Drug | Remote Team AP | On-Site AP | Preferred Storage for AP | Medications that should not be prepared on Friday for Monday AP | HAM Medication | LASA Medication | Vial Size | Do Not Refrigerate | Protect From Light | Filter Requirement | Primary or seconding Tubing | Low-Sorb tubing required | Non-DEHP Container | Do Not Shake | Vesicant / Irritant | Standard IV Fluids | Infusion Concentration | Infusion Time | Diluent to Reconstitute | Room Temp Stability | Stability in Refrigerator | Special Precautions | Overfill | Administration Instructions | References | remainder vials for reuse (6 hours SDV - hood[340B]-NO, but can reject, 28d MDV) | Notes (anything additional you need to know) |
ado-trastuzumab emtansine (Kadcyla) |
No | No | N/A | N/A | Yes | Yes | 160 mg 100 mg |
N/A | NO | In-Line Filter 0.2 - 0.22 micron | Secondary | NO | NO | Do Not Shake | Irritant with vesicant-like properties | 250 mL NS | N/A | Loading dose: 90 min. Subsequent dose: 30 min. |
100 mg vial + 5 mL SWI or 160 mg vial + 8 mL SWI (Conc: 20 mg/mL) |
Use immediately at RT | 24 hrs |
DO NOT SHAKE Swirl gently until dissolved/gently invert bag to mix. |
Add drug into bag (overfill + drug volume) | Infuse over 90 minutes for first infusion, 30 minutes for subsequent infusion if first dose well tolerated. Do not give as IV push or bolus. Monitor pt for infusion reactions. | 1, 8 | SDV | Reconstitution instructions say "add" to infusion bag containing NS 250 ml. |
alemtuzumab (Campath) |
No | No | N/A | N/A | Yes | No | 30 mg/mL | N/A | Protect vials and dilution from light | NO | Secondary | NO | NO | Do Not Shake | NO | 100 mL NS or D5W | N/A | 2 hrs | 30 mg/mL Solution: for the 3 mg and 10 mg dose, use 1 ml syringe calibrated in increments of 0.01 ml. For the 30 mg dose, use 1 ml or 3 ml syringe calibrated in 0.1 ml | Use within 8 hrs of dilution. | Use within 8 hrs of dilution. | Gently invert the bag to mix the solution. Use 1 mL or 3 mL syringe. |
Add drug into bag (overfill + drug volume) | IV infusion over 2 hours. Do not give as IV push or bolus. | 1, 3, 8 | SDV | |
alemtuzumab (Lemtrada) **Commercially available for MS** | No | No | N/A | N/A | Yes | No | 12 mg/1.2 mL (10 mg/mL) |
N/A | Protect vials and dilution from light | NO | Secondary | NO | NO | Do Not Shake | NO | 100 mL NS or D5W | N/A | 4 hrs | 10 mg/mL Solution | Use within 8 hrs of dilution. | Use within 8 hrs of dilution. | Gently invert the bag to mix the solution. | N/A | IV infusion over 4 hours. Do not give as IV push or bolus. | 1, 8 | SDV | |
arsenic trioxide (Trisenox) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | No | 12 mg/6 mL (2 mg/mL) - preferred OR 10 mg/10 mL (1 mg/mL) |
N/A | NO | NO | Secondary | NO | NO | N/A | NO | 100 - 250 mL NS or D5W | N/A | 1-2 hrs | 2 mg/mL Solution OR 1mg/mL Solution |
24 hrs | 48 hrs | Filter the drug before dilution with 5 micron filter needle if medication in ampule. | Add drug into bag (overfill + drug volume) | Infusion duration may be extended up to 4 hours if acute vasomotor reactions are observed | 1, 8 | SDV | Note multiple concentrations exist, verify product prior to verifying and mixing. |
azaCITIDine IV (Vidaza) |
No | No | N/A | N/A | Yes | Yes | 100 mg | Do not refrigerate; use immediately |
NO | NO | Secondary | NO | NO | N/A | NO | IV: 50 - 100 mL NS | For Peds: 0.9-4 mg/mL | IVPB: 10-40 min | IV: 10 mL SWFI (10 mg/mL) when diluted in NS | Must be completed within 1 hr of reconstitution | N/A | Shake or roll vial until solution is dissolved and clear. Very limited stability and must be prepared immediately prior to each dose. Incompatible with dextrose. | Add drug into bag (overfill + drug volume) | Infuse over 10-40 minutes and complete within 1 hour of reconstitution. | 1, 8 | SDV | IVPB |
azaCITIDine SUBQ (Vidaza) |
No | No | N/A | N/A | Yes | Yes | 100 mg | N/A | NO | DO NOT FILTER | N/A | N/A | N/A | N/A | N/A | N/A | SQ: Divide dose >4 mL equally into 2 syringes | N/A | SUBQ: 4 mL SWFI (25 mg/mL) | 1 hr after reconstitution | 8 hrs | Slowly add 4 mL SWFI to each vial. Vigorously shake or roll vial until suspension forms (will be cloudy). Divide doses requiring more than 1 vial. Do not filter after reconstitution. If removed from refrigerator, suspension may be allowed to equilibrate at RT for 30 minutes prior to administration. | No (syringe) | Resuspend contents of syringe by vigorously rolling between palms immediately prior to administration. Rotate injection sites. Sites should be 1 inch from previous sites. Don't administer in bruised or reddened areas. | 1, 8 | SDV | Dispensed in a syringe. |
BCG (Tice BCG) |
No | No | N/A | N/A | Yes | No | 50 mg | N/A | Protect from light; wrap syringe in brown bag | DO NOT FILTER | N/A | N/A | 50mL syringe | Do Not Shake | N/A | TV 50 mL PF NS (Intravesicular only) |
N/A | N/A | Reconstitute with 1 mL sterile PF saline using a 3 mL syringe. Add to vial, swirl gently to form suspension | 2 hrs | 2 hrs | Clean with bleach. Irrigation only. Avoid cross-contamination. Handle carefully - biohazard. |
No (syringe) | Intravesical | 1, 8 | SDV | Dispensed in a syringe. |
Belantamab Mafodotin-blmf (Blenrep) | Yes | No | 100 mg | N/A | NO | 0.2 micron filter may be used | Secondary | NO | NO | Do Not Shake | NO | 250 mL NS | 0.2-2 mg/ml | 30 minutes | Reconstitute with 2 ml SWFI (Conc: 50 mg/ml) | After removal from refrigerator, administer within 6 hours including infusion time. | 24 hours | Prior to reconstitution, remove vials from refrigerator and allow to stand at RT for 10 minutes. Gently swirl and do not shake. Discard if particulate is present. Diluted solution should be clear and colorless. | Add drug into bag (overfill + drug volume) | If refrigerated, allow to equilibrate prior to administration. Infuse over 30 minutes using a PVC or PO infusion set. Filtration not required. If filtered, use 0.22 micron PES filter. | 1, 8 | SDV | REMs requirements. | ||||
belinostat (Beleodaq) |
No | No | N/A | N/A | Yes | No | 500 mg | Do not refrigerate | NO | 0.22 micron inline filter | Secondary | NO | NO | N/A | NO | 250 ml NS | N/A | 30 minutes | Reconstitute with 9 mL SWFI (Conc: 50 mg/mL) |
Solutions diluted for infusion in NS may be stored up to 36 hours at RT including infusion time | N/A | Swirl vial contents until there are no visible particles in the reconstituted solution. Do not use if cloudy or precipitate is present. | Add drug into bag (overfill + drug volume) | Infuse over 30 minutes using a 0.22 micron inline filter. Increase infusion time to 45 minutes if pain or other signs and symptoms occur. | 1, 8 | SDV | |
bendamustine (Bendeka) |
No | No | N/A | N/A | Yes | No | 100 mg (25 mg/mL) | N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Irritant with vesicant-like properties | 50 mL NS or D5W | 0.49-5.6 mg/mL | 10 min | 25 mg/mL Solution | NS: 6 hrs D5W: 3 hrs Infusion must be completed within this time |
24 hrs Infusion must be completed within this time |
Allow the vial to reach room temperature prior to use. Do not use if particulate observed after reaching RT. Store intact vials and vials reconstituted for solution in original carton. Partially used vials are stable for up to 28 days. Do no withdraw more than 6 doses from each vial. | Add drug into bag (overfill + drug volume) | Infuse over 10 minutes. Administration times for off-label uses/doses vary by protocol. | 1, 8 | MDV | Note formulation. |
bendamustine (Belrapzo) |
No | No | N/A | N/A | Yes | No | 100 mg (25 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Irritant with vesicant-like properties | 500 mL NS | 0.05-0.7 mg/mL | CLL: 30 minutes NHL: 60 minutes | 25 mg/mL Solution | 3 hours (including infusion time) | 24 hours (including infusion time) | Allow the vial to reach room temperature prior to use. Do not use if particulate observed after reaching RT. Store intact vials and vials reconstituted for solution in original carton. Partially used vials are stable for up to 28 days. Do no withdraw more than 6 doses from each vial. | Add drug into bag (overfill + drug volume) | Infusion varies with diagnosis. For CLL - infuse over 30 minutes. For NHL - infuse over 60 minutes. | 1,8 | MDV | Note formulation. |
