Where should methotrexate be compounded?

Methotrexate is an antineoplastic medication used in the treatment of various cancers and autoimmune diseases. Due to its potential toxicity and the risk of contamination, it should be compounded in a controlled environment that ensures both safety for the technician and the integrity of the medication.

Compounding methotrexate in a biological safety cabinet is appropriate because these cabinets are specifically designed to protect both the healthcare worker and the environment from hazardous drugs. They provide a sterile work area while also ventilating harmful fumes or particles away from the operator. The cabinet employs HEPA filtration to ensure that air entering the work zone is contaminant-free, which is crucial when handling cytotoxic drugs like methotrexate.

Using a standard pharmacy area would not provide the necessary safeguards against exposure to hazardous materials. Compounding in a refrigerator, while important for the storage of some medications requiring refrigeration, does not address the safety concerns related to handling toxic substances. A laminar flow hood is primarily used for sterile compounding of non-hazardous medications and, while it can provide particle-free air, it does not offer the same level of protection against hazardous drug exposure as a biological safety cabinet specifically designed for such purposes. Thus, compounding methotrexate in a biological safety cabinet is