NCCN Cancer

BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative
Status) Aldesleukin 22 million units (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 unit/mL (1.1 mg/mL)1,2
48 h F1
50 mL D5W1 30 70 mcg/mL1 Less than 30 mcg/mL: dilute in D5W containing human albumin 0.1%2
48 h F1
- do not use in-line filter1,2 - avoid bacteriostatic water for injection or NS due to increased aggregation1
Alemtuzumab 30 mg/mL (Genzyme previously Bayer)3 (F)(PFL) do not shake no preservative4
N/A
filter NOT required4 30 mg/mL4
discard unused portion4
SC syringe5
discard at the end of the day F or RT
- do not shake6
100 mL NS or D5W4
8 h F or RT4 **(PFL)6
100 mL NS or D5W7
8 h F or RT6 **(PFL)6
BC Cancer Agency Chemotherapy Preparation and Stability Chart version 2.00 Activation Date: 2 March 2006 Revised Date: 01 Apr 2013
1/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Amifostine 500 mg (MedImmune) (RT) no preservative8 Amsacrine 75 mg/1.5 mL (Erfa Canada) (RT) no preservative10 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
9.7 mL NS only8
50 mg/mL8
24 h F, 5 h RT8
2550 mL*NS only8
540 mg/mL: 24 h F,8 5 h RT
- discard cloudy solution9
glass syringes preferred during reconstitution; max. time in plastic syringe10: 15 min 13.5 mL supplied diluent (L-lactic acid)1 transfer 1.5mL from ampoule into the diluent vial10
5 mg/mL10
24 h RT10 PFL10
500 mL D5W10 (plastic or glass container)10
7 d F, 48 h RT10,11,12
2/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Asparaginase13 (asparaginase E. coli) 10,000 units (Orphan Pharmaceutical International) (F) no preservative14 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
do not shake; roll to reconstitute15,9 4 mL SWI16 Intradermal test9: 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)9
2500 units/mL13
48 h F, RT13
syringe13
14 d F17, 13
50 mL*NS or D5W17,11
14 d F,17,11 2 d RT17,18
3/90
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 preservative19 PEG-asparaginase (pegasparagase) (pegylated asparaginase E. coli) 750 units/mL (Enzon) (F) no preservative20 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
do not shake; roll to reconstitute19 1-2 mL NS19
10000-5000 units/mL
15 min in original container; 8 h in a glass or polypropylene syringe19
glass or polypropylene syringe19
8 h in a glass or polypropylene syringe19
N/A
750 units/mL20
IM: maximum volume 2 mL; if greater than 2 mL use multiple sites20
syringe: 4 h20,21
- discard cloudy solution20 - do not shake20 - do not use if stored out of refrigerator for greater than 48 h20 - do not use if previously frozen20
IV: 100 mL NS or D5W20
bag: 4 h20,21
4/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Azacitidine 100 mg (Celgene) (RT) no preservative22 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4 mL SWI22 shake vigorously22
25 mg/mL22
8 h F, 45 min RT22
SC syringe22
8 h F, 45 min RT23 Refrigerated syringes23: allow up to 30 min prior to administration to reach a temperature of approximately 20 - 25C discard syringe if time elapsed at RT is greater than 30 min
- discard if contains large particles22 - re-suspend syringe contents before injection by vigorously rolling syringe between palms22
BCG 81 mg (Sanofi Pasteur) (F)(PFL) preservative24
do not shake; roll to reconstitute24 3 mL supplied diluent24 record time of reconstitution
10.5 8.7108 CFU/vial (Connaught strain)24
2 h F, RT24
50 mL NS24
2 h F or RT after reconstitution24 **(PFL)24
5/90
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 preservative25 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1 mL preservative free NS for injection25 use reconstitution device provided allow to stand for a few minutes, then gently swirl to suspend25
1 to 8108 CFU/vial25
2 h F (PFL)25
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 NS25
2 h F25
- overfill unknown - protect from light25 - do not filter25
6/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Bendamustine 25 mg 100 mg (Lundbeck) (RT)(PFL) no preservative26 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
