Chemostabilitychart1july2010formatted 101011233228 Phpapp02

BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative
Status) Aldesleukin 22 million IU (1.3 mg) (Novartis) (F)(PFL) no preservative1 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1.2 mL SWI1,2 direct diluent against side of vial during reconstitution1 do not shake1
18 million IU/mL (1.1 mg/mL)1,2
48 h F1
50 mL D5W1 30 70 mcg/mL1 < 30 mcg/mL: dilute in D5W containing human albumin 0.1%2
48 h F1
- cytotoxic3 - do not use in-line filter1,2 - avoid bacteriostatic water for injection or NS due to increased aggregation1 - cytotoxic7 - do not shake8
Alemtuzumab 30 mg/mL (Genzyme previously Bayer)4 (F)(PFL) do not shake no preservative5
N/A
filter NOT required 30 mg/mL5
discard unused portion5
SC syringe
discard at the end of the day F or RT
100 mL NS or D5W5
8 h F or RT5 **(PFL)8
Alemtuzumab 30 mg/3 mL (Schering/Ilex) (F)(PFL) do not shake no preservative9
N/A
use 5 micron filter to withdraw drug from ampoule8 10 mg/mL9
SC syringe6
discard at the end of the day F or RT8
- cytotoxic7 - do not shake8
BC Cancer Agency Chemotherapy Preparation and Stability Chart version 2.00 Activation Date: 2 March 2006 Revised Date: 1 July 2010
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
100 mL NS or D5W9
8 h F or RT8 **(PFL)8
Amifostine 500 mg (MedImmune) (RT) no preservative10 Amsacrine 75 mg/1.5 mL (Erfa Canada) (RT) no preservative12
9.7 mL NS only10
50 mg/mL10
24 h F, 5 h RT10
2550 mL*NS only10
540 mg/mL: 24 h F,10 5 h RT
- noncytotoxic10 - discard cloudy solution11
glass syringes preferred during reconstitution; max. time in plastic syringe12: 15 min 13.5 mL supplied diluent (L-lactic acid)1 transfer 1.5mL from ampoule into the diluent vial12
5 mg/mL12
24 h RT12 PFL12
500 mL D5W12 (plastic or glass container)12
7 d F, 48 h RT12,13,14
- cytotoxic15
2/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Asparaginase16 (asparaginase E. coli) 10,000 units (Orphan Pharmaceutical International) (F) no preservative17 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
do not shake; roll to reconstitute18,11 4 mL SWI19 Intradermal test11: Reconstitute with 5 mL SWI to give 2000 units/mL Transfer 0.1 mL to 10 mL vial (or 12 mL syringe) Add 9.9 mL SWI roll to dissolve to give 20 units/mL 2 unit test dose = 0.1 mL (Note: the rest of the reconstituted vial has a concentration of 2000 units/mL)11
2500 units/mL16
48 h F, RT16
syringe16
14 d F20, 16
- cytotoxic3
50 mL*NS or D5W20,13
14 d F,20,13 2 d RT20,21
3/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Erwinia asparaginase (asparaginase Erwinia chrysanthemi) 10,000 units (Orphan Pharmaceuticals International) (F) no preservative22 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
do not shake; roll to reconstitute22 1-2 mL NS22
10000-5000 units/mL
15 min in original container; 8 h in a glass or polypropylene syringe22
glass or polypropylene syringe22
8 h in a glass or polypropylene syringe22
- cytotoxic3
4/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) PEG-asparaginase (pegasparagase) (pegylated asparaginase E. coli) 750 units/mL (Enzon) (F) no preservative23 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
750 units/mL23
IM: maximum volume 2 mL; if >2 mL use multiple sites23
syringe: 4 h23,24
- cytotoxic3 - discard cloudy solution23 - do not shake23 - do not use if stored out of refrigerator for > 48 h23 - do not use if previously frozen23
IV: 100 mL NS or D5W23
bag: 4 h23,24
5/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Azacitidine 100 mg (Celgene) (RT) no preservative25 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4 mL SWI25 shake vigorously25
25 mg/mL25
8 h F, 45 min RT25
SC syringe25
45 min RT25 prepare immediately before use and use within 45 min, or discard.
- cytotoxic3 - discard if contains large particles25 - re-suspend syringe contents before injection by vigorously rolling syringe between palms25 - cytotoxic7
BCG 81 mg (Sanofi Pasteur) (F)(PFL) preservative26
do not shake; roll to reconstitute26 3 mL supplied diluent26 record time of reconstitution
10.5 8.7108 CFU/vial (Connaught strain)26
2 h F, RT26
50 mL NS26
2 h F or RT after reconstitution26 **(PFL)26
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) BCG (Tice substrain) 50 mg = 1 to 8 x 108 CFU (Hospira/Organon) (F)(PFL) no preservative27 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1 mL preservative free NS for injection27 use reconstitution device provided allow to stand for a few minutes, then gently swirl to suspend27
1 to 8108 CFU/vial27
2 h F (PFL)27
transfer from vial to 60 mL syringe, rinse vial with another 1 mL NS. Add rinse to same 60 mL syringe. qs to 50 mL with NS27
2 h F27
- cytotoxic3 - overfill unknown - protect from light27 - do not filter27
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Bendamustine 25 mg single-use vial 100 mg single-use vial (Cephalon) (RT)(PFL) no preservative28 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
25 mg vial: add 5 mL SWI 100 mg vial: add 20 mL SWI28 Shake well to yield a clear, colourless to a pale yellow solution. Expected to completely dissolve within 5 minutes28
5 mg/mL28
30 minutes28
500 mL NS28 0.2-0.6 mg/mL28
24 h F, 3 h RT28
- cytotoxic3
Bevacizumab 100 mg/4 mL 400 mg/16 mL (Roche) (F)(PFL) do not shake no preservative29 Bleomycin 15 IU (NB: dose in units only) (Bristol) (F) no preservative31
N/A
25 mg/mL29
1.4-16.5 mg/mL30 100-250 mL NS only29,30
48 h F, RT21,29,30
- cytotoxic7 - do not shake29
6 mL*NS31
2.5 IU/mL
48 h F31
50 mL*NS31
24 h RT31
- cytotoxic7 - no overfill32
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Bleomycin 15 IU (NB: dose in units only) (Hospira) (F)(PFL) no preservative33 Bortezomib 3.5 mg (Ortho Biotech formally Millennium) (RT)(PFL) no preservative36 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
6 mL*NS or SWI33
2.5 IU/mL33
48 h F, 24 h RT33
50 mL *NS, SWI33
24 h RT34
- cytotoxic7 - no overfill35
3.5 mL NS36
1 mg/mL36
2d RT13,37
syringe36
8 h RT38
- cytotoxic7
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Busulfan 60 mg/10 mL (Orphan Medical) (F) no preservative39 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
use 5-micron nylon filter provided with ampoule to withdraw drug39 6 mg/mL39
NS or D5W (dilute in volume 10 times the busulfan volume to ~ 0.5 mg/mL)39
complete administration within 12 h F: NS39 8 h RT: NS, D5W
- cytotoxic7
Carboplatin 50 mg/5 mL 150 mg/15 mL 450 mg/45 mL (Hospira) (RT)(PFL) no preservative40
N/A
10 mg/mL40
0.3-10 mg/mL41 NS, D5W11,40 do NOT use aluminum-containing needle or syringe41
24 h RT,42 48 h F40
- cytotoxic7 - do NOT use aluminumcontaining needle, syringe or tubing41
Carboplatin 50 mg/5 mL 150 mg/15 mL 450 mg/45 mL (Novopharm) (RT)(PFL) no preservative43
N/A
10 mg/mL43
discard unused portion RT43
0.5-10 mg/mL44 NS, D5W11,43,45 do NOT use aluminum-containing needle or syringe43
8 h RT43
10/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Carmustine 100 mg (Bristol Labs) (F) no preservative46 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
3 mL diluent (supplied)46 diluent to reach RT, then dissolve drug with 3 mL diluent; add 27 mL SWI46 record time of reconstitution
3.3 mg/mL in 10% ethanol46
24 h F, 8 h RT46
glass46 or polyolefin container11 500 mL NS or D5W46
24 h F: in glass,46 or polyolefin container11 use within 4 h of reconstitution RT46
- cytotoxic7 - do not use if product has oily droplets46
Cetuximab 100 mg/50 mL 200 mg/100 mL (ImClone/BMS) (F) do not dilute do not shake no preservative47
N/A
2 mg/mL47
discard unused portion after 12 h F, 8 h RT47
syringe47
12 h F, 8 h RT47
sterile evacuated container or bag e.g. polyolefin, polyethylene, ethylene vinyl acetate, DEHP plasticized PVC, PVC bag, or glass47
12 h F, 8 h RT47
- cytotoxic3 - administer with a 0.2 or 0.22 micron low protein binding in-line filter47 - normal saline may be used to flush the line47 - solution may contain white particulates which do not affect product quality47
11/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cisplatin 10 mg/10 mL 50 mg/50 mL 100 mg/100mL (Hospira) (RT)(PFL) no preservative48 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL48
48 h RT49
< 60 mg: 100 mL NS* > 60 mg: 250 mL NS* 500 or 1000 mL *NS, D5-NS, D5-1/2S; D5NS with mannitol; D51/2S with mannitol48,50; D5W1/3S with mannitol48 do NOT use aluminum-containing needle or syringe48
48 h RT49
Cladribine 10 mg/10 mL (Janssen-Ortho) (F)(PFL) no preservative51
N/A
1 mg/mL51
SC syringe52 cassette51
48h F, end of day RT13,51,53,54
- cytotoxic7 - shake vigorously to dissolve any precipitates from refrigeration11 - bacteriostatic NS contains benzyl alcohol51
500 mL NS only51 Do NOT use D5W51
24 h RT51
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qs to 100 mL with bacteriostatic NS only via SIMS

