These procedures are the standards expected when handling Cytotoxic or Biotherapy for all staff within the CDHB. Any staff involved in Cytotoxic or Biotherapy management should be familiar with all procedures.

They are reviewed by the Canterbury Regional Cancer and Haematology Service Senior Nursing team.

If you have any queries please contact one of us, contact details are on the Our Staff page.

The CDHB has adopted antineoplastic drug administration procedures developed by eviQ. While these procedures cover all key aspects of administration, they DO NOT always reflect clinical practice within the Canterbury Regional Cancer and Haematology Service.

Therefore CRITICAL NOTES have been developed to highlight practice differences and must be used in conjunction with the CDHB policy and procedures. If you are unsure, please discuss with the senior nurses in your area.  

Safe Handling and Waste & Spill Management


As a minimum, you must don the following Personal Protective Equipment (PPE) when  handling any cytotoxic drugs that are administered as solutions.

  • Chemo protectant gloves. These are non-sterile gloves with reinforced finger tips & a long cuff. The current brand that is being is HALYARD.
  • Long sleeve impermeable gown that has a cuff.

Some situations may require the need to also don goggles/face shield and a mask.

As a miminum, you must don chemo protectant gloves when handling oral chemotherapy medication.

Safe Handling and Waste & Spill Management



Please follow the CDHB CVAD policy and use the IV administration procedure when administering intravenous cytotoxic drugs via a CVAD.

IV Administration

SC/IM Administration

Oral Administration

Cytotoxic Spill Kits

Are available from the Oncology Ward. Please note, if you require a spill kit in  an ongoing basis, please see the cytotoxic spill kit contents (below) to order items through the Oracle ordering system.

Cytotoxic spill kit contents 

Infusion Related Reactions

Please see local area procedures for managing infusion related reactions or refer to Hospital Health Pathways

Extravasation Management


There is conflicting evidence  around the use of antidotes when treating cytotoxic drug related extravasations. If this occurs in your area, please contact one of the pharmacists who work in the haematology/oncology areas for advice regarding the use of antidotes. See the 'Our Staff' page for contact details.

Extravasation Overview

Extravasation Management Table

Immediate Management Flow Chart

Extravasation Assessment Tool

Patient Information sheet

Care at home after extravasation - cold or warm compress

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Page last reviewed: 09 October 2018