Bendamustine (TREANDA) | 180 mg/2ml (90 mg/ml) | N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Irritant with vesicant-like properties | 500 ml NS | 0.2 to 0.7 mg/ml | CLL: 30 minutes NHL: 60 minutes | 90 mg/ml Solution | 2 hours (including infusion time) | 24 hrs | Do not combine Treanda formulations. Check compatibility with CSTD. If using a syringe to withdraw and transfer Treanda injection from the vial into the infusion bag, only use a polypropylene syringe and metal needle with a polypropylene hub. Admixture should be clear. | Add drug into bag (overfill + drug volume) | Infusion varies with diagnosis. For CLL - infuse over 30 minutes. For NHL - infuse over 60 minutes. | 1.8 | SDV | Note formulation. | ||||||
Bendamustine (TREANDA) | 100 mg 25 mg | N/A | Protect vials from light | NO | secondary | NO | NO | N/A | Irritant with vesicant-like properties | 500 ml NS | 0.2 to 0.6 mg/ml | CLL: 30 minutes NHL: 60 minutes |
25 mg vial: 5 ml SWFI 100 mg vial: 20 ml SWFI (Conc: 5 mg/ml) Transfer to infusion bag within 30 minutes |
3 hours (including infusion time) | 24 hrs | Do not combine Treanda formulations. | Add drug into bag (overfill + drug volume) | 1.8 | SDV | Note formulation. | |||||||
bleomycin IV (Blenoxane) |
No | No | N/A | N/A | Yes | No | 15 units 30 units |
N/A | NO | NO | Secondary | NO | NO | N/A | Irritant | 100 mL NS PEDs: 50 mL NS CI : 1000 mL NS |
0.015 units/mL - 3 units/mL | IVPB: 10 minutes CI: 24 hrs |
15 unit vial + 5 mL NS 30 unit vial +10 mL NS (conc: 3 units/mL) |
24 hrs | N/A | D5W is not recommended | Add drug into bag (overfill + drug volume) | IV does should be administered slowly over 10 minutes. | 1, 3, 4, 8 | SDV | |
bleomycin IM/SUBQ (Blenoxane) |
No | No | N/A | N/A | Yes | No | 15 units 30 units |
N/A | NO | NO | N/A | N/A | NO | N/A | N/A | N/A | 3-15 units/mL | N/A | 15 unit vial: 1 mL SWFI 30 unit vial: 2 mL SWFI (conc: 15 units/mL) |
24 hrs | N/A | D5W is not recommended | No (syringe) | May cause pain at injection site. | 1, 3, 4, 8 | SDV | Dispensed in a syringe. |
bleomycin Intrapleural (Blenoxane) |
No | No | N/A | N/A | Yes | No | 15 units 30 units |
N/A | NO | NO | N/A | N/A | NO | N/A | N/A | Intrapleural: 50 ml NS | N/A | N/A | 60 units in 50-100 mL sodium chloride for injection. | 24 hrs | N/A | D5W is not recommended | No | 60 units in 50 to 100 mL NS; use of topical anesthetics or opioid analgesia is usually not necessary. | 1, 3, 4, 8 | SDV | Dispensed in a syringe. |
blinatumomab (Blincyto) |
No | No | N/A | N/A | Yes | No | 35 mcg | Okay to refrigerate | Protect vials from light | 0.2 micron in-line filter ONLY for 24-hour and 48-hour bag; NO filter needed for 7-day bag | NO for hospital bags; pump tubing required for ambulatory pumps -- prime line with active drug solution | YES for hospital bags; not necessary for ambulatory pumps | Non-DEHP Container | Do Not Shake | N/A |
24-hour or 48-hour prep: 270 mL-NS 7-dayprep: 90mL bacteriostatic NS |
12.5 mcg/mL | 24 hours OR 48 hours OR 168 hours |
See reconstitution tables in package insert | Preservative-Free = 48 hours Preservative = 7 days |
Preservative-Free = 8 days Preservative = 14 days |
Do not reconstitute blincyto vial with IV solution stabilizer. PRIME THE IV TUBING WITH THE PREPARED SOLUTION (DO NOT PRIME WITH JUST NS). Remove air from the final product (especially for ambulatory infusion pumps). | ERx built to include all pertinent factors in order to have set administration rates per PI | Infusion rates are set (and should not be modified) based off dosing and days needed. There will be residual drug left over after each infusion; this is to ensure the full dose was given. Do not flush the blincyto infusion line, especially when change infusion bags. Flushing lines can result in excess dosage and complications thereof. | 1, 8 | ||
bortezomib IV (Velcade) |
Yes | No | Refrigerated | N/A | Yes | No | 3.5 mg | Okay to refrigerate | Protect vials from light | NO | NO | NO | NO | N/A | Irritant | NS only | IV Push: 1 mg/mL | IV Push: 3-5 seconds | IV: 3.5 mL NS (Conc:1 mg/mL) | 8 hrs | 5 days | Reconstituted product should be a clear and colorless solution. Doses should be given 72 hrs apart. FATAL IF GIVEN INTRATHECALLY. |
No (syringe) | Administer via rapid IV push over 3-5 second | 1, 2, 3, 5, 8 | SDV | Dispensed in a syringe. |
bortezomib SUBQ (Velcade) |
No | No | N/A | N/A | Yes | No | 3.5 mg | Okay to refrigerate | Protect vials from light | NO | N/A | N/A | NO | N/A | N/A | N/A | SQ Inj: 2.5 mg/mL | N/A | SQ: 1.4 mL NS (Conc: 2.5 mg/mL) | 8 hrs | Syringe: 24 hours | Reconstituted product should be a clear and colorless solution. Doses should be given 72 hrs apart. FATAL IF GIVEN INTRATHECALLY. |
No (syringe) | Not all bortezomib products are approved for subq administration. | 1, 2, 3, 5, 8 | SDV | Dispensed in a syringe. |
brentuximab vedotin (Adcetris) |
No | No | N/A | N/A | Yes | No | 50 mg | N/A | Protect vials from light | NO | NO | NO | NO | Do Not Shake | NO | 100 mL NS or D5W | 0.4 - 1.8 mg/mL | 30 min | 50 mg vial + 10.5 mL SWFI (Conc: 5 mg/mL) |
Use immediately at RT | 24 hrs | Direct the stream toward the wall of vial, not directly at the cake or powder. Gently swirl the vial to aid dissolution. The reconstituted solution should be clear, colorless, and free of particles |
Add drug into bag (overfill + drug volume) | Infuse over 30 minutes. Do not administer as IV push or bolus. | 1, 8 | SDV | |
busulfan (Busulfex) |
No | No | N/A | N/A | Yes | No | 60 mg/10 ml (6 mg/ml) |
N/A | NO | NO | NO | NO | NO | Mix by inversion | Irritant | NS or D5W Dilution volume should be 10 times the volume of busulfan injection | Approx 0.5 mg/mL | 2 hrs (Central Line) |
6 mg/mL Solution | 8 hrs including infusion time | 12 hrs including infusion time | Always add Busulfex to diluent, not the diluent to Busulfex. Mix thoroughly by inverting several times. Incompatible with polycarbonate containing syringes, filters, or IV tubing. Verify compatibility with CSTD. Do not use vial if particulate matter is present. |
ERx is set to calculate 1:10 drug volume: diluent volume to hit concentration of 0.54 mg/mL | Infuse dose over two hours. Flush indwelling catheter with approximately 5 ml NS or D5W before and after infusion. | 1, 8 | SDV | |
cabazitaxel (Jevtana) |
No | No | N/A | N/A | Yes | No | 60 mg | Do not refrigerate vials. Drug diluted for infusion may be refrigerated | NO | 0.22 micron inline filter | Primary | YES | Non-DEHP Container | Do Not Shake | NO | 250 mL NS or D5W Larger vol if dose > 65 mg |
0.1 - 0.26 mg/mL | 1 hr | 60 mg vial + all of supplied diluent (Conc: 10 mg/mL) (Use within 30 min) |
8 hrs | 24 hrs | Direct diluent toward the wall of vial to limit foaming. Thoroughly mix by gently inverting the bottle or bag. Do not use if crystallization forms. |
Add drug into bag (overfill + drug volume) | Infuse over 1 hour using a 0.22 micron inline filter. Do not use polyurethane containing infusion sets for administration. Allow to reach room temperature prior to infusion. | 1, 8 | SDV | |
CARBOplatin (Paraplatin) |
Yes (Do not include desensitization) | No | Room Temperature | Do Not Prep on Friday | Yes | Yes | 50 mg 150mg 450 mg 600 mg 1000 mg (10 mg/mL) |
Do not refrigerate | Protect vials from light | NO | Secondary | NO | NO | N/A | Irritant | 100 - 250 mL NS or D5W | May be diluted as low as 0.5 mg/mL | ≥15 min | 10 mg/mL Solution | 24 hrs | N/A | Needles or IV administration sets that contain aluminum should not be used in the preparation or administration of carboplatin due to potential precipitate and loss of potency. | Add drug into bag (overfill + drug volume) | Infuse over at least 15 minutes; usually infused over 15 to 60 minutes. Some protocols may require infusions up to 24 hours. | 1, 2, 4, 8, 12 | MDV | No preservative, manufacturer recommends use within 8 hours |
carfilzomib (Kyprolis) |
No | No | N/A | N/A | Yes | No | 10 mg 30 mg 60 mg |
