SFGH Admin P and P 16.

36 Appendix B: SFGH Hazardous Drug List - January 2014

Agent
Acitretin
Ado-trastuzumab emtansine
Azacitidine
BCG
Bendamustine
Bleomycin
Bortezomib
Brentuximab
Cabazitaxel

Dosage Form
capsule

film-coated tablet

Capecitabine

film-coated tablet

Carfilzomib

IV
film-coated tablet
chewtabs
po liquid

Carboplatin

IV

Carfilzomib

IV

Chlorambucil

film-coated tablet
capsule

Chloramphenicol

Cidofovir
Cisplatin

Clonazepam

Handling & Admin

A
B

IV
IV
intravesical
IV
IV
IV
IV
IV

Cabergoline

Carbamazepine

Status
Intact
Opened

C
C
C
C
C
C
C
C
Intact
Rx to crush and dispense in oral syringe
Intact
Rx to crush and dispense in oral syringe
Better for Oncology to change to IV 5-FU

Intact

teratogen

NIOSH 2012

cytotoxic
cytotoxic
live bacteria
cytotoxic
cytotoxic
cytotoxic
cytotoxic
cytotoxic

UHC 2009
UHC 2009
UHC 2009
UHC 2009
UHC 2009

NIOSH 2012

C
C

cytotoxic

UHC 2009

cytotoxic
reproductive harm, teratogen,
carcinogen

NIOSH 2012

cytotoxic

UHC 2009

C
C

cytotoxic

Intact
Rx to crush and dispense in oral syringe

Intact
Opened

B
B

IV

IV
IV

C
C

Intact
Intact (ask MD if can change to lorazepam,
which is safe to be crushed)

cytotoxic

UHC 2009

"Gray Syndrome" in newborns

UHC 2009

cytotoxic
cytotoxic

UHC 2009
UHC 2009

teratogen

NIOSH 2012

ophthamic

film-coated tablet
disintegrating tab
(NF*)

Source

reproductive harm, carcinogen

Intact

Hazard

A
A

Handling/Admin (A) = gloves recommended; (B) = use PPE (gloves, gowns, safety glasses, fitted N95 respirator, as needed to minimize exposure);
(C) = Cytotoxic PPE per SFGH Admin P and P 3.26; NF = non-formulary
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SFGH Admin P and P 16.36 Appendix B: SFGH Hazardous Drug List - January 2014
Agent
Cyclophosphamide

Dosage Form
IV
capsule

Cyclosporine

Docetaxel
Doxorubicin
Doxorubicin - liposomal

po liquid
IV
IV
IV
ER or EC tablets
Sprinkles
IV
IV
IV

Dronedarone

film-coated tablet

Cytarabine
Dacarbazine
Divalproex

Dutasteride

Entecavir
Epirubicin

capsule
film-coated tablet

Status
Intact

Handling & Admin

C

C
C
A
A
C
C
C
Intact
Rx to crush and dispense in oral syringe

Intact
Opened
Intact

B
B

IV
IV
IV
IV

Hydroxyurea

capsule

Ifosfamide
Irinotecan

IV
IV

Lomustine

capsule

UHC 2009
UHC 2009

teratogen

NIOSH 2012

cytotoxic
cytotoxic
cytotoxic

UHC 2009
UHC 2009
UHC 2009

reproductive harm

NIOSH 2012

reproductive harm

NIOSH 2004

teratogenic in animal studies

NIOSH 2010

cytotoxic

UHC 2009

cytotoxic

UHC 2009

reproductive harm

NIOSH 2004

cytotoxic
cytotoxic
cytotoxic
cytotoxic

UHC 2009
UHC 2009
UHC 2009
UHC 2009

anti-neoplastic, skin toxicity

UHC 2009

cytotoxic
cytotoxic

UHC 2009
UHC 2009

cytotoxic

UHC 2009

C
Intact

Fludarabine
Fluorouracil
Ganciclovir
Gemcitabine

cytotoxic
cytotoxic

capsule

film-coated tablet

UHC 2009

po liquid (NF*)
IV

IV
Finasteride

immunosuppressant

Intact
Etoposide

Source
UHC 2009

A
B
B

Intact
Intact

Hazard
cytotoxic

Rx to crush and dispense in oral syringe

Intact
Rx to open and dispense in oral syringe

Intact
Rx to open and dispense in oral syringe

A
B
C
C
C
C
C
C
C
C
C
C

Handling/Admin (A) = gloves recommended; (B) = use PPE (gloves, gowns, safety glasses, fitted N95 respirator, as needed to minimize exposure);
(C) = Cytotoxic PPE per SFGH Admin P and P 3.26; NF = non-formulary
2

