The Cause of Contamination for Blister Pack Containing Fluorouracil Oral Tablets

Kawamoto, Eiko; Hamahara, Anna; Kanemitsu, Asako; Takami, Yoichiro; Moriyama, K.; Hanada, Takae; Inoue, Yuichi; Nagase, Ayaka; Yamamoto, Akira; Ogawa, Tsugufumi; Egawa, Takashi; Shimada, Kenji

doi:10.5649/jjphcs.41.630

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…For oral HDs, such as cyclophosphamide or 5-fluorouracil tablets, the risk of exposure to HDs was evaluated by analysing the amount of drugs on the surfaces of the blister packages, and the amount of HDs that may be inadvertently ingested by caregivers during drug administration using feeding tubes 10–12. In a study of injectable anticancer drugs, Böhlandt et al reported that drugs were dispersed via sweat, saliva, and excrement in the homes of patients treated with anticancer drugs 13.…”

Section: Introductionmentioning

confidence: 99%

Risk of exposure of patients’ family members to lenalidomide at home

et al. 2023

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ObjectivesLenalidomide, a hazardous drug, has strict distribution controls. However, the risk of contamination with lenalidomide when patients take the drug has not been studied and the risk of drug exposure to people in the patient’s living environment is unknown. Thus, we investigated the amount of lenalidomide that could be dispersed during the period between removal of the capsule and returning the used blister packages, and we considered the conditions under which lenalidomide could be dispersed and countermeasures.MethodsThe amount of lenalidomide contamination was measured on the outside of the unused blister packages returned by the patients, on the surface of the capsule, and on the inside of the package immediately after removal of the capsule. In addition, the amount of contamination was measured on the blister packages used by the patients and on the gloves worn by the pharmacists on receipt of the packages. Lenalidomide was analysed by liquid chromatography–tandem mass spectrometry.ResultsLenalidomide amounts on the outside of the unused blister packages returned by the three patients were <10, <10, and 26.8 ng/pack, those on the capsule surface immediately after removal from the packages were 297, 388, and 297 ng/capsule, and those on the inside of packages immediately after removal of all capsules were 143, 184, and 554 ng/pack, respectively. A median of 15.6 ng/pack lenalidomide was detected on the surface of packages used by the patients (n=18). The lenalidomide remaining in the packages immediately after capsule removal (~200 ng/pack), except for the 15.6 ng/pack detected in the packages used by the patients, may have been dispersed in the patient’s living environment (~90% or more). The maximum amount of lenalidomide on the surface of the packages used by the patients was over 2500 ng/pack.ConclusionsThe amount of lenalidomide contamination per package was found to be at least 100 ng less after collection by the pharmacist than immediately after removal of the capsules. Therefore, it is recommended to clean the surrounding area and wash one’s hands after taking the capsules.

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Section: Introductionmentioning

confidence: 99%

Risk of exposure of patients’ family members to lenalidomide at home

et al. 2023

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Contamination of Capsules and Blister Packs by Dutasteride

Takami

Matsuoka

Okazaki

et al. 2016

Jpn. J. Pharm. Health Care Sci.

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We previously reported that various amounts of hazardous drugs, cyclophosphamide and fluorouracil had contaminated both the inside and outside of their blister packs. However, contamination from the non-antineoplastic drug, dutasteride, which primarily has adverse reproductive effects on female healthcare workers in the clinical setting, pregnant women and their families, has not been elucidated. Here we show that dutasteride was detected on both the inside and outside of blister packs of Avolve ® Capsules. The amount of dutasteride extracted from blister packs and softcapsules was measured by LC-MS/MS. In addition, dutasteride was also detected on the surface of the softcapsules. Dutasteride attached to the surface of a capsule can become attached to others by physical contact. Our data suggest that pregnant women and their families can be exposed to dutasteride attached to blister packs and the surface of capsules, and female healthcare workers in contact with Avolve ® Capsules can also be exposed to dutasteride. It is necessary to take measures to prevent unintended exposure to females.

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The Cause of Contamination for Blister Pack Containing Fluorouracil Oral Tablets

Cited by 2 publications

References 6 publications

Risk of exposure of patients’ family members to lenalidomide at home

Risk of exposure of patients’ family members to lenalidomide at home

Contamination of Capsules and Blister Packs by Dutasteride

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