Oral Cancer Drug Therapy

Building on the Oral Cancer Drug Therapy Safe Use and Safe Handling Guideline CAPCA released in September 2015, we are pleased to share the Safe Use and Handling of Oral Anti-Cancer Drugs (OACDs) in Community Pharmacy: A Pan-Canadian Consensus Guideline to more wholly meet the specific needs of the community pharmacy sector.


Different types of cancer are treated with chemotherapy, an approach that uses powerful chemical agents to kill fast-growing cancer cells. While many patients benefit from this type of treatment, the use of chemotherapy drugs must be strictly controlled because of their toxic properties.

Regardless of whether it is given intravenously or orally, chemotherapy treatment carries the risk of side effects and drug toxicity (overdose or adverse drug reaction). Intravenous chemotherapy treatment is administered in Canadian hospitals and cancer clinics by trained health care providers who follow established protocols for safe drug use and handling and conduct close patient monitoring.

Oral cancer drug therapies enable patients to self-administer their cancer treatment at home. This offers many advantages to patients and helps the system respond more efficiently to the demand for treatment services. However, this approach may increase the risk to some patients because it relies on the patient and family to safely handle drugs, follow complex dosing instructions and independently monitor for side effects. It also depends on a range of providers outside the hospital environment to safely prescribe and dispense chemotherapy drugs.

The growing availability and use of oral cancer drug therapy has highlighted a lack of standardized processes, safeguards and standards for the use and handling of these drugs.

Though CAPCA released a safe handling of OACDs guideline in 2015 to address system wide issues, we recognized that it did not adequately address the specific needs of those working in community rather than cancer specific pharmacies. As such, we have worked collaboratively with the community pharmacy sector to develop a guideline that is specific to this setting.

Development of our Safe Use and Handling of Oral Anti-Cancer Drugs (OACDs) Guidelines

For both the 2015 and 2017 OACD guidelines we followed a development process that included a review of existing literature, key informant interviews and an expert workshop to create, review and finalize each set of recommendations. The external review process for both guidelines engaged more than 70 organizations in Canada and the US with a mandate in patient or medication safety, occupational health and safety, transportation of hazardous drugs, and/or pharmacy practice.

In addition to the process described above, the new Safe Use and Handling of Oral Anti-Cancer Drugs in Community Pharmacy guideline engaged an equal number of experts from the cancer system as the community pharmacy sector to more specifically tailor the recommendations for their unique context.

Use of the Guideline

Please review both guidelines within the context of the setting in which you work, and distribute them as widely as possible throughout your networks. Both guidelines have limited their scope to OACDs, but we recognize that many of these recommendations could be applied to the safe handling of many other hazardous drugs and encourage their use within a broader context.


We welcome any questions or comments about the guideline and its development, please contact Gunita Mitera, CAPCA ED, at gmitera@capca.ca.

Guideline Links:

2015 Oral Cancer Drug Therapy Safe Use and Safe Handling Guideline

2017 Safe Use and Handling of Oral Anti-Cancer Drugs (OACDs) in Community Pharmacy A Pan-Canadian Consensus Guideline