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Medications listed are available on OH EPIC Formulary, unless otherwise noted.
Not all formulary medications are available at each facility. Please refer to your local pharmacy for available inventory.
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.
Do not use if discolored or visible particles present
Incompatible in D5W.

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.
    17    
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.
    17    
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.
    17    
** 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 - 

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