N/A | Protect vials from light | NO | Secondary | NO | NO | Do Not Shake | NO | Dose ≤ 60 mg: 50 mL D5W Dose > 60 mg: 100 mL D5W |
N/A | 10-30 min | 10 mg vial + 5 mL SWFI 30 mg vial + 15 mL SWFI 60 mg vial + 29 mL SWFI (Conc: 2 mg/mL) |
4 hrs | 24 hrs | Direct diluent toward the wall of vial to limit foaming. Gently swirl/invert vial for 1 min or complete dissolution. DO NOT SHAKE. If foaming occurs, allow solution to rest for 2-5 min. |
Add drug into bag (overfill + drug volume) | Administer over 10-30 minutes depending on the regimen. Flush line immediately before and after infusion with NS or D5W | 1, 8 | SDV | Reconstitution instructions mention use of needle vs CSTD |
carmustine (BiCNU) |
No | No | N/A | N/A | Yes | No | 100 mg | N/A | Protect from light | NO | Primary | YES | Non-DEHP Container | N/A | Irritant | 500 mL NS or D5W | Final minimum concentration = 0.2 mg/mL |
2 hrs | 100 mg vial + 3 mL supplied alcohol, then + 27 mL SWFI (Conc: 3.3 mg/mL) |
8 hrs | 24 hrs, followed by additional 6 hours at room temperature. | High-dose carmustine (transplant dose): Infuse over at least 2 hours to avoid excessive flushing, agitation, and hypotension. High-dose carmustine may be fatal if not followed by stem cell rescue. | ERx set to 1:1 drug/volume | Infuse over at least 2 hours through a free-flowing saline or dextrose infusion. Administer through a central catheter to alleviate venous pain/irritation. Do not exceed a rate of 1.66 mg/m2/minute. | 1, 4, 8, 18 | SDV | Per Micromedex compatibility with NS - concentrations up to 1mg/mL when compounded in polyethylene-lined bags, at room temperature, found carmustine losses of 10% at the 3 hours mark. Per Micromedex compatibility with D5W - concentrations up to 1mg/mL when compounded in polyolefin plastic bags, at room temperature, found carmustine remained 96% intact at the 4 hours mark. Because of this data, OHS stem cell transplant sites agree on standardizing to mixing in D5W, at a maximum concentration of 1mg/mL, and should be prepared as close to administration as possible. |
cidofovir (Vistide) |
No | No | N/A | N/A | No | No | 75 mg/mL | N/A | NO | NO | Secondary | NO | NO | N/A | NO | 100 mL NS | N/A | 1 hour | 75 mg/mL Solution | Immediate use | 24 hrs including administration time | Dilute dose in 100 mL prior to infusion. |
N/A | For IV infusion only. Infuse over 1 hour. | 1, 8 | SDV | |
CISplatin (Platinol) |
Yes | No | Room Temperature | N/A | Yes | Yes | 50 mg 100 mg 200 mg (1 mg/mL) |
Do Not Refrigerate | Protect vials from light | NO | Secondary | NO | NO | N/A | Vesicant (> 0.5 mg/mL) |
100 - 2000 mL NS PEDs: Per Protocol |
N/A | ≥15 min CI: 24 hrs (Max: 1 mg/min) |
1 mg/mL Solution | 4 days | N/A | Do not use with aluminum containing needles. | Add drug into bag (overfill + drug volume) If goes over maximum volume allowance, manipulate during verification to just overfill only |
Has been infused over 30 minutes to 4 hours, at a rate of 1 mg/minute or as a continuous infusion. Refer to protocol. | 1, 2, 4, 8 | MDV | Could potentially be a problem with the overfill amount |
Cladribine (Leustatin) |
No | No | N/A | N/A | Yes | No | 10 mg/10 mL (1 mg/mL) |
N/A | Protect vials from light | Filter prior to dilution | Secondary | NO | NO | N/A | Irritant | 500 mL NS | N/A | 24 hrs Other infusion times per protocol |
1 mg/mL Solution Filter through 0.22 micron syringe filter prior to dilution |
24 hours in PVC container | May be stored for up to 8 hours prior to infusion | Filter through 0.22 micron syringe filter prior to further dilution. D5W is not recommended |
Add drug into bag (overfill + drug volume) | Usually administered over continuous infusion or over 2 hours; infusions over 3 hours have also been reported. | 1, 8 | SDV | A precipitate my develop at lower temps. May be resolubilized at RT or by vigorous shaking |
CLOFarabine (Clolar) |
No | No | N/A | N/A | Yes | Yes | 20 mg/20 mL (1 mg/mL) |
Do Not Refrigerate | NO | Filter prior to dilution | Secondary | NO | NO | N/A | NO | NS or D5W | 0.15 - 0.4 mg/mL | 2 hrs | 1 mg/mL Solution Filter through 0.22 micron syringe filter prior to further dilution |
24 hrs | N/A | Filter through 0.22 micron syringe filter prior to further dilution. | Add drug into bag (overfill + drug volume) | Infuse over 2 hours for relapsed/refractory ALL. May be infused over 1 hour (off-label). Continuous IV fluids are encouraged to decrease adverse events and tumor lysis. | 1, 3, 8 | SDV | |
cyclophosphamide (Cytoxan) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | Yes | 500 mg 1000 mg 2000 mg |
N/A | NO | NO | Secondary | NO | NO | N/A | Irritant | D5W or NS | D5W: Minimum concentration of 2 mg/mL NS: 0.24 mg/mL to 10 mg/mL 20 mg/mL for direct injection |
Varies with protocol | 500 mg vial + 25 mL SWFI or NS 1000 mg vial + 50 mL SWFI or NS 2000 mg vial + 100 mL SWFI or NS (Conc: 20 mg/mL) |
24 hrs | 48 hrs | Direct injection: reconstitute with NS only. | Add drug into bag (overfill + drug volume) | Infusion rate varies with protocol. | 1, 3, 4, 8 | SDV | Note differing products. One option is straight drug in a syringe |
cyclophosphamide (Cytoxan) |
Yes | No | Refrigerated | N/A | Yes | Yes | 500 mg/2.5 mL 1000 mg/5 mL 2000 mg/10 mL (200 mg/mL) |
N/A | NO | NO | Secondary | NO | NO | N/A | Irritant | D5W or NS | 2 mg/mL to 20 mg/mL for direct injection |
Varies with protocol | 200 mg/mL solution | 24 hrs | 6 days | Contains Alcohol, Do not use sterile water for direct injection. | Add drug into bag (overfill + drug volume) If goes over maximum volume allowance, manipulate during verification to just overfill only |
Infusion rate varies with protocol. | 1, 8 | MDV | Note differing products. One option is straight drug in a syringe |
CYTarabine (Ara-C, Cytosar) |
Yes | No | Refrigerated | Do not Prep on Friday for IT and IV syringe | Yes | Yes | 100 mg/5 mL PF (20 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | NO | 250-1000 mL NS or D5W PEDs: Per Protocol |
Max 100 mg/mL for subcutaneous infusion | IV Push: over 15-30 minutes. IVPB: 1-3 hours CI over 12-24 hrs. |
20 mg/mL PF Solution | 24 hrs IT: 4 hrs IV Syringe: 24 hrs |
7 days IT: N/A IV Syringe: 24 hrs |
Use PF NS for intrathecal preparations. Solutions containing bacteriostatic agents may be used for SubQ and standard doses, BUT not for IT or high-dose therapies | Add drug into bag (overfill + drug volume) | Intrathecal doses should be administered as soon as possible. | 1, 2, 3, 4, 8 | SDV | Note differing strengths of product |
CYTarabine (Ara-C, Cytosar) |
Yes | No | Refrigerated | Do not Prep on Friday for IV syringe | Yes | Yes | 2000 mg/20 mL PF (100 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | NO | 250-1000 mL NS or D5W PEDs: Per Protocol |
Max 100 mg/mL for subcutaneous infusion | IV Push: over 15-30 minutes. IVPB: 1-3 hours CI over 12-24 hrs |
100 mg/mL PF Solution | 24 hrs IV Syringe: 24 hrs |
7 days IV Syringe: 24 hrs |
Do not use bulk bottle for intrathecal. Solutions containing bacteriostatic agents may be used for SubQ and standard doses, BUT not for IT or high-dose therapies | Add drug into bag (overfill + drug volume) | 1, 8 | SDV | Note differing strengths of product | |
dacarbazine (DTIC) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | No | 100 mg 200 mg |
N/A | Light Protect vials and solution | NO | Secondary | NO | NO | N/A | Irritant | 250 mL NS or D5W | N/A | 15-60 min | 100 mg vial + 9.9 mL SWFI 200 mg vial + 19.7 mL SWFI (Conc: 10 mg/mL) |
8 hrs | 24 hrs | Too rapid infusion = severe venous irritation. | Add drug into bag (overfill + drug volume) | Infuse over 15-60 minutes. Rapid infusion may cause severe venous irritation. | 1, 2, 4, 8 | SDV | |
DACTINomycin (Cosmgen) |
No | No | N/A | N/A | Yes | Yes | 0.5 mg | Do Not Refrigerate | Light Protected | DO NOT FILTER | Secondary | NO | NO | N/A | Vesicant | 50 mL NS or D5W May be injected directly into tubing of running solution |
≥ 0.01 mg/mL | IV Push: 5 min IVPB: 10-15 min |
0.5 mg vial + 1.1 mL PF SWFI (Conc: 0.5 mg/mL) |
