Published: 7 March 2024

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Medicine safety reminder: avoid unintentional poisoning in the home

Published 7 March 2024
Prescriber Update 45(1): 8–11
March 2024

Key messages

  • Some medicines can be highly toxic to people or pets, even in small amounts.
  • Young children are at particular risk of unintentional poisoning from medicines.
  • Consider safe prescribing strategies when prescribing medicines that are known to be harmful when used inappropriately.
  • Remind patients to:
    • keep all medicines out of sight and reach of children and pets
    • never share prescription medicines.


Substances found around the house, including medicines, are common causes of unintentional poisoning in children and pets.1,2 About 20 percent of families with pre-school age children experience a poisoning every year.3 However, it is important to remember that people of any age can be poisoned by medicines found in the home.4

Medsafe is also aware of fatal cases of poisoning from fluorouracil (5-FU) cream in pets in New Zealand and overseas.5 The New Zealand data sheet and consumer medicine information (CMI) for Efudix were recently updated with animal safety advice.6,7

General considerations

The risks associated with a poisoning will depend on several factors relating to the medicine (eg, the type and quantity of the medicine involved, the route of exposure) and individual characteristics such as age, weight, medical history.8–10

While most exposures are unlikely to have serious outcomes, some medicines can cause serious toxicity or death, even in very small amounts.9–11

Poisoning in children

More than half of calls to the New Zealand National Poisons Centre relate to children aged under 5 years, and children aged 1 to 3 years are the most likely age group to be poisoned. This includes poisoning from household chemicals and medicines.1

Table 1 lists some of the medicines most commonly reported to the National Poisons Centre for poisonings in children aged under 5 years.

Table 1: Examples* of medicines most commonly reported in poisonings of children aged under 5 years

Paracetamol Anti-inflammatories Thyroid medicines
Multivitamins Antihistamines Antibiotics
Oral contraceptives Cold and flu medicines  

* Not an exhaustive list.
Source: bpacNZ. 2022. Childhood poisonings: hazardous substances around the home November 2022. URL: bpac.org.nz/2022/docs/hazardous.pdf (accessed 15 January 2024).

Table 2: Examples* of medicines that can cause significant toxicity in children in small amounts (one or two tablets)
Class Examples
Calcium channel blockers Diltiazem, verapamil
Opioids Morphine, fentanyl
Tricyclic antidepressants Amitriptyline, nortriptyline
Sulfonylureas Glipizide, gliclazide
Anti-gout medicines Colchicine
* Not an exhaustive list.
Source: bpacNZ. 2022. Childhood poisonings: hazardous substances around the home November 2022. URL: bpac.org.nz/2022/docs/hazardous.pdf (accessed 15 January 2024).

Poisoning in pets

Pets metabolise many medicines differently from humans.12 Some medicines commonly used in humans are highly toxic to pets, for example, anti-inflammatories, paracetamol, cold and flu medicines, antihistamines, antidepressants and vitamins.2,11,12

Topical medicines (such as creams and ointments) can also be harmful when ingested by pets, including by licking if off the skin. Those containing 5-FU, calcipotriol or minoxidil are particularly harmful, even in small amounts.13

Safety advice

Consider safe prescribing strategies when prescribing medicines that are known to be harmful when used inappropriately.14

Remind patients to:

  • keep all medicines out of sight and reach of children and pets
  • never share prescription medicines
  • store medicines in their original containers and separately from food
  • put medicines away immediately after use
  • not rely on child-resistant caps (they are not child-proof)
  • safely dispose of old or unused medicines by returning them to the pharmacy.15,16

In addition, remind patients using topical medicines to:

  • avoid letting pets contact or lick the container or the skin where the medicine was applied
  • wash hands thoroughly after using
  • safely discard or clean any items (eg, cloths, applicators, clothing) that may contain medicine residue.6,13

More information

Medicine safety

Medicines

For more information about a particular medicine, see the data sheet and consumer medicines information (CMI): Search for a data sheet or CMI.

Poisons

For information about poisons or in case of child or pet poisoning, call:

Or seek advice from a health professional or vet.

References

  1. National Poisons Centre. Facts about childhood poisoning. URL: poisons.co.nz/articles-and-info/poisoning-issues-specific-to-young-children/view/facts-about-childhood-poisoning/ (accessed 15 January 2024).
  2. Animal Poisons Helpline. Most common animal poisons. URL: animalpoisons.com.au/common-poisons (accessed 15 January 2024).
  3. National Poisons Centre. Resources. URL: poisons.co.nz/resource/ (accessed 16 February 2024).
  4. Healthify. 2023. Preventing poisoning 18 August 2023. URL: healthify.nz/hauora-wellbeing/p/preventing-poisoning/ (accessed 19 February 2024).
  5. US Food & Drug Administration. 2023. Don't expose pets to prescription topical fluorouracil medicine for people 3 May 2023. URL: www.fda.gov/animal-veterinary/animal-health-literacy/dont-expose-pets-prescription-topical-fluorouracil-medicine-people (accessed 15 January 2024).
  6. iNova Pharmaceuticals (New Zealand) Limited. 2023. Efudix New Zealand Data Sheet 27 September 2023. URL: www.medsafe.govt.nz/profs/Datasheet/e/Efudixcr.pdf (accessed 15 January 2024).
  7. iNova Pharmaceuticals (New Zealand) Limited. 2023. Efudix New Zealand Consumer Medicine Information 27 September 2023. URL: www.medsafe.govt.nz/Consumers/CMI/e/efudix.pdf (accessed 15 January 2024).
  8. Animal Poisons Centre. Poisons information 24 hr hotline. URL: animalpoisonscentre.com.au/poisons-information-24-hr-hotline/ (accessed 19 January 2024).
  9. bpacNZ. 2022. Childhood poisonings: hazardous substances around the home November 2022. URL: bpac.org.nz/2022/docs/hazardous.pdf (accessed 15 January 2024).
  10. Starship Clinical Guidelines. 2017. Poisoning – management of childhood 13 June 2017. URL: starship.org.nz/guidelines/poisoning-management-of-childhood/ (accessed 15 January 2024).
  11. SPCA. Human drugs that can poison your dog. URL: www.spca.nz/advice-and-welfare/article/human-drugs-that-can-poison-your-dog (accessed 19 January 2024).
  12. Animal Poisons Helpline. Paracetamol and your pet. URL: animalpoisons.com.au/news/paracetamol-and-your-pet (accessed 15 January 2024).
  13. Animal Poisons Helpline. Are they toxic or not? URL: animalpoisons.com.au/news/are-they-toxic-or-not (accessed 15 January 2024).
  14. bpacNZ. Safer prescribing of high-risk medicines. bpacNZ Article series. URL: bpac.org.nz/Series/pdf/safer-prescribing.pdf (accessed 19 February 2024).
  15. National Poisons Centre. Preventing poisoning in the home. URL: poisons.co.nz/articles-and-info/common-poisons-around-the-home/view/preventing-poisoning-in-the-home/ (accessed 15 January 2024).
  16. National Poisons Centre. Pets get poisoned too. URL: poisons.co.nz/articles-and-info/poisoning-issues-specific-to-other-family-members/view/pets-get-poisoned-too/ (accessed 15 January 2024).
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