CPhT CONNECT™ Magazine - Volume 5 Issue 2

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The NIOSH Hazardous Drug List

NIOSH LIST OF HAZARDOUS DRUGS IN HEALTHCARE SETTINGS 2024 TABLE 1

Table 1 contains drugs that have MSHI in the pack- age insert and/or meet the NIOSH definition of a hazardous drug and one or more of these criteria: • Are classified by the National Toxicology Program (NTP) as “known to be a human carcinogen.” • Are classified by the International Agency for Research on Cancer (IARC) as Group 1 “car- cinogenic to humans” or Group 2A “probably carcinogenic to humans.” Many of these drugs are cytotoxic, and many are hazardous to those workers who are actively trying to conceive, who are pregnant or may become preg- nant, and who are breastfeeding because the drugs may be excreted in breast milk. It should be noted that not all then drugs listed in Table are antineo- plastic drugs. Drugs reviewed for this update were

new drug approvals or received new safety-related warnings from FDA in the period from January 2014 through December 2015. Drugs underlined and in red font were added on the 2024 List Update. Table abbreviations and footnotes. AHFS = American Hospital Formulary Service; MSHI = manufacturer’s special handling information; NA = not available. * Drugs identified as IARC Group 2B “possibly carcinogenic to humans” or as NTP “reasonably anticipated to be a human carcinogen are listed in Table 1 because they have MSHI. Refer to Table 2 NIOSH List of Hazardous Drugs in Healthcare Settings 2024-Table 1.

Table 1-Cancer Classification Designation by Organization

Drug

AHFS Classification

MSHI

Biologics Li - cense Applica - tion

IARC and NTP Classification

ado-trastuzumab emtansine Antineoplastic agents

Yes Yes Yes Yes

Yes

altretamine amsacrine

Antineoplastic agents Antineoplastic agents Antineoplastic agents

No No No

IARC Group 2B*

arsenic trioxide

IARC Group 1 carcinogen. NTP “known to be a human carcinogen” IARC Group 2A carcinogen. NTP “reasonably anticipated. to be a human carcinogen” IARC Group 1 carcinogen; NTP “known to be human carcinogen”

azacitidine

Antineoplastic agents

Yes

No

azathioprine

Immunosuppressive agents; immunomodulatory agents; disease-modifying antirheu- matic drugs

Yes

No

belantamab mafodotin

Antineoplastic agents Antineoplastic agents Antineoplastic agents Antineoplastic agents Antineoplastic agents Antineoplastic agents Antineoplastic agents Antineoplastic agents Antineoplastic agents

Yes Yes Yes Yes Yes Yes Yes

No No No No No

belinostat

bendamustine

bleomycin bortezomib

IARC Group 2B*

brentuximab vedotin

Yes

busulfan

No No No

IARC Group 1 carcinogen

cabazitaxel capecitabine

Yes

Yes

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