Safe Handling of Chemotherapy Medicine at Home

Children’s Minnesota cares about the safety and well-being of your child and those who treat and care for them. As a caregiver, you play an important role and are an extension of the care team for your child. To help ensure the safest environment possible for your child, Children’s Minnesota is committed to providing information to help you prepare and protect your child and other caregivers. This information will help you and your loved ones handle hazardous medicines at home. If you have questions about a specific medication or these safe handling guidelines, please contact your care team.   

What are hazardous medicines?

Your child’s provider has determined your child needs a medicine that is considered hazardous. While this medication is intended to help your child, it can be harmful to other people, so requires special handling. Hazardous medicines are used to treat many medical conditions but can damage healthy cells and be harmful to people giving them.  

Your medication label will say if it is considered a hazardous medicine. The risk of harm from handling hazardous medicine is small, but it is a good idea to avoid exposure as much as possible. If you are pregnant, trying to get pregnant, or breastfeeding, speak to your nurse, doctor, or pharmacist about safe ways to care for your child. 

Chemotherapy (chemo) refers to certain medicines used to treat cancer and other conditions. Chemotherapies are considered hazardous because they kill cancer cells and may cause short-term or long-term health effects if not handled carefully. Chemo medicines must be handled carefully at home to prevent you, your family members and pets from contacting the chemo medication either directly or indirectly through your child's bodily fluids.

What are bodily fluids?

Bodily fluids are liquids within a person's body. Some examples include:

• Tears
• Blood
• Urine (pee)
• Stool (poop)
• Mucus
• Saliva (spit)
• Vomit (puke or throw up)

How do I handle chemotherapy at home? 

You, your child, family members and pets may encounter chemo at home either by direct contact or through your child’s bodily fluids. Always wear personal protective equipment (PPE), including disposable (single use) gloves during chemotherapy contact, including all the situations below.  

• Storage, preparation and disposal 
• Giving chemo  
• Cleaning (spills and bathroom/toilet areas) 
• Changing of diapers, or areas where your child pees and poops 
• Medication splashing 

How long should I follow chemo safety guidelines? 

Chemotherapy can stay in your child’s body for several days after completing therapy. In general, follow these guidelines while taking the medication and approximately 2 days after the last dose. Speak to your nurse, doctor, or pharmacist about the type of chemotherapy medicine your child is on and how long you should follow safety guidelines. 

What supplies will I need at home? 

Your home care nurse or home care company will supply: 

• Box of disposable gloves 
• Chemo waste bucket 
• PPE for chemo administration (one kit per dose) 
• Chemo spill kit 

You may want to also have these items on hand: 

• Heavy-duty garbage bags for PPE disposal
• Disposable gloves for cleaning up bathrooms 
• Waterproof bedding/mattress covers 

How do I store the medicine? 

Your pharmacist or nurse will tell you if there are any special storage instructions. 

• Keep all medicines out of reach of children or pets. 
• Keep hazardous medicines separate from all other medicines. 
• If the medicine needs to be refrigerated, separate it from other foods. Use a separate bin in the refrigerator or place the medicine in a container. 
• Keep the hazardous medicine in its original bottle or container. Do not place it in a pill box with other non-hazardous medicines. 

How do I prepare to give the medicine?

Prepare the work area you will be giving the medicine in. Choose an uncluttered counter or table away from:

• Windows, fans, and vents
• Areas where food is prepared
• Carpeted areas
• Areas where children and pets play

Gather the following supplies:  

• Box of disposable gloves 
• Chemo waste bucket 
• PPE kit for chemo administration 
• Chemo spill kit 
• Heavy-duty garbage bag — for PPE disposal 
• Your child’s medicine and supplies to give it 

Before preparing your child's medicine:

• Wash your hands with soap and water.
• Put on the PPE from the chemo administration kit. Do not use torn or punctured gloves.
• Place paper towels or a disposable, absorbent plastic-backed mat over your work surface.

How do I give the medicine?

• Before touching the medicine inside the container, check it for damage or if it’s a liquid medicine, make sure it is not leaking. Do not use the medicine if it looks damaged or leaking.  
• Your provider, nurse, or pharmacist will explain how and when to give your child their medicine. Follow the directions given to you on how to safely give the medication.  
• Make sure your child takes the medicine exactly as told. If you have any questions or a dose is missed, contact your provider, nurse, or pharmacist for further instructions.   

