Empty vials of mtx --- in the trash? Does this seem right to you?

I asked my pharmacy what do I do with the empty or part empty vials of mtx? Do I put them in the sharps container? I was shocked when she told me to put them in the trash or with my empty glass recycling bin. She said do not place in the sharp containers. Does this seem right to you? My city fines us if we don't recycle properly. No glass with paper ....$50 fine...surely glass milk bottles and chemo drug vials do not go together...do they?

[MickeyJoints]

Hi Suzanne,

I was given a sharps bin for my Metoject. Filled it up and took it to the GP's surgery. They got rid of it.

If it's vials - not part of an injection mechanism - from which you draw-up the drug, I'd be tempted to drain them and put them in the glass disposal.

As for mixing the types of containers, I believe they clean them up and melt them again in a furnace to recover usable glass. So mixing milk bottles with vials is neither here nor there.

Local variations of recycling may mean you can't do that where you are...

[helixhelix]

How odd. What the problem with putting them in the sharps bin I wonder? I'd ask another pharmacist!

Are the vials even glass? Somerimes things come in a very hard plastic now.

Moving to France I was surprised that they only seem to have one type of sharps bin, whereas in U.K. there are different coloured ones for different levels of contamination. So there are strange variations across the world.

[Hidden in reply to helixhelix]

I've only notice the yellow sharp bins here, in Canada...but I'm not sure if they have different colour ones for different levels of contaminations. I never really paid attention before as I never had the need too.

I will ask another pharmacy about the vials as it does seem very odd to me to flush the left over drug or just put them in the glass recycling bin.

My neighbour got a $50.00 fine for putting chicken bones in the garbage!

We have to take ant poison containers to certain regulated places, but not chemo drugs? Strange....

[nomoreheels in reply to Hidden]

It's usually just the lid that's a different colour Sue, it's just the body of the bin that's yellow. This link is a guide as to what goes in which initial.co.uk/sharps-dispos.... As you'll see the purple is for cytotoxic & cytostatic sharps AND meds with cytotoxic contents.... I read that as vials. I must say I'm surprised you were told to put them in your household rubbish or glass/plastic recycle bins. x

[Frankiefarr]

My hospital would have a fit here if you did that. I am not even allowed to put a cotton swab in the rubbish, it has to be burnt.

If you are drawing up injections from a glass vial, to be honest I'd be questioning your consultant. That's a very old fashioned way of doing it and is banned here

[Hidden in reply to Frankiefarr]

Drawing up the injections from a glass vial is very old fashioned indeed. When I asked my rheumy about the metoject pens instead of the needle and vials, he told me they where recalled by Health Canada. I wonder if the recall was temporary? I see my rheumy on wednesday, I'll have to ask him.

[Cathy777 in reply to Hidden]

Oh that is so wrong. I was given strict instructions tgat my Mtx pens must be put in a sharps bin. I get this from my GP and once filled I return it for a new one. This drug is very poisonous and should be disposed of correctly. Please check with your surgery.

[Hidden in reply to Cathy777]

I too think it's wrong. I will be asking my rheumy on wednesday. I think the person at the pharmacy told me what she thought, not what was legal. If I find out the truth is different, then I will report her.

[Hidden in reply to Frankiefarr]

Wow - I would be in such trouble here then...

[Leonwp]

Good question i only had tablets and returned them but you raise a very interesting and important question. How about breaking the liquid into toilet to be treated as waste water, chemicals bleach etc is and putting empty vials in your glass recycling. Blessings. Leon

[Hidden in reply to Leonwp]

Hello Leon

We have to return ant poison containers and such to a specific regulated recycling place..so why not chemo drugs? I think the person at the pharmacy is wrong. I will ask another pharmacy or my rheumy this wednesday.

Peace to you

Sue

[AgedCrone in reply to Leonwp]

NO.....you must return all unused drugs to your local pharmacy to be disposed of safely (how they do that I don't know) but putting any drugs down the loo into the public sewer system is a real No No!

[Leonwp]

Thank you Sue im sure its a question many should have answered, my etanercept and cymzia have all been presealed jabs so once empty as tgey had needles they went in my sharps box but you make a very good point it is extremely toxic after all. Well done for raising it. Every day this forum surprises me. Blessings Leon.

[Hidden in reply to Leonwp]

Yes this forum is very informative, I would be lost without it. My hubby used to think it odd for me to ask advice from people who live in another country than me....but now he encourages me. It doesn't matter where we live when dealing with RA.

