CHEMOTHERAPY PREPARATION AND STABILITY CHART

BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART
DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special
(Storage Prior to Use, With: Stability Precautions/Notes
Manufacturer, Preservative
Status)
Aldesleukin
22 million IU 1.2 mL SWI1,2 18 million IU/mL 48 h F1 50 mL D5W1 48 h F1 - cytotoxic3
(1.3 mg) (1.1 mg/mL)1,2 - do not use in-line
(Novartis) direct diluent against 30 – 70 mcg/mL1 filter1,2
(F)(PFL) side of vial during - avoid
no preservative1 reconstitution1 < 30 mcg/mL: dilute in bacteriostatic water
D5W containing for injection or NS
do not shake1 human albumin 0.1%2 due to increased
aggregation1

Alemtuzumab - cytotoxic7
5 6
30 mg/mL N/A filter NOT required discard unused SC syringe discard at the end of - do not shake8
(Genzyme previously portion5 the day F or RT
Bayer)4 30 mg/mL5
(F)(PFL)
do not shake
no preservative5

100 mL NS or D5W5 8 h F or RT5

**(PFL)8

Alemtuzumab
30 mg/3 mL N/A use 5 micron filter discard unused SC syringe6 discard at the end of - cytotoxic7
(Schering/Ilex) to withdraw drug portion9 the day F or RT8 - do not shake8
(F)(PFL) from ampoule8
do not shake
no preservative9 10 mg/mL9

BC Cancer Agency Chemotherapy Preparation and Stability Chart© version 2.00 1/77
Activation Date: 2 March 2006
Revised Date: 1 July 2010

Status)

100 mL NS or D5W9 8 h F or RT8

**(PFL)8

Amifostine
500 mg 9.7 mL NS only10 50 mg/mL10 24 h F, 5 h RT10 25–50 mL*NS only10 5–40 mg/mL: - noncytotoxic10
(MedImmune) 24 h F,10 5 h RT - discard cloudy
(RT) solution11
no preservative10

Amsacrine
75 mg/1.5 mL glass syringes 5 mg/mL12 24 h RT12 500 mL D5W12 7 d F, 48 h RT12,13,14 - cytotoxic15
(Erfa Canada) preferred during
(RT) reconstitution; PFL12 (plastic or glass
no preservative12 max. time in plastic container)12
syringe12: 15 min

13.5 mL supplied
diluent (L-lactic
acid)1

transfer 1.5mL from
ampoule into the
diluent vial12


Status)
Asparaginase16
(asparaginase E. coli) do not shake; roll to 2500 units/mL16 48 h F, RT16 syringe16 14 d F20, 16 - cytotoxic3
10,000 units reconstitute18,11
(Orphan 4 mL SWI19
Pharmaceutical Intradermal test11:
International)  Reconstitute with
(F) 5 mL SWI to give
no preservative17 2000 units/mL
 Transfer 0.1 mL to
10 mL vial (or 12
mL syringe)
 Add 9.9 mL SWI
roll to dissolve to
give 20 units/mL
 2 unit test dose =
0.1 mL
(Note: the rest of the
reconstituted vial
has a concentration
of 2000 units/mL)11

50 mL*NS or D5W20,13 14 d F,20,13 2 d RT20,21


Status)
Erwinia asparaginase
(asparaginase Erwinia do not shake; roll to 10000-5000 15 min in original glass or 8 h in a glass or - cytotoxic3
chrysanthemi) reconstitute22 units/mL container; 8 h in a polypropylene polypropylene
10,000 units glass or syringe22 syringe22
(Orphan 1-2 mL NS22 polypropylene
Pharmaceuticals syringe22
International)
(F)
no preservative22


Status)
PEG-asparaginase
(pegasparagase) N/A 750 units/mL23 discard unused IM: maximum volume syringe: 4 h23,24 - cytotoxic3
(pegylated portion23 2 mL; if >2 mL use - discard cloudy
asparaginase E. coli) multiple sites23 solution23
750 units/mL - do not shake23
(Enzon) - do not use if
(F) stored out of
no preservative23 refrigerator for > 48
h23
- do not use if
previously frozen23

