How to Safely Handle Oral Chemotherapy

This information will help you or your caregiver safely handle oral chemotherapy (chemotherapy you take by mouth) at home.

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About Chemotherapy

What is chemotherapy?

Chemotherapy is medication that your healthcare provider may prescribe you to help treat your cancer. You can take these medications at home. They come in different forms, such as pills (tablets and capsules) and liquids.

Why is it important to understand how to handle these medications?

These medications attack fast-growing cancer cells in your body, but they can also damage normal healthy cells. While the risk of having side effects from handling these medications is low, it’s important to handle them safely and carefully.

What is the best way to store oral chemotherapy medications?

  • Keep all chemotherapy medications in a sealed container away from children and pets.
  • Store your medications in a cool, dry place, away from heat, sunlight, and moisture.
  • Don’t store your medications in the bathroom or in a cabinet over your kitchen stove. It may get warm and humid in these areas.
    • You may need to store certain medications in the refrigerator. Read the label on your medications to learn how to store it.
  • After taking your medications, make sure to put them away.
  • Keep your medications in their original container. Don’t store them in daily pill boxes.
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Handling Chemotherapy Safely

This section includes general information about oral chemotherapy medications. For specific information about preparing and taking your medications, refer to your medication list or ask your healthcare provider.

How do I safely handle oral chemotherapy medications?

  • Don’t crush, break, or open any pills unless your healthcare provider tells you to.
    • If you need to split or open pills, wear a facemask that covers your nose and mouth.
  • Don’t touch these medications if you’re pregnant, could become pregnant, or are breastfeeding.
  • Wash your hands for at least 20 seconds before and after touching your medications.
  • Wear disposable gloves (gloves that you throw away) when handling chemotherapy, regardless of the form it comes in.
    • If your caregiver is helping you, they’ll need to wear disposable gloves too. They should throw the gloves away after using them and wash their hands.
  • You may want to wear an apron when preparing and taking liquid chemotherapy, especially if you need to crush or dissolve pills. This will keep you from getting medication on your clothing. If you get medication on your apron, wash it separately from other clothing using hot water.
 

How do I prepare a dose of oral chemotherapy?

If you can’t swallow your medication whole, your healthcare provider may instruct you to prepare your dose of chemotherapy at home before taking it. Follow your healthcare provider’s instructions on how to prepare your medication.

Here are some general guidelines on how to dissolve oral chemotherapy if your healthcare provider instructs you to:

  1. Gather your medications and supplies on an uncluttered counter or table, away from windows, fans, heating ducts, and where you prepare food. You’ll need (see Figure 1):
    • Your medications
    • An oral syringe and syringe cap
    • An apron
    • A facemask
    • Disposable gloves
    • A disposable pad or aluminum foil
    • A cup of tap water. Make sure the water isn’t hot.
    • A plastic bag you can tightly close
    • A pill crusher or splitter, if needed
      Figure 1. Gather your supplies

      Figure 1. Gather your supplies

  2. Wash your hands with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer.
  3. Put on your disposable gloves. Also put on your mask and apron if mixing or crushing pills, giving medications to a child, or giving medication in a NG or G-tube.
  4. Clean the area and cover the counter with a disposable pad or aluminum foil.
  5. Remove the plunger from the syringe (see Figure 2).
    Figure 2. Parts of the syringe

    Figure 2. Parts of the syringe

  6. Place the amount of pills you need for your dose into the barrel of the syringe.
    • If your healthcare provider instructed you to crush or cut your medication, do this before placing it into the barrel of the syringe. Make sure to do this with a pill crusher or splitter (see Figure 3). Don’t use a knife. If you have questions about crushing or cutting your medication, talk with your healthcare provider.
      Figure 3. Pill crusher (left) and pill splitter (right)

      Figure 3. Pill crusher (left) and pill splitter (right)

