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Cytotoxic Drugs: Safe Handling in the Workplace


Cytotoxic drugs (sometimes known as antineoplastics)

Describe a group of medicines that contain chemicals which are toxic to cells, preventing their replication or growth, and so are primarily used to treat cancer. Once inside the body, their action is not generally tightly targeted, and they can produce side effects both to the patients and others who become exposed.

What are the Risks?

Exposure injuries resulting from the following activities:                                    

  • Preparation
  • Administration
  • Handling patient waste
  • Transport and waste disposal, or
  • Cleaning spills


Inadequate control measures could lead to:

  • Abdominal distress, hair loss, nasal sores, vomiting, and liver damage
  • Contact dermatitis and local allergic reaction
  • Fetal loss in pregnant women and malformations in the children of pregnant women
  • Alterations to normal hematologic count
  • Abnormal formation of cells and mutagenic activity or mutations forming

Who is at Risk?

Pharmacists, pharmacy technicians, medical and nursing staff, laboratory staff, veterinary practitioners and others.

Thus, appropriate control measures must be in place to secure them all.

Control of Exposure!

Measures to control exposure should be applied in the following order:

  • Use adequate engineering controls
  • Control exposure at the source, by using adequate extraction systems and appropriate organizational measures
  • Issue personal protective equipment (PPE)

Cytotoxic drugs are handled differently as compared to other active pharmaceutical ingredients. Specialized containment system is required to secure workers, facilities, the environment and the product itself as well.

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