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Pain Management Stability Charts

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                 Analgesics, Chemotherapeutics and Antibiotics Drug Stability Chart
                             using the Accufuser® Drug Delivery System

Accufuser, Accufuser 275, Accufuser Plus, Accufuser CTx and Accufuser ABx, disposable elastomeric silicone balloon infusers, are
indicated for continuous infusion of medications for pain management, chemotherapy, thalassemia and antibiotic therapy through
intravenous, subcutaneous, percutaneous, intraoperative, perineural or epidural routes.

                                 ®
The material of the Accufuser        balloon is silicone. This material has been used widely throughout the medical device industry since 1980
as a means to infuse blood products, nutritionals, chemotherapeutics, analgesics, antibiotics and other drugs.


The stability data on drugs tested in Accufuser® relate to chemical stability with silicone and microbiological stability too. Medications were
transferred into Accufuser silicone balloon and placed at room temperature, and in some cases refrigerated.


Special attention must be paid to the drug’s potential for precipitation, which may occur depending on preparation, storage condition,
temperature, concentration, pH and specific diluents.


These guidelines were developed as a result of testing performed by independent laboratories, and after a review of various medical
publications drug manufacturers’ product information. These guidelines should be used as a reference only; they are not intended to
replace specific instruction from physicians or pharmacists with experience and additional information about administration of these drugs.


If there is a medication to be administered but not listed in these charts, please refer to the pharmaceutical manufacturer’s recommendation
on that specific drug’s compatibility with silicone and stability information.
                                                                                                        ®
The fact that a medication is not listed here does not mean that it is not compatible with Accufuser.

                                                          (Last updated : May 4, 2009)
2
                                                                                           ®
                                                 Drug Stability Data in Accufuser
                                                                                                                                 (Unit: day)
                                                                                                                     Stability
                                                                             Concentration
                Drugs                        Preparation / Diluent                                  Room Temperature              Refrigerated
                                                                                (mg/ml)
                                                                                                          (23-25℃)                    (4℃)
             TRAMADOL                         300mg in 60ml NS                   5mg/ml                     28                         N.A.
             TRAMADOL                         400mg in 60ml NS                  6.6mg/ml                    28                         N.A.
             TRAMADOL                         500mg in 60ml NS                  8.3mg/ml                    28                         N.A.
             TRAMADOL                         600mg in 96ml NS                  6.3mg/ml                    28                         N.A.
             TRAMADOL                         800mg in 96ml NS                  8.3mg/ml                    28                         N.A.
                                          Tramadol 250mg+Ketorolac
     TRAMADOL + KETOROLAC                                                     4.2+1mg/ml                    17                         N.A.
                                               60mg in 60ml NS
                                          Tramadol 350mg+Ketorolac
     TRAMADOL+ KETOROLAC                                                    5.8mg+1.5mg/ml                  28                         N.A.
                                               90mg in 60ml NS
                                          Tramadol 500mg+Ketorolac
     TRAMADOL+ KETOROLAC                                                     8.3+1.8mg/ml                   28                         N.A.
                                              110mg in 60ml NS
                                          Tramadol 400mg+Ketorolac
     TRAMADOL+ KETOROLAC                                                     4.2+0.9mg/ml                   28                         N.A.
                                               90mg in 96ml NS
                                          Tramadol 550mg+Ketorolac
     TRAMADOL+ KETOROLAC                                                     5.7+1.6mg/ml                   28                         N.A.
                                              150mg in 96ml NS
                                          Tramadol 800mg+Ketorolac
     TRAMADOL+ KETOROLAC                                                     8.3+1.9mg/ml                   28                         N.A.
                                              180mg in 96ml NS
            KETOROLAC                          90mg in 50ml NS                  1.8mg/ml                    28                         N.A.
Note: NS – normal saline, D5W – dextrose 5% in water, N.A. – information not available at time of print
3
                                                                                          ®
                                               Drug Stability Data in Accufuser (cont’d)
                                                                                                                           (Unit: day)
                                                                                                                     Stability
                                                                             Concentration
            Drugs                        Preparation / Diluent                                      Room Temperature             Refrigerated
                                                                                (mg/ml)
                                                                                                          (23-25℃)                  (4℃)
        KETOROLAC                         110mg in 60ml NS                      1.8mg/ml                    28                       N.A.
        KETOROLAC                         120mg in 96ml NS                      1.2mg/ml                    28                       N.A.
        KETOROLAC                         180mg in 96ml NS                      1.9mg/ml                    28                       N.A.
        BUPIVACAINE                       0.125% in 60ml NS                     0.125%                      30                       N.A.
        BUPIVACAINE                      0.125% in 120ml NS                     0.125%                      30                       N.A.
        BUPIVACAINE                      0.125% in 240ml NS                     0.125%                      30                       N.A.
         MORPHINE                  84mgmorphine sulfate in 84ml NS              1.0mg/ml                    70                       N.A.
         MORPHINE                 126mg morphine sulfate in 84ml NS             1.5mg/ml                    70                       N.A.
         MORPHINE                168mg morphine sulfate in 84ml NS              2.0mg/ml                    70                       N.A.
       FENTANYL CIT.                   Fentanyl cit. D5W or NS                 20mcq/ml                     30                    30 at 3℃
Note: NS – normal saline, D5W – dextrose 5% in water, N.A. – information not available at time of print
4
                                                                                             ®
                                                  Drug Stability Data in Accufuser (cont’d)
                                                                                                                                         (Unit: day)