25 mg vial: add 5 mL SWI26 100 mg vial: add 20 mL SWI26 shake well; dissolves completely in 5 minutes26
5 mg/mL26
30 minutes26
500 mL NS26 0.2-0.6 mg/mL26
complete administration within 24 h F, 3 h RT26
Bevacizumab 100 mg/4 mL 400 mg/16 mL (Roche) (F)(PFL) do not shake no preservative27 Bleomycin 15 units (NB: dose in units only) (Bristol) (F) no preservative29
N/A
25 mg/mL27
1.4-16.5 mg/mL28 100-250 mL NS only27,28
48 h F, RT18,27,28
- do not shake27
6 mL*NS29
2.5 units/mL
48 h F29
50 mL*NS29
24 h RT29
- no overfill30
7/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Bleomycin 15 units (NB: dose in units only) (Hospira) (F)(PFL) no preservative31 Bleomycin 15 units (NB: dose in units only) (PPC) (F)(PFL) no preservative34 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
6 mL*NS or SWI31
2.5 units/mL31
48 h F, 24 h RT31
50 mL *NS, SWI31
24 h RT32
- no overfill33
6 mL NS34
2.5 units/mL34
48 h F34
50 mL NS34
24 h RT34
Bortezomib 3.5 mg (Ortho Biotech formally Millennium) (RT)(PFL) no preservative35
3.5 mL NS35
1 mg/mL35
2d RT11,36
syringe35
8 h RT37
8/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Brentuximab 50 mg (Seattle Genetics) (F)(PFL) no preservative38 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes Solution should be clear to slightly opalescent, colorless and free of visible particulates38
10.5 mL SWI38 Direct diluent against side of vial during reconstitution38 Do NOT shake38 Use reconstituted solution within 24 h F38
5 mg/mL38
24 h F38
0.4-1.8 mg/mL in NS, D5W, Lactated Ringers (i.e. 100-250 mL) 38,39
24 h F38 Do NOT freeze38
9/90
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 preservative40 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
use 5-micron nylon filter provided with ampoule to withdraw drug40 6 mg/mL40
NS or D5W (dilute in volume 10 times the busulfan volume to ~ 0.5 mg/mL)40
complete administration within 12 h F: NS40 8 h RT: NS, D5W
Cabazitaxel 60 mg/1.5 mL (sanofi-aventis canada Inc.) (RT)41
- 4.5 mL of supplied diluent (i.e. entire vial contents) 41 - slowly direct diluent against inside of concentrate vial during reconstitution41 - mix by repeated inverting for 45 seconds41 - do not shake41 - let sit for 5 min41
10 mg/mL{41
1h RT41
NS or D5W{41 (e.g. 250 mL) 0.10 0.26 mg/mL41
complete administration within 8 h RT41
- use 0.22 micron in-line filter41 - use non-PVC (non-DEHP) bag and tubing41 - diluent contains 13%(w/w) ethanol in water41 - discard if crystallization occurs41
10/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) CARBOplatin 50 mg/5 mL 150 mg/15 mL 450 mg/45 mL 600 mg/60 mL (Hospira) (RT)(PFL) no preservative42 CARBOplatin 50 mg/5 mL 150 mg/15 mL 450 mg/45 mL (Teva/Novopharm) (RT)(PFL) no preservative45 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
10 mg/mL42
0.3-10 mg/mL43 NS, D5W9,42 do NOT use aluminum-containing needle or syringe43
24 h RT,44 48 h F42
- do NOT use aluminumcontaining needle, syringe or tubing43
N/A
10 mg/mL45
discard unused portion RT45
0.5-10 mg/mL46 NS, D5W9,45,47 do NOT use aluminum-containing needle or syringe45
8 h RT45
11/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Carmustine 100 mg (Bristol Labs) (F) no preservative48 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
3 mL diluent (supplied)48 diluent to reach RT, then dissolve drug with 3 mL diluent; add 27 mL SWI48 record time of reconstitution
3.3 mg/mL in 10% ethanol48
24 h F, 8 h RT48
glass48 or polyolefin container9 500 mL NS or D5W48
24 h F: in glass,48 or polyolefin container9 use within 4 h of reconstitution RT48
- do not use if product has oily droplets48
Cetuximab 100 mg/50 mL 200 mg/100 mL (ImClone/BMS) (F) do not dilute do not shake no preservative49
N/A
2 mg/mL49
discard unused portion after 12 h F, 8 h RT49
syringe49
12 h F, 8 h RT49
sterile evacuated container or bag e.g. polyolefin, polyethylene, ethylene vinyl acetate, DEHP plasticized PVC, PVC bag, or glass49
12 h F, 8 h RT49