  7. Place the plunger back into the barrel of the syringe (see Figure 4).
    Figure 4. Syringe with pills inside

    Figure 4. Syringe with pills inside

  8. Pull up 5 to 10 milliliters (mL) of tap water into syringe (see Figure 5). Only mix your dose with water. Don’t use other liquids unless your healthcare provider instructs you to.
    Figure 5. Pull up 5 to 10 mL of water

    Figure 5. Pull up 5 to 10 mL of water

    • Put the cap on the syringe.
    • Gently rock or swirl the syringe back and forth to help your medication dissolve in the water.
      • The pill may not dissolve completely. You may see small white particles floating in the water. You can take the medication like this.
      • Medications being administered in a NG or G-tube should be completely dissolved before use.
    • Take the dose as soon as the pill breaks apart. This usually happens within 2 to 5 minutes depending on the medication.
    • After taking your medication, pull up another 5 mL of tap water into the same syringe and drink it/insert it into the NG or G-tube. This will help you get all the medication left in the syringe.
      • If you’re using a NG or G-tube, you must flush the tube with 10 to 20 mL of water. Follow your healthcare provider’s instructions.
    • Place the disposable bed pad or aluminum foil and gloves in a plastic bag. Close it tightly and throw the bag away in your trash.
    • Clean the counter or table surface with soap and warm water.
    • Wash your hands with soap and water for at least 20 seconds, even if your skin didn’t come in contact with your medications.
    • Remove your apron. If you got medication on it, wash it separately from other clothing using hot water.

    How should I handle my body fluids if I’m taking chemotherapy?

    Some of your medications may be in your body fluids (such as your urine, bowel movements, vomit, vaginal fluid, or semen) during and after your therapy. For more information on handling body fluids while you’re taking chemotherapy, read the resource Safe Handling of Chemotherapy and Biotherapy at Home.

    What should I do if I accidentally spill or splash my medication or body waste?

    If your medication or bodily fluid spill or splashes, follow the guidelines in this section. For a quick reference, read the resource Follow the 4 Cs if Your Chemo Leaks or Spills.

    Make a spill kit

    You should be ready to clean up medication spills while you’re taking or giving chemotherapy at home. Make a spill kit that has the supplies below. Keep the kit where you can easily reach it.

    You’ll need:

    • 2 pairs of disposable gloves
    • Paper towels or an absorbent towel that can be thrown away
    • Dish soap or laundry detergent
    • 2 plastic bags that seal (1-gallon size or larger)

    What to do if your medication spills or splashes

    1. Before cleaning the spill, make sure all children and pets are away from the area.
    2. Put on 2 pairs of disposable gloves.
    3. Soak up the spill with paper towels.
    4. Wash the area with dish soap or laundry detergent and water.
    5. Put dirty paper towels and cleaning supplies in a plastic bag.
    6. Take off your gloves. Put them in the bag with the dirty paper towels. Seal the bag tightly. Wash your hands for at least 20 seconds.

    What to do if your medication gets in your eyes or on your skin

    If your medication gets on your skin, wash the area with soap and water. Call your healthcare provider if you have any redness, pain, or burning on your skin.

    If your medication splashes in your eyes, rinse them with running water right away. Keep the water flowing over your open eyes for 10 to 15 minutes. Call your healthcare provider to ask for more instructions.

    What to do if your medication gets on your clothing or linens

    1. Put on a pair of disposable gloves.
    2. Make sure that the items with medication on them don’t touch any part of your body.
    3. Wash the clothing and linens in hot water. Don’t wash them with any other items.

    If possible, wash the dirty clothes and linens right away. If you can’t wash them right away, put them in a plastic bag until they can be washed.

    How do I get rid of unused oral medication I’m no longer taking?

    If you have any leftover or expired medications, you can bring them to Memorial Sloan Kettering’s (MSK) medication pharmacy drop box to dispose of them. You can find the drop box at the 425 East 67th Street entrance of the Haupt building. Your healthcare provider can’t get rid of your medications for you so don’t bring them to your visit. There may be other drop boxes in your community. For more information, read the resource Getting Rid of Unused Medications.

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