4 hrs from reconstitution to completion of infusion | N/A | Very corrosive to soft tissue. | Add drug into bag (overfill + drug volume) | Infuse over 10-15 minutes, may be given slow IVP off label. | 1, 4, 10 | SDV | No IM or SubQ, may be dispensed in bag or syringe |
DAUNOrubicin (Cerubidine) |
Yes | No | Room Temperature | Do Not Prep on Friday | Yes | Yes | 20 mg/4 mL (5 mg/mL) |
N/A | Protect vials and infusion from light | NO | Secondary | NO | NO | N/A | Vesicant | IVPB: 100 mL NS | N/A | IV Push: 5 min IVPB: 15-30 min |
5 mg/mL Solution | 24 hrs | N/A | Avoid extravasation | Add drug into bag (overfill + drug volume) | Administer as slow IV push into a rapidly flowing IV or as infusion over 15-30 minutes. | 1, 4, 10 | SDV | No IM or SubQ, may be dispensed in bag or syringe |
DAUNOrubicin/ CYTarabine Liposomal (Vyxeos) |
No | No | N/A | N/A | Yes | Yes | 44 mg daunorubicin/100 mg cytarabine | N/A | Protect vials from light | Not required, but may use >15 micron filter | Secondary | NO | For peds doses diluted in <500 mL | Do Not Shake | May be an irritant | 500 mL NS or D5W | N/A | 90 minutes | Add 19 ml SWFI. Carefully swirl contents for 5 minutes/gently invert vial very 30 seconds. Let rest for 15 minutes after reconstitution (Conc: 2.2 mg/ml daunorubicin component) |
Use immediately at RT | 4 hrs | Allow vials to equilibrate to RT for 30 minutes. Gently invert each vial 5 times prior to withdrawing dose. Mix bag by gentle inversion. | Add drug into bag (overfill + drug volume) | Administer over 90 minutes via infusion pump through a central venous catheter | 1, 8 | SDV | No IM or SubQ. Drug is dosed on daunorubicin component. |
decitabine (Dacogen) |
No | No | N/A | N/A | Yes | No | 50 mg | N/A | NO | NO | Secondary | NO | NO | N/A | NO | 50 - 250 mL NS or D5W | 0.1 - 1 mg/mL | 1-3 hrs | 50 mg + 10 mL SWFI (Conc: 5 mg/mL) |
Must be used w/in 15 min of reconstitution if added to room temperature solution for infusion | 4 hrs using COLD solution for infusion | Use cold solution for infusion | Add drug into bag (overfill + drug volume) | Infuse over 1-3 hours depending on dosing regimen | 1, 8 | SDV | |
dexrazoxane Brand (Zinecard) |
No | No | N/A | N/A | No | No | 500 mg 250 mg |
N/A | NO | NO | Secondary | NO | NO | N/A | NO | LR | 1.3 - 3 mg/mL | Infuse over 15 minutes | 250 mg + 25 mL SWFI 500 mg + 50 mL SWFI (Conc: 10 mg/mL) |
1 hr | 4 hrs | Do not mix dexrazoxane for injection with other drugs. | N/A | Administer the final diluted solution of dexrazoxane by intravenous infusion over 15 minutes before the administration of doxorubicin. DO NOT ADMINISTER VIA AN INTRAVENOUS PUSH. Administer doxorubicin within 30 minutes after the completion of dexrazoxane for infusion. | 1, 8 | SDV | Note formulation |
dexrazoxane (Generic) |
No | No | N/A | N/A | No | No | 500 mg 250 mg |
N/A | NO | NO | Secondary | NO | NO | N/A | NO | NS or D5W | 1.3 - 5 mg/mL | Infuse by slow IV push or rapid drip infusion | 250 mg + 25 mL supplied diluent 500 mg + 50 mL supplied diluent (Conc: 10 mg/mL) |
6 hrs | 6 hrs | Do not mix dexrazoxane for injection with other drugs. | N/A | The reconstituted solution should be given by slow IV push or rapid drip intravenous infusion from a bag. After completing the infusion of dexrazoxane for injection, and prior to a total elapsed time of 30 minutes (from the beginning of the dexrazoxane for injection infusion), the intravenous injection of doxorubicin should be given. | 1, 8 | SDV | Note formulation |
DOCEtaxel (Taxotere) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | Yes | 200mg/10 mL 160 mg/8 mL 80 mg/4 mL 20 mg/1mL (20mg/mL) |
N/A | Protect from light | NO | Primary PRIME LINE WITH DRUG |
YES | Non-DEHP Container | Do Not Shake | Vesicant | 250 - 500 mL NS or D5W Intravesical: 37.5 mg in 50 ml NS |
0.3 - 0.74 mg/mL | 60 min | 20 mg/mL Solution | 4 days Syringe: 24 hours |
7 days Syringe: 24 hours |
Multiple concentrations exist. Some formulations contain alcohol. Coring of the rubber stopper is possible. | Add drug into bag (overfill + drug volume) | Infuse over 1 hour through nonsorbing polyethylene lined non DEHP tubing. | 1, 3, 4, 8 | MDV | Note concentration. Drug may dispensed in bag or syringe. |
DOCEtaxel (Taxotere) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | Yes | 160 mg/16 mL 80 mg/8 mL 20 mg/2 mL (10mg/mL) |
N/A | Protect from light | NO | Primary PRIME LINE WITH DRUG |
YES | Non-DEHP Container | Do Not Shake | Vesicant | 250 - 500 mL NS or D5W Intravesical: 37.5 mg in 50 ml NS |
0.3 - 0.74 mg/mL | 60 min | 10 mg/mL Solution | 4 days Syringe: 24 hours |
7 days Syringe: 24 hours |
Multiple concentrations exist. Some formulations contain alcohol. Coring of the rubber stopper is possible | Add drug into bag (overfill + drug volume) | Infuse over 1 hour through nonsorbing polyethylene lined non DEHP tubing. | 1, 3, 4, 8 | MDV | Note concentration. Drug may dispensed in bag or syringe. |
DOXOrubicin (Adriamycin) |
Yes | No | Room Temperature | Do Not Prep on Friday | Yes | Yes | 200 mg/100 mL 150 mg/75 mL 50 mg/25 mL 20 mg/10 mL 10 mg/5 mL (2mg/mL) |
N/A | Protect vials and dilution from light | NO | Secondary | NO | NO | N/A | Vesicant | 50 to 1000 mL D5W or NS | N/A | IV Push: 5 min IVPB: ≥15 min CI: 24 hrs |
2 mg/mL Solution | 24 hrs | 24 hrs | Add drug into bag (overfill + drug volume) | Administer IV push over at least 3 to 10 minutes or by continuous infusion. Do not administer IM or SubQ. | 1, 2, 3, 4, 8, 10 | SDV | Note formulation. Drug may dispensed in bag or syringe. | |
DOXOrubicin Liposomal (Doxil) |
No | No | N/A | N/A | Yes | Yes | 20 mg/ 10 mL 50 mg/25 mL (2mg/mL) |
N/A | NO | DO NOT FILTER | Secondary | NO | NO | N/A | Irritant | Dose ≤90 mg: 250 mL D5W Dose >90 mg: 500 mL D5W |
Max: 0.36 mg/mL | Titrate per protocol (Initial ≤1 mg/min, then 1 hr) | 2 mg/mL Solution | Use immediately at RT | 24 hrs | Not compatible with NS. Do not administer IV push. | Add drug into bag (overfill + drug volume) | Initiate first infusion at 1 mg/min. If no reaction, complete then may given over 1 hour | 1, 8 | SDV | Note formulation. |
elotuzumab (Empliciti) |
No | No | N/A | N/A | Yes | No | 400 mg 300 mg |
N/A | Protect vials and dilution from light | 0.2-1.2 micrometer low protein-binding | Secondary | NO | NO | Do Not Shake | NO | NS or D5W (not to exceed 5mL/kg of patient weight) |
1-6 mg/mL | Titrate per protocol | 300 mg vial + 13 mL SWFI (Deliverable volume: 12 mL) 400 mg vial + 17 mL SWFI (Deliverable volume: 16 mL) (Conc: 25 mg/mL) |
8 hrs Infusion must be completed within 24 hours of reconstitution |
24 hrs Infusion must be completed within 24 hours of reconstitution |
Avoid vigorous agitation. DO NOT SHAKE. After reconstitution, allow solution to stand for 5-10 min. Do not use if discolored. |
Add drug into bag (overfill + drug volume) | For IV infusion only. Do not administer as IV push or bolus. | 1, 8 | SDV | |
enfortumab vedotin (Padcev) |
No | No | N/A | N/A | Yes | No | 20 mg 30 mg |
N/A | Protect from light | NO | Secondary | NO | NO | Do Not Shake | May be an irritant | D5W or NS | 0.3 to 4 mg/mL | 30 minutes | 20 mg vial + 2.3 mL SWFI 30 mg vial + 3.3 mL SWFI (Conc: 10 mg/mL) Slowly swirl vial until contents dissolved. Allow reconstituted vials to settle until bubbles are gone. |
Immediate use | 8 hrs | Do not administer as IV push or bolus. Gently invert to mix. | Add drug into bag (overfill + drug volume) | Infuse over 30 minutes | 1, 8 | SDV | |
epiRUBicin (Ellence) |
No | No | N/A | N/A | Yes | Yes | 200 mg/100 mL 50 mg/25 mL (2mg/mL) |
N/A | Protect from light | NO | Secondary | NO | NO | N/A | Vesicant | 50 - 100 mL NS IVP into tubing of freely flowing NS or D5W |
Max 2 mg/mL | IV Push: 3-5 min IVPB: 15- 20 min |
2 mg/mL Solution | 24 hrs | 24 hrs | Given through Y-tube or three way stopcock of free flowing NS or D5W. Product may "gel" at refrigerated temperatures, will return to slightly viscous solution at RT. | Add drug into bag (overfill + drug volume) | Infuse over 15-20 minutes or slow IVP. Do not infuse over <3 minutes. Infuse through free-flowing IV. | 1, 3, 8, 10, 13 | SDV | |