IV: 100 mL NS or bag: 4 h23,24
D5W23


Status)
Azacitidine
100 mg 4 mL SWI25 25 mg/mL25 8 h F, SC syringe25 45 min RT25 - cytotoxic3
(Celgene) 45 min RT25
(RT) shake vigorously25 prepare immediately - discard if contains
no preservative25 before use and use large particles25
within 45 min, or
discard. - re-suspend
syringe contents
before injection by
vigorously rolling
syringe between
palms25
BCG
81 mg do not shake; roll to 10.5 ± 8.7×108 2 h F, RT26 50 mL NS26 2 h F or RT after - cytotoxic7
(Sanofi Pasteur) reconstitute26 CFU/vial reconstitution26
(F)(PFL) (Connaught
preservative26 3 mL supplied strain)26 **(PFL)26
diluent26

record time of
reconstitution


Status)
BCG
(Tice substrain) 1 mL preservative 1 to 8×108 2 h F (PFL)27 transfer from vial to 2 h F27 - cytotoxic3
50 mg = 1 to 8 x 108 free NS for CFU/vial27 60 mL syringe, rinse - overfill unknown
CFU injection27 vial with another 1 mL - protect from
(Hospira/Organon) NS. Add rinse to light27
(F)(PFL) use reconstitution same 60 mL syringe. - do not filter27
no preservative27 device provided qs to 50 mL with NS27

allow to stand for a
few minutes, then
gently swirl to
suspend27


Status)
Bendamustine
25 mg single-use vial 25 mg vial: add 5 5 mg/mL28 30 minutes28 500 mL NS28 24 h F, 3 h RT28 - cytotoxic3
100 mg single-use vial mL SWI
(Cephalon) 100 mg vial: add 20 0.2-0.6 mg/mL28
(RT)(PFL) mL SWI28
no preservative28
Shake well to yield a
clear, colourless to a
pale yellow solution.
Expected to
completely dissolve
within 5 minutes28

Bevacizumab
100 mg/4 mL N/A 25 mg/mL29 discard unused 1.4-16.5 mg/mL30 48 h F, RT21,29,30 - cytotoxic7
400 mg/16 mL portion29 - do not shake29
(Roche) 100-250 mL NS
(F)(PFL) only29,30
do not shake
no preservative29
Bleomycin
15 IU 6 mL*NS31 2.5 IU/mL 48 h F31 50 mL*NS31 24 h RT31 - cytotoxic7
(NB: dose in units only) - no overfill32
(Bristol)
(F)
no preservative31


Status)
Bleomycin
15 IU 6 mL*NS or SWI33 2.5 IU/mL33 48 h F, 24 h RT33 50 mL *NS, SWI33 24 h RT34 - cytotoxic7
(NB: dose in units only) - no overfill35
(Hospira)
(F)(PFL)
no preservative33
Bortezomib
3.5 mg 3.5 mL NS36 1 mg/mL36 2d RT13,37 syringe36 8 h RT38 - cytotoxic7
(Ortho Biotech formally
Millennium)
(RT)(PFL)
no preservative36


Status)
Busulfan
60 mg/10 mL N/A use 5-micron nylon discard unused NS or D5W (dilute in complete - cytotoxic7
(Orphan Medical) filter provided with portion39 volume 10 times the administration within
(F) ampoule to busulfan volume to ~ 12 h F: NS39
no preservative39 withdraw drug39 0.5 mg/mL)39 8 h RT: NS, D5W

6 mg/mL39

Carboplatin
50 mg/5 mL N/A 10 mg/mL40 discard unused 0.3-10 mg/mL41 24 h RT,42 48 h F40 - cytotoxic7
150 mg/15 mL portion40 - do NOT use
450 mg/45 mL NS, D5W11,40 aluminum-
(Hospira) containing needle,
(RT)(PFL) do NOT use syringe or tubing41
no preservative40 aluminum-containing
needle or syringe41

Carboplatin
50 mg/5 mL N/A 10 mg/mL43 discard unused 0.5-10 mg/mL44 8 h RT43 - cytotoxic7
150 mg/15 mL portion RT43 - do NOT use
450 mg/45 mL NS, D5W11,43,45 aluminum-
(Novopharm) containing needle,
(RT)(PFL) do NOT use syringe or tubing43
no preservative43 aluminum-containing
needle or syringe43


Status)
Carmustine
100 mg 3 mL diluent 3.3 mg/mL in 10% 24 h F, 8 h RT46 glass46 or polyolefin 24 h F: in glass,46 or - cytotoxic7
(Bristol Labs) (supplied)46 ethanol46 container11 polyolefin container11 - do not use if
(F) product has oily
no preservative46 diluent to reach RT, 500 mL NS or D5W46 use within 4 h of droplets46
then dissolve drug reconstitution RT46
with 3 mL diluent;
add 27 mL SWI46

record time of
reconstitution

Cetuximab
100 mg/50 mL N/A 2 mg/mL47 discard unused syringe47 12 h F, 8 h RT47 - cytotoxic3
200 mg/100 mL portion after 12 h - administer with a
(ImClone/BMS) F, 8 h RT47 0.2 or 0.22 micron
(F) low protein binding
do not dilute sterile evacuated 12 h F, 8 h RT47 in-line filter47
do not shake container or bag e.g. - normal saline
no preservative47 polyolefin, may be used to
polyethylene, flush the line47
ethylene vinyl - solution may
acetate, DEHP contain white
plasticized PVC, PVC particulates which
bag, or glass47 do not affect
product quality47


