home

●How to limit contact with any body fluids that could contain hazardous medicines (like urine, saliva, or vomit)

●Other steps that you and others can take to stay safer

The exact steps to take depend on what kind of hazardous medicine you are taking.

This article does not replace the specific advice given by your doctor, nurse, or pharmacist. If you have questions about any medicines you are taking, or if you would like more facts, ask your health care team.

What are hazardous medications? — "Hazardous" means something that could be harmful or dangerous.

Hazardous medicines include those that are very strong or could cause harm if not handled correctly. Examples include:

●Chemotherapy – These medicines kill cancer cells or stop them from growing.

●Immunotherapy – These medicines work with the body's immune system to stop cancer growth.

●Immunosuppressants – These medicines lower the immune system's ability to fight infection. People take these medicines after an organ transplant so that their body does not reject the new organ. They are also used to treat some autoimmune diseases.

●Radiopharmaceuticals – These medicines give off radiation to treat cancer.

●Others – Many other medicines can also cause problems if not handled properly. An example is finasteride, which can be used to treat hair growth problems or an enlarged prostate. This medicine is not safe to take during pregnancy. The medicine should not be handled by anyone who is or could become pregnant.

Some things you should know about hazardous medicines:

●They can come as pills, creams, shots, or other forms. You might get hazardous medicines like chemotherapy in the hospital or infusion clinic. Some medicines can stay in your body for a few days, so you will need to take some steps to stay safer once you are home.

●They can have different effects on your body. For example, some cancer-fighting medicines can change the way cells grow and how the body fights disease. Other types of medicine affect how your immune system works. Being exposed to hazardous medicines could increase your risk of new health problems.

●Being exposed to small amounts for a short time does not usually lead to problems. But even if the risk is low, it's best for caregivers and others at home to avoid or limit contact with these medicines as much as possible. If there is anyone at home who is pregnant, could get pregnant, or is breastfeeding, it is especially important that they do not come in contact with hazardous medicines.

How do I know if I have been prescribed a hazardous medicine? — Your doctor, nurse, or pharmacist will tell you the name of the medicine and give you more specific instructions. You should also review the information that comes with the medicine. It will tell you if there are any special steps or warnings for handling the medicine safely.

Have your doctor or nurse write the name of the hazardous medicine in this space: _______________________

What supplies might I need at home? — When a person is taking a hazardous medicine, a few basic supplies can help keep everyone safe. Throw away disposable supplies after 1 use. Do not reuse them.

Examples of supplies that you might need include:

●Disposable gloves

●Small plastic medicine cups

●Paper towels

●Disposable pads or adult diapers

●Plastic bags or a special trash bin for used supplies

●A special kit to help clean up any spills

●A special container to store these medicines in

Residue from some medicines can stay on surfaces like hands, counters, or pill boxes. This is why it is so important to wash your hands with soap and water every time that you handle a hazardous medicine, and to use disposable supplies.

How do I take a hazardous medicine? — Take the medicine exactly as your doctor ordered. Do not crush, break, or open any pills unless your doctor tells you to.

Hazardous medicine should only be handled by the person taking it, if possible. Anyone who is pregnant, breastfeeding, or who could become pregnant should not handle these medicines.

There are a few simple steps to take to handle a hazardous medicine correctly. Below is an example of how to give hazardous medicine pills at home:

●Get your supplies and medicine ready. Do this away from people, pets, and where anyone eats or prepares food.

●Have a resealable plastic bag nearby to throw away trash in.

●Wash your hands thoroughly with soap and water. Put on disposable gloves before handling the medicine.

●After taking the medicine, clean any surfaces that the medicine might have touched.

●Throw away the gloves and any other used supplies in the plastic bag, and seal it shut. Throw that bag away in the trash.

●Wash your hands thoroughly with soap and water. Hand sanitizers are not a substitute for soap and water. They do not fully remove all medicine residue that might be on your hands.

Where should I store these medicines?