DELTEC INC. MEDICATION CASSETTES51; filter
at least 7 days51
drug and diluent through 0.22u filter as each solution is being introduced into the medication Clodronate 300 mg/10 mL (Oryx) (RT) no preservative55 N/A 30 mg/mL discard unused portion55 500 mL NS or D5W55 12 h RT55 - noncytotoxic
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cyclophosphamide 200 mg 500 mg 1000 mg 2000 mg (Baxter) (RT)(PFL) no preservative56 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
NS56 200 mg: 10 mL 500 mg: 25 mL 1000 mg: 50 mL 2000 mg: 100 mL56
20 mg/mL56
72 h F,56,57 24 h RT56
< 1 g: 100 mL NS* > 1 g: 250 mL NS* high dose in BMT: may need 500 NS* NS, D5W, D5NS56
72 h F,56,57 24 h RT56
- cytotoxic7
Cyclosporine 50 mg/1 mL 250 mg/5 mL (Novartis) (RT)(PFL) no preservative58
N/A
50 mg/mL58
NS, D5W58 dilute to concentration between 1:20 and 1:10058
dilute immediately prior to use58
- cytotoxic3 - polyoxyethylated castor oil/ethanol vehicle58 - do NOT refrigerate or freeze58 - use non-PVC bag and tubing59
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cytarabine 100 mg/1 mL 1000 mg/10mL 2000 mg/20mL (Hospira) (RT)(PFL) no preservative60 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A record time of puncture
100 mg/mL60
24 h RT60
100 mL*NS, Water for Injection, D5W, Lactated Ringers60
72 h F, 24 h RT from initial vial puncture60
- cytotoxic7 - do not use for IT injection
Cytarabine IT injection60 100 mg/1 mL 1000 mg/10mL 2000 mg/20mL (Hospira) (RT)(PFL) no preservative60
100 mg/mL60
24 h RT60
diluents containing preservatives should NOT be used for intrathecal administration60 qs to 6 mL with preservative free NS61
use within 4 h of initial vial puncture11,13
- cytotoxic7 - auxiliary label62: IT - label to include route in full (i.e., INTRATHECAL injection) attached to both syringe and outer ziplock bag62
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cytarabine SC injection: 100 mg (Pfizer) (RT)(PFL) no preservative63 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
100 mg: 5 mL BWI63
100 mg: 20 mg/mL63
48 h RT63,64
syringe
14 d F, 48 h RT64
- cytotoxic7 - for high dose use, do not use diluent containing benzyl alcohol65 - do not use for IT injection - cytotoxic7 - protect container from light during storage and administration67 - overfill unknown - cytotoxic7 - protect container from light during storage and administration67 - no overfill69,35
Dacarbazine 100 mg 200 mg (Abraxis) (F)(PFL) no preservative66
100 mg: 9.9 mL SWI66 200 mg: 19.7 mL SWI66
10 mg/mL66
72 h F, 8 h RT66
250-500 mL*NS or D5W
24 h F, 8 h RT66 **(PFL)11,66 see Special Precautions/Notes Column 24 h F68 **(PFL)67 see Special Precautions/Notes Column
Dacarbazine 200 mg 600 mg (Hospira) (F)(PFL) no preservative68
200 mg: 19.7 mL SWI68 600 mg: 59.1 mL SWI68
10 mg/mL68
48 h F, 8 h RT68 (PFL)69
0.193.0 mg/mL13,68 250-500 mL*NS or D5W
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Dactinomycin 0.5 mg (Ovation)70 (RT)(PFL) no preservative71 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1.1 mL SWI(preservative free)71 Do NOT use SWI with preservative (may form precipitate)71
0.5 mg/mL71 (500 mcg/mL)
24 h F, RT72
syringe71,73
24 h F, RT
74
- cytotoxic3 - do not filter71,73 .
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Daunorubicin 20 mg (Erfa Canada Inc.)75 (RT)(PFL)76 no preservative77 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4 mL SWI75
5 mg/mL75,78
48 h F, 24 h RT77
100-250 mL in isotonic solution e.g., NS75 no data for D5W77
24 h RT, 48 h F75
- cytotoxic3
17/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Daunorubicin 20 mg (Novopharm) (RT)(PFL) no preservative79 Dexrazoxane 250 mg 500 mg (Pfizer) (RT) no preservative80 Docetaxel 20 mg/0.5 mL 80 mg/2 mL (Sanofi-Aventis) (F, RT) (PFL) no preservative83 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4 mL SWI79
5 mg/mL79
24 h RT, 48 h F79 (PFL)79
100-250 mL NS or D5W11
48 h F, 24 h RT79 **(PFL)79 6 h RT81
- cytotoxic7
supplied diluent80: 250 mg: 25 mL 500 mg: 50 mL
10 mg/mL80
6 h F80
empty viaflex bag80
- cytotoxic82
supplied diluent : - if vials were refrigerated, allow to warm for 5 min at RT. Withdraw entire contents of the diluent and inject the entire contents of the syringe into the corresponding concentrate vial. Mix by repeated inversions for 45 sec DO NOT SHAKE Let sit for 5 minutes83,84
10 mg/mL83
48 h F, RT13,85
0.30.74 mg/mL (e.g., 250 mL NS or D5W)83
complete administration within 4 h F,83 48 h RT86,87
- cytotoxic7 - non-PVC bag and tubing only83
18/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Doxorubicin 10 mg 50 mg 150 mg (Hospira) (RT)(PFL) no preservative88 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
NS, SWI, D5W88 (NS reconstitution takes longer) 10 mg: 5 mL 50 mg: 25 mL 150 mg: 75 mL
2 mg/mL88
48 h F, 24 h RT13,88
syringe88
48 h F, 24 h RT13,89
- cytotoxic7
0.22 mg/mL90 100 mL*NS88
48 h F, 24 h RT13,90
19/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Doxorubicin 10 mg/5 mL 20 mg/10 mL 50 mg/25 mL 200 mg/100 mL (Novopharm) (F)(PFL) no preservative91 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
2 mg/mL
8 h91
syringe91
48 h F, 24 h RT91 from initial vial puncture
- cytotoxic7
Doxorubicin 10 mg/5 mL 50 mg/25 mL 200 mg/100 mL (Pfizer) (F) no preservative92 Doxorubicin Pegylated Liposomal 20 mg/10 mL 50 mg/25 mL (Schering) (F) no preservative93
N/A
2 mg/mL92
discard unused portion92,74
syringe92
48 h F, 24 h RT92
- cytotoxic3
N/A
2 mg/mL93
< 90 mg: 250 mL D5W only93 90 mg: 500mL D5W only
24 h F93
- cytotoxic7 - do not filter93