Status)
Cisplatin
10 mg/10 mL N/A 1 mg/mL48 48 h RT49 < 60 mg: 100 mL NS* 48 h RT49 - cytotoxic7
50 mg/50 mL > 60 mg: 250 mL NS* - do NOT use
100 mg/100mL aluminum-
(Hospira) 500 or 1000 mL *NS, containing needle,
(RT)(PFL) D5-NS, D5-1/2S; D5- syringe or tubing48
no preservative48 NS with mannitol; D5-
1/2S with
mannitol48,50; D5W-
1/3S with mannitol48

do NOT use
aluminum-containing
needle or syringe48

Cladribine
10 mg/10 mL N/A 1 mg/mL51 discard unused SC syringe52 48h F, end of day - cytotoxic7
(Janssen-Ortho) portion51 RT13,51,53,54 - shake vigorously
(F)(PFL) cassette51 to dissolve any
no preservative51 precipitates from
refrigeration11
- bacteriostatic NS
contains benzyl
alcohol51

500 mL NS only51 24 h RT51

Do NOT use D5W51


Status)

qs to 100 mL with at least 7 days51
bacteriostatic NS
only via SIMS
DELTEC INC.
MEDICATION
CASSETTES®51; filter
drug and diluent
through 0.22u filter as
each solution is being
introduced into the
medication

Clodronate
300 mg/10 mL N/A 30 mg/mL discard unused 500 mL NS or D5W55 12 h RT55 - noncytotoxic
(Oryx) portion55
(RT)
no preservative55


Status)
Cyclophosphamide
200 mg NS56 20 mg/mL56 72 h F,56,57 24 h < 1 g: 100 mL NS* 72 h F,56,57 24 h RT56 - cytotoxic7
500 mg RT56 > 1 g: 250 mL NS*
1000 mg 200 mg: 10 mL high dose in BMT:
2000 mg 500 mg: 25 mL may need 500 NS*
(Baxter) 1000 mg: 50 mL
(RT)(PFL) 2000 mg: 100 mL56 NS, D5W, D5NS56
no preservative56

Cyclosporine N/A 50 mg/mL58 discard unused NS, D5W58 dilute immediately prior - cytotoxic3
50 mg/1 mL portion58 to use58
250 mg/5 mL dilute to concentration
(Novartis) between 1:20 and - polyoxyethylated
(RT)(PFL) 1:10058 castor oil/ethanol
no preservative58 vehicle58

- do NOT
refrigerate or
freeze58

- use non-PVC bag
and tubing59


Status)
Cytarabine
100 mg/1 mL N/A 100 mg/mL60 24 h RT60 100 mL*NS, Water for 72 h F, 24 h RT from - cytotoxic7
1000 mg/10mL Injection, D5W, initial vial puncture60 - do not use for IT
2000 mg/20mL record time of Lactated Ringer’s60 injection
(Hospira) puncture
(RT)(PFL)
no preservative60

Cytarabine
IT injection60 N/A 100 mg/mL60 24 h RT60 diluents containing use within 4 h of initial - cytotoxic7
100 mg/1 mL preservatives should vial puncture11,13 - auxiliary label62:
1000 mg/10mL record time of NOT be used for “IT”
2000 mg/20mL puncture intrathecal - label to include
(Hospira) administration60 route in full (i.e.,
(RT)(PFL) INTRATHECAL
no preservative60 qs to 6 mL with injection) attached
preservative free NS61 to both syringe and
outer ziplock bag62


Status)
Cytarabine
SC injection: 100 mg: 5 mL BWI63 100 mg: 48 h RT63,64 syringe 14 d F, 48 h RT64 - cytotoxic7
100 mg 20 mg/mL63 - for high dose
(Pfizer) use, do not use
(RT)(PFL) diluent containing
no preservative63 benzyl alcohol65
- do not use for IT
injection