                                                                                                                                          Stability

           Drugs                                                 Preparation / Diluent                Concentration         Room Temperature          Refrigerated
                                        Brand
                                                                                                                                (23-25℃)                (4-8℃)

        BLEOMYCIN                    BLENOXANE                  Bleomycin sulfate in NS                4㎍/ml in NS                 14                     28

         CISPLATIN                 CDDP, PLATINOL                    Cisplatin in NS                   1mg/ml in NS                14                     N.A.

    CYCLOPHOSPHAMIDE                  CYTOXAN                   Cyclophosphamide in NS                 8mg/ml in NS                 6                     28

        CYTARABINE                      ARA-C                       Cytarabine in NS                  5mg/ml in D5W                30                     30

       DOXORUBICIN                ADRIAMYCIN, ADR                  Doxorubicin in NS                   1mg/ml in NS                14                     30

        ETOPOSIDE                  VESPESID, VP-16                     Etoposide                   2-4mg/ml in NS or D5W            8                     N.A.

       FLOXURIDINE                      FUDR                    Floxuridine in NS or D5W          5-10mg/ml in NS or D5W           14                     N.A.

      FLUOROURACIL                   5-FU (Mayne)                  Fluorouracil in NS             1.6-14.5mg/ml in NS/D5W          14                     31

                               HOLOXAN, UROMITEXAN
    IFOSFAMIDE+MESNA                                              IFO + MESNA in NS                  16+3.2mg/ml in NS              8                     N.A.
                                         (Asta)

    LEUCOVORIN CALCIUM              WELLCOVORIN             Leucovorin calcium in NS or D5W       10-20mg/ml in NS or D5W          7*                     N.A.

 METHOTREXATE SODIUM                 FOLEX, MTX                   Methotrexate in NS                  1-2mg/ml in NS               14                     N.A.

      MITOXANTRONE
                                    NOVANTRONE                    Mitoxantrone in NS                   2mg/ml in NS                7*                      7
      HYDROCLORIDE

                                                           Vinblastine sulfate in the dark both
    VINBLASTINE SULFATE                VELBAN                                                      1mg/ml in NS or D5W             21                     21
                                                                       NS or D5W

        VINCRISTINE                    ONCOVIN                 Vincristine in Nacl or D5W          20㎍/ml in Nacl or D5W           21                     25

Note: NS – normal saline, D5W – dextrose 5% in water, N.A. – information not available at time of print, * - temperature not specified
5
                                                                                          ®
                                               Drug Stability Data in Accufuser (cont’d)
                                                                                                                           (Unit: day)

                                                                                                                          Stability

               Drugs                          Brands                        Concentration                  Room Temperature           Refrigerated

                                                                                                               (23-25℃)                  (4-8℃)

        ALGLUCERASE INJ.                     Ceredase                 1.2-1.5units/ml in 100ml NS                N.A.                      7

           CIMETHIDINE                       Tegamet                 900mg in 100ml D5W or NS                     7                        8

        DESFERRIOXAMINE                       Desferal                 250mg/ml in NS or D5W                      7                       N.A.