20/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Epirubicin 10 mg/5 mL 50 mg/25 mL 200 mg/100 mL (Pfizer) (F)(PFL) no preservative94 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
2 mg/mL94
8 h94
syringe94
48 h F, 24 h RT from initial vial puncture94
- cytotoxic7
100 mL*NS or D5W11
2 d F, RT: NS or D5W49
21/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Etoposide 100 mg/5 mL 500 mg/25 mL 1000 mg/50 mL (BMS) (RT) preservative95 Etoposide 100 mg/5 mL 200 mg/10 mL 500 mg/25 mL 1000 mg/50 mL (Novopharm) (RT)(PFL) no preservative99 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL95
14 d RT11,13,96,97,98
0.2 0.4 mg/mL95 500 mL*NS or D5W95
0.2 mg/mL: 48 h RT13,95 0.4 mg/mL: 24 h RT95
- cytotoxic7 - use non-PVC bag and tubing only
N/A
20 mg/mL99
NS Stabilty is concentration dependent
0.2-0.3 mg/mL: 7 d F,100 2 d RT87,100 0.4-0.5 mg/mL: 1 d F,100 1 d RT100 0.6-9.0mg/mL: generally unstable100 9.5 mg/mL: 2 d F,100 1d RT100 10-12 mg/mL: 7 d F,100 2 d RT87,100 4 h RT99,101
- cytotoxic7 - use non-PVC bag and tubing only
D5W99
22/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Fludarabine 50 mg (Berlex) (F) no preservative102 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
2 mL SWI102
25 mg/mL102
48 h F or RT13,49
dilute to maximum of 1 mg/mL102,103 100 mL*NS or D5W102
48 h F, RT13,49
- cytotoxic7
Fludarabine 50 mg (Novopharm) (F) no preservative104
N/A
25 mg/mL104
dilute to maximum of 1 mg/mL104 100 mL*NS or D5W
48 h F, 24 h RT104
- cytotoxic7
23/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Fluorouracil 5000 mg/100 mL (Hospira) (RT)(PFL) no preservative105 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
50 mg/mL105
8 h RT105,106
syringe13
48 h RT13,21,106
- cytotoxic7
2-10 mg/mL in D5W105,106 50-1000 mL*D5W
24 h RT105,106
CIVI: ambulatory pump106
complete within 8 d11,13,107
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Gemcitabine 200 mg 1000 m g (Eli-Lilly) (RT) no preservative108
200 mg: 5 mL NS 1000 mg: 25 mL NS108
38 mg/mL108
48 h RT108,109
syringe108
48 h RT,13,108,109
- cytotoxic7
0.110 mg/mL NS108,109
48 h F, RT13,108,109
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Gemcitabine 200 mg 1000 mg 2000 mg (Hospira) RT110 no preservative111 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
200 mg vial: 5 mL NS 1000 mg vial: 25 mL NS 2000 mg vial: 50 mL NS110
38 mg/mL110
48 RT110,112,74
syringe110
24 h RT110,112
- cytotoxic7
26 mg/mL-0.1 mg/mL NS110,112 Gemcitabine 200 mg 1000 mg (Novopharm) RT no preservative113 Gemcitabine 200 mg 1000 mg (Sandoz Standard) RT no preservative115 200 mg vial: 5mL NS 1000 mg vial: 25 mL NS114 38 mg/mL114 24 h RT114 38 mg/mL 0.1 mg/mL NS114
48 h RT112,74
24 RT114
- cytotoxic7
200 mg vial: 5 mL NS 1000 mg vial: 25 mL NS115
38 mg/mL115
48 h RT115,116
syringe115
48 h RT115,117,116
- cytotoxic7
26/77
38 mg/mL-0.1 mg/mL NS or D5W115,118
48 h RT13,119
27/77
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Idarubicin 5 mg 10 mg (Pfizer) (RT)(PFL) no preservative120 Idarubicin 5 mg/5 mL 10 mg/10 mL 20 mg/20 mL (Pfizer) (F)(PFL) no preservative120 Ifosfamide 1000 m g 3000 mg (Baxter) (RT) 11 no preservative122 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
vial under negative pressure120 5 mg: 5 mL SWI 10 mg: 10 mL SWI120 N/A
1 mg/mL120
48 h F,120 24 h RT (PFL)120
syringe
48 h F,13, 120 24 h RT13 (PFL)120
- cytotoxic7
1 mg/mL120
same as reconstituted solution121
syringe
Discard 48 h F,13,120 24 h RT13 (PFL)120
- cytotoxic7
1000 mg: 20 mL SWI122 3000 mg: 60 mL SWI shake well
50 mg/mL122
48 h F13,122
0.620 mg/mL122 5001000 mL*NS, D5W, D5-NS, D5-1/2NS, Lactated Ringers11,122
72 h F122 24 h F, RT when mixed with mesna11 D5W or Lactated Ringers when mixed 2 d F13,124
- cytotoxic7
Interferon Alfa -2b 18 million IU/3 mL (Schering) (F)(or up to 7 days at RT before use) no preservative123
N/A
6 million IU/mL123
48 h F13,123
syringe123
- cytotoxic7
28/77
0.3 million IU/mL123 50 mL NS123 Interferon Alfa -2b 25 million IU/2.5 mL (Schering) (F)(or up to 7 days at RT before use) no preservative123 N/A 10 million IU/mL123 48 h F13,123 syringe123
24 h F, RT124
2 d F13,124
- cytotoxic7
0.3 million IU/mL123 50 mL NS123 Interferon Alfa -2b 10 million IU (Schering) (F) no preservative123 1 mL supplied diluent (SWI) 123 do not shake; roll to reconstitute123 > 0.1 million IU/mL124 100 mL NS125 10 million IU/mL123 24 h F123 syringe123
24 h F, RT124
24 h F, RT124
- cytotoxic7
48 h RT11,13
29/77
1 mL BWI123 do not shake; roll to reconstitute123
48 h F, RT13,123
syringe125
14 d F, 48 h RT13,125
100 mL NS125 Interferon Alfa -2b 18 million IU (Schering) (F) no preservative123 1 mL supplied diluent123 do not shake; roll to reconstitute123 > 0.1 million IU/mL126 100 mL NS125 1 mL BWI123 do not shake; roll to reconstitute123 100 mL NS125 48 h F, RT13 syringe123 18 million IU/mL123 24 h F123 syringe123
48 h RT11,13 24 h F, RT124 - cytotoxic7
48 h RT11,13
14 d F13,125
48 h RT11,13
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Irinotecan 40 mg/2 mL 100 mg/5 mL 500 mg/25 mL (Hospira) (RT)(PFL) no preservative127 Irinotecan 40 mg/2 mL 100 mg/5 mL (Pfizer) (RT)(PFL) no preservative130 Irinotecan 40 mg/2 mL 100 mg/5 mL (Sandoz) (RT)(PFL) no preservative131 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL127
2 days RT13,128,129
0.12 2.8 mg/mL127 500 mL11 D5W (preferred), NS127
24 h RT: D5W, NS127 48 h F: D5W (PFL)127
- cytotoxic7 - do NOT refrigerate if in NS130
N/A
20 mg/mL130
0.12 2.8 mg/mL130 500 mL11 D5W (preferred), NS130
24 h RT: D5W, NS130 48 h F: D5W (PFL)130
- cytotoxic7 - do NOT refrigerate if in NS130
N/A