Dacarbazine
100 mg 100 mg: 9.9 mL 10 mg/mL66 72 h F, 8 h RT66 250-500 mL*NS or 24 h F, 8 h RT66 - cytotoxic7
200 mg SWI66 D5W - protect container
(Abraxis) 200 mg: 19.7 mL **(PFL)11,66 from light during
(F)(PFL) SWI66 see Special storage and
no preservative66 Precautions/Notes administration67
Column - overfill unknown

Dacarbazine
200 mg 200 mg: 19.7 mL 10 mg/mL68 48 h F, 8 h RT68 0.19–3.0 mg/mL13,68 24 h F68 - cytotoxic7
600 mg SWI68 - protect container
(Hospira) 600 mg: 59.1 mL (PFL)69 250-500 mL*NS or **(PFL)67 from light during
(F)(PFL) SWI68 D5W see Special storage and
no preservative68 Precautions/Notes administration67
Column - no overfill69,35


Status)
Dactinomycin
0.5 mg 1.1 mL 0.5 mg/mL71 24 h F, RT72 syringe71,73 24 h F, RT
74
- cytotoxic3
(Ovation)70 SWI(preservative (500 mcg/mL) - do not filter71,73
(RT)(PFL) free)71 .
no preservative71
Do NOT use SWI
with preservative
(may form
precipitate)71

Status)
Daunorubicin
20 mg 4 mL SWI75 5 mg/mL75,78 48 h F, 24 h RT77 100-250 mL in 24 h RT, 48 h F75 - cytotoxic3
(Erfa Canada Inc.)75 isotonic solution e.g.,
(RT)(PFL)76 NS75
no preservative77
no data for D5W77


Status)
Daunorubicin
20 mg 4 mL SWI79 5 mg/mL79 24 h RT, 48 h F79 100-250 mL 48 h F, 24 h RT79 - cytotoxic7
(Novopharm) NS or D5W11
(RT)(PFL) (PFL)79 **(PFL)79
no preservative79
Dexrazoxane
250 mg supplied diluent80: 10 mg/mL80 6 h F80 empty viaflex bag80 6 h RT81 - cytotoxic82
500 mg 250 mg: 25 mL
(Pfizer) 500 mg: 50 mL
(RT)
no preservative80
Docetaxel
20 mg/0.5 mL supplied diluent : 10 mg/mL83 48 h F, RT13,85 0.3–0.74 mg/mL complete - cytotoxic7
80 mg/2 mL - if vials were administration within - non-PVC bag and
(Sanofi-Aventis) refrigerated, allow to (e.g., 250 mL NS or 4 h F,83 48 h RT86,87 tubing only83
(F, RT) (PFL) warm for 5 min at D5W)83
no preservative83 RT. Withdraw entire
contents of the
diluent and inject the
entire contents of
the syringe into the
corresponding
concentrate vial. Mix
by repeated
inversions for 45 sec
DO NOT SHAKE
Let sit for 5
minutes83,84


Status)

Doxorubicin
10 mg NS, SWI, D5W88 2 mg/mL88 48 h F, 24 h syringe88 48 h F, 24 h RT13,89 - cytotoxic7
50 mg (NS reconstitution RT13,88
150 mg takes longer)
(Hospira) 10 mg: 5 mL
(RT)(PFL) 50 mg: 25 mL
no preservative88 150 mg: 75 mL

0.2–2 mg/mL90 48 h F, 24 h RT13,90

100 mL*NS88


Status)
Doxorubicin
10 mg/5 mL N/A 2 mg/mL 8 h91 syringe91 48 h F, 24 h RT91 - cytotoxic7
20 mg/10 mL from initial vial
50 mg/25 mL record time of puncture
200 mg/100 mL puncture
(Novopharm)
(F)(PFL)
no preservative91

Doxorubicin
10 mg/5 mL N/A 2 mg/mL92 discard unused syringe92 48 h F, 24 h RT92 - cytotoxic3
50 mg/25 mL portion92,74
200 mg/100 mL
(Pfizer)
(F)
no preservative92

Doxorubicin
Pegylated Liposomal N/A 2 mg/mL93 discard unused < 90 mg: 250 mL 24 h F93 - cytotoxic7
20 mg/10 mL portion93 D5W only93 - do not filter93
50 mg/25 mL
(Schering) ≥ 90 mg: 500mL D5W
(F) only
no preservative93


Status)
Epirubicin
10 mg/5 mL N/A 2 mg/mL94 8 h94 syringe94 48 h F, 24 h RT from - cytotoxic7
50 mg/25 mL initial vial puncture94
200 mg/100 mL record time of
(Pfizer) puncture
(F)(PFL)
no preservative94

