1 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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