eriBULin (Halaven) |
No | No | N/A | N/A | Yes | Yes | 1 mg/2 ml (0.5 mg/ml) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | NO | 100 ml NS | N/A | 2-5 minutes | 0.5 mg/ml Solution | 4 hrs | 24 hrs | Add drug into bag (overfill + drug volume) | Infuse over 2-5 minutes | 1, 8 | SDV | ||
etoposide (VP-16) |
Yes | No | Room Temperature | Do Not Prep on Friday | Yes | No | 1000 mg/50 mL 500 mg/25 mL 100 mg/5 mL (20mg/mL) | N/A | NO | NO | Primary | YES | Non-DEHP Container | Do Not Shake | Irritant | NS or D5W | 0.2 - 0.4 mg/mL (see stability section) |
30-60 min | 20 mg/mL Solution | 24 hrs | 24 hrs | Monitor closely for precipitation. | Add drug into bag (overfill + drug volume) | Administer standard doses over at least 30-60 minutes to minimize hypotension | 1, 3, 4, 8, 15, 16, 18 | MDV | Reference 15 - In BMT regimens, 10mg/mL solutions are extremely well tolerated and can be assigned an expiry date not exceeding 5 days when stored either at refrigeration or room temperature. Micromedex IV Compatibility Charts - If compounding concentrations >0.5 mg/mL, refer to charts to determine safety and stability. |
etoposide PHOSPHATE (Etopophos) |
No | No | N/A | N/A | Yes | No | 100 mg | N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Irritant | NS or D5W | 0.1 - 20 mg/mL | 5 min - 3.5 hrs | 100 mg vial + 5 mL SWFI (Conc: 20 mg/mL) |
24 hrs | 24 hrs | Do not administer as an IV bolus over less than 5 minutes | Add drug into bag (overfill + drug volume) | Infuse over 5 minutes to 3.5 hours | 1, 8 | SDV | |
fam-trastuzumab deruxtecan (Enhertu) |
No | No | N/A | N/A | Yes | No | 100 mg | N/A | Light Protect vials and solution | 0.2 - 0.22 micron in-line filter | Primary | YES | NO | Do Not Shake | NO | 100 mL D5W | N/A | First dose: 90 min. Subsequent dose: 30 min. |
100 mg vial + 5 ml SWFI (Conc: 20 mg/mL) Swirl vial gently until completely dissolved. |
4 hours including infusion time | 24 hours. Allow to come to room temperature prior to infusion. | Do not use NS. Do not administer as IV push or bolus. Gently invert infusion bag to thoroughly mix. | Add drug into bag (overfill + drug volume) | Administer first infusion over 90 minutes. If tolerated, subsequent infusions may given over 30 minutes. | 1, 8 | SDV | |
floxuridine (FUDR) |
No | No | N/A | N/A | Yes | No | 500 mg | N/A | NO | NO | Secondary | NO | NO | N/A | N/A | 100 mL NS or D5W for Intra-arterial administration |
N/A | Continuous hepatic intra-arterial infusion using an infusion pump | 500 mg vial + 5 mL SWFI (Conc: 100 mg/mL) |
24 hrs | Reconstituted vials should be stored under refrigeration for not more than 2 weeks | Intra-arterial infusion only | Add drug into bag (overfill + drug volume) | Continuous hepatic intra-arterial infusion using an infusion pump | 1, 3, 4, 8 | SDV | |
fludarabine (Fludara) |
Yes | No | Room Temperature | Do Not Prep on Friday | Yes | No | 50 mg/2 mL (25 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | NO | 100 mL or 125 mL NS or D5W | N/A | 30 min | 25 mg/mL Solution | 48 hrs | 48 hrs | Add drug into bag (overfill + drug volume) | Manufacturer recommends administering over 30 minutes. Continuous infusions and boluses | 1, 2, 4, 8 | SDV | ||
fluorouracil (5-FU) |
Yes | No | Room Temperature | N/A | Yes | No | 5000 mg/100 mL 2500 mg/50 mL 1000 mg/20 mL 500 mg/10 mL (50mg/mL) |
Do Not Refrigerate | Protect vials from light | Not required, but may use >15 micron filter | Secondary | NO | NO | N/A | Irritant | NS or D5W | N/A | IV Push: 1-15 min CI: 24 hrs |
50 mg/mL Solution | 4 days | N/A | May be slightly discolored. Storage at cool temp inc chance of precipitation. Heat and shake to dissolve precipitate. |
Overfill not included due to ERx settings for CADD pumps | May be administered by IV bolus or CADD pump | 1, 3, 8 | SDV, MDV | Dispensed in IVPB, cassette, and syringe |
ganciclovir (Cytovene) |
No | No | N/A | N/A | No | No | 500 mg/250 mL 500 mg/10 mL (50 mg/mL) |
N/A | NO | NO | Secondary | NO | NO | N/A | May be an irritant | 100 mL NS or D5W | </= 10 mg/mL | 60 minutes | 50 mg/mL Solution | N/A | 24 hours | N/A | Administer by slow IV infusion over at least 1 hour. | 1, 8 | SDV | ||
gemcitabine (Gemzar) |
Yes | No | Room Temperature | Do Not Prep Syringe on Friday | Yes | No | 200 mg/5.26 mL 1000 mg/26.3 mL 2000 mg/52.6 mL (38 mg/mL) |
Do Not Refrigerate | NO | NO | Secondary | NO | NO | N/A | Irritant | NS | minimum final concentration of 0.1 mg/ml | 30 min (Longer infusion for certain protocols) |
38 mg/mL Solution | 4 days Syringe: 24 hours |
N/A | Add drug into bag (overfill + drug volume) | Infuse over 30 minutes. Some protocols call FDR(fixed dose rate) of 10 mg/m2/minute | 1, 3, 8 | SDV | May be dispensed in a syringe for intravesical | |
gemtuzumab ozogamicin (Mylotarg) |
No | No | N/A | N/A | Yes | No | 4.5 mg | N/A | Protect vials and infusion from light | Inline 0.2 micron filter | Secondary PRIME LINE WITH DRUG |
NO | NO | Do Not Shake | NO | NS Doses <3.9 mg must be prepared in a syringe. Gently invert to mix. |
0.075 mg/mL to 0.234 mg/mL | 2 hours | 4.5 mg vial + 5 ml SWFI (Conc: 1 mg/mL) | 6 hours including preparation and infusion | 18 hours including preparation and infusion | Allow vials to come to room temperature prior to reconstitution for approximately 5 minutes. Protect from light during storage, preparation and administration. | Remove overfill and drug volume in order to make total volume of 50 or 100 ml. | Infuse over 2 hours through a 0.2 micorn in-line filter. Protect IV bag from light-during infusion. Infusion line does not need protected from light. Do not administer as IV push or bolus | 1, 8 | SDV | May be dispensed in a syringe or as IVPB |
IDArubicin (Idamycin) |
No | No | N/A | N/A | Yes | Yes | 20 mg/20 mL 10 mg/mL 5 mg/mL (1mg/1mL) |
N/A | Protect from light | NO | Secondary | NO | NO | N/A | Vesicant | Into tubing of freely flowing NS or D5W | N/A | 10-15 min | 1 mg/mL Solution | 24 hrs | 24 hrs | Slightly hazy solution = normal | Add drug into bag (overfill + drug volume) | For IV admin only. Do not administer IM or SubQ. Administer as slow injection over 10-15 minutes into a free-flowing IV. | 1, 3, 4, 8 | SDV | Dispensed in a syringe, possibly an IVPB as well. |
ifosfamide (Ifex) |
Yes | No | Refrigerated | N/A | Yes | No | 3000 mg 1000 mg |
Do Not Refrigerate | NO | NO | Secondary | NO | NO | N/A | Irritant | NS or D5W | 0.6 - 20 mg/mL | ≥30 min CI: 24 hrs |
3000 mg vial + 60 mL SWFI 1000 mg vial + 20 mL SWFI (Conc: 50 mg/mL) |
24hrs +/- mesna | 7 days with mesna: No data |
Powder products only | Add drug into bag (overfill + drug volume) If goes over maximum volume allowance, manipulate during verification to just overfill only | Administer IV over at least 30 minutes. Infusion times may vary with protocol. | 1, 2, 3, 4, 8 | SDV | |
inotuzumab ozogamicin (Besponsa) |
No | No | N/A | N/A | Yes | No | 0.9 mg | N/A | Protect vials and infusion from light | NO | Secondary | NO | NO | Do Not Shake | NO | TV of 50 ml NS | N/A | 1 hour | 0.9 mg vial + 4 mL SWFI (0.25 mg/ml) Gently swirl to dissolve |
4 hrs | 3 hrs | Maximum time from reconstitution to the end of the infusion should be </= 8 hours. Refrigerated solutions should be allowed to reach RT ~ 1 hour prior to administration. Gently invert container to mix | Remove overfill and drug volume in order to make TV of 50 mL. | Infuse over 1 hour at a rate of 50 ml/hr | 1, 8 | SDV | |
isatuximab (Sarclisa) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | No | 500 mg/25 mL 100 mg/ 5 mL (20 mg/mL) |
N/A | Protect vials from light | 0.22 micron in-line filter | Secondary | NO | NO | Do Not Shake | NO | 250 ml NS or D5W (total volume) |
N/A | Titration | 20 mg/mL Solution | 5 hrs | 45 hrs, followed by 5 hrs including infusion time at room temperature | Gently homogenize the diluted solution by inverting the bag. | Remove drug volume from bag before adding drug (overfill only) | Administer as an IV infusion. | 1, 8 | SDV | |
