Plumb’s™

Keeping patients safe and healthy is always your primary focus in veterinary practice, but it’s equally crucial to prioritize the safety and well-being of your veterinary team members and clients. That means knowing which drugs on your pharmacy shelf can be harmful to humans and making sure team members and clients know how to handle them safely. It also means ensuring that certain individuals—like team members who are pregnant—don’t handle some hazardous veterinary drugs at all.

Let’s look at which common small animal medications have the potential to harm humans and what you need to know to keep staff and clients safe.

Handout: Drugs That Pose Human Risk

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Common Hazardous Drugs Used in Small Animal Veterinary Practice

The National Institute for Occupational Safety and Health (NIOSH) defines hazardous drugs as those that are known or suspected to cause adverse health effects from exposures in the workplace.¹

Drugs considered hazardous exhibit one or more of the following characteristics in humans or animals:

Carcinogenicity
Teratogenicity or other developmental toxicity
Reproductive toxicity
Organ toxicity at low doses
Genotoxicity

The NIOSH publishes a list of hazardous drugs that details why a particular drug is considered hazardous and what steps should be taken to reduce the risk.

While the NIOSH doesn’t evaluate drugs labeled exclusively for veterinary use, a number of the human drugs on the list are used in veterinary patients. Several veterinary drugs—while not evaluated by the NIOSH—also pose potential health risks to humans and require special handling.

The table below provides an alphabetized list of hazardous drugs commonly prescribed or used in veterinary practice, including known hazards and recommended precautions to protect the veterinary team and your clients.

Drug	Hazard	Precautions
Apomorphine	Genotoxic (damaging to DNA); animal reproduction studies have shown adverse effects on the fetus	Wear gloves and other personal protective equipment (eg, face masks when handling apomorphine powder) to minimize the risk of accidental exposure.
Azathioprine	Proven mutagen and carcinogen; may cause fetal harm	People who are pregnant should avoid handling azathioprine. Wear disposable gloves (do not reuse) and thoroughly wash hands after handling.
Bedinvetmab Frunevetmab	Blocks nerve growth factor, involved in embryogenesis and nervous system development; hypersensitivity reactions, including anaphylaxis, can occur after accidental self-injection^3,4	People who are pregnant, trying to conceive, or breastfeeding should take extreme care to avoid self-injection and avoid handling if possible. Use personal protective equipment to minimize the risk of accidental self-injection.
Chemotherapeutics (eg, carboplatin, vincristine)	Carcinogens	People who are pregnant should not handle chemotherapeutics. Wear disposable gloves while handling medication, litter, or bodily fluids and waste. Review the specific handling requirements for each drug.
Chloramphenicol	Anticipated to be a human carcinogen; serious and fatal blood dyscrasias have been reported²; may cause adverse effects on the fetus	People who are pregnant should not handle chloramphenicol. Wear disposable gloves and avoid crushing or cutting pills. Do not allow the drug to contact your skin, eyes, or mucous membranes. Wear gloves when disposing of vomit.
Cyclosporine	Known carcinogen; potential risk of birth defects	People who are pregnant should avoid handling cyclosporine. Rinse skin or eyes exposed to powder or liquids.
Dexmedetomidine oromucosal gel	Can be absorbed through mucous membranes; can cause uterine contractions and/or a decrease in fetal blood pressure⁵	People who are pregnant should not handle this medication. Wear gloves when handling this medication or coming into contact with the dog’s mouth after application. If this drug comes in contact with your eyes, nose, or mouth, flush the exposed area with water for 15 minutes and contact a physician.⁵
Diethylstilbestrol	Known carcinogen; can cause birth defects if taken during pregnancy	People who are pregnant should be careful not to accidentally take this drug. Wear gloves and avoid inhaling any dust from split or crushed tablets. Wash or rinse skin or eyes exposed to powder or liquids immediately and thoroughly.
Estriol	Known carcinogen; can cause birth defects if taken during pregnancy	People who are pregnant should be careful not to accidentally take this drug. Wear gloves and avoid inhaling any dust from split or crushed tablets. Wash or rinse skin or eyes exposed to powder or liquids immediately and thoroughly.
Finasteride	May cause adverse effects on the fetus	People who are or may become pregnant or are breastfeeding should avoid handling this medication.
Methimazole	Teratogenic; crosses the placenta in humans concentrating in the fetal thyroid gland; high rate of transfer into breast milk	People who are or may become pregnant or are breastfeeding should avoid handling this medication and the litter or bodily fluids of treated animals. People with low thyroid hormones should also avoid handling. Do not break or crush tablets. Wear disposable gloves while handling this medication, the litter or bodily fluids of treated animals, and broken or moistened tablets. Thoroughly wash hands after handling.
Misoprostol	High risk for causing miscarriages	Should not be used in households with people who are pregnant. At a minimum, people who are pregnant must not handle or be exposed to this drug and must avoid direct contact with litter or bodily fluids.
Mitotane	Can cause fetal harm	People who are pregnant should avoid handling mitotane. Wear disposable gloves while handling medication, litter, or bodily fluids. Thoroughly wash hands after handling.
Oclacitinib	Severe eye irritation⁶	Thoroughly wash hands after handling.
Ropinirole	Can be absorbed across intact skin; may cause adverse effects like headache, nausea, vomiting, dizziness, orthostatic hypotension, and sleepiness⁷; has adverse effects on embryo-fetal development in rodent studies⁷	People who are pregnant, planning to become pregnant, or breastfeeding should not handle ropinirole. Wear gloves and protective eyewear to minimize the risk of accidental exposure.
Tacrolimus	Increases the risk of lymphomas and other malignancies; can cause fetal harm	People who are pregnant should avoid handling tacrolimus. Wear disposable gloves while handling medication, litter, or bodily fluids. Thoroughly wash hands after handling.
Toceranib	Can cause serious adverse effects in people; can affect blood vessel development in the fetus and cause fetal harm⁸	People who are or may become pregnant or are breastfeeding should avoid handling this medication, litter, or bodily fluids of treated animals. Keep medication and the bodily fluids of treated animals out of reach of children. Wear disposable gloves while handling this medication, the litter or bodily fluids of treated animals, and broken or moistened tablets. Thoroughly wash hands after handling.
Transdermal fentanyl	Residual drug in patches can pose a significant risk to humans, especially children⁹	Wear gloves and ensure the surface of the patch doesn’t contact the caregiver’s skin. Keep in a secure location that is out of sight and reach of pets and children. Take additional steps if the patch doesn’t stick to the patient’s skin (eg, adhesives, bandages) and double-check placement frequently. Have clients dispose of used patches via a drug take-back program or flush them down the toilet.¹⁰
Trilostane	Teratogenic effects and early pregnancy loss in laboratory animals¹¹	People who are pregnant should not handle trilostane. Wear disposable gloves and wash hands. Do not empty capsule contents or attempt to divide the capsules.
Zonisamide	Teratogenic in multiple miscellaneous animal species	People who are pregnant, nursing, or trying to conceive should avoid handling this medication. Wash hands after handling.

