methotrexate
PrintTrade Name(s): Methotrexate; Jylamvo; Otrexup; Rasuvo; Trexall; Xatmep | |
Group 1: Antineoplastic Hazardous | AHFS Class: Antineoplastic Agents |
Action | Gloves | Gown | Eye/Face | Mask | CSTD | Notes/Instructions |
Dispensing prepackaged formulations |
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Preparing an Injectable Dose | If risk of spill or splash | If risk of inhalation | If dosage form allows |
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Activity | Gloves | Gown | Eye/Face | Mask | Notes/Instructions |
Dispensing prepackaged formulations |
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Counting/Repackaging tablets or capsules | Recommended if pregnant, breast feeding, or trying to conceive. | If risk of dust inhalation |
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Repackaging oral liquids | If risk of spill or splash | If risk of inhalation |
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Formulation | Gloves | Gown | Eye/Face | Mask | CSTD |
Prepared injectable (vial, syringe, IV solution*, irrigation**) | If splash possible or recommended if pregnant, breast feeding, or trying to conceive | If inhalation possible or recommended if pregnant, breast feeding, or trying to conceive | If dosage form allows | ||
Manufacturer packaged pre-filled syringe or injector | If provided in kit, or if dosage form allows |
* Intravenous tubing already attached and primed.
** Bladder, HIPEC, limb perfusion, etc.
Reference: NIOSH 2016, USP <800>
Formulation | Gloves | Gown | Eye/Face | Mask | Notes/Instructions |
Tablet or capsule - from unit-dose package | or Recommended if pregnant, breast feeding, or trying to conceive. |
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Liquid - oral or feeding tube | If potential for splash, vomit or spit up |
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Reference: NIOSH 2016, USP <800>
Type of Instance | Gloves | Gown | Mask | Eye/Face | Notes/Instructions |
Receiving undamaged HD shipping container |
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Receiving damaged HD shipping container | If container must be opened | If container must be opened | If container must be opened |
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Spill Cleanup | Large volume | Large volume |
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Reference: USP <800>
Hazardous Pharmaceutical | Trace Chemo | Biohazardous and Sharps |
1. Non-returnable hazardous, chemo and EPA regulated drugs. (Patient specific prescriptions, partially used blister packs, containers with more than 3% medication remaining) 2. Empty bottles or packaging of P-Listed drugs. (Warfarin, nicotine, epinephrine, nitroglycerin, physostigmine) 3. PPE with visible contamination from hazardous drug. | 1. Waste contaminated through contact with chemotherapeutic agents. (Empty vials, IV bags, syringes and tubing) 2. PPE worn while handling hazardous drugs with NO visible contamination. (Gowns, gloves and masks) 3. Used CSTD devices. | 1. All sharps capable of cutting or piercing the skin. (Needles/syringes, broken ampules, lancets) 2. Items contaminated with blood or other potentially infectious materials. (Tubing, bags or dressings containing blood, contaminated waste from isolation patients) |
Dosage Form | Ship to Institution or Pharmacy | Ship to Locations Outside of ODOC |
Tablets and Capsules |
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Liquid, Topical, and Transdermal |
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PPE | Standards |
Shoe Covers |
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Gowns |
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Gloves |
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Face Shields |
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Goggles |
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N95 Masks |
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Removal and Disposal |
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Reference: USP <800>
- Toxic if swallowed.
- Causes skin irritation.
- Causes serious eye irritation.
- May damage fertility or the unborn child.
Reference: SDS - Cayman Chemical
Methotrexate anti-tumor activity is a result of the inhibition of folic acid reductase, leading to inhibition of DNA synthesis and inhibition of cellular replication. The mechanism involved in its activity against rheumatoid arthritis is not known.
Reference: Drug Bank
Embryo-Fetal, Bone Marrow, Liver, Lung, and Kidney Toxicity Risk