irinotecan (Camptosar) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | No | 300 mg/15 mL 100 mg/ 5 mL 40 mg/mL (20 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Irritant | 250 - 500 mL D5W | 0.12 - 2.8 mg/mL | 90 min | 20 mg/mL Solution | 24 hrs | 48 hrs | D5W preferred (NS = precipitation) | Add drug into bag (overfill + drug volume) | Administer by IV infusion over 90 minutes. Some peds protocols give over 1 hour. | 1, 3, 4, 8 | SDV | |
irinotecan liposome (Onivyde) |
No | No | N/A | N/A | Yes | No | 43 mg/10 mL (4.3 mg/mL) |
N/A | Protect from light | DO NOT FILTER | Secondary | NO | NO | Do Not Shake | NO | 500 mL NS or D5W | N/A | 90 min | 4.3 mg/mL Solution | 4 hrs | 24 hrs | Mix diluted solution by gentle inversion. Allow diluted solution to come to RT prior to admin. | Add drug into bag (overfill + drug volume) | Administer by IV infusion over 90 minutes | 1, 8 | SDV | |
ixabepilone (Ixempra Kit) |
No | No | N/A | N/A | Yes | No | 45 mg 15 mg | Do Not Refrigerate | Protect vials from light | in-line 0.2 micron | Primary | YES | Non-DEHP Container | Do Not Shake | Irritant | LR | 0.2 - 0.6 mg/mL | 3 hrs | 15 mg + 8 mL of supplied diluent 45 mg + 23.5 mL of supplied diluent (Conc: 2 mg/mL) |
6 hrs including infusion time | N/A | Allow vials to stand at room temperature for 30 mins prior to preparation; precipitate will dissolve as the vial warms to RT. Gently swirl and invert vial until completely dissolved. | Add drug into bag (overfill + drug volume) | Infuse over 3 hours | 1, 8 | SDV | |
loncastuximab tesirine (Zynlonta) |
No | No | N/A | N/A | Yes | No | 10 mg | N/A | Protect vials from light | 0.2-0.22 micron | Secondary | NO | NO | Do not Shake | Irritant with vesicant-like properties | 50 mL D5W | N/A | 30 minutes | 10 mg vial + 2.2 mL SWFI (Conc: 5 mg/ml) |
8 hrs | 24 hrs | Inject diluent for reconstitution toward the inside wall of vial. Swirl the vial gently until the powder is completely dissolved. | Add drug into bag (overfill + drug volume) | Infuse over 30 minutes | 1, 8 | SDV | Reconstitution instructions say "add" to infusion bag containing D5W 50 ml. |
lurbinectedin (Zepzelca) |
No | No | N/A | N/A | Yes | No | 4 mg | N/A | NO | NO | Secondary | YES | Non-DEHP Container | NO | Vesicant | 250 mL NS or D5W | N/A | 60 minutes | 4 mg vial + 8 mL SWFI (Conc: 0.5 mg/mL) |
24 hours including infusion time | 24 hours including infusion time | Add drug into bag (overfill + drug volume) | Infuse over 60 minutes | 1, 8 | SDV | ||
melphalan (Alkeran) |
No | No | N/A | N/A | Yes | No | 50mg | Do Not Refrigerate | NO | NO | Secondary | NO | NO | NO | Vesicant | NS | BMT: 2 mg/mL Non-BMT: 0.1 - 0.45 mg/mL |
15 min | 50mg vial + 10 mL supplied diluent (Conc: 5 mg/mL) |
Complete w/in 1 hr of reconstitution | N/A | Reconstitute by rapidly injecting 10 mL of supplied diluent directly into the vial and immediately shake vial vigorously until clear solution is obtained. Prepare as close to the administration time as possible (less than 15 minutes preparation and delivery time). |
Add drug into bag (overfill + drug volume) | Infusion over 15 minutes | 1, 18 | Propylene-glycol based melphalan 2mg/mL was stable in NS for 2 hours at room temperature and for 4 hours refrigerated at 4 degrees Celsius. A precipitate formed after 6 hours under refrigeration. | |
melphlalan (Evomela) |
No | No | N/A | N/A | Yes | No | 50mg | Do Not Refrigerate | NO | NO | Secondary | NO | NO | NO | Vesicant | NS | Max 2 mg/mL | 30 min | 5 mg/mL | Stable for 4 hours at room temperature plus the 1 hour following reconstitution | 24 hrs | Use NS solution (8.6mL as directed) to reconstitute Evomela. | Remove drug volume and overfill in order to make total volume of 500mL | Infusion over 30 minutes | 1, 18 | Captisol-enabled melphalan 2mg/mL was stable in NS for 24 hours at room temperature and when refrigerated at 4 degrees Celsius. | |
methotrexate (Folex, MTX) (IT CNR available) |
Yes | No | Room Temperature | Do Not Prep Syringe on Friday | Yes | Yes | 1000 mg/40 mL 250 mg/10 mL 50 mg/2 mL (25 mg/mL) |
N/A | Protect vials and dilution from light | NO | Secondary | NO | NO | N/A | NO | 50 - 1000 mL NS or D5W IT: 5 - 6 mL PF NS IM: 2 mL per site (if > 2 mL, use multiple syringes) PEDs: Per Protocol |
Max 25 mg/mL | IVP: each 10 mg over 1 min. IVPB: ≥30 min or CI over 24 hrs. |
25 mg/mL PF Solution | 72 hrs IT: 4 hrs IM Syringe: 24 hrs |
72 hrs IT: N/A IM Syringe: 24 hrs |
Use Preservative-Free NS for intrathecal preparations and for high-dose methotrexate | Add drug into bag (overfill + drug volume) If goes over maximum volume allowance, manipulate during verification to just overfill only |
May be administered as slow IVP, bolus infusion, 24 hour continuous infusion, or IM. | 1, 3, 4, 8, 13 | SDV | May be dispensed in IVPB or syringe. |
mirvetuximab soratansine (Elahere) |
No | No | N/A | N/A | Yes | No | 100mg/20mL (5 mg/mL) |
N/A | Protect vials from light | PES in-line 0.2-0.22 micron | Primary PRIME LINE WITH DRUG |
NO | NO | Do Not Shake | NO | D5W | 1 - 2 mg/mL | Titration | 5 mg/mL solution | 8 hours | 12 hours | Not compatible with NS | Add drug into bag (overfill + drug volume) If goes over maximum volume allowance, manipulate during verification to just overfill only |
1, 8 | SDV | ||
mitoMYcin (Mutamycin) |
No | No | N/A | N/A | Yes | Yes | 40 mg 20 mg 5 mg |
N/A | Protect vials and dilution from light | Yes for opthalmic preparations | Secondary | NO | NO | N/A | Vesicant | 50 mL NS 40 mg/40 mL NS Bladder Irrigation |
Undiluted: 0.5 mg/mL Diluted: 0.02 - 0.04 mg/mL |
IV Push: 5-10 min IVPB: 15-30 min |
5 mg vial + 10 mL SWFI 20 mg vial + 40 mL SWFI 40 mg vial + 80 mL SWFI (Conc: 0.5 mg/mL) |
NS: 3 hrs D5W: 3 hrs |
24 hrs | Filter eye preps with 0.22 micron filter. Bladder irrigation in syringe 1 mg/mL dilution. |
Drug volume, if ever in an IVPB also include overfill and drug volume | Administer as slow IVP via freely-running saline infusion. Also administered intravesically and intra-arterially. | 1, 3, 4, 8, 13 | SDV | Dispensed in a syringe. |
mitoXANTRONE (Novantrone) |
No | No | N/A | N/A | Yes | Yes | 20 mg/mL 12.5 mg/12.5 mL 30 mg/15 mL (2 mg/mL) |
N/A | NO | NO | Secondary | NO | NO | N/A | Irritant with vesicant-like properties | 100 mL (at least 50 mL) NS or D5W CI: 1000 mL NS |
N/A | IVPB: 15-30 min CI: 24 hrs |
2 mg/mL Solution | 48 hrs | Protect from light: 7 days |
Do not administer IT, SubQ, IM, or intra-arterial. | Add drug into bag (overfill + drug volume) | Usually administered as a short IV infusion over 5 to 15 minutes. Do not infuse over less than 3 to 5 minutes. | 1, 2, 3, 4, 8, 19 | SDV | syringe |
mycophenolate (Cellcept) |
No | No | N/A | N/A | No | No | 500 mg | Do not refrigerate | NO | NO | Secondary | NO | NO | N/A | NO | 1 g: add to 140 mL D5W 1.5 g: add to 210 mL D5W |
6 mg/mL | No less than 2 hours | 500 mg vial + 14 mL D5W Total Volume = 15 mL (Conc: 33.3 mg/mL) |
4 hrs | N/A | Label with gloves/handle carefully sticker. Not compatible with NS. |
N/A | Do not administer IV solution by rapid or bolus injection. | 1, 8 | SDV | |
nelarabine (Arranon) |
No | No | N/A | N/A | Yes | No | 250 mg/50 mL (5 mg/mL) |
Do Not Refrigerate | NO | NO | Secondary | NO | NO | N/A | NO | Do not dilute | 5 mg/mL | Adults: 2 hrs PEDs: 1 hr |
5 mg/mL Solution | 8 hrs | N/A | Transfer the appropriate dose into empty PVC bag. | Straight drug | Infuse over 2 hours for adults, and 1 hour for peds. | 1, 8 | SDV | empty bag |
omacetaxine (Synribo) |
No | No | N/A | N/A | Yes | No | 3.5 mg | N/A | Protect from light | NO | N/A | N/A | N/A | Do Not Shake | N/A | N/A | N/A | N/A | 3.5 mg vial + 1 mL NS (Conc: 3.5 mg/mL) |
12 hrs | 6 days | Gently swirl until solution is clear | Straight drug | Administer SubQ | 1, 8 | SDV | syringe, goes through OSP |
oxaliplatin (Eloxatin) |
Yes | No | Refrigerated | N/A | Yes | No | 200 mg/40 mL 100 mg/20 mL 50 mg/10 mL (5 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Irritant with vesicant-like properties | 250 - 500 mL D5W | N/A | 2 hrs | 5 mg/mL Solution | 4 days | 10 days | Incompatible with NS. | Add drug into bag (overfill + drug volume) | Administer as IV infusion over 2 hours. Flush line with D5W before and after infusion. | 1, 2, 3, 4, 8, 10 | SDV | |