- administer with a 0.2 or 0.22 micron low protein binding in-line filter49 - normal saline may be used to flush the line49 - solution may contain white particulates which do not affect product quality49
12/90
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 preservative50 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL50
48 h RT51
Less than or equal to 60 mg: 100 mL NS* Greater than 60 mg: 250 mL NS* 500 or 1000 mL *NS, D5-NS, D5-1/2S; D5NS with mannitol; D51/2S with mannitol50,52; D5W1/3S with mannitol50
48 h RT51
13/90
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 (Sandoz) (RT)(PFL) no preservative53 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL53
48 h RT54,53
Less than or equal to 60 mg: 100 mL NS* Greater than 60 mg: 250 mL NS* NS; 0.45 % Sodium Chloride with or without mannitol55 2 L of D5 on one-half or one-third NS containing 37.5 g of mannitol53
24 h RT53
Cladribine 10 mg/10 mL (Janssen-Ortho) (F)(PFL) no preservative56
N/A
1 mg/mL56
SC syringe57
48h F, end of day RT11,56,58,59
- shake vigorously to dissolve any precipitates from refrigeration56
500 mL NS only56 Do NOT use D5W56
24 h RT56
14/90
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
Cassette: qs to 100 mL with bacteriostatic NS only via SIMS

DELTEC INC. MEDICATION CASSETTES56 filter
at least 7 days56
drug and diluent through 0.22 micron filter as each solution is being introduced into the cassette Cladribine 10 mg/10 mL (PPC) (F)(PFL) no preservative60 N/A 1 mg/mL60 discard unused potion60 SC syringe57 500 mL NS only Do NOT use D5W discard end of day11,59,60 24 h RT
15/90
Cassette: qs to 100 mL with bacteriostatic NS only via SIMS

DELTEC INC. MEDICATION CASSETTES60 filter
at least 7 days60
drug and diluent through 0.22 micron filter as each solution is being introduced into the cassette Clodronate 300 mg/10 mL (Oryx) (RT) no preservative61 N/A 30 mg/mL discard unused portion61 500 mL NS or D5W61 12 h RT61
16/90
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 preservative62 CycloSPORINE 50 mg/1 mL 250 mg/5 mL (Novartis) (RT)(PFL) no preservative65 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
NS63 200 mg: 10 mL 500 mg: 25 mL 1000 mg: 50 mL 2000 mg: 100 mL62
20 mg/mL62
48 h F,62,64,54 24 h RT62
Less than or equal to 1 g: 100 mL NS* Greater than 1 g: 250 mL NS* high dose in BMT: may need 500 NS* NS, D5W, D5NS62
72 h F,62,64 24 h RT62
N/A
50 mg/mL65
NS, D5W65 dilute to concentration between 1:20 and 1:10065
dilute immediately prior to use65
- polyoxyethylated castor oil/ethanol vehicle65 - do NOT refrigerate or freeze65 - use non-PVC bag and tubing66
17/90
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 preservative67 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A record time of puncture
100 mg/mL67
24 h RT67
100 mL*NS, Water for Injection, D5W, Lactated Ringers67
72 h F, 24 h RT from initial vial puncture67
- do not use for IT injection
Cytarabine 100 mg (Pfizer) (RT)(PFL) no preservative68
NS, D5W, SWI or BWI68 100 mg: 5 mL68
100 mg: 20 mg/mL68
Reconstituted with NS, D5W or SWI: discard at end of day68,54 Reconstituted with BWI: 48 h RT68
NS, D5W68
0.5 mg/mL: 48 h RT68,54 8-32 mg/mL: 48 h RT68,54
- for high dose use, do not use diluent containing benzyl alcohol68
18/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cytarabine IT injection67 100 mg/1 mL 1000 mg/10mL 2000 mg/20mL (Hospira) (RT)(PFL) no preservative67 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
100 mg/mL67
24 h RT67
diluents containing preservatives should NOT be used for intrathecal administration67 qs to 6 mL with preservative free NS69
use within 4 h of initial vial puncture9,11
- auxiliary label70: IT - label to include route in full (i.e., INTRATHECAL injection) attached to both syringe and outer ziplock bag70
Cytarabine IT injection 100 mg (Pfizer) (RT)(PFL) no preservative68
Preservative-free NS68 100 mg: 5 mL68
100 mg: 20 mg/mL68
discard at end of day68,54
diluents containing preservatives should NOT be used for intrathecal administration68 qs to 6 mL with preservative free NS69
use within 4 h of initial vial puncture9,11
19/90
