Oral medication can often be prescribed instead of intravenous options. Switching intravenous to oral administration can help to reduce the carbon footprint of clinical care, and has clinical, resource, and cost benefits. This article outlines the environmental benefits of oral over intravenous medications, and offers pointers on how to safely embed appropriate prescribing and intravenous to oral switches (IVOS) into clinical practice.
Overuse of intravenous medicines when oral formulations would be more appropriate is a global phenomenon, according to the World Health Organization.1 Intravenous medicines are associated with a higher rate of bloodstream and catheter related infections, require more nursing resources to administer, and are less comfortable for patients than oral equivalents. They are also more expensive (both for the medication and for the equipment required for administration).2
The carbon footprint of the manufacture and disposal of packaging is likely to be greater for all intravenous medications compared with their oral forms. Based on UK emissions data, one estimate of the carbon footprint of oral and intravenous paracetamol found that 1 g oral paracetamol (0.003 kg CO2e) used in the perioperative period had a 68-fold lower carbon footprint than 1 g intravenous paracetamol in glass packaging (0.193 kg CO2e) and a 45-fold lower footprint than 1 g intravenous paracetamol …