PACLitaxel (Taxol) |
Yes | No | Room Temperature | Do Not Prep on Friday | Yes | Yes | 300 mg/50 mL 150 mg/25 mL 100 mg/16.7 mL 30 mg/5 mL (6 mg/mL) |
N/A | Protect vials from light | 0.22 micron inline filter | Primary PRIME LINE WITH DRUG |
YES | Non-DEHP Container | N/A | Irritant with vesicant-like properties | 250 - 1000 mL NS or D5W |
0.3 - 1.2 mg/mL | 1-3 hrs CI: 24 hrs |
6 mg/mL Solution | 24 hrs | N/A | Chemo dispensing pin should not be used to withdraw paclitaxel from vial. Check compatibility with closed system transfer devices. | Remove drug volume and overfill in order to make total volume of 250mL or 500mL | Infuse over 1, 3 or 24 hours. May also be given IP. | 1, 2, 3, 4, 8 | MDV | |
PACLitaxel (Protein & Albumin Bound) (Abraxane) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | Yes | 100 mg | N/A | Protect from light | DO NOT FILTER | Secondary | NO | NO | Do Not Shake | May be an irritant | Do not dilute | N/A | 30-40 min | 100 mg vial + 20 mL NS (Conc: 5 mg/mL) |
3 hrs | 23 hrs | Slowly inject 20 mL of NS onto the INSIDE WALL OF THE VIAL to avoid foaming. Allow the vial to sit for a minimum of 5 min to ensure proper wetting of the lyophilized cake/powder. Gently swirl the vial for at least 2 min until complete dissolution of powder. If foaming or clumping occurs, stand solution for at least 15 min until foam subsides. |
Straight drug | Administer IV over 30-40 minutes | 1, 8 | SDV | empty bag |
pamidronate (Aredia) |
No | No | N/A | N/A | No | No | 90 mg/10 mL (9 mg/mL) 60 mg/10 mL (6 mg/mL) 30 mg/10 mL (3 mg/mL) |
Do not refrigerate solution formulation | NO | NO | Secondary | NO | NO | N/A | NO | 250 mL - 1000 mL NS or D5W depending upon indication | N/A | 2-24 hrs | 9 mg/mL, 6 mg/mL, and 3 mg/mL Solution | 24 hrs | N/A | N/A | Infusion rates vary by indication. | 1, 8 | SDV | ||
PEMEtrexed (Alimta) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | Yes | 1000 mg 750 mg 500 mg 100 mg |
N/A | NO | NO | Secondary | NO | NO | N/A | NO | TV 100 mL NS | N/A | 10 min | 1000 mg + 40 mL PFNS 750 mg vial + 30 mL PFNS 500 mg vial + 20 mL PFNS 100 mg vial + 4.2 mL PFNS (Conc: 25 mg/mL) |
Immediate use | 24 hrs | Incompatible in solution containing calcium or LR. | Remove overfill and drug volume in order to make total volume of 100 mL. | Infuse over 10 minutes. | 1, 2, 3, 4, 8 | SDV | |
pentostatin (Nipent) |
No | No | N/A | N/A | Yes | No | 10 mg | N/A | NO | NO | Secondary | NO | NO | N/A | NO | 25 - 50 mL NS or D5W | IVP: 2 mg/mL 0.18 - 0.33 mg/mL |
IV Push: 5 min IVPB: 20-30 min |
10 mg vial + 5 mL SWFI (Conc: 2 mg/mL) |
8 hrs | N/A | Add drug into bag (overfill + drug volume) | Administer IV over 20-30 minutes or as a bolus infusion. | 1, 4, 7, 8, 10 | SDV | May be dispensed in IVPB or syringe. | |
pertuzumab (Perjeta) |
Yes (420 mg maintenance dose only) | No | Refrigerated | Do Not Prep on Friday | Yes | No | 420 mg/14 mL (30 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | Do Not Shake | NO | 250 mL NS | N/A | 840 mg: 60min 420 mg: 30-60 min |
30 mg/mL Solution | 24 hrs | 24 hrs | Mix by gentle inversion. DO NOT SHAKE. Not compatible with D5W. |
Add drug into bag (overfill + drug volume) | IV infusion only. Infuse initial dose over 60 minutes, infusion maintenance dose over 30-60 minutes. Do not administer IV push or as a rapid bolus. | 1, 3, 8, 14 | SDV | |
pertuzumab/ trastuzumab/ hyaluronidase (Phesgo) |
No | No | N/A | N/A | Yes | Yes | 1200 mg/600 mg/30,000 units ----------- 600 mg/600 mg/20,000 units |
N/A | Protect vials from light | NO | N/A | N/A | N/A | Do Not Shake | N/A | N/A | N/A | Loading dose: 8 min. Maintenance dose: 5 min. | N/A | 4 hrs | 24 hrs | For subcutaneous use only, do not administer by other routes. | No (syringe) | Subcutaneous only, alternate the injection site between left and right thigh. | 1, 8 | SDV | Dispensed in a syringe |
polatuzumab vedotin (Polivy) |
No | No | N/A | N/A | Yes | No | 140 mg | N/A | Protect vials from light | 0.2 - 0.22 micron | Secondary | NO | NO | Do Not Shake | NO | 50 mL NS or D5W (minimum volume) | 0.72 - 2.7 mg/mL | Initial dose: 90 min. Subsequent doses: 30 min. | 140 mg vial + 7.2 mL SWFI (Conc: 20 mg/mL) |
4 hours in NS 6 hours in D5W |
24 hrs in NS 36 hours in D5W |
Slowly inject 7.2 mL of SWFI onto the INSIDE WALL OF THE VIAL. Swirl gently until completely dissolved. Gently invert bag to mix, limit agitation of dilution. |
Add drug into bag (overfill + drug volume) | Administer first infusion over 90 minutes. If tolerated, subsequent infusions may given over 30 minutes. | 1, 8 | SDV | |
PRALAtrexate (Folotyn) |
No | No | N/A | N/A | Yes | Yes | 40 mg/2 mL 20 mg/1 mL (20 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | NO | Do not dilute | N/A | IVP: 3-5 min | 20 mg/mL Solution | Use immediately | N/A | Manufacturer recommends immediate use. | Straight drug | IV Push through a side port of free flowing NS. | 1, 8 | SDV | Dispensed in a syringe |
romiDEPsin (Istodax) |
No | No | N/A | N/A | Yes | Yes | 10 mg | Do Not Refrigerate | Protect from Light | NO | Secondary | NO | NO | N/A | NO | 500 mL NS | N/A | 4 hrs | 10 mg + 2.2 mL supplied diluent (Conc: 5 mg/mL) |
24 hrs | N/A | Manufacturer recommends use as soon as possible. | Add drug into bag (overfill + drug volume) | Must be diluted prior to infusion. Infuse over 4 hours. | 1, 8 | SDV | |
sacituzumab govitecan (Trodelvy) |
No | No | N/A | N/A | Yes | No | 180 mg | N/A | Protect vials and infusion from light | NO | Secondary PRIME LINE WITH DRUG |
NO | NO | Do Not Shake | NO | TV 500 mL NS for pts weighing <170 kg. Divide dose equally into two 500 mL NS bags for pts weighing > 170 kg. |
1.1 - 3.4 mg/mL | Initial dose: 3 hours. Subsequent doses: 1-2 hours. | 180 mg vial + 20 mL NS (Conc: 10 mg/mL) |
4 hours | 24 hours; once removed from the refrigerator must be used within 8 hours including infusion time | Allow vials to come to room temperature prior to reconstitution and dilution. Gently swirl vials and allow to dissolve for up to 15 minutes. Dilute immediately. | Remove overfill and drug volume in order to make total volume of 500 mL. | Administer the initial dose over 3 hours. If well tolerated, may run subsequent infusions over 1-2 hours. | 1, 8 | SDV | |
streptozocin (Zanosar) |
No | No | N/A | N/A | Yes | No | 1000 mg | N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Irritant with vesicant-like properties | 50 - 250 mL NS or D5W | Max 100 mg/mL | Varies | 1000 mg vial + 9.5 mL NS (Conc: 100 mg/mL) |
12 hrs | 12 hrs | Add drug into bag (overfill + drug volume) | Administer as a rapid IV injection or as short or prolonged infusion. | 1, 4, 8 | SDV | ||
talimogene laherparepvec (Imlygic) |
No | No | N/A | N/A | Yes | No | 1 million PFU/mL ----------- 100 million PFU/mL |
N/A | Protect vials from light | NO | N/A | N/A | N/A | Do Not Shake | N/A | Do not dilute | N/A | Intralesional injections | 1 million PFU/mL ------------ 100 million PFU/mL |
1 million PFU: 12 hrs 100 million PFU: 48hrs |
1 million PFU: 24 hrs 100 million PFU: 1 week | Store at -80 degree Celsius freezer. Store in the carton until use. Thaw frozen vials at RT until liquid (approx. 30-70 minutes). Swirl gently. Handle carefully - follow biohazard policy. |
Straight drug | Inject intralesionally into cutaneous, subcutaneous and/or nodal lesions. | 1, 8 | SDV | syringe |
temozolomide (Temodar) |
No | No | N/A | N/A | Yes | No | 100 mg | Refrigerate vials. Do not refrigerate dilution. | NO | NO | Secondary | NO | NO | Do Not Shake | NO | Do not dilute | 2.5 mg/mL | 90 min | 100 mg vial + 41 mL SWFI (Conc: 2.5 mg/mL) |
14 hrs (including infusion time) | N/A | Bring the vial to RT prior to reconstitution. Gently swirl. Transfer the appropriate dose into empty bag. Must be infused in NS containing line. | Straight drug | Infuse over 90 minutes. | 1, 8 | SDV | empty 250 mL bag |
temsirolimus (Torisel) |