100 mL*NS or D5W11 2 d F, RT: NS or
D5W49


Status)
Etoposide
100 mg/5 mL N/A 20 mg/mL95 14 d RT11,13,96,97,98 0.2– 0.4 mg/mL95 0.2 mg/mL: - cytotoxic7
500 mg/25 mL 48 h RT13,95 - use non-PVC bag
1000 mg/50 mL 500 mL*NS or D5W95 0.4 mg/mL: and tubing only
(BMS) 24 h RT95
(RT)
preservative95

Etoposide 0.2-0.3 mg/mL:
100 mg/5 mL N/A 20 mg/mL99 discard unused NS 7 d F,100 2 d RT87,100 - cytotoxic7
200 mg/10 mL portion99 0.4-0.5 mg/mL: - use non-PVC bag
500 mg/25 mL Stabilty is 1 d F,100 1 d RT100 and tubing only
1000 mg/50 mL concentration 0.6-9.0mg/mL:
(Novopharm) dependent generally unstable100
(RT)(PFL) 9.5 mg/mL:
no preservative99 2 d F,100 1d RT100
10-12 mg/mL:
7 d F,100 2 d RT87,100

D5W99 4 h RT99,101


Status)
Fludarabine
50 mg 2 mL SWI102 25 mg/mL102 48 h F or RT13,49 dilute to maximum of 48 h F, RT13,49 - cytotoxic7
(Berlex) 1 mg/mL102,103
(F)
no preservative102 100 mL*NS or D5W102

Fludarabine
50 mg N/A 25 mg/mL104 discard unused dilute to maximum of 48 h F, 24 h RT104 - cytotoxic7
(Novopharm) portion104 1 mg/mL104
(F)
no preservative104 100 mL*NS or D5W


Status)
Fluorouracil
5000 mg/100 mL N/A 50 mg/mL105 8 h RT105,106 syringe13 48 h RT13,21,106 - cytotoxic7
(Hospira)
(RT)(PFL)
no preservative105

2-10 mg/mL in 24 h RT105,106
D5W105,106

50-1000 mL*D5W

CIVI: ambulatory complete within
pump106 8 d11,13,107


Status)

Gemcitabine
200 mg 200 mg: 5 mL NS 38 mg/mL108 48 h RT108,109 syringe108 48 h RT,13,108,109 - cytotoxic7
1000 m g 1000 mg: 25 mL
(Eli-Lilly) NS108
(RT)
no preservative108

0.1–10 mg/mL 48 h F, RT13,108,109
NS108,109


Status)
Gemcitabine
200 mg 200 mg vial: 5 mL 38 mg/mL110 48 RT110,112,74 syringe110 24 h RT110,112 - cytotoxic7
1000 mg NS
2000 mg 1000 mg vial: 25 mL
(Hospira) NS
RT110 2000 mg vial: 50 mL
no preservative111 NS110

26 mg/mL-0.1 mg/mL 48 h RT112,74
NS110,112

Gemcitabine
200 mg 200 mg vial: 5mL 38 mg/mL114 24 h RT114 38 mg/mL – 0.1 24 RT114 - cytotoxic7
1000 mg NS mg/mL NS114
(Novopharm) 1000 mg vial: 25 mL
RT NS114
no preservative113

Gemcitabine
200 mg 200 mg vial: 5 mL 38 mg/mL115 48 h RT115,116 syringe115 48 h RT115,117,116 - cytotoxic7
1000 mg NS
(Sandoz Standard) 1000 mg vial: 25 mL
RT NS115
no preservative115


Status)

38 mg/mL-0.1 mg/mL 48 h RT13,119
NS or D5W115,118


Status)
Idarubicin
5 mg vial under negative 1 mg/mL120 48 h F,120 24 h RT syringe 48 h F,13, 120 24 h RT13 - cytotoxic7
10 mg pressure120 (PFL)120 (PFL)120
(Pfizer)
(RT)(PFL) 5 mg: 5 mL SWI
no preservative120 10 mg: 10 mL
SWI120
Idarubicin
5 mg/5 mL N/A 1 mg/mL120 same as syringe Discard 48 h F,13,120 24 - cytotoxic7
10 mg/10 mL reconstituted h RT13
20 mg/20 mL solution121 (PFL)120
(Pfizer)
(F)(PFL)
no preservative120
Ifosfamide
1000 m g 1000 mg: 20 mL 50 mg/mL122 48 h F13,122 0.6–20 mg/mL122 72 h F122 - cytotoxic7
3000 mg SWI122 24 h F, RT when mixed
(Baxter) 3000 mg: 60 mL 500–1000 mL*NS, with mesna11
(RT) 11 SWI D5W, D5-NS,
no preservative122 D5-1/2NS, Lactated D5W or Lactated
shake well Ringer’s11,122 Ringer’s when mixed