How do I clean up and throw away used chemo medicine and supplies? 

How you clean up and dispose of chemo medicine and supplies depends on if the medicine is in a pill, liquid, or IV. Follow the directions given to you by your provider, nurse, or pharmacist on how to dispose of medicine and supplies.  

Place the following into the chemo waste bucket:  

• Medicine packaging in hazardous drug (HD) bag 
• Visibly dirty PPE 
• Visibly dirty chemo mat 
• Used sharps and medicine packaging 

Put the following items into a trash bag, close tightly, and dispose into the regular trash container: 

• Unsoiled PPE  
• Unsoiled chemotherapy mat 

Wash your hands with soap or water after handling hazardous medicines.

How do I stay safe around body fluids with chemo? 

Chemotherapy can stay in your child’s body for several days after completing therapy, including your child’s body fluids. Follow these guidelines to stay safe around body fluids while taking the medication and approximately 2 days after the last dose. 

Gloves and skin protection 

Wear disposable gloves any time you touch your child’s body fluids. Use a new pair each time you need to touch body fluids.  

• Wipe away tears or saliva with a tissue and put the tissue into the chemo waste bucket. 
• Clean your child’s skin well with each diaper change. Apply protective cream to the skin to reduce irritation from contact with the chemo medicine. 
• Wash your hands with soap and water after you remove the gloves. 
• Dry your hands with paper towels and put the towels into the regular trash. 

Disposal for bodily fluids 

Put the following items into a trash bag, close tightly, and dispose into the regular trash container: 

• Used disposable gloves 
• Disposable wipes, paper towels, and tissues used to clean up any body fluids 
• Disposable diapers, pads, or underwear 

Toileting 

Put the toilet lid down before you flush to avoid splashing. If the toilet has no lid, cover it with a plastic-backed pad before flushing. Flush the toilet 2 times after your child uses it. 

• If possible, have your child use a separate toilet from others in the home. 
• If using a separate toilet is not possible, wear gloves to clean the toilet seat after each use. 
• Always have your child wash both hands with soap and water after using the toilet. 

Avoid any splashing when emptying vomit from a container into the toilet. 

• Empty vomit into toilet and flush 2 times.
• Wash the container with warm, soapy water and rinse it. 
• Pour wash and rinse water into the toilet, then flush the toilet 2 times. 
• Dry the container with paper towels and put the towels into a plastic bag and then into the chemo waste bucket. 

Laundry 

Wear disposable gloves to handle laundry dirty with body fluids. Do not hold laundry close to your body or allow it to touch your clothing. 

• Place items into a sealed plastic bag until you wash them. 
• Wash sheets or clothes dirty with body fluids separately from other laundry. 
• Do not wash dirty items by hand.
• Always wash items 2 times in a washing machine using hot water and regular laundry soap. 

What happens if the chemo medicine splashes or spills? 

If chemo or body fluids splash onto someone’s skin: 

• Rinse the skin with large amounts of water, then wash with soap and water for 10 minutes 
• Contact your provider if redness or soreness develops 

If chemo or body fluids splash into someone’s eye: 

• Place head under water faucet or hose and rinse eye with water for at least 15 minutes 
• Contact your provider 

If chemo or body fluids splash onto clothing: 

• Put on disposable gloves.
• Remove the clothing. Do not touch wet material with your bare hands. 
• Wash the skin under the clothing if it got wet 
• Place clothing in a sealed plastic bag until you can wash it 

If the chemo spills: 

• Keep all children and pets away from the spill.
• Closely follow all directions provided in the chemo spill kit.
• Use the pads to cover the chemo spill so it does not spread.
• Do NOT touch the chemo spill with your bare hands.  

Remember these key tips for safe handling of chemotherapy medicine at home 

1. If possible, avoid contact with chemotherapy medicine if you are pregnant or breastfeeding.  
2. You and your child should wash your hands with soap and water before and after handling chemotherapy medicines.  
3. Wear disposable gloves when handling chemotherapy medicine tablets, capsules or liquids.  
4. Properly clean, dispose of, or store the equipment and chemotherapy medicine. 

Questions? 

This information is not specific to your child but provides general information. If you have any questions, please call your clinic. 

Reviewed USP 800 Committee 4/2024

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