Surface contamination of counting tools after mock dispensing of cyclophosphamide in a simulated outpatient pharmacy

Abstract

Dispensing one or more prescriptions of 40 cyclophosphamide 50 mg tablets contaminates pharmacy counting tools, and an increased number of prescriptions dispensed correlates with increased level of contamination. Counting out three or more prescriptions leads to trays having contamination that surpasses the threshold at which worker exposure may be increased. Pharmacies should consider devoting a separate tray to cyclophosphamide tablets, as cross-contamination could occur with other drugs and the efficacy of decontamination methods is unclear. Employee exposure could be minimized with the use of personal protective equipment, environmental controls, and cleaning trays between uses. Future investigation should assess the extent of drug powder dispersion, the effects of various cleaning methods, and the potential extent of contamination with different oral cytotoxic drugs.

Residual contamination in antineoplastic drug packaging

“…According to the analyses, of the four boxes evaluated, all presented contamination. There is no surface contamination limit considered safe, 22,23 so levels of DOX and CP above 1 ng/filter can be considered contaminated. In other words, any level of contamination, even those that may be below the LLQ demand special attention since they can cause various risks.…”