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 preservative71 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
100 mg: 5 mL BWI71
100 mg: 20 mg/mL71
48 h RT71,72
Syringe
14 d F, 48 h RT72
- for high dose use, do not use diluent containing benzyl alcohol73 - do not use for IT injection
Dacarbazine 100 mg 200 mg (Abraxis) (F)(PFL) no preservative74
100 mg: 9.9 mL SWI74 200 mg: 19.7 mL SWI74
10 mg/mL74
72 h F, 8 h RT74
250-1000 mL*NS or D5W
24 h F, 8 h RT74 **(PFL)9,74 see Special Precautions/Notes Column
- protect container from light during storage and administration75 - overfill unknown
Dacarbazine 200 mg 600 mg (Hospira) (F)(PFL) no preservative76
200 mg: 19.7 mL SWI76 600 mg: 59.1 mL SWI76
10 mg/mL76
48 h F, 8 h RT76 (PFL)77
0.193.0 mg/mL11,76 250-1000 mL*NS or D5W
24 h F76 **(PFL)75 see Special Precautions/Notes Column
- protect container from light during storage and administration75 - no overfill77,33
20/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Dactinomycin 0.5 mg (Lundback) (RT)(PFL) no preservative78 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1.1 mL SWI(preservative free)78 Do NOT use SWI with preservative (may form precipitate) 78
0.5 mg/mL (500 mcg/mL) 78
discard at end of day
syringe
use within 4 h of initial vial puncture54
- drug loss reported with some cellulose ester membrane inline filters78
10 mcg/mL or greater78 D5NS78 0.5 mg/mL80 (500 mcg/mL) 24 h F, RT81 syringe80,82 24 h F, RT54 - do not filter80,82
Dactinomycin 0.5 mg (Ovation)79 (RT)(PFL) no preservative80
1.1 mL SWI(preservative free)80 Do NOT use SWI with preservative (may form precipitate)80
DAUNOrubicin 20 mg (Erfa Canada Inc.)83 (RT)(PFL)84 no preservative85
4 mL SWI83
5 mg/mL83,86
48 h F, 24 h RT85
100-250 mL in isotonic solution e.g., NS83 no data for D5W85
24 h RT, 48 h F83
21/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DAUNOrubicin 20 mg (Teva/Novopharm) (RT)(PFL) no preservative87 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4 mL SWI87
5 mg/mL87
24 h RT, 48 h F87 (PFL)87
100-250 mL NS or D5W9
48 h F, 24 h RT87 **(PFL)87
22/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Degarelix 120 mg vial (Ferring) (RT) do not shake no preservative88 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
3 mL SWI (included solvent) per vial88 do NOT use bacteriostatic water for injection88 swirl gently; keep vial vertical at all times88 reconstitution may take up to 15 min88
40 mg/mL88
2 h RT88
SC syringe88
2 h RT89
23/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Degarelix 80 mg vial (Ferring) (RT) do not shake88 no preservative88 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4.2 mL SWI (included) 88 do NOT use bacteriostatic water for injection88 swirl gently; keep vials vertical at all times88 reconstitution may take up to 15 min88
20 mg/mL88
2 h RT88
SC syringe88
2 h RT89
Denosumab 120 mg/1.7 mL (Amgen) (F)(PFL) do not shake no preservative90
N/A
71 mg/mL90
discard unused portion90,90,91,54
sc syringe90
use within 4 h of initial puncture54
- do not use if solution is cloudy; trace amounts of translucent to white proteinaceous particles are acceptable90 - avoid vigorous shaking90 - bring to room temperature 15-30 minutes prior to administration90
24/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Dexrazoxane 250 mg 500 mg (Pfizer) (RT) no preservative92 Dexrazoxane (same formulation, no diluent provided) 250 mg 500 mg (Pfizer) (RT)94 no preservative Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
supplied diluent92: 250 mg: 25 mL 500 mg: 50 mL
10 mg/mL92
6 h F92
empty viaflex bag92
6 h RT93
SWI94 250 mg: 25 mL 500 mg: 50 mL
10 mg/mL94
30 min RT/4 h F94
MUST BE FURTHER DILUTED With Lactated Ringers Injection to 1.3 3.0 mg/mL94
1 h RT/4 h F94
25/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DOCEtaxel 20 mg/2 mL 80 mg/8 mL 160 mg/16 mL (Hospira) (F,RT)(PFL) preservative95 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
n/a
10 mg/mL95