Interferon Alfa -2b
18 million IU/3 mL N/A 6 million IU/mL123 48 h F13,123 syringe123 2 d F13,124 - cytotoxic7
(Schering)
(F)(or up to 7 days at
RT before use)
no preservative123


Status)

≥ 0.3 million IU/mL123 24 h F, RT124

50 mL NS123

Interferon Alfa -2b
25 million IU/2.5 mL N/A 10 million IU/mL123 48 h F13,123 syringe123 2 d F13,124 - cytotoxic7
(Schering)
(F)(or up to 7 days at
RT before use)
no preservative123

≥ 0.3 million IU/mL123 24 h F, RT124

50 mL NS123

Interferon Alfa -2b
10 million IU 1 mL supplied 10 million IU/mL123 24 h F123 syringe123 24 h F, RT124 - cytotoxic7
(Schering) diluent (SWI) 123
(F)
no preservative123 do not shake; roll to
reconstitute123

> 0.1 million IU/mL124 48 h RT11,13

100 mL NS125


Status)

1 mL BWI123 48 h F, RT13,123 syringe125 14 d F, 48 h RT13,125

do not shake; roll to
reconstitute123

100 mL NS125 48 h RT11,13

Interferon Alfa -2b
18 million IU 1 mL supplied 18 million IU/mL123 24 h F123 syringe123 24 h F, RT124 - cytotoxic7
(Schering) diluent123
(F)
no preservative123 do not shake; roll to
reconstitute123

> 0.1 million IU/mL126 48 h RT11,13

100 mL NS125

1 mL BWI123 48 h F, RT13 syringe123 14 d F13,125

do not shake; roll to
reconstitute123

100 mL NS125 48 h RT11,13


Status)
Irinotecan
40 mg/2 mL N/A 20 mg/mL127 2 days RT13,128,129 0.12– 2.8 mg/mL127 24 h RT: D5W, NS127 - cytotoxic7
100 mg/5 mL - do NOT
500 mg/25 mL 500 mL11 D5W 48 h F: D5W refrigerate if in
(Hospira) (preferred), NS127 (PFL)127 NS130
(RT)(PFL)
no preservative127

Irinotecan
40 mg/2 mL N/A 20 mg/mL130 discard unused 0.12– 2.8 mg/mL130 24 h RT: D5W, NS130 - cytotoxic7
100 mg/5 mL portion130 - do NOT
(Pfizer) 500 mL11 D5W 48 h F: D5W refrigerate if in
(RT)(PFL) (preferred), NS130 (PFL)130 NS130
no preservative130

Irinotecan
40 mg/2 mL N/A 20 mg/mL131 discard unused 0.12-2.8 mg/mL131 24 h RT: D5W NS131 - cytotoxic3
100 mg/5 mL portion131,74 48 h F: D5W131
(Sandoz) D5W (recommended)
(RT)(PFL) NS131 (PFL)131
no preservative131


Status)
Ixabepilone
15 mg 8 mL supplied 2 mg/mL 1 h RT132 0.2 – 0.6 mg/mL in 6 h RT132 - cytotoxic3
(contains 16 mg) diluent Lactated Ringer’s - use 0.2-1.2
45 mg Injection USP (use micron in-line
(contains 47 mg) 23.5 mL supplied 2 mg/mL non-PVC infusion filter132
(BMS) diluent container)132 - use non-PVC
(F)(PFL) (i.e., DEHP-free)
no preservative132 administration
set132

Leucovorin
50 mg/5 mL N/A 10 mg/mL133 5 mL vial: discard syringe134 7 d F134 - noncytotoxic
500 mg/50 mL unused portion133 48 h RT87,134
(Hospira)
(F)(PFL) 50 mL vial: 8 h
no preservative133

0.05-10 mg/mL133 24 h RT133: NS, D5W,
Lactated Ringer’s,
Ringer’s

50-250 mL* NS, 8 h RT133: D10W, D5-
D5W, Lactated NS
Ringer’s, Ringer’s,
D10W, D5-NS


Status)
Leucovorin
50 mg/5 mL N/A135 10 mg/mL135 5 mL vial: discard syringe 8 h135,13 - noncytotoxic
500 mg/50 mL unused portion135
(Novopharm)
(F)(PFL)135 50 mL vial:
discard unused
portion135

