Safe handling of hazardous medicines at home: Giving cut tablets

If your child’s hazardous medicine dose includes part of a tablet that needs to be cut, please review the instructions on this page.

What is hazardous medicine?

Hazardous medicines are used to treat a variety of medical conditions. For example, chemotherapy is used to treat cancer, and immunosuppressants are used to prevent organ rejection after a transplant.

Hazardous medicine can damage healthy cells. Anyone handling hazardous medicine should keep themselves protected.

Although the risk of harm from handling hazardous medicine is small, it is a good idea to avoid exposure. This includes not tasting your child’s medicine. If you are pregnant or breastfeeding, it is best to avoid contact with hazardous medicine. If possible have someone else give your child their cut tablet.

Preparing the space

You will need to gather certain supplies and take careful steps when setting up your work area. Your child’s health-care provider will help you make a list of the supplies you will need. You can buy these materials at a grocery or drug store.

To handle your child’s hazardous medicine at home, choose an uncluttered counter or table away from windows, fans, vents, areas where you prepare food, and where children and pets play.

If you are cutting your child’s tablets, a gown, mask and gloves offer protection. Other supplies will include:

• paper towels or a disposable, absorbent plastic-backed mat — to contain any spills
• a plastic bag — for waste disposal
• a medicine cup — to hold cut tablets
• tweezers — to pick up the medicine
• a tablet cutter, also called a pill splitter
• a suitable drink such as water. Your child’s health-care provider will tell you which drinks are suitable
• your child’s medicine

If your child cannot swallow the cut tablet, see the information on Safe handling of hazardous medicines at home – Cutting and preparing tablets as a liquid.

Giving your child cut tablets

Before cutting a tablet to give to your child:

• Wash your hands with soap and water.
  
• Put on your gloves, gown and mask.
• Place paper towels or a disposable, absorbent plastic-backed mat over your work surface.

Giving the medicine

1. Open the tablet cutter.
2. Open the medicine bottle and use the tweezers to remove the required number of tablets. Place the tablets into the medicine cup and put the lid back on the medicine bottle as soon as possible.

3. Use a tablet cutter for correct dosage

   Using the tweezers place a tablet in the tablet cutter. If the tablet has a score mark, line this up with the blade of the tablet cutter. Close the tablet cutter and press down firmly. Use the tweezers to place the portion of the tablet to be taken into the medicine cup.

4. When you are done, use the tweezers to return the remaining piece of the tablet to the original medicine bottle. You can use this piece for your child’s next dose. Only cut as many tablets as you need at one time. If any tablet pieces are not intact, place them in a container or plastic bag clearly marked for disposal of hazardous medicines.
5. Make sure your child has washed their hands. Using the medicine cup (and not their hands) have your child swallow each tablet or cut tablet, with an approved drink.
6. After your child has taken their medicine, they will need to wash their hands again.
7. Wash the tablet splitter with warm soapy water after each use.

Only cut as many tablets as you need at one time. If any tablet pieces are not intact, place them in a container or plastic bag clearly marked for disposal of hazardous medicines.

While preparing your child’s cut tablets, please remember:

• Use the tablet cutter and tweezers to give the hazardous medicine only. Do not use them for other medicines.

Clean-up and storage of hazardous medicines

Hazardous medicines should be handled safely. It is important to carefully handle the clean up of the supplies and work area, and to dispose of wastes properly.

Remember these key tips for safe handling of hazardous medicines at home.

• If possible, avoid contact with hazardous medicines if you are pregnant or breastfeeding.
• You and your child should wash your hands before and after handling hazardous medicines.
• Wear gloves when handling hazardous medicine tablets, capsules or liquids.
• Properly clean, dispose or store the equipment and hazardous medicine.

All disposable items that have been in contact with hazardous medicines, such as used paper towels and gloves, must go into a designated plastic waste bag or container. Contact the Household Hazardous Waste Depot in your neighbourhood to see if they will accept the waste bags or containers. If such a service does not exist in your area, ask a member of your child's health-care team about other options.

You may wash and reuse some of your supplies, but do not rinse them in the kitchen sink over other dishes or utensils. If you are reusing an item, such as the medicine cup, rinse it with warm soapy water and allow it to air dry. Clean the sink after washing your supplies.

Always store hazardous medicines away from children and pets. If stored at room temperature, place them in a locked box, away from moisture and direct sunlight, and in a cool, dry place. If the medicine needs refrigeration, place it in a separate container at the back of the fridge. Return the medicine to the locked box or fridge after each use. Do not keep any medicine in your purse, knapsack or diaper bag.

Take special precautions with your child's waste (vomit, urine and stool) while they are taking hazardous medicine

While your child is taking hazardous medicine, some of the drug is broken down and removed from the body through urine and stool. It may also appear in vomit. It is important that you protect yourself and others from hazardous medicine in your child's urine, stool or vomit by following these guidelines:

• When changing your child’s diaper, wear disposable gloves and place diapers in a sealed plastic bag before disposal.
• If your child is toilet trained, have your child close the lid, to avoid splashes, and flush twice after using the toilet. Always make sure they wash their hands afterwards.
• Have supplies ready in case you need to quickly clean up any accident. You need a paper towel, soap and water, disposable gloves, and a disposable container, such as an empty ice cream container.
• Use a plastic mattress cover to protect the mattress from accidents.
• Keep a plastic container close by in case of vomiting. If you use the container, empty the contents into the toilet and wash with warm soapy water.
• Wear disposable gloves when you are handling any bodily wastes, such as changing soiled sheets or cleaning up vomit.
• Wash soiled clothes or sheets separately from other laundry. If they cannot be washed right away, place them in a sealed plastic bag and set it aside.
• Once you are all finished, wash your hands.