      DEXAMETHASONE SOD.                     Decadron                  4-24mg/ml in NS or D5W                     7                       N.A.

           DOBUTAMINE                         Doburex                         1-4mg/ml                            2                        7

         HEPARIN SODIUM                          -                    20-35units/ml in NS or D5W                  4                       14

        METOCLOPROMIDE                        Regian                   2-5mg/ml in NS or D5W                      2                        2

        ODANSETRON HYD.                       Zofran                 15mg/kg in 50ml NS or D5W                    7                       14

        PENTAMIDINE ISETH.                    Pentam                  1 or 2mg/ml in NS or D5W                    2                       N.A.

            RANITIDINE                        Zantac                    2mg/ml in NS or D5W                       28                      92

      METHYLPREDNISOLONE                    Novopharm                   1-10mg/ml in NS/D5W                      2.56                     18

           PAMIDRONATE                    Mayne Pharma                  0.06-0.36mg/ml in NS                      17                      21

Note: NS – normal saline, D5W – dextrose 5% in water, N.A. – information not available at time of print,
6
                                                                                                         ®
                                     Stability Data of Antibiotics and Antivirals in Accufuser
                                                                                                     (Unit: day, unless otherwise indicated)

                                                                                                                      Stability

               Drugs                             Brands                     Concentration            Room Temperature             Refrigerated

                                                                                                          (23-25℃)                   (4℃)

           TICARCILLIN &                                                    30+1mg/ml in NS
                                       Timentin (GlaxoSmithKline)                                             7                        7
         CLAVULANIC ACID                                                    60+2mg/ml in NS

          PIPERACILLIN &                                                20+2.5mg/ml in NS/D5W
                                                 Tazocin                                                     14                       14
           TAZOBACTAM                                                  80mg+10mg/ml in NS/D5W

           GANCICLOVIR                         Cimevene                  1-5mg/ml in NS or D5W                3                        8

                                                                            30mg/ml in SW                     3                        4
         AMPICILLIN SOD.                 Ampicillin sod. (Sigma)
                                                                             30mg/ml in NS                    3                        4

                                                                          10,000 units in D5W                N.A.                      2
         PENICILLIN G POT.              Penicillin G pot. (Sigma)
                                                                           50,000 units in NS                N.A.                      7

                                                                            5mg/ml in D5W                     2                       42
          OXACILLIN SOD.                  Oxacillin sod. (Fluka)
                                                                             5mg/ml in NS                     7                       42

                                                                            2.5mg/ml in D5W                  14                       42
          NAFCILLIN SOD.                  Nafcillin sod. (Sigma)
                                                                            2.5mg/ml in NS                    7                       42

                                                                           5mg/ml in NS/D5W               30 hours                    30

             CEFEPIME                       Axepim (Bristol)               30ml/ml in NS/D5W              30 hours                    21

                                                                          60mg/ml in NS/D5W               30 hours                    12

           VANCOMYCIN                            Hospira              2.5mg/ml, 5mg/ml in NS/D5W             14                       29

           MEROPENEM                    MERREM (Astra Zenaca)               5-20mg/ml in NS            Less than 1 hour               4.5

Notes ----- NS: Normal Saline, D5W: 5% Dextrose, N.A.: Information not available at time of print.
7
                                                                                                     ®
                                Stability Data of Antibiotics and Antivirals in Accufuser (cont’d)
                                                                                                     (Unit: day, unless otherwise indicated)

                                                                                                                      Stability

               Drugs                            Brands                      Concentration            Room Temperature             Refrigerated

                                                                                                          (23-25℃)                   (4℃)

            ERTAPENEM                    INVANZ (Merck Frosst)              5-40mg/ml in NS           Less than 24 hours            82 hours

           CLINDAMYCIN                         SANDOZ                    2-12mg/ml in NS/D5W                  7                       21

            CEFAZOLIN                         Novopharm                  5-40mg/ml in NS/ D5W                 3                       14

           CEFTRIAXONE                     Rocephin (Roche)              5-40mg/ml in NS/D5W                  2                       14

                                                                            5-40mg/ml in NS                   1                        7
           CEFTAZIDIME                  Fortaz (GlaxoSmithKline)
                                                                           5-40mg/ml in D5W                   1                        3

Notes ----- NS: Normal Saline, D5W: 5% Dextrose, N.A.: Information not available at time of print.

								
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