20 mg/mL131
0.12-2.8 mg/mL131 D5W (recommended) NS131
24 h RT: D5W NS131 48 h F: D5W131 (PFL)131
- cytotoxic3
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Ixabepilone 15 mg (contains 16 mg) 45 mg (contains 47 mg) (BMS) (F)(PFL) no preservative132 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
8 mL supplied diluent 23.5 mL supplied diluent
2 mg/mL 2 mg/mL
1 h RT132
0.2 0.6 mg/mL in Lactated Ringers Injection USP (use non-PVC infusion container)132
6 h RT132
- cytotoxic3 - use 0.2-1.2 micron in-line filter132 - use non-PVC (i.e., DEHP-free) administration set132 - noncytotoxic
Leucovorin 50 mg/5 mL 500 mg/50 mL (Hospira) (F)(PFL) no preservative133
N/A
10 mg/mL133
5 mL vial: discard unused portion133 50 mL vial: 8 h
syringe134
7 d F134 48 h RT87,134
0.05-10 mg/mL133
24 h RT133: NS, D5W, Lactated Ringers, Ringers 8 h RT133: D10W, D5NS
50-250 mL* NS, D5W, Lactated Ringers, Ringers, D10W, D5-NS
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Leucovorin 50 mg/5 mL 500 mg/50 mL (Novopharm) (F)(PFL)135 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A135
10 mg/mL135
5 mL vial: discard unused portion135 50 mL vial: discard unused portion135
syringe
8 h135,13
- noncytotoxic
0.060-1.0 mg/mL135
24 h RT NS, Lactated Ringers, Ringers135 12 h RT D5W, D10W135 6 h RT D5NS135
50-250 mL* NS, D5W, Lactated Ringers, Ringers, D10W, D10NS135
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Mechlorethamine 10 mg (Ovation Pharmaceuticals/Merck) no preservative136 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
do NOT use if discoloured or water droplets form in vial before reconstitution136 10 mL SWI or NS136 record time of reconstitution
1 mg/mL136
use within 4 h of reconstitution RT11,13
syringe136
complete administration 4 h of reconstitution RT11,13,136
- cytotoxic7
100 mL NS49,136
complete administration within 4 h of reconstitution RT13,49,136
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Medroxyprogesterone 250 mg/5 mL (Pfizer) (RT) preservative18 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
50 mg/mL18
use within 4 h of initial puncture11,137
syringe: IM only18
use within 4 h of initial vial puncture11,137
- cytotoxic7 - auxiliary label: shake before use18
Medroxyprogesterone Depo 150 mg/1mL (Pfizer) (RT) preservative18 Melphalan 50 mg (GSK) (RT)(PFL) no preservative138
N/A record time of puncture 10mL supplied diluent138 immediately after adding diluent, shake vigorously138 record time of reconstitution
150 mg/mL18
syringe: IM only18
- cytotoxic7 - auxiliary label: shake before use18
5 mg/mL138
2 h RT138 do NOT refrigerate
0.1 0.45 mg/mL in NS only138 (e.g., > 45 mg and < 110 mg in 250 mL NS)*
complete administration within 60 min from time of initial reconstitution at RT11
- cytotoxic7
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Mesna 1000 mg/10mL (PPC) (RT) preservative139 Methotrexate 50 mg/2mL 500 mg/20mL 1 g/40mL 5 g/200mL (Hospira) (RT)(PFL) no preservative140
N/A
100 mg/mL139
14 d F, RT13,139
> 1mg/mL139 NS or D5W
48 h F, 24 h RT139
- noncytotoxic
N/A
25 mg/mL140
50mg: discard unused portion140 500mg, 1 g, 5 g: 8 h F, RT140
syringe
2 d F, RT11,141,142
- cytotoxic7 - for high-dose regimens (e.g., 1-8 g/m2 as a single dose)143 use preservative-free methotrexate11 - do not use for IT injection
0.42 mg/mL140 100 mL* NS, D5W high dose (e.g., 1-8 g/m2 as a single dose)143,144-146: 500 1000 mL*
24 h RT140
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Methotrexate IT Injection140: Only preservative free methotrexate may be administered by the intrathecal route140 50 mg/2mL147 (Hospira) (RT)(PFL) no preservative140 Methotrexate 50 mg/2mL 500 mg/20mL (Hospira) (RT)(PFL) preservative140
N/A
25 mg/mL140
qs to 6 mL with preservative free NS61
- cytotoxic7 - auxiliary label62: IT - label to include route in full (i.e., INTRATHECAL injection) attached to both syringe and outer ziplock bag62 - cytotoxic7 - high-dose regimen(e.g., 1-8 g/m2 as a single dose)144-146: use preservative-free methotrexate11 - do not use for IT injection
N/A
25 mg/mL140
24 h F141
syringe
14 d F87,141
0.42 mg/mL140 e.g., 100 mL*NS, D5W140 Mitomycin 5 mg 20 mg (Novopharm) (RT)(PFL) no preservative148 SWI 5 mg: 10 mL 20 mg: 40 mL shake well148 0.5 mg/mL148 48 h F, RT13,148 (PFL)148 syringe13
4 h RT140
14 d F, 48 h RT13,148
- cytotoxic7
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0.02-0.04 mg/mL148 NS, D5W, sodium lactate148 Mitomycin 5 mg 20 mg (BMS) (RT)(PFL) no preservative149 SWI 5 mg: 10 mL 20 mg: 40 mL shake well149 0.020.04 mg/mL NS, D5W, sodium lactate149 0.5 mg/mL149 48 h F, RT13,149 (PFL)149 syringe11
3 h RT: D5W 12 h RT: NS 24 h RT: sodium lactate148 14 d F, 48 h RT11,21 - cytotoxic7
12 h RT: NS 3h: D5W 24 h: sodium lactate149
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Mitoxantrone 20 mg/10 mL 25 mg/12.5 mL (Hospira) (RT)(PFL) no preservative150 Mitoxantrone 20 mg/10 mL (Novopharm) (RT)(PFL) no preservative151 Mitoxantrone 20 mg/10 mL (Pharmaceutical Partners of Canada) (RT) no preservative153 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
2 mg/mL150
0.2-0.6 mg/mL150 NS, D5W150 > 50 mL*150
NS: 24 h F, RT150 **(PFL)150
- cytotoxic7
N/A
2 mg/mL151
NS, D5W151 > 50 mL*151 NS, D5W2 > 50 mL*153
24 h RT151 **(PFL)152 24 h RT153
- cytotoxic7
N/A
2 mg/mL153
- cytotoxic7
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Octreotide 50 mcg/mL; 100 mcg/mL; 500 mcg/mL (Novopharm) (F)(PFL) no preservative multidose vials (5mL): 200 g/mL (F)(PFL) 154 preservative
N/A
50 mcg/mL 100 mcg/mL 500 mcg/mL154
sc syringe154
