Safe Handling of Oral Chemotherapeutic Agents in Clinical Practice: Recommendations From an International Pharmacy Panel — JOP

* Copyright © 2011 by American Society of Clinical Oncology

Safe Handling of Oral Chemotherapeutic Agents in Clinical Practice: Recommendations From an International Pharmacy Panel

1. Susan Goodin, PharmD,
2. Niesha Griffith, MS,
3. Beth Chen, PharmD,
4. Karen Chuk, BScPhm,
5. Mikael Daouphars, PharmD, PhD,
6. Christian Doreau, PharmaD,
7. Rinku A. Patel, PharmD,
8. Rowena Schwartz, PharmD,
9. Maria José Tamés,
10. Robert Terkola, aHPh,
11. Barbara Vadnais, MSc,
12. Debbie Wright, DPharm and
13. Klaus Meier, PharmD

+ Author Affiliations

1. Division of Pharmaceutical Sciences, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Pharmacy, The Arthur G. James Cancer Hospital at The Ohio State University, Columbus, OH; Biologics, Cary, NC; Outpatient Pharmacy Site Operations, University Health Network–Princess Margaret Hospital, Toronto, Ontario; Faculty of Pharmacy, University of Montreal; Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada; Cancer Centre Henri Becquerel, Rouen, France; CD Conseil, Antibes and Paris, France; Diplomat Specialty Pharmacy, Deerfield, IL; Weinberg and Oncology Pharmacy, The Johns Hopkins Hospital, Baltimore, MD; Pharmacy Department, Onkologikoa, San Sebastian, Spain; Pharmacy Department, Sozialmedizinisches Zentrum Süd, Kaiser-Franz-Josef-Spital mit Gottried von Preyer'schem Kinderspital, Vienna, Austria; Southampton Oncology Centre, Southampton General Hospital, Southampton, United Kingdom; Hospital and Clinical Pharmacy, Heidekreis-Klinikum GmbH, Soltau, Germany

1. Corresponding author: Susan Goodin, PharmD, FCCP, BCOP, Division of Pharmaceutical Sciences, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany St, New Brunswick, NJ 08901; e-mail: goodin@umdnj.edu.

Abstract

Although there has been a significant increase in the availability and use of oral chemotherapeutic agents, the guidelines around their safe handling are still evolving. Although oral chemotherapy is associated with ease of administration, it has the same exposure risks to health care practitioners, patients, and their caregivers as intravenous formulations, and because it is administered in the home, to the families of patients. However, the general misconception appears to be that exposure risk is low and therefore oral chemotherapeutic agents present little risk and are safer to handle. In a series of three roundtable meetings, a team of international pharmacists from North America and Europe reviewed existing guidelines and identified gaps in recommendations that we believe are important for safe handling. The present article is a compilation of these gaps, especially applicable to manufacturers and distributors, storage and handling, and patient education regarding safe handling. These recommendations, on the basis of our experience and of best practices, provide an international perspective and can be adapted by institutions and practices for development of standardized procedures specific to their needs for the safe handling of oral chemotherapeutic agents.

* Accepted November 12, 2010.

Safe Handling of Oral Chemotherapeutic Agents in Clinical Practice: Recommendations From an International Pharmacy Panel — JOP