0.060-1.0 mg/mL135 24 h RT NS, Lactated
Ringer’s, Ringer’s135

50-250 mL* NS, 12 h RT D5W,
D5W, Lactated D10W135
Ringer’s, Ringer’s,
D10W, D10NS135 6 h RT D5NS135


Status)
Mechlorethamine
10 mg do NOT use if 1 mg/mL136 use within 4 h of syringe136 complete - cytotoxic7
(Ovation discoloured or water reconstitution administration
Pharmaceuticals/Merck) droplets form in vial RT11,13 4 h of reconstitution
no preservative136 before RT11,13,136
reconstitution136

10 mL SWI or NS136

record time of
reconstitution

100 mL NS49,136 complete
administration within
4 h of reconstitution
RT13,49,136


Status)
Medroxyprogesterone
250 mg/5 mL N/A 50 mg/mL18 use within 4 h of syringe: IM only18 use within 4 h of initial - cytotoxic7
(Pfizer) initial vial puncture11,137 - auxiliary label:
(RT) record time of puncture11,137 shake before use18
preservative18 puncture

Medroxyprogesterone
Depo N/A 150 mg/mL18 use within 4 h of syringe: IM only18 use within 4 h of initial - cytotoxic7
150 mg/1mL initial puncture11,137 - auxiliary label:
(Pfizer) record time of puncture11,137 shake before use18
(RT) puncture
preservative18
Melphalan
50 mg 10mL supplied 5 mg/mL138 2 h RT138 0.1– 0.45 mg/mL in complete - cytotoxic7
(GSK) diluent138 NS only138 administration within
(RT)(PFL) do NOT 60 min from time of
no preservative138 immediately after refrigerate (e.g., > 45 mg and < initial reconstitution at
adding diluent, 110 mg in 250 mL RT11
shake vigorously138 NS)*

record time of
reconstitution


Mesna
1000 mg/10mL N/A 100 mg/mL139 14 d F, RT13,139 > 1mg/mL139 48 h F, 24 h RT139 - noncytotoxic
(PPC)
(RT) NS or D5W
preservative139

Methotrexate
50 mg/2mL N/A 25 mg/mL140 50mg: discard syringe 2 d F, RT11,141,142 - cytotoxic7
500 mg/20mL unused portion140 - for high-dose
1 g/40mL regimens (e.g., 1-8
5 g/200mL 500mg, 1 g, 5 g: g/m2 as a single
(Hospira) 8 h F, RT140 dose)143 use
(RT)(PFL) preservative-free
no preservative140 methotrexate11
- do not use for IT
injection

0.4–2 mg/mL140 24 h RT140

100 mL*
NS, D5W

high dose (e.g., 1-8
g/m2 as a single
dose)143,144-146: 500–
1000 mL*


Methotrexate
IT Injection140: N/A 25 mg/mL140 discard unused qs to 6 mL with use within 4 h of initial - cytotoxic7
Only preservative free portion140 preservative free NS61 puncture11,13 - auxiliary label62:
methotrexate may be “IT”
administered by the - label to include
intrathecal route140 route in full (i.e.,
50 mg/2mL147 INTRATHECAL
(Hospira) injection) attached
(RT)(PFL) to both syringe and
no preservative140 outer ziplock bag62

Methotrexate
50 mg/2mL N/A 25 mg/mL140 24 h F141 syringe 14 d F87,141 - cytotoxic7
500 mg/20mL - high-dose
(Hospira) regimen(e.g., 1-8
(RT)(PFL) g/m2 as a single
preservative140 dose)144-146: use
preservative-free
methotrexate11
- do not use for IT
injection

0.4–2 mg/mL140 4 h RT140

e.g., 100 mL*NS,
D5W140

Mitomycin
5 mg SWI 0.5 mg/mL148 48 h F, RT13,148 syringe13 14 d F, 48 h RT13,148 - cytotoxic7
20 mg 5 mg: 10 mL (PFL)148
(Novopharm) 20 mg: 40 mL
(RT)(PFL)
no preservative148 shake well148


0.02-0.04 mg/mL148 3 h RT: D5W
12 h RT: NS
NS, D5W, sodium 24 h RT: sodium
lactate148 lactate148

Mitomycin
5 mg SWI 0.5 mg/mL149 48 h F, RT13,149 syringe11 14 d F, 48 h RT11,21 - cytotoxic7
20 mg 5 mg: 10 mL
(BMS) 20 mg: 40 mL (PFL)149
(RT)(PFL)
no preservative149 shake well149

0.02–0.04 mg/mL 12 h RT: NS
3h: D5W
NS, D5W, sodium 24 h: sodium lactate149
lactate149