20mg/2 mL vial: discard unused portion91,95 ______________ 80 mg/8 mL or 160 mg/16 mL vial (maximum number of punctures: up to 3 doses can be removed when a venting needle is also inserted i.e., 6 punctures total)96 14 d F **(PFL)91,95
0.3-0.74 mg/mL95 (250 mL NS or D5W95)
complete administration within 4 h F,95 48 h RT95,91
- use non-PVC (non-DEHP) bag and IV administration set95 - do not use chemo dispensing pins97
26/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DOCEtaxel 20 mg/0.5 mL 80 mg/2 mL (sanofi-aventis) (F, RT) (PFL) no preservative98 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
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 minutes98
10 mg/mL98
48 h F, RT98
0.3-0.74 mg/mL98 (250 mL NS or D5W98
complete administration within 4 h F9848 h RT91,91,99
- use non-PVC (non-DEHP) bag and IV administration set98
DOXOrubicin 10 mg 50 mg 150 mg (Hospira) (RT)(PFL) no preservative100
NS, SWI, D5W100 (NS reconstitution takes longer) 10 mg: 5 mL 50 mg: 25 mL 150 mg: 75 mL
2 mg/mL100
48 h F, 24 h RT11,100
syringe100
48 h F, 24 h RT11,101
27/90
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 (Teva/Novopharm) (F)(PFL) no preservative102 DOXOrubicin 10 mg/5 mL 50 mg/25 mL 200 mg/100 mL (Pfizer) (F) no preservative103 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
2 mg/mL
8 h102
syringe102 100 mL NS*
48 h F, 24 h RT102 from initial vial puncture
N/A
2 mg/mL103
discard unused portion103,54
syringe103 100 mL NS*
48 h F, 24 h RT103
28/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DOXOrubicin Pegylated Liposomal 20 mg/10 mL 50 mg/25 mL (Janssen) (F) no preservative104 DOXOrubicin Pegylated Liposomal 20 mg/10 mL 50 mg/25 mL (Schering) (F) no preservative105 Epirubicin 10 mg/5 mL 20 mg/10 mL 50 mg/25 mL 150 mg/75 mL 200 mg/100 mL (Novopharm) (F)(PFL) no preservative106 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
2 mg/mL104
Less than 90 mg: 250 mL D5W only104 Greater than or equal to 90 mg: 500mL D5W only104
24 h F104
- do not filter104
N/A
2 mg/mL105
Less than 90 mg: 250 mL D5W only105 Greater than or equal to 90 mg: 500mL D5W only
24 h F105
- do not filter105
N/A106
2 mg/mL106
8 h F, RT106
syringe106
48 h F, 24 h RT From initial vial puncture106
29/90
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 (PPC) (F)(PFL) no preservative107 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
2 mg/mL107
8 h107
syringe107
48 h F, 24 h RT From initial vial puncture107
100 mL *NS or D5W
2 d F, RT: NS or D5W107,91 48 h F, 24 h RT from initial vial puncture108
Epirubicin 10 mg/5 mL 50 mg/25 mL 200 mg/100 mL (Pfizer) (F)(PFL) no preservative108
2 mg/mL108
8 h108
syringe108
100 mL*NS or D5W9
2 d F, RT: NS or D5W51
30/90
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) preservative109 Etoposide 100 mg/5 mL 200 mg/10 mL 500 mg/25 mL 1000 mg/50 mL (Teva/Novopharm) (RT)(PFL) no preservative113 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL109
RT
9,11,110,111,112
14 d
0.2 0.4 mg/mL109 500 mL*NS or D5W109
0.2 mg/mL: 48 h RT11,109 0.4 mg/mL: 24 h RT109
- use non-PVC bag and tubing only
N/A
20 mg/mL113
NS Stability is concentration dependent
0.2-0.3 mg/mL: 7 d F1142 d RT115,114 0.4-0.5 mg/mL: 1 d F1141 d RT1140.69.0mg/mL: generally unstable 9.5 mg/mL: 2 d F1141d RT114 10-12 mg/mL: 7 d F1142 d RT115,114 4 h RT113,116
- use non-PVC bag and tubing only
D5W113
31/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Fludarabine 50 mg (Berlex) (F) no preservative117 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
2 mL SWI117
25 mg/mL117
48 h F or RT11,51
dilute to maximum of 1 mg/mL117,118 100 mL*NS or D5W117
48 h F, RT11,51
Fludarabine 50 mg (Teva/Novopharm) (F) no preservative119
N/A
25 mg/mL119
dilute to maximum of 1 mg/mL119 100 mL*NS or D5W
48 h F, 24 h RT119
32/90
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 preservative120 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
50 mg/mL120
8 h RT120,121
syringe11
48 h RT11,18,121
2-10 mg/mL in D5W120,121 50-1000 mL*D5W CIVI: ambulatory pump121 Fluorouracil 500 mg/10 mL 5000 mg/100 mL (Sandoz) (RT)(PFL) no preservative123 N/A 50 mg/mL123 4 h RT91 syringe