[Leonwp in reply to Hidden]

Absolutely right! One big global family of support, gentle hugs and kind words from genuine people who know and who care flying across the ether, maybe especially appropriate at this time of year, as i know for a fact Santa has RA and a difficult work schedule.

[Seenie]

Suzanne I'm in ontario and no way would I put those glass vials in the trash or in the glass recycling, mtx is nasty stuff. I was putting them in the sharps container until my pharmacist said to collect them separately and return them to the pharmacy They put them in with the unused drugs for disposal. That seemed correct to me.

[Hidden in reply to Seenie]

Thank you Seenie. That sounds logical to me, so I will return it back to the pharmacy.

I wanted to talk to another pharmacy but we had a freak major snow storm here in BC, the phone lines were down and I can't get out of my driveway.

[Seenie in reply to Hidden]

I heard that you are having white excitement on the lower mainland! I just collect the wee vials and take them back to where they came from. Hey, that's the same as taking empties back to the bottle shop! LOL

[Hidden]

Any glass vial should be put in the sharps especially if their is medication left in it. I would query this with your Rheumatology team .

[Frankiefarr]

I see some people mention the pens. How do they work. At the moment I receive the medication pre drawn up in individual doses. I have to attach the needle, then inject it. The complete unit is then put in the sharps bin. The rheumy was quite clear on this. Once the needle is attached it is a sealed unit. Is this different to the pens?

[nomoreheels in reply to Frankiefarr]

Very much different Frankie, I would think yours are fiddly to prep? I've been injecting MTX 7 years, initially a pre-filled syringe but now I'm prescribed it in pen form. This may help you, the video shows how to inject with the pen metoject.co.uk/healthcare-p...

[Hidden in reply to nomoreheels]

Thanks for the video information nomoreheels. I will be speaking with my rheumatologist on wednesday about proper disposal. I will also ask if the metoject pens are still on recall here.

[nomoreheels in reply to Hidden]

Recall Sue?

[Hidden in reply to nomoreheels]

Yes recall. Health Canada recalled metoject last year.

healthycanadians.gc.ca/reca...

[nomoreheels in reply to Hidden]

Oh I see! But as it only applied to one strength they recalled all strengths? I didn't know but then it wouldn't apply here, different manufacturer. Am I being thick, what is a machine stop?

[Hidden in reply to nomoreheels]

I don't have a clue what a machine stop is. Yes they recalled all strengths last year.

Maybe someone from Canada will comment and tell us if they are back on the market?

I will be asking my rheumy tomorrow.

[nomoreheels in reply to Hidden]

Maybe it's something like a general halt on manufacturing as a fault was found on the one strength.

I hope you can swap to pens, or even prefilled syringes, either would be easier than now for you. Maybe it's a cost thing, they'll be considerably more expensive than drawing it up yourself.

[Hidden in reply to Frankiefarr]

I too have to attach the needle to the syringe before I draw the mtx from the vial. Do you live in Canada? If not, have the metoject pens been recalled in your country?

[beeckey in reply to Frankiefarr]

Yes the pens are much better and very easy to use you just click it into where you inject then put it into a sharps bin

[ElizabethAnneM]

In UK as mtrx is a cytotoxic drug it has to be dealt with in a purple topped bin and then it is disposed of appropriately.

If anyone has the patience to go through this document it is all in there somewhere:-

gov.uk/government/uploads/s...

When my partner was on injections of mtrx. He had deliveries from the pharmacy and a waste collection service to take away the sharps and vials were all included in the sharps bin.

The costs for this are borne by the Clinical Commissioning Group. (in UK). Although I know some pharmacies will process purple bins if they are tight on budget they will do anything to avoid the costs.

I am on tablet form and once had a query and tipped the tablets from the pot to my hand and the pharmacist nearly had a coronary! I understand that handling any tablets is a no no (as sweat from your hands contaminates the pills) but as I only had a few left I deemed it ok to do on this occasion. I also commented that putting them down my throat was a serious enough risk any ingested drug via my hand was hardly likely to do me any further harm!

He laughed!

Always refer any questions about disposal to your Rheumy team. We really don't want any more of this stuff contaminating our water table than necessary.

[Frankiefarr]

Wow nomoreheels. That is different. I assume the reason we don't have them here is that damn postcode lottery again. I think it's a bit crazy that we expect RD sufferers to twist off the vial caps whilst holding the needle in the other hand and then twisting them together when they don't expect us to be able to do up our own shirt buttons!!!!