single use vials: use within 4 h multidose vials: use within 14 d F74,154
- noncytotoxic
200 mcg/mL154
14 d F74,154
infusion: NS154
single use vials or multidose vials: 24 h RT154 24 h RT18 - noncytotoxic10
Octreotide (Sandostatin) 1000 mcg/5 mL (Novartis) (F)(PFL) preservative18
N/A
200 mcg/mL18
50200 mL NS18,11,156 SC infusion: adjust volume to ensure infusion rate of 25 mcg/h18
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Octreotide (Sandostatin) 50 mcg/1 mL 100 mcg/1 mL 500 mcg/1 mL (Novartis) (F)(PFL) no preservative18 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
50 mcg/mL 100 mcg/mL 500 mcg/mL18
50-100 mL11,156 NS18 SC infusion: adjust volume to ensure infusion rate of 25 mcg/h18
24 h RT18
- noncytotoxic10
Octreotide (Sandostatin LAR) 10 mg 20 mg 30 mg (Novartis) (F)(PFL) preservative155
2 mL supplied diluent gently run 2 mL down sides of the vial; do NOT disturb for 25 min, then swirl moderately18 record time of reconstitution
10 mg: 5 mg/mL 20 mg: 10 mg/mL 30 mg: 15 mg/mL18
deep intragluteal administration only18
use within 4 h of initial reconstitution18,13
- noncytotoxic10 - do NOT shake
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Oxaliplatin 50 mg/10 mL 100 mg/20 mL 200 mg/40 mL (Sanofi-Aventis) (RT)(PFL) no preservative157 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
5 mg/mL157
0.2-1.3 mg/mL158 1.32 mg/mL157,158 250500 mL D5W157 do NOT use NS or other chloridecontaining solution157 do NOT use aluminum-containing needle and syringe157
0.2-1.3 mg/mL: 14 d F, 48 h RT159,87,158 1.3-2 mg/mL: 48 h F, 24 h RT157
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Oxaliplatin 50 mg 100 mg (Sigmacon) (RT) no preservative160 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
SWI, D5W: 50 mg: 10 mL 100 mg: 20 mL do NOT use NS or other chloridecontaining solution160 do NOT use aluminumcontaining needle and syringe160
5 mg/mL160
24 h F160
500 mL D5W do NOT use NS or other chloridecontaining solutions (degrades)160 do NOT use aluminum-containing needle and syringe160
24 h F, 6 h RT160
Paclitaxel 30 mg/5 mL 100 mg/16.7 mL 300 mg/50 mL (Biolyse) (RT)161 no preservative
N/A
6 mg/mL162
8 h RT162
0.31.2 mg/mL in NS, D5W162 (e.g., 1001000 mL)* 0.1 mg/mL in NS163 0.012-0.1 mg/mL164
0.3-1.2 mg/mL: 24 h RT162 0.1 mg/mL: 44 h F, RT163 0.012-0.09 mg/mL: 16 h RT164
- cytotoxic7 - use non-PVC bag and tubing with inline filter162
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Paclitaxel 30 mg/5 mL 100 mg/16.7 mL 300 mg/50 mL (BMS) (RT)(PFL) no preservative165
N/A
6 mg/mL165
30 mg: 48 h RT13,165 100 mg: 48 h RT13,165 300 mg: 24 h RT165
0.31.2 mg/mL in NS, D5W, D5-NS, D5 in Ringers165 (e.g.,1001000 mL)*
24 h RT165
- cytotoxic7 - use non-PVC and tubing with in-line filter165
0.11 mg/mL in NS, D5W166 Devices with spikes e.g., chemo dispensing pins, should not be used with paclitaxel vials165
48 h F, RT166
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Paclitaxel, nab 100 mg paclitaxel and approximately 900 mg human albumin (Abraxis Oncology) (RT)(PFL) no preservative167 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
inject 20 mL NS over > 1 min (a chemo pin may be used)168 - direct flow to INSIDE vial wall - stand solution for > 5 min - gently swirl and/or invert vial slowly for > 2 min167 N/A
5 mg/mL167
8 h F, PFL167
in empty sterile PVC or nonPVC infusion bag167,168
8 h RT167
- cytotoxic167 - do NOT filter167 - non-PVC tubing is NOT needed - the use of an inline filter is not recommended168
Pamidronate 30 mg/10 mL 60 mg/10 mL 90 mg/10 mL (Hospira) (RT) no preservative169
3 mg/mL 6 mg/mL 9 mg/mL169
0.060.36 mg/mL NS, D5W169 do NOT mix with calcium containing solution (e.g., Ringers)169 e.g., 250 mL NS170
24 h F followed by 24 h RT (total 48 h)169 **(PFL)169
- noncytotoxic171
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Pamidronate 30 mg/10 mL 60mg/10 mL 90 mg/10 mL (Sandoz Canada) RT no preservative172
N/A172
3 mg/mL 6 mg/mL 9 mg/mL172
NS or D5W172 do NOT mix with calcium containing solution (e.g., Ringers)172
24 h RT172
- noncytotoxic171
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Panitumumab 100 mg/5 mL 200 mg/10 mL 400 mg/20 mL (Amgen) (F)(PFL) do not shake no preservative173 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL173
1000 mg: 100 mL NS173 >1000mg: 150 mL NS173 1-10mg/mL173,174
24 h F, 6 h RT173,174
- cytotoxic3 - administer with 0.2 or 0.22 micron low protein binding in-line filter173 - solution may contain particulates which do not affect product quality173 - do not administer if discoloured173 - cytotoxic7
Pemetrexed 100 mg 500 mg (Eli Lilly) (RT) no preservative175
100 mg: 4.2 mL preservative-free NS 500 mg: 20 mL preservative-free NS175
25 mg/mL175
24 h F, RT175
100 mL preservative-free NS175 do NOT mix with calcium containing solution (e.g., Ringers)176 syringe177
24 h F, RT175
Porfimer 15 mg 75 mg (Axcan) (RT)(PFL) no preservative177
6.6 mL D5W 31.8 mL D5W177 record time of reconstitution
2.5 mg/mL177
24 h F (PFL)177
use within 4 h of initial reconstitution13,178 **(PFL)177
- noncytotoxic7 - avoid contact with skin and eyes; protect exposed area from light177
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Raltitrexed 2 mg (AstraZeneca) (F, RT)(PFL) no preservative179 Raltitrexed 2 mg (Hospira) (F, RT)(PFL) no preservative180
4 mL SWI179
0.5 mg/mL179
24 h F, RT179
50250 mL NS, D5W179
24 h F, RT179
- cytotoxic7
4 mL SWI180
0.5 mg/mL180
24 h F, RT180
50250 mL NS, D5W180
24 h F, RT180
- cytotoxic3
