• BLACK container labeled for BULK CHEMO waste shall be utilized for chemotherapy waste with residual of 3% or more drug remaining. All chemotherapy is considered regulated/RCRA by EPA/RCRA and USP 800 regulations. Waste vendor picks up.
  
• Yellow “Trace” Chemo containers are ordered through Lawson and picked up by the vendor or the department with responsibility for biohazard waste in each facility (along with regulated medical waste, red sharps, and non-regulated Rx waste). Containers shall be used for “empty” chemotherapy vials, IV bags, syringes, along with any material used during the preparation, administration and handling of the chemotherapy, including all personal protective equipment (PPE).
  

• *Off site clinics do not return pharmaceutical waste to pharmacy
• Arsenic Trioxide (Trisenox) vials, IV bags, tubing, syringes and other materials used in preparation and administration shall be disposed of a segregated "PBKC" listed waste in 8-gallon black waste containers and labels provided by hazardous waste vendor. **Under NO circumstances can arsenic trioxide be combined with other hazardous waste**

• Off site clinics to not return pharmaceutical waste to pharmacy

• *Off-site locations do not return pharmaceutical waste to pharmacy

• *Off-site locations do not return pharmaceutical waste to pharmacy.

• *Off-site locations do not return pharmaceutical waste to pharmacy.

• Separately from any HazDs
• In an externally vented, negative pressure room with at least 12 air changes per hour (ACPH).
• Drugs that require refrigeration shall be stored:
• Separately from non-HazDs
• In a dedicated refrigerator
• In an externally vented, negative pressure room with at least 12 air changes per hour (ACPH).
• Drugs received in the manufacturer's final dosage form or in a form that requires only counting or repackaging may be stored:
• Preferably in a negative pressure room
• Preferable separate from non-HazDs

• Perform sterile compounding in a C-PEC utilizing aseptic technique.
• A disposable chemo prep pad may be used when compounding within a C-PEC (BSC/CACI), however one MUST be used when compounding within a PEC (LFWB/CACI).
• Tubing for HazD sterile products should be primed in the pharmacy with the primary fluid, with the exception of HazDs that, according to their AoR, do not have to be primed, and titratable HazDs that should be primed with active drug.
• CSTDs should be used when compounding HazDs when the dosage form allows
• Any second layer PPE should be removed/discarded prior to exiting the C-PEC

Decontaminate finished product prior to removing from the C-PEC (Best Practice)

• At the conclusion of compounding/manipulation, doff the outer gloves inside of the C-PEC.
• Place the gloves into a sealable receptacle or resealable plastic bag (located in the C-PEC) with yellow (chemotherapy, cytotoxic) HazD label or sticker. The receptacle or resealable clear plastic bag will be disposed of as yellow trace RCRA waste.
• Wipe the finished product with Peridox®RTU followed by sIPA and place on cleanest side of the C-PEC deck.
  
• Wipe the inner gloved hands with Peridox®RTU prior to removing finished product form the C-PEC.
• Remove finished product from the C-PEC, label, and place into a resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• Prior to donning second pair of gloves, sanitize inner gloved hands by applying 70% Isopropyl Alcohol (sIPA), rub gloved hands together, and allow to dry.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• The bag must be placed into a hard-sided closable container that reduces the risk of breakage, and facilitates spill containment. 
• The container must be clearly marked with the appropriate hazardous drug label or sticker.
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• The bag must be placed into a hard-sided closable container that reduces the risk of breakage, and facilitates spill containment.
• The container must be clearly marked with appropriate
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• If HazD is in liquid form or has been manipulated, resealable plastic bag must be placed into a hard-sided closable container that reduces the risk of breakage, and facilitates spill containment.
• The container must be clearly marked with the appropriate hazardous drug label or sticker.
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• If HazD is in liquid form or has been manipulated, resealable plastic bag must be placed into a hard-sided closable container that reduces the risk of breakage, and facilitates spill containment.
• The container must be clearly marked with appropriate hazardous drug label or sticker.
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• If HazD is in liquid form or has been manipulated, resealable plastic bag must be placed into a hard-sided closable container that reduces the risk of breakage, and facilitates spill containment.
• The container must be clearly marked with appropriate hazardous drug label or sticker.
• Pneumatic Tube NOT allowed.

• Transport in appropriate resealable clear plastic bag with yellow (chemotherapy, cytotoxic) HazD labeling or sticker.
• If HazD is in liquid form or has been manipulated, resealable plastic bag must be placed into a hard-sided closable container that reduces the risk of breakage, and facilitates spill containment.
• The container must be clearly marked with appropriate hazardous drug label or sticker.
• Pneumatic Tube NOT allowed.