24 h RT120,121
complete within 8 d9,11,122 4 h RT91
D5W123
24 h RT123
33/90
CIVI: ambulatory pump
complete within 8 d9,11,122
Gemcitabine 200 mg 1000 mg 2000 mg (Accord Healthcare) (RT) no preservative124
200 mg: 5 mL NS 1000 mg: 25 mL NS 2000 mg: 50 mL NS124
38 mg/mL124
24 h RT124
0.1 mg/mL - 10 mg/mL NS124
48 h RT125,111
Gemcitabine 200 mg 1000 m g (Eli-Lilly) (RT) no preservative126
200 mg: 5 mL NS 1000 mg: 25 mL NS126
38 mg/mL126
48 h RT126,127
syringe126
48 h RT,11,126,127
0.110 mg/mL NS126,127
48 h F, RT11,126,127
34/90
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) RT128 no preservative129 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 NS128
38 mg/mL128
48 RT128,130,54
syringe128
24 h RT128,130
0.1 mg/mL - 26 mg/mL NS128,130 Gemcitabine 200 mg 1000 mg (Teva/Novopharm) RT no preservative131 Gemcitabine 200 mg 1000 mg (Sandoz Standard) RT no preservative133 200 mg vial: 5mL NS 1000 mg vial: 25 mL NS132 38 mg/mL132 24 h RT132 0.1 mg/mL - 38 mg/mL NS132
48 h RT130,54
24 RT132
200 mg vial: 5 mL NS 1000 mg vial: 25 mL NS133
38 mg/mL133
48 h RT133,134
syringe133
48 h RT133,135,134
0.1 mg/mL - 38 mg/mL NS or D5W133,136
48 h RT11,137
35/90
36/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) IDArubicin 5 mg 10mg (Pfizer) (RT)(PFL) no preservative138 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
5 mg: 5 mL SWI138 10 mg: 10 mL SWI138 vial contents under negative pressure138 do NOT use BWI to reconstitute138
1 mg/mL138
48 h F, 24 h RT138 **(PFL) 138
syringe138
48 h F, 24 h RT
138
- avoid alkaline solutions138
IDArubicin PFS 5 mg/5 mL 10 mg/10 mL 20 mg/20 mL (Pfizer) (F)(PFL) no preservative138 IDArubicin 5 mg/5 mL 10 mg/10 mL 20 mg/20 mL (PPC) (F)(PFL) no preservative139
N/A
1 mg/mL138
24 h RT, 48 h F **(PFL)
138
syringe138
4 hours from initial puncture91
- avoid alkaline solutions

138
N/A
1 mg/mL139
discard unused solution139
syringe139
4 hours from initial puncture91
- avoid alkaline solutions139
37/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Ifosfamide 1000 m g 3000 mg (Baxter) (RT) 9 no preservative140 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1000 mg: 20 mL SWI140 3000 mg: 60 mL SWI shake well
50 mg/mL140
48 h F11,140
0.620 mg/mL140 5001000 mL*NS, D5W, D5-NS, D5-1/2NS, Lactated Ringers9,140
72 h F140 24 h F, RT when mixed with mesna9 D5W or Lactated Ringers when mixed 72 h F 24 h RT141 24 h F, RT when mixed with mesna9 D5W or Lactated Ringers when mixed 24 h RT142 - *may also use empty IV bag and qs to final volume of 250 mL with NS, D5W142
Ifosfamide 1000 mg 3000 mg (PPC) (RT) no preservative141,141
1000 mg: 20 mL SWI 3000 mg: 60 mL SWI141 shake well
50 mg/mL141
72 h F, 24 h RT141
0.6-20 mg/mL141 500-1000 mL *NS D5W; Lactated Ringers141
Iniparib 100 mg/10 mL (sanofi-aventis) (F) no preservative142
N/A
10 mg/mL
250 mL NS, D5W dilute to 250 mL final volume by withdrawing volume from bag equal to volume of drug to be added*142
38/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Interferon Alfa -2b 18 million units/3 mL (Schering) (F)(or up to 7 days at RT before use) 143 preservative144 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
6 million units/mL143
48 h F11,143
syringe143
2 d F11,145
Greater than or equal to 0.3 million IU/mL143 50 mL NS143 Interferon Alfa -2b 10 million units/1 mL 25 million units/2.5 mL (Schering) (F)(or up to 7 days at RT before use) 143 preservative144 N/A 10 million units/mL143 48 h F11,143 syringe143
24 h F, RT145
2 d F11,145
0.3 million IU/mL143 50 mL NS143
24 h F, RT145
39/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Interferon Alfa -2b 10 million units (Schering) (F) 143 no preservative (unless reconstituted with BWI)144 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1 mL supplied diluent (SWI) 143 do not shake; roll to reconstitute143
10 million units/mL143
24 h F143
syringe143
24 h F, RT145
Greater than 0.1 million IU/mL145 100 mL NS146
48 h RT9,11
1 mL BWI143 do not shake; roll to reconstitute143
48 h F, RT11,143
syringe146
14 d F, 48 h RT11,146