●Keep hazardous medicines in a safe place out of the reach of children and pets. A high, locked cabinet is the safest choice.

●Keep hazardous medicine pills in their original bottle or in a separate pill box from other pills. Keep them away from other household members' medicines. Mark this pill box, and use it for 1 type of hazardous medicine only.

●Check the labels on all medicines for storage directions. If there is no information, ask your pharmacist how to store them.

●If you need to store medicine in the refrigerator, put the medicine container in another container or a bag that you can seal. Keep it away from food.

How do I handle body fluids? — Many hazardous medicines stay in your body for a few days after you take them. During this time, your body gradually gets rid of them through your urine or bowel movements. For a short time, these medicines can also be in other body fluids such as blood, vomit, sweat, mucus, semen, or vaginal fluid. If other people touch these body fluids, they could be harmed.

●You can use the toilet as normal after you have taken a hazardous medicine. After using the toilet, close the lid and flush twice. Then, wash your hands well with soap and water. Also, wash your skin if you get urine or bowel movement on it.

●You might need help managing your body fluids. Be sure that your caregiver wears gloves when they touch your skin, bedding, or surfaces that might have touched your body fluids.

•Use disposable wipes to clean body fluids off of your skin.

•Wear disposable pads or a diaper, or use a bed pad, if you have trouble with bladder or bowel control.

•Rinse a bedpan or urinal with water after each use, using disposable gloves. Wash it with soap and water at least 1 time each day.

•Rinse a basin that you vomit into after each use, using disposable gloves. Wash it with soap and water at least 1 time each day.

●Wash your clothes normally unless there are hazardous medicines on them or they are soiled with urine, bowel movement, or another body fluid. If clothes have any of these things on them, use gloves to handle them before washing. Then, wash them twice in hot water, separate from your other laundry.

What should I do if the medicine gets on me? — Some hazardous medicines can irritate the skin. If you get medicine on your skin by accident, wash the area with soap and plenty of cool water. Then, gently pat dry. If the area stays red or irritated, or if you get a rash, call your doctor.

If a hazardous medicine splashes in your eye, flush your eye with tap water for 10 to 15 minutes. Then, call your doctor right away.

How do I get rid of extra medicine? — Check with your pharmacy and local health department for disposal instructions. You might be able to take leftover medicines to a pharmacy "medicine take-back" program or special facility. Do not flush them or throw them away in the regular trash.

Supplies that touch the medicine can be sealed in a plastic bag and thrown away in the regular trash. You need a special waste container to dispose of syringes and needles (picture 1).

What else should I know?

●Ask your doctor if you or your partner need to use condoms or another method of birth control. You might need to prevent pregnancy or exposure to body fluids (semen or vaginal fluid).

●People who are pregnant or breastfeeding should not handle hazardous medicines or anything that touches these medicines. If you think that you have gotten pregnant while taking a hazardous medicine or caring for someone who is on a hazardous medicine, talk to your doctor right away.

●Some hazardous medicines give off radiation. These are called "radiopharmaceuticals." They are given in the hospital, usually by specialists in nuclear medicine. Once you get home, you might need to avoid close contact with others for a short time, sleep in a separate room for a few days, and take some extra precautions when using the bathroom. If you get this type of medicine, the nuclear medicine team will tell you exactly what to do at home to help others avoid being exposed to radiation.

When should I call the doctor? — Call for an ambulance (in the US and Canada, call 9-1-1) or get emergency care if you start a new medicine and have any serious symptoms such as:

●Wheezing or trouble breathing

●Chest pain or tightness

●Passing out, or feeling like you might pass out

●Swelling of your face, lips, tongue, or throat

●Seizures

Call for advice if:

●You are having side effects from a medicine, or notice changes in the way you feel, like feeling dizzy or confused.

●You have questions about any of the medicines you take. Talk with your doctor about your care each time you visit.

●Your health problem is not better, or you are feeling worse.

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