eriBULin
Print| Trade Name(s): Halaven | |
| Group 1: Antineoplastic Hazardous | AHFS Class: Antineoplastic Agents |
| Formweb: eriBULin | |
| Info Links: Chemotherapy Extravasation Policy | |
Administration:
Injectable = vial, syringe, IV solution, irrig solution, non-ampule, AN (LH)
| Activity | Glove | Gown | Eye | Mask (N95/PAPR) | CSTD |
| Administration |  |  |
If splashing possible |
If inhalation possible |  |
| Waste/Disposal of drug | | |  If splashing possible |
Nursing Antineoplastic Drugs PPE and Work Practices (Link to a file uploaded to Rhazdrugs or to a file on your intranet, or a shared drive.)
Patient Care Activities:
AN- PPE During Handling of Bodily Fluids, contaminated materials (LH)
Handling of bodily fluids and/or contaminated materials
| Drug Form | Glove | Gown | Eye | Mask (N95/PAPR) | Shoe |
| All forms | | | If splashing possible |
Disposal:
Antineoplastic Agents (LH)
Receiving and Storage:
AN-Receiving & Storage (LH)
| Form | Receipt Packaging | Environment | Glove | Storage |
| Intact tablet/capsule from UD package | Separate totes, plastic wrap | Neutral/normal or negative pressure room, not in sterile compounding area |  | Final dosage forms of AN may be stored with normal inventory. Refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
| Non-intact, repackaged tablet or capsule | N/A | N/A | | Segregated area, negative pressure room, externally ventilated, minimum 12 ACH; refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
| Oral liquid drug or feeding tube | Separate totes, plastic wrap | Neutral/normal or negative pressure room, not in sterile compounding area | | Final dosage forms of AN may be stored with normal inventory. Refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
| Powder for oral liquid | Separate totes, plastic wrap | Neutral/normal or negative pressure room, not in sterile compounding area | | Segregated area, negative pressure room, externally ventilated, minimum 12 ACH; refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
| Topical drug | Separate totes, plastic wrap | Neutral/normal or negative pressure room, not in sterile compounding area | | Final dosage forms of AN may be stored with normal inventory. Refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
| Powder, solution for inhalation | Separate totes, plastic wrap | Neutral/normal or negative pressure room, not in sterile compounding area | | Final dosage forms of AN may be stored with normal inventory. Refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
| Vial; ampule; pre-filled syringe | Separate totes, plastic wrap | Neutral/normal or negative pressure room, not in sterile compounding area | | Final dosage forms may be stored with normal inventory. AN requiring manipulation must be segregated area, negative pressure room, externally ventilated, minimum 12 ACPH; refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
| Intravenous solution | Separate totes, plastic wrap | Neutral/normal or negative pressure room, not in sterile compounding area | | Final dosage forms may be stored with normal inventory. AN requiring manipulation must be segregated area, negative pressure room, externally ventilated, minimum 12 ACPH; refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
| Irrigation solution | Separate totes, plastic wrap | Neutral/normal or negative pressure room, not in sterile compounding area | | Final dosage forms may be stored with normal inventory. AN requiring manipulation must be segregated area, negative pressure room, externally ventilated, minimum 12 ACPH; refrigerated AN must be stored in dedicated fridge in negative pressure area with minimum 12 ACPH. |
Spill Containment | Notes/Instructions | PPE Required |
 | Wear N95 or PAPR mask if you see powders present |  |
Preparation:
Injectable (AN), or any bulk powder of any group (LH)
| Glove | Gown | Eye | Mask | Shoe | Head Cover | Hood/Cabinet | CSTD | Notes/Instructions |
(outer layer should be sterile) |
(outer layer should be chemo rated) |
|  |  |
| | Any secondary layers of PPE should be removed/discarded prior to exiting the C-PEC |
Transport:
Transport of AN
| Form | Prep Instructions | Pneumatic Tube |
| Intact tablet/capsule from UD package | Sealed plastic bag, single pair of gloves, cautionary labeling |  |
| Non-intact, repackaged tablet or capsule | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Oral liquid drug or feeding tube | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Topical drug | Sealed plastic bag, single pair of gloves, cautionary labeling |  |
| Powder, solution for inhalation | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Vial; ampule; pre-filled syringe | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Intravenous solution | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Irrigation solution | Sealed plastic bag, single pair of gloves, cautionary labeling | |
Assessment of Risk:
Group 1 NIOSH - Full USP <800> precautions required - No Assessment of Risk allowed.
| Dosage Form | Risk of Exposure | Packaging | Pharmacy Manipulation |
| Injectable | May occur when compounding and administration | Not eligible for AoR | Not eligible for AoR |
PPE:
PPE Guidelines
| |  | | |  | | |
| Chemotherapy rated/tested (tested to ASTM D6978-05 (2013), Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs) | Disposable
| Should be worn in situations where eye, mouth, or nasal splashing is possible (i.e., during a bladder instillation of a hazardous drug) | Goggles protect the eyes, but not the face, against spraying. | Certified N95 | Powered air purifying respirator | required for compounding sterile and nonsterile hazardous drugs | required for compounding sterile and nonsterile hazardous drugs |
| Powder-free | Shown to resist permeation by hazardous drugs
| N95 offers no protection against gases and vapors. | For events such as large spills when an IV bag breaks or a line disconnects and leaks, or where there is known or suspected airborne exposure to vapors or gases | Double booties required for HD preparation areas, top layer is doffed before exiting the HD buffer room. | |||
| Inspect for visible defects | Must close in the back (no open front) | Surgical masks do NOT provide respiratory protection from drug exposure | Hazardous drugs with potential to vaporize at room temperature: • Carmustine • Cisplatin •Cyclophosphamide • Etoposide • 5-Fluorouracil • lfosfamide • Thiotepa | ||||
| Double gloving is recommended for all activities involving hazardous drugs except for handling intact, unit-dose oral agents, when one pair of chemotherapy-tested gloves is acceptable | Long sleeves with closed cuffs that are elastic or knit | ||||||
| When wearing double gloves, tuck the cuff of the inner glove under the gown sleeve and the cuff of the outer glove over the gown sleeve. | No seams or closures that could allow hazardous drugs to pass through | ||||||
| During medication manipulation/compounding the outer layer should be sterile | In preparation areas gowns should be changed every 2-3 hours or immediately after a spill or splash | ||||||
Change gloves every 30 minutes unless permeation testing has noted shorter time limits
| Gowns worn in hazardous drug handling areas must NOT be worn to other areas |
Sequence for Donning & Doffing PPE
References: Oncology Nursing Society, NIOSH
Mechanism of Action:
Eribulin inhibits the growth phase of microtubules without affecting the shortening phase and sequesters tubulin into nonproductive aggregates. Eribulin exerts its effects via a tubulin-based antimitotic mechanism leading to G2/M cell-cycle block, disruption of mitotic spindles, and, ultimately, apoptotic cell death after prolonged mitotic blockage. [FDA]
Reference: Drug Bank
Exposure Risk:
- Toxic if swallowed
- Toxic in contact with skin
- Toxic if inhaled
- Suspected of causing genetic defects
- Suspected of causing cancer
- Suspected of damaging fertility or the unborn child
Reference: PubChem
Safety Data Sheet(s):
Approved on September 12, 2024