100 mL NS146 Interferon Alfa -2b 18 million units(Schering) (F) 143 no preservative (unless reconstituted with BWI)144 1 mL supplied diluent143 do not shake; roll to reconstitute143 18 million units/mL143 24 h F143 syringe143
48 h RT9,11 24 h F, RT145
40/90
> 0.1 million IU/mL147 100 mL NS146 1 mL BWI143 do not shake; roll to reconstitute143 100 mL NS146 48 h F, RT11 syringe143
48 h RT9,11
14 d F11,146
48 h RT9,11
41/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Ipilimumab 50 mg/10 mL 200 mg/40 mL (BMS Canada) (F)(PFL) no preservative148 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
5 mg/mL
24 h F,RT148
1 4 mg/mL in NS, D5W 100 mL

148
24 h F,RT148
OR undiluted in empty viaflex bag or glass bottle (allow vials to stand at RT for ~5 min prior to withdrawal of contents)148
- do NOT shake148 - administer with 0.2 or 0.22 low protein binding inline filter148 - vials may contain translucent-towhite amorphous particles148 - discard if cloudy or has pronounced colour change (should be clear to pale yellow)148 - flush line with NS or D5W after infusion148
42/90
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 preservative149 Irinotecan 40 mg/2 mL 100 mg/5 mL (Pfizer) (RT)(PFL) no preservative152 Irinotecan 40 mg/2 mL 100 mg/5 mL (Sandoz) (RT)(PFL) no preservative153 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL149
2 days RT11,150,151
0.12 2.8 mg/mL149 500 mL9 D5W (preferred), NS149
24 h RT: D5W, NS149 48 h F: D5W (PFL)149
- do NOT refrigerate if in NS152
N/A
20 mg/mL152
0.12 2.8 mg/mL152 500 mL9 D5W (preferred), NS152
24 h RT: D5W, NS152 48 h F: D5W (PFL)152
- do NOT refrigerate if in NS152
N/A
20 mg/mL153
0.12-2.8 mg/mL153 D5W (recommended) NS153
24 h RT: D5W NS153 48 h F: D5W153 (PFL)153
43/90
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 preservative154 Leucovorin 50 mg/5 mL 500 mg/50 mL (Hospira) (F)(PFL) no preservative155 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 RT154
0.2 0.6 mg/mL in Lactated Ringers Injection USP (use non-PVC infusion container)154
6 h RT154
- use 0.2-1.2 micron in-line filter154 - use non-PVC (i.e., DEHP-free) administration set154
N/A
10 mg/mL155
5 mL vial: discard unused portion155 50 mL vial: 8 h
syringe156
7 d F156 48 h RT115,156
0.05-10 mg/mL155
24 h RT155: NS, D5W, Lactated Ringers, Ringers 8 h RT155: D10W, D5NS
50-250 mL* NS, D5W, Lactated Ringers, Ringers, D10W, D5-NS
44/90
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 (Teva/Novopharm) (F)(PFL)157 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A157
10 mg/mL157
5 mL vial: discard unused portion157 50 mL vial: discard unused portion157
syringe
8 h157,11
0.060-1.0 mg/mL157
24 h RT NS, Lactated Ringers, Ringers157 12 h RT D5W, D10W157 6 h RT D5NS157
50-250 mL* NS, D5W, Lactated Ringers, Ringers, D10W, D10NS157
45/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Mechlorethamine 10 mg (Ovation Pharmaceuticals/Merck) no preservative158 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
do NOT use if discoloured or water droplets form in vial before reconstitution158 10 mL SWI or NS158 record time of reconstitution
1 mg/mL158
use within 4 h of reconstitution RT9,11
syringe158
complete administration 4 h of reconstitution RT9,11,158
100 mL NS51,158
complete administration within 4 h of reconstitution RT11,51,158
46/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Melphalan 50 mg (GSK) (RT)(PFL) no preservative159 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
10mL supplied diluent159 immediately after adding diluent, shake vigorously159 record time of reconstitution
5 mg/mL159
2 h RT159 do NOT refrigerate
0.1 0.45 mg/mL in NS only159 (e.g., greater than 45 mg and less than or equal to 110 mg in 250 mL NS)*
complete administration within 60 min from time of initial reconstitution at RT9
Mesna 1000 mg/10mL (PPC) (RT) preservative160
N/A
100 mg/mL160
14 d F, RT11,160
Greater than or equal to 1mg/mL160 NS or D5W
48 h F, 24 h RT160
47/90
Methotrexate 50 mg/2mL 500 mg/20mL 1 g/40mL 5 g/200mL (Hospira) (RT)(PFL) no preservative161