Status)
Mitoxantrone
20 mg/10 mL N/A 2 mg/mL150 discard unused 0.2-0.6 mg/mL150 NS: 24 h F, RT150 - cytotoxic7
25 mg/12.5 mL portion150
(Hospira) NS, D5W150 **(PFL)150
(RT)(PFL)
no preservative150 > 50 mL*150

Mitoxantrone
20 mg/10 mL N/A 2 mg/mL151 discard unused NS, D5W151 24 h RT151 - cytotoxic7
(Novopharm) portion151
(RT)(PFL) > 50 mL*151 **(PFL)152
no preservative151
Mitoxantrone
20 mg/10 mL N/A 2 mg/mL153 discard unused NS, D5W2 24 h RT153 - cytotoxic7
(Pharmaceutical portion153 > 50 mL*153
Partners of Canada)
(RT)
no preservative153


Octreotide
50 mcg/mL; 100 N/A 50 mcg/mL discard unused sc syringe154 single use vials: use - noncytotoxic
mcg/mL; 500 mcg/mL 100 mcg/mL portion154 within 4 h
(Novopharm) 500 mcg/mL154 multidose vials: use
(F)(PFL) within 14 d F74,154
no preservative
multidose vials (5mL):
200 µg/mL
(F)(PFL)
154
preservative

200 mcg/mL154 14 d F74,154 infusion: NS154 single use vials or
multidose vials: 24 h
RT154

Octreotide
(Sandostatin) N/A 200 mcg/mL18 discard unused 50–200 mL NS18,11,156 24 h RT18 - noncytotoxic10
1000 mcg/5 mL portion155
(Novartis)
(F)(PFL) SC infusion: adjust
preservative18 volume to ensure
infusion rate of 25
mcg/h18


Status)
Octreotide
(Sandostatin) N/A 50 mcg/mL discard unused 50-100 mL11,156 24 h RT18 - noncytotoxic10
50 mcg/1 mL 100 mcg/mL portion18
100 mcg/1 mL 500 mcg/mL18 NS18
500 mcg/1 mL
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
no preservative18 infusion rate of 25
mcg/h18

Octreotide
(Sandostatin LAR) 2 mL supplied 10 mg: 5 mg/mL discard unused deep intragluteal use within 4 h of initial - noncytotoxic10
10 mg diluent 20 mg: 10 mg/mL portion18 administration only18 reconstitution18,13 - do NOT shake
20 mg 30 mg: 15 mg/mL18
30 mg gently run 2 mL
(Novartis) down sides of the
(F)(PFL) vial; do NOT
preservative155 disturb for 2–5
min, then swirl
moderately18

record time of
reconstitution


Status)
Oxaliplatin
50 mg/10 mL N/A 5 mg/mL157 discard unused 0.2-1.3 mg/mL158 0.2-1.3 mg/mL: - cytotoxic7
100 mg/20 mL portion157 14 d F, 48 h RT159,87,158 - do NOT use
200 mg/40 mL 1.3–2 mg/mL157,158 aluminum-
(Sanofi-Aventis) 1.3-2 mg/mL: containing needle,
(RT)(PFL) 250–500 mL D5W157 48 h F, 24 h RT157 syringe or
no preservative157 tubing157
do NOT use NS or
other chloride-
containing solution157

do NOT use
aluminum-containing
needle and syringe157


Status)
Oxaliplatin
50 mg SWI, D5W: 5 mg/mL160 24 h F160 500 mL D5W 24 h F, 6 h RT160 - cytotoxic7
100 mg 50 mg: 10 mL - do NOT use
(Sigmacon) 100 mg: 20 mL do NOT use NS or aluminum-
(RT) other chloride- containing needle,
no preservative160 do NOT use NS or containing solutions syringe or tubing160
other chloride- (degrades)160
containing
solution160 do NOT use
aluminum-containing
do NOT use needle and syringe160
aluminum-
containing needle
and syringe160

Paclitaxel
30 mg/5 mL N/A 6 mg/mL162 8 h RT162 0.3–1.2 mg/mL in NS, 0.3-1.2 mg/mL: - cytotoxic7
100 mg/16.7 mL D5W162 24 h RT162 - use non-PVC bag
300 mg/50 mL (e.g., 100–1000 mL)* and tubing with in-
(Biolyse) 0.1 mg/mL: line filter162
(RT)161 44 h F, RT163
no preservative 0.1 mg/mL in NS163
0.012-0.09 mg/mL:
0.012-0.1 mg/mL164 16 h RT164


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