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NIOSH Hazardous Drugs 2024 — Reference for Nurses
v1.0.0 · NIOSH 2024 · Built-in · Last reviewed Dec 2024
NIOSH Hazardous Drugs 2024
CDC NIOSH List of Hazardous Drugs in Healthcare Settings · Tables 1 & 2 · Essential for oncology, chemo, and reproductive health nurses
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Table 1 — Drugs with manufacturer special handling information (MSHI) in package insert AND/OR classified as carcinogens by NTP or IARC. Requires full USP <800> compliance.
Table 2 — All other hazardous drugs meeting NIOSH criteria. May include reproductive/developmental hazards. Eligible for Assessment of Risk under USP <800>.
31 drugs found
Azathioprine
Table 2
AHFS Class: Immunosuppressant
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Do not crush tablets. Teratogenic.
Chloramphenicol
Table 2
AHFS Class: Antibiotic
PPE & Handling: Gloves. Avoid prolonged skin contact. Bone marrow suppression risk.
Cidofovir
Table 2
AHFS Class: Antiviral
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves, gown, eye protection. Nephrotoxic and reproductive hazard.
Colchicine (injectable)
Table 2
AHFS Class: Anti-gout
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown for injectable form.
Cyclosporine
Table 2
AHFS Class: Immunosuppressant
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Reproductive hazard.
Degarelix
Table 2
AHFS Class: Hormone antagonist
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Reproductive/developmental hazard.
Diethylstilbestrol (DES)
Table 2
AHFS Class: Hormone
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Potent reproductive hazard.
Estrogen (oral tablets)
Table 2
AHFS Class: Hormone
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves when handling crushed or split tablets.
Finasteride
Table 2
AHFS Class: 5-alpha reductase inhibitor
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves. Women who are or may be pregnant must not handle crushed or broken tablets — absorbed through skin.
Flutamide
Table 2
AHFS Class: Antiandrogen
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Reproductive hazard.
Ganciclovir
Table 2
AHFS Class: Antiviral
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves, gown, eye protection. Reproductive hazard — teratogenic in animals.
Goserelin
Table 2
AHFS Class: Hormone agonist
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves. Reproductive hazard.
Leflunomide
Table 2
AHFS Class: DMARD
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Teratogenic — long half-life (active metabolite persists).
Lenalidomide
Table 2
AHFS Class: Immunomodulatory
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Severe teratogen — REMS program. Female workers of childbearing age must use contraception.
Leuprolide
Table 2
AHFS Class: Hormone agonist
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves. Reproductive/developmental hazard.
Megestrol
Table 2
AHFS Class: Progestin
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown for liquid form. Reproductive hazard.
Metotrexate (oral low-dose)
Table 2
AHFS Class: DMARD/Antineoplastic
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves when handling. Do not crush. Teratogenic at any dose.
Mycophenolate mofetil
Table 2
AHFS Class: Immunosuppressant
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Do not crush or open capsules. Teratogenic.
Nafarelin
Table 2
AHFS Class: Hormone agonist
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves. Reproductive hazard.
Nicotine (patch/gum)
Table 2
AHFS Class: Smoking cessation
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves when applying patches to patients. Avoid skin contact.
Oxytocin (injectable)
Table 2
AHFS Class: Oxytocic
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves for handling concentrated forms. Reproductive hazard.
Podophyllin
Table 2
AHFS Class: Antimitotic
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Teratogenic. Avoid all skin contact.
Pomalidomide
Table 2
AHFS Class: Immunomodulatory
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Severe teratogen — REMS program required.
Progesterone (injectable)
Table 2
AHFS Class: Hormone
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Reproductive hazard.
Raloxifene
Table 2
AHFS Class: Hormone antagonist
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves. Reproductive hazard.
Ribavirin
Table 2
AHFS Class: Antiviral
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves, gown, N95 mask if aerosolized. Teratogenic — female healthcare workers of childbearing age should avoid exposure.
Tacrolimus
Table 2
AHFS Class: Immunosuppressant
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Reproductive hazard.
Testosterone
Table 2
AHFS Class: Androgen
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves when applying topical forms. Absorbed through skin. Reproductive hazard.
Tretinoin (all-trans retinoic acid)
Table 2
AHFS Class: Retinoid/Antineoplastic
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves. Highly teratogenic — avoid all exposure in pregnancy.
Valganciclovir
Table 2
AHFS Class: Antiviral
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves and gown. Do not crush tablets. Reproductive hazard.
Zidovudine (AZT)
Table 2
AHFS Class: Antiretroviral
⚠ Reproductive/Developmental Hazard
PPE & Handling: Gloves. Reproductive hazard.