SFGH Admin P and P 16.36 Appendix B: SFGH Hazardous Drug List - January 2014
Agent
Melphalan
Mercaptopurine
Methotrexate
Mitomycin
Mitoxantrone

Dosage Form
capsule
IV
film-coated tablet
film-coated tablet

Oxaliplatin
Oxcarbazepine
Paclitaxel
Paclitaxel-albumin bound
Paroxetine
Pemetrexed

capsule
po liquid
IV
film-coated tablet
po liquid (NF*)
IV
IV
film-coated tablet

capsule

Podofilox

Topical

Procarbazine

capsule
film-coated tablet
capsule
po liquid (NF*)
film-coated tablet

Risperidone

Streptozocin

Intact
Rx to crush and dispense in oral syringe
Intact
Rx to crush and dispense in oral syringe

Intact

Intact

disintegrating tab
po liquid
Consta IM inj (NF*)
IV

Hazard

Source

cytotoxic

UHC 2009

reproductive harm

UHC 2009

reproductive harm, teratogen

UHC 2009

cytotoxic
cytotoxic

UHC 2009
UHC 2009

teratogen, immunosuppressant

UHC 2009

cytotoxic
reproductive harm, teratogen,
carcinogen

UHC 2009

B
C
Intact

A
B
C
C

Intact

NIOSH 2012

cytotoxic
cytotoxic

UHC 2009
UHC 2009

teratogen

NIOSH 2012

cytotoxic

UHC 2009

carcinogen, mutagen

NIOSH 2012

immunosuppressant

UHC 2009

cytotoxic

UHC 2009

teratogen

UHC 2009

teratogenic in rats

NIOSH 2010

cytotoxic

UHC 2009

po liquid
IV

Phenoxybenzamine

Ribavirin

Handling & Admin

C
C
C
C
C
C
C
C
C

IV/SQ/IM
IV
IV
film-coated tablet

Mycophenolate

Status
Intact

B
C
Intact
Opened
Intact
Rx to open and dispense in oral syringe
Intact
Intact

A
B
B
C
C
A
A
B

Intact

Intact

A
B
B
C

Handling/Admin (A) = gloves recommended; (B) = use PPE (gloves, gowns, safety glasses, fitted N95 respirator, as needed to minimize exposure);
(C) = Cytotoxic PPE per SFGH Admin P and P 3.26; NF = non-formulary
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SFGH Admin P and P 16.36 Appendix B: SFGH Hazardous Drug List - January 2014
Agent

Dosage Form

Tacrolimus

capsule

Tetracycline

capsule

Topotecan
Valganciclovir

Valproic Acid
Vinblastine
Vincristine
Vinorelbine
Ziprasidone
Zoledronic Acid
Zonisamide

IV
film-coated tablet
po liquid (NF*)
capsule
po liquid
IV
IV
IV
IV
capsule

Status
Intact
Opened
Intact
Opened

Handling & Admin

A
B
A
B
C
C
C

Intact

Intact

C
C
C

Intact
Opened

immunosuppressant

UHC 2009

teratogen

NIOSH 2012

cytotoxic

UHC 2009

reproductive harm, teratogen

UHC 2009

teratogen

NIOSH 2012

cytotoxic
cytotoxic
cytotoxic

UHC 2009
UHC 2009
UHC 2009

genotoxin, carcinogen, teratogen

NIOSH 2012

teratogen

NIOSH 2012

teratogen

NIOSH 2010

A
B
B
B

IM
IV
capsule

Source

A
B
B

Intact
Opened

Hazard

A
B

Handling/Admin (A) = gloves recommended; (B) = use PPE (gloves, gowns, safety glasses, fitted N95 respirator, as needed to minimize exposure);
(C) = Cytotoxic PPE per SFGH Admin P and P 3.26; NF = non-formulary
4