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Rituximab 100 mg/10 mL 500 mg/50 mL (Roche) (F)(PFL) no preservative181 Streptozocin 1g (Pfizer) (F)(PFL) no preservative182 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
10 mg/mL181
14 mg/mL in NS, D5W) 181 (e.g., 500 mg/250 mL, 1000 mg/500 mL)*
24 h F + additional 12 h RT181
- noncytotoxic3
9.5mL NS, SWI, D5W182
100 mg/mL182
48 h F,182 24 h RT
syringe182 50-500 mL*NS, D5W, SWI182
48 h F, 24 h RT182 48 h F, 24 h RT182
- cytotoxic7
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Temozolomide 100 mg (Schering) (F) do not dilute183 do not shake183 no preservative183 Temsirolimus 30 mg/1.2 mL (Wyeth) (F)(PFL)184,185 no preservative186 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
41 mL SWI183
2.5 mg/mL183
14 h F, RT183
empty 250 mL PVC bag183
14 h RT183
- cytotoxic{3
1.8 mL supplied diluent184,185
10 mg/mL184,185
24 h RT184,185 (PFL)184
250 mL NS184,185
Complete administration within 6 h184,185
- cytotoxic3 - use non-PVC bag and non-PVC tubing with in-line filter184,185 - cytotoxic7 - do NOT refrigerate18 - use non-PVC bag and tubing18
Teniposide 15 mg/1.5 mL (Bristol) (RT) preservative18
N/A
10 mg/mL18
0.1, 0.2, 0.4, or 1 mg/mL in NS or D5W18
0.1, 0.2, 0.4mg/mL: 24 h RT18 1 mg/mL: complete administration within 4h of preparation18
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Thiotepa 15 mg (Bedford) (F)(PFL) no preservative187 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1.5 mL SWI187 filter through 0.22 micron filter187 record time of reconstitution
10 mg/mL187
8 h F187
50 mL* NS187
use within 4 h of initial reconstitution188,187 **(PFL)187,189
- cytotoxic7 - do not use if precipitates or remains opaque187 - do not use for IT injection
syringe: reconstituted solution is hypotonic and must be further diluted with NS prior to use187 (final concentration of 0.5-1 mg/ml is nearly isotonic)190
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Thiotepa IT injection: 15 mg (Bedford) (F)(PFL) no preservative187 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
diluents containing preservatives should NOT be used for intrathecal administration 1.5 mL SWI187 filter through 0.22 micron filter187 record time of reconstitution
10 mg/mL187
8 h F187
qs to 6 mL with preservative free NS191
- auxiliary label61 IT - label to include route in full (i.e., INTRATHECAL injection) attached to both syringe and outer ziplock bag61 - cytotoxic7 - do not use if precipitates or remains opaque187
Thyrotropin alfa 1.1 mg (Genzyme) (F)(PFL) no preservative192
1.2 mL SWI192 swirl contents192; do not shake
0.9 mg/mL192
24 h F192
syringe192
24 h F192
- noncytotoxic
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Tocilizumab 80 mg/4 mL 200mg/10 mL 400 mg/20 mL (Genentech) (F)(PFL) no preservative193 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL193
6 h193, 21
100 mL NS dilute to 100 mL final volume by withdrawing volume of NS from 100 mL bag equal to volume of drug required for dose prior to adding drug193
24h F193; 6 h RT194
- cytotoxic3 - to prevent foaming: slowly add drug to infusion bag and gently invert bag to mix193
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Topotecan 4 mg (GSK) (RT)(PFL) no preservative195,196 Topotecan 4 mg (GSK) (RT)(PFL) single use no preservative198 Trastuzumab 440 mg (Roche) (F) preservative199 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4 mL SWI195
1 mg/mL195
24 h F, RT195
0.010.5 mg/mL197 50 mL NS, D5W195
24 h F, RT195
- cytotoxic7
4 mL SWI198
1 mg/mL198
24 h F, RT198
0.020 0.5 mg/mL198
24 h F, RT198
cytotoxic3
20 mL supplied BWI swirl vial gently; allow to stand undisturbed for 5 min199
21 mg/mL199
14 d F13,199
250mL NS199 do NOT use dextrose containing solutions199
24 h F, RT199
- noncytotoxic3 - do NOT shake199
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Treosulfan 1g 5g (medac) (RT) no preservative200 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
pre-heat SWI to 30C (not higher) shake vial carefully before adding the warmed SWI 1 g vial: 20 mL SWI, while slightly shaking vial and syringe; continue shaking the reconstituted solution for another 2 min{{10494}} 5 g vial: 100 mL SWI, while slightly shaking vial and syringe; continue shaking the reconstituted solution for another 2 min200
50 mg/mL200
48 h RT13,200
undiluted201 dilute with NS or D5W in empty infusion bag for final concentration = 20 mg/mL200
48 h RT13,200
- cytotoxic3 - compatible with polytetrafluoroethyl ene filters200 - may require vigorous shaking to reconstitute200
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Vinblastine 10 mg/10 mL (Hospira) (F)(PFL) no preservative154 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL154
syringe11,154
4 h F, RT202,203
- cytotoxic7 - label with: WARNING: FOR INTRAVENOUS USE ONLY FATAL IF GIVEN BY OTHER ROUTES204,205
100250 mL NS, D5W206
24 h F, RT202,203
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Vincristine 2 mg/2 mL 5 mg/5 mL (Hospira) (F)(PFL) no preservative207 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL207
8 h F, RT207
50 mL*NS, D5W207
24 h F, 6 h RT,207 **(PFL)207
- cytotoxic7 - label with: WARNING: FOR INTRAVENOUS USE ONLY FATAL IF GIVEN BY OTHER ROUTES204,205 - cytotoxic7 - label with: WARNING: FOR INTRAVENOUS USE ONLY FATAL IF GIVEN BY OTHER ROUTES204,205
Vincristine 1 mg/1 mL 2 mg/2 mL 5 mg/5 mL (Novopharm) (F)(PFL) preservative208
N/A
1 mg/mL208
14 d F, RT208
50 mL*NS, D5W208
72 h F, 24 h RT65 **(PFL)208
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Vinorelbine 10 mg/1 mL 50 mg/5 mL (GSK) (F)(PFL) no preservative209 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