How to Keep Team Members and Clients Safe

A hazardous medication list can act as a visual reminder of hazardous drugs, help prevent accidental exposures, and ensure veterinary team members are aware of the potential risks involved and can effectively educate clients.

Consider adding auxiliary labels to medications that alert clinic staff to take extra precautions and remind team members to educate pet owners about these drugs.

You could also store hazardous drugs in a separate location in the clinic as a reminder that extra care is needed while handling or limit access to these medications to specific staff members.

How Plumb’s™ Can Help With Safe Handling of Hazardous Drugs

Having access to a trusted source of accurate and continually updated drug information—with details about the potential hazards a drug can pose—is crucial.

The drug information in Plumb’s™ is continually updated by our team of experts and available in seconds from any internet-connected device, so you can quickly—and confidently—prescribe.

Plumb’s™ also includes drug handouts that help you quickly provide high-quality drug information to pet owners. These easy-to-access handouts contain all the essential information a pet owner needs about a drug, like what it’s used for, its common side effects, and tips on giving the medication at home.

Each drug handout also includes a section that addresses whether the drug carries any human risk and how to handle it safely so pet owners have the information they need to stay safe.

With Plumb’s™, you have the information you need to help keep your clients and veterinary team members safe—and confidently care for your patients.

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Handle With Care: Veterinary Drugs That Pose a Human Risk

Handout: Drugs That Pose Human Risk

Common Hazardous Drugs Used in Small Animal Veterinary Practice

How to Keep Team Members and Clients Safe

How Plumb’s™ Can Help With Safe Handling of Hazardous Drugs

Think you could use Plumb’s™ in your practice?

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