No | No | N/A | N/A | Yes | No | 25 mg | Refrigerate vials. Do not refrigerate dilution. | Protect vials and dilution from light | 0.2-5 micron | Primary | Yes | Non-DEHP Container | Avoid excessive shaking | NO | 250 mL NS | N/A | 30-60 min | 25 mg/mL vial + 1.8 mL supplied diluent (Conc: 10 mg/mL) (stable 24 hrs in vial at RT) |
6 hrs after the addition to NS | N/A | Mix well by inversion of the vial. Allow sufficient time for air bubbles to subside. | Add drug into bag (overfill + drug volume) | Infuse over 30-60 minutes, | 1, 8 | SDV | |
thiotepa (Tepadina) |
No | No | N/A | N/A | Yes | No | 15mg 100mg |
N/A | Protect vials and dilution from light | 0.22 micron syringe filter prior to dilution AND 0.2 micron in-line filter on final product | Secondary | No | No | N/A | Irritant | IVPB: 100 - 10000 mL NS IT: 10 mL PF NS |
IVPB: 0.5 - 1 mg/mL | 3 hours | 15 mg vial + 1.5 mL SWFI (Conc: 10 mg/mL) 100 mg vial + 10 mL SWFI (Conc: 10mg/mL) |
Use immediately If not used immediately, stable for 4 hours |
Use immediately If not used immediately, stable for 24 hours |
Filter through 0.22 micron syringe filter prior to dilution | Add drug into bag (overfill + drug volume) | 1, 8 | SDV | ||
tisotumab vedotin (Tivdak) |
No | No | N/A | N/A | Yes | No | 40 mg | N/A | Protect vials and infusion from light | 0.2 micron in-line filter | Secondary | NO | NO | Do Not Shake | NO | NS or D5W | 0.7 mg/mL to 2.4 mg/mL | 30 minutes | 40 mg vial + 4 mL SWFI (Conc: 10 mg/mL) |
Use immediately | NS: 18 hours D5W: 25 hours |
If refrigerated, complete administration of the diluted infusion solution within 4 hours including infusion time. | Add drug into bag (overfill + drug volume) | Infusion over 30 minutes. Do not infuse as IV push or bolus. | 1, 8 | SDV | |
topotecan (Hycamtin) |
Yes | No | Refrigerated | N/A | Yes | No | 4 mg/4 mL (1 mg/mL) |
N/A | Protect vials and infusion from light | NO | Secondary | NO | NO | N/A | Irritant | 50 - 100 mL NS or D5W |
0.01 - 0.5 mg/mL | IVPB: 30 min CI: 24 hrs |
1 mg/mL Solution | 24 hrs | 7 days | Add drug into bag (overfill + drug volume) | Administer IV piggyback over 30 minutes | 1, 2, 3, 4, 10 | SDV | ||
trabectedin (Yondelis) |
No | No | N/A | N/A | Yes | No | 1 mg | N/A | NO | 0.2 micron in-line filter | Secondary | NO | NO | N/A | Vesicant | NS or D5W | N/A | IVPB: 3 hours CI: 24 hrs |
1 mg + 20 mL SWFI (Conc: 0.05 mg/mL) |
30 hours including infusion time | N/A | Infusion must be completed within 30 hours of reconstitution. | Add drug into bag (overfill + drug volume) | Infuse as a continuous infusion over 24 hours, off-label as IVPB over 3 hours. | 1, 8 | SDV | |
vinBLAStine (Velban) |
Yes | No | Refrigerated | N/A | Yes | Yes | 10 mg/10 mL (1 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Vesicant | 25-50 mL NS IVPB | Max 1 mg/mL | IVPB: 15 min | 1 mg/mL Solution | 24 hrs | 7 days | FATAL IF GIVEN INTRATHECALLY | Add drug into bag (overfill + drug volume) | Administer in IVPB only and give as a short infusion. | 1, 2, 3, 4, 8 | MDV | |
vinCRIStine (Oncovin) |
Yes | No | Refrigerated | N/A | Yes | Yes | 2 mg/2 mL 1 mg/mL (1mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Vesicant | 25-50 mL NS IVPB | 0.0015 - 0.08 mg/mL | IVPB: 15 min | 1 mg/mL Solution | 48 hrs | 5 days | FATAL IF GIVEN INTRATHECALLY | Add drug into bag (overfill + drug volume) | Administer in IVPB only and give as a short infusion. | 1, 2, 3, 4, 8 | SDV | |
vinorelbine (Navelbine) |
Yes | No | Refrigerated | Do Not Prep on Friday | Yes | No | 50 mg/5 mL (10 mg/mL) |
N/A | Protect vials from light | NO | Secondary | NO | NO | N/A | Vesicant | 25-50 mL NS IVPB |
0.5 - 2 mg/mL |
IVPB: 6-10 min | 10 mg/mL Solution | 24 hrs | 24 hrs | FATAL IF GIVEN INTRATHECALLY | Add drug into bag (overfill + drug volume) | Administer IVPB only over 6-10 minutes, followed by at least 75 mL compatible IV solution. | 1, 2, 3, 4, 8 | SDV | |
ziv-aflibercept (Zaltrap) |
No | No | N/A | N/A | Yes | No | 200 mg/8 mL 100 mg/4 mL (25 mg/ mL) |
N/A | Protect vials from light | 0.2 micron polyether sulfone filter | Secondary | NO | NO | N/A | NO | NS or D5W | 0.6-8 mg/mL | 1 hour | 25 mg/mL Solution | 8 hrs | 24 hrs | After initial vial puncture, do not re-enter vial. | Add drug into bag (overfill + drug volume) | Infuse over 1 hour. Do not administer as an IV push or bolus. | 1, 8 | SDV | |
zoledronic acid (Zometa) |
No | Yes | Refrigerated | Do Not Prep on Friday | No | No | 4mg/5 mL (0.8 mg/mL) |
N/A | NO | NO | Secondary | NO | NO | N/A | NO | 100 mL NS or D5W | N/A | 15 minutes | 0.8 mg/mL Solution | Immediate Use | 23 hrs | Do not mix with calcium containing solutions. If refrigerated, allow to come to room temperature prior to administration. | N/A | Infuse over at least 15 minutes | 1, 8 | SDV | |
EPOCH (vincCRIStine, DOXOrubicin, etoposide) | No | No | N/A | N/A | Yes | Yes | see individual components | N/A | See individual components; Protect dilution from light | NO | Primary | YES | Non-DEHP Container | Do Not Shake | Vesicant | Etoposide </= 125mg: 500 mL NS Etoposide > 125mg: 1000 mL NS |
Vincristine: 0.001-0.002 mg/mL Doxorubicin: 0.025-0.05 mg/mL Etoposide: </= 0.25 mg/mL |
CI: 24 hrs | See individual components | 36 hrs | N/A | EPOCH bags can ONLY be safely given over 24 hours. No extended infusion bags. | Remove overfill and drug volume in order to make total volume of 500 or 1000 mL. | Infuse as a continuous infusion over 24 hours | 6, 8 | See individual components | |
HIPEC (CISplatin & DOXOrubicin) |
yes | Light Protected | Exactamix Container | IP: 2000 mL Dianeal Low Calcium 1.5% (Dialysis Solution) Transferred to Exactamix Bag |
90 min | 24 hrs | Transfer contents of peritoneal dialysis solution to an empty Exactamix bag before adding chemo drugs. Overfill and volume of drug added are not removed. No tubing is attached to bag. No spiros cap is attached to bag. Add “Not for IV Use” Label. |
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HIPEC (mitoMYcin & DOXOrubicin) |
No | Light Protected | Exactamix Container | IP: 2000 mL Dianeal Low Calcium 1.5% (Dialysis Solution) Transferred to Exactamix Bag |
90 min | 24 hrs | Transfer contents of peritoneal dialysis solution to an empty Exactamix bag before adding chemo drugs. Overfill and volume of drug added are not removed. No tubing is attached to bag. No spiros cap is attached to bag. Add “Not for IV Use” Label. |
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HIPEC (melphalan) |
No | Exactamix Container | IP: 2000 mL Dianeal Low Calcium 1.5% (Dialysis Solution) Transferred to Exactamix Bag |
60 min | Complete w/in 1 hr of reconstitution | N/A | Transfer contents of peritoneal dialysis solution to an empty Exactamix bag before adding chemo drugs. Overfill and volume of drug added are not removed. No tubing is attached to bag. No spiros cap is attached to bag. Add “Not for IV Use” Label. Prepare as close to the administration time as possible (less than 15 minutes preparation and delivery time). MUST DOCUMENT IN MELPHALAN BINDER. |
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** add reuse to sterile products policy - column Q |
** issue - prep site - and HL7 - field is only 5 characters in CATO - disp prep location Epic is in RXE 40 - Ginger |
prep site - interim pick defaults to prep site 1 - PS1 - all use this |
** storage will need to be the same - 797 - ISO 5 - compounding - made in hood; use CSTD - so microbial is 2 weeks. if e.g. bendamustine - Treanda is 1 x use; Bendeka - multidose vial. Picks the lesser of 2 #s so if remainder of the med, then that is what shows for the remainder. so have to put chemical because shorter |
also change fluid name a bit… error; universal BUD - Joe |
** UID=Med ID, not Epic ERX (conc level) - product in general unless talking about a specific vial size; then need med ID if more than 1 vial size. HL7 interface - Med ID comes through |
e.g. amiodarone - central vs peripheral; low-rate syringes 3mL vs 50mL syringe and we have 2 Med ID - so have to build both of these. So, name will have to be discreet as well and in this case is it 4 products? ==> |
**BOP labeling rules re: generic vs Brand - Angie - |