10 mg/mL209
syringe: 1.5 3.0 mg/mL in NS or D5W209
24 h F, RT209
0.5 2.0 mg/mL209 50 mL*NS, D5W, NS, D5NS, Ringers, Ringers Lactate209 Vinorelbine 10 mg/1 mL 50 mg/5 mL (Hospira) (F)(PFL) no preservative210 N/A 10 mg/mL210 discard unused portion210 syringe: 1.5 3.0 mg/mL in NS or D5W210
24 h F, RT209
24 h F, RT210
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0.5 2.0 mg/mL210 50 mL* NS, D5W, NS, D5NS, Ringers, Ringers Lactate210 Vinorelbine 10 mg/1 mL 50 mg/5mL (Pierre Fabre Pharma Canada) (F)(PFL) no preservative211 N/A211 10 mg/mL211 discard unused portion211 syringe: 1.5-3.0 mg/mL in D5W or NS211
24 h F, RT210
24 h F, RT211
0.5-2.0 mg/mL211 NS, D5W, NS, D5NS, Ringers, Ringers Lactate211
24 h F, RT211
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* Suggested volume based on usual dose range and any concentration range of stability data ** Protect from light means minimizing exposure to direct sunlight over a storage period. More specific information on protection from light (eg, protecting container and tubing during administration) will be indicated in the Under the Special Precautions/Notes column.
Centres are not to change the content locally but should forward suggestions to the Cancer Drug Manual staff. Explanatory Notes
Stability data assume products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the classification outlined in USP 797.21,212 Vial stability: Stability of solution after first puncture or reconstituted solution Storage temperature: If information states same stability with refrigerator and room temperature storage, then bold refrigerated as preferred (ie, to minimize growth of micro-organisms). Cytotoxic: hazardous (see Policy II-20 for more details). Discard unused portion: Unused portion from single use vials should be discarded at the end of the day. State overfill known if the manufacturer states overfill within acceptable limits is present.
PFL = protect from light RT = room temperature F = refrigerated SWI = sterile water for injection NS = normal saline D5W = dextrose 5% BWI = bacteriostatic water for injection
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References 1. Novartis Pharmaceuticals Canada Inc. PROLEUKIN product monograph. Dorval, Quebec; 6 July 2006. 2. McEvoy GK, editor. AHFS 2008 Drug Information. Bethesda, Maryland: American Society of Health-System Pharmacists, Inc. p. 917-925. 3. National Institute for Occupational Safety and Health (NIOSH). Preventing occupational exposures to antineoplastic and other hazardous drugs in healthcare settings. Cincinnati, Ohio: NIOSH - Publications Dissemination; September 2004. p. 31-40. 4. Rui Paiva. Personal communication. Business Unit Director, Transplant and Oncology; 1 June 2009. 5. Bayer HealthCare Pharmaceuticals. MabCampath Package Insert. Toronto, Ontario; 1 September 2007. 6. Lundin J, Porwit-MacDonald A, Rossmann ED, et al. Cellular immune reconstitution after subcutaneous alemtuzumab (anti-CD52 monoclonal antibody, CAMPATH-1H) treatment as first-line therapy for B-cell chronic lymphocytic leukaemia. Leukemia 2004(18):484-490. 7. National Institute for Occupational Safety and Health (NIOSH). Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Healthcare Settings (Draft). Cincinnati, OH; 25 March 2004. 8. Berlex Canada Inc. Campath Drug Information. San Antonio, Texas; undated. 9. Schering AG. MABCAMPATH Package Leaflet. Berlin, Germany; April 2002. 10. MedImmune Pharma B.V. Ethyol Package Insert. The Netherlands; 2003. 11. Trissel LA. Handbook on Injectable Drugs. 13th ed. Bethesda, MD: American Society of Health-System Pharmacists, Inc.; 2005. 12. Erfa Canada Inc. AMSA PD injection product monograph. Westmount, Quebec; 16 August 2005.
BC Cancer Agency Chemotherapy Preparation and Stability Chart version 2.00 Activation Date: 2 March 2006 Revised Date: 1 July 2010 62/77
13. BC Cancer Agency. Pharmacy Policy Number II-20: Guiding Principles for Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer Agency; 6 January 2006. 14. Tanya Leduc. Personal communication. Acting editor, BC Cancer Agency Cancer Drug Manual; 2 June 2008. 15. National Institute for Occupational Safety and Health (NIOSH). Preventing occupational exposures to antineoplastic and other hazardous drugs in healthcare settings. Cincinnati, Ohio: NIOSH - Publications Dissemination; 25 March 2004. p. 71-83. 16. Orphan Pharma International. Kidrolase Product Monograph. Limonest, France; 2005. 17. Robert Sarrazin B Pharm. Personal communication. Consultant, OPi Inc. February 2005. 18. Repchinsky C editor. Compendium of Pharmaceuticals and Specialties. 12th ed. Ottawa, Ontario: Canadian Pharmacists Association; 2004. 19. OPi SAS. Kidrolase Product Monograph. Laval, Quebec; 2003. 20. Rhone-Poulenc Rorer. Kidrolase Package Insert. Montreal, Quebec; 2004. 21. The United States Pharmacopeia (USP). General Chapter 797: Pharmaceutical compounding - sterile preparations. USP 27-NF 22. Rockville, Maryland: The United States Pharmacopeial Convention, Inc.; 2004. 22. Orphan Pharma International. Erwinase Product Monograph. Limonest, France; 2005. 23. Enzon Pharmaceuticals Inc. Oncaspar Product Monograph. Bridgewater, New Jersey; 2003. 24. BC Cancer Agency Provincial Systemic Therapy Program. Provincial Systemic Therapy Program Policy III-20: Prevention and Management of Extravasation of Chemotherapy. Vancouver, British Columbia: BC Cancer Agency; 1 September 2006. 25. Celgene. VIDAZA product monograph. Oakville, Ontario; 22 October 2009.
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative

