[Pharmwaste] Chemo drugs
Ed Gottlieb
EGottlieb at cityofithaca.org
Mon Apr 9 14:42:30 EDT 2018
New info from Jim Mullowney below. Contact him for more information: jmullowney at pharma-cycle.com<mailto:jmullowney at pharma-cycle.com>
Unofficial draft of the updated USP [set standards, publish International Pharmacopoeia] "General Chapter <800> on Hazardous Drugs, handling in healthcare settings" states that materials with trace amounts of Hazardous Drugs must be discarded as a Hazardous Waste. This includes items contaminated in the medical care facility and patient-care environment, which can include the home.
Problem Chemotherapy Drugs That Are Excreted at High Concentrations & Can Damage Others at Ultra-low Doses1
Generic Name Other Names Excretion Administered Dose
% Danger Period Dose/Weight Amount
Actinomycin D Dactinomycin, Cosmenogen 30% 7 Days ≤ 50 ug/Kg ≤ 4 mg
Bleomycin Blenoxane 60-70% 1 Day ≤ 50 units (mg)/Kg ≤ 4000 mg
Carboplatin Paraplatin 65-75% 1 Day ≤ 12 mg/Kg ≤ 960 mg
Cisplatin Platin 13-17% 1 Day ≤ 3.3 mg/Kg ≤ 264 mg
Cyclophosphamide Endoxan, Cytoxan, Neosar, Procytox, Revimmune
5-25% 1 Day ≤ 50 mg/Kg ≤ 4000 mg
Dacarbazine DTIC, DTIC-Dome 40% 1 Day ≤ 4.5 mg/Kg ≤ 360 mg
Daunorubicin HCl Cerubidine 65% 3 Days ≤ 1.5 mg/Kg ≤120 mg
Doxorubicin Adriamycin, Rubex, Doxil, Caelyx, Myocet
45-55% 5 Days ≤ 2.5 mg/Kg ≤ 200 mg
Epirubicin Ellence, Pharmorubicin 55% 4 Days ≤ 40 mg/Kg ≤ 3200 mg
Etoposide Eposin, Etopophos, Vepesid, VP-16 45% 5 Days ≤ 3.3 mg/Kg ≤ 264 mg
Floxuridine Fdur 20% 1 Day ≤ 0.6 mg/Kg ≤ 48 mg
Fludarabine Fludara 40-60% 1 Day ≤ 0.83 mg/Kg ≤ 66.4 mg
Fluorouracil 5-FU, Adrucil, Carac, Efudix, Efudex, Fluoroplex
7-20% 1 Day ≤ 12 mg/Kg ≤ 960 mg
Idarubicin Zavedos, Idamycin 20% 8 Days ≤ 0.4 mg/Kg ≤ 32 mg
Ifosfamide Mitoxana, Ifex 12-18% 1 Day ≤ 40 mg/Kg ≤ 3200 mg
Irinotecan Camptosar, Campto 25-50% 2 Days ≤ 11.7 mg/Kg ≤ 936 mg
Mitomycin Mitosol 10% 1 Day ≤ 0.67 mg/Kg ≤ 53.6 mg
Mitoxantrone 24% 5 Days ≤ 0.47 mg/Kg ≤ 37.6 mg
Oxaliplatin Eloxatin 35% 1 Day ≤ 2.8 mg/Kg ≤ 224 mg
Methotrexate Trexall, MTX, Amethopterin 80-90% 1 Day ≤ 15 mg/Kg ≤ 1200 mg
Temozolomide Temodar 18% 7 Days ≤ 50 mg/Kg ≤ 4000 mg
Topotecan Hycamtin 70 -75% 9 Days ≤ 0.05 mg/Kg ≤ 4 mg
Restricted use
Arsenic trioxide Trisenox 15% 1 Day ≤ 15 mg/Kg ≤ 1200 mg
Clofarabine 49-60% 1 Day ≤ 1.7 mg/Kg ≤ 138 mg
Melphalan Alkeran 10-15% 1 Day 6 mg 6 mg
Teniposide Vumon 4-12% 5 Days ≤ 8.3 mg/Kg ≤ 666 mg
Valrubicin Valstar 99% 1 Day 800 mg 800 mg
1. Information summarized from the Drug Package Inserts - information required by the FDA from pharmaceutical companies before each drug is approved for use in humans.
2. Estimated percent of drug dose that exits patient's body as parental drug or active metabolite as well as excretion period.
3. Doses will vary depending on disease and doctors' recommendations. See individual Drug Inserts for more details.
4. Where needed, converted from mg/m2 to mg/Kg
Ed Gottlieb
Industrial Pretreatment Coordinator
Ithaca Area Wastewater Treatment Facility
525 3rd Street
Ithaca, NY 14850
(607) 273-8381<tel:(607)%20273-8381>
fax: (607) 273-8433<tel:(607)%20273-8433>
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