18 million IU/mL (1.1 mg/mL)1,2

Alemtuzumab 30 mg/mL (Genzyme previously Bayer)4 (F)(PFL) do not shake no preservative5

filter NOT required 30 mg/mL5

discard unused portion5

discard at the end of the day F or RT

Alemtuzumab 30 mg/3 mL (Schering/Ilex) (F)(PFL) do not shake no preservative9

use 5 micron filter to withdraw drug from ampoule8 10 mg/mL9

discard unused portion9

discard at the end of the day F or RT8

- cytotoxic7 - do not shake8

2550 mL*NS only10

540 mg/mL: 24 h F,10 5 h RT

- noncytotoxic10 - discard cloudy solution11

500 mL D5W12 (plastic or glass container)12

do not shake; roll to reconstitute22 1-2 mL NS22

15 min in original container; 8 h in a glass or polypropylene syringe22

glass or polypropylene syringe22

8 h in a glass or polypropylene syringe22

discard unused portion23

IM: maximum volume 2 mL; if >2 mL use multiple sites23

IV: 100 mL NS or D5W23

4 mL SWI25 shake vigorously25

BCG 81 mg (Sanofi Pasteur) (F)(PFL) preservative26

do not shake; roll to reconstitute26 3 mL supplied diluent26 record time of reconstitution

10.5 8.7108 CFU/vial (Connaught strain)26

2 h F or RT after reconstitution26 **(PFL)26

- cytotoxic3 - overfill unknown - protect from light27 - do not filter27

500 mL NS28 0.2-0.6 mg/mL28

discard unused portion29

1.4-16.5 mg/mL30 100-250 mL NS only29,30

- cytotoxic7 - do not shake29

discard unused portion39

NS or D5W (dilute in volume 10 times the busulfan volume to ~ 0.5 mg/mL)39

complete administration within 12 h F: NS39 8 h RT: NS, D5W

Carboplatin 50 mg/5 mL 150 mg/15 mL 450 mg/45 mL (Hospira) (RT)(PFL) no preservative40

discard unused portion40

0.3-10 mg/mL41 NS, D5W11,40 do NOT use aluminum-containing needle or syringe41

- cytotoxic7 - do NOT use aluminumcontaining needle, syringe or tubing41

Carboplatin 50 mg/5 mL 150 mg/15 mL 450 mg/45 mL (Novopharm) (RT)(PFL) no preservative43

discard unused portion RT43

0.5-10 mg/mL44 NS, D5W11,43,45 do NOT use aluminum-containing needle or syringe43

- cytotoxic7 - do NOT use aluminumcontaining needle, syringe or tubing43

3.3 mg/mL in 10% ethanol46

glass46 or polyolefin container11 500 mL NS or D5W46

24 h F: in glass,46 or polyolefin container11 use within 4 h of reconstitution RT46

- cytotoxic7 - do not use if product has oily droplets46

discard unused portion after 12 h F, 8 h RT47

- cytotoxic7 - do NOT use aluminumcontaining needle, syringe or tubing48

Cladribine 10 mg/10 mL (Janssen-Ortho) (F)(PFL) no preservative51

discard unused portion51

48h F, end of day RT13,51,53,54

500 mL NS only51 Do NOT use D5W51

qs to 100 mL with bacteriostatic NS only via SIMS

Cyclosporine 50 mg/1 mL 250 mg/5 mL (Novartis) (RT)(PFL) no preservative58

discard unused portion58

NS, D5W58 dilute to concentration between 1:20 and 1:10058

dilute immediately prior to use58

N/A record time of puncture

100 mL*NS, Water for Injection, D5W, Lactated Ringers60

72 h F, 24 h RT from initial vial puncture60

- cytotoxic7 - do not use for IT injection