N/A
25 mg/mL161
50mg: discard unused portion161 500mg, 1 g, 5 g: 8 h F, RT161
syringe
2 d F, RT9,162,163
- for high-dose regimens (e.g., 1-8 g/m2 as a single dose)164 use preservative-free methotrexate9 - do not use for IT injection
0.42 mg/mL161 100 mL* NS, D5W high dose (e.g., 1-8 g/m2 as a single dose)164,165-167: 500 1000 mL* Methotrexate IT Injection161: Only preservative free methotrexate may be administered by the intrathecal route161 50 mg/2mL168 (Hospira) (RT)(PFL) no preservative161 N/A 25 mg/mL161 discard unused portion161 qs to 6 mL with preservative free NS69
24 h RT161
use within 4 h of initial puncture9,11
48/90
Methotrexate 50 mg/2mL 500 mg/20mL (Hospira) (RT)(PFL) preservative161
N/A
25 mg/mL161
14 d F169,54
syringe
14 d F115,162
- high-dose regimen(e.g., 1-8 g/m2 as a single dose)165-167: use preservative-free methotrexate9 - do not use for IT injection
0.42 mg/mL161 e.g., 100 mL*NS, D5W161 Mitomycin 5 mg 20 mg (Teva/Novopharm) (RT)(PFL) no preservative170 SWI 5 mg: 10 mL 20 mg: 40 mL shake well170 0.02-0.04 mg/mL170 NS, D5W, sodium lactate170 Mitomycin 5 mg 20 mg (BMS) (RT)(PFL) no preservative171 SWI 5 mg: 10 mL 20 mg: 40 mL shake well171 0.5 mg/mL171 48 h F, RT11,171 (PFL)171 syringe9 0.5 mg/mL170 48 h F, RT11,170 (PFL)170 syringe11
24 h RT169
14 d F, 48 h RT11,170
3 h RT: D5W 12 h RT: NS 24 h RT: sodium lactate170 14 d F, 48 h RT9,18
49/90
0.020.04 mg/mL NS, D5W, sodium lactate171
12 h RT: NS 3h: D5W 24 h: sodium lactate171
50/90
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 preservative172 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
2 mg/mL172
0.2-0.6 mg/mL172 NS, D5W172 Greater than or equal to 50 mL*172
NS: 24 h F, RT172 **(PFL)172
MitoXANTRONE 20 mg/10 mL (Teva/Novopharm) (RT)(PFL) no preservative173 MitoXANTRONE 20 mg/10 mL (Pharmaceutical Partners of Canada) (RT) no preservative175
N/A
2 mg/mL173
NS, D5W173 Greater than or equal to 50 mL*173
24 h RT173 **(PFL)174
N/A
2 mg/mL175
NS, D5W2 Greater than or equal to 50 mL*175
24 h RT175
51/90
Octreotide 50 mcg/mL; 100 mcg/mL; 500 mcg/mL (Omega) (F)(PFL) no preservative176 multidose vials (5mL): 200 g/mL (F)(PFL) preservative176
N/A
50 mcg/mL 100 mcg/mL 500 mcg/mL176
Use within 4 h176
NS176 Volume adjusted to ensure a continuous infusion of octreotide at 25 mcg/hour176
24 h RT176
200 mcg/mL176
15 d F176
NS176 Volume adjusted to ensure a continuous infusion of octreotide at 25 mcg/hour176
24 h RT176
Octreotide 50 mcg/mL; 100 mcg/mL; 500 mcg/mL (Teva/Novopharm) (F)(PFL) no preservative multidose vials (5mL): 200 g/mL (F)(PFL) preservative177
N/A
sc syringe177
single use vials: use within 4 h multidose vials: use within 14 d F54,177
200 mcg/mL177
14 d F54,177
infusion: NS177
single use vials or multidose vials: 24 h RT177
52/90
Octreotide (Sandostatin) 1000 mcg/5 mL (Novartis) (F)(PFL) preservative15
N/A
200 mcg/mL15
50200 mL NS15,9,179 SC infusion: adjust volume to ensure infusion rate of 25 mcg/h15
24 h RT15
53/90
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 preservative15 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
50-100 mL9,179 NS15 SC infusion: adjust volume to ensure infusion rate of 25 mcg/h15
24 h RT15
Octreotide (Sandostatin LAR) 10 mg 20 mg 30 mg (Novartis) (F)(PFL) no preservative178
2 mL supplied diluent gently run 2 mL down sides of the vial; do NOT disturb for 25 min, then swirl moderately15 record time of reconstitution
10 mg: 5 mg/mL 20 mg: 10 mg/mL 30 mg: 15 mg/mL15
deep intragluteal administration only15
use within 4 h of initial reconstitution15,11
- do NOT shake
54/90
Ofatumumab 100 mg/ 5 mL 1000 mg/50 mL (GlaxoSmithKline) (F)(PFL) no preservative180
n/a
20 mg/mL180
discard unused portion
1000 mL NS180 or alternatively, 2000 mg doses may be supplied in 2 x 500 mL NS180 withdraw volume from bag equal to volume of drug to be added180
48 h RT180
administer with 0.2 micron low protein binding in-line filter180 do NOT shake; mix by slow inversion to avoid formation of foam180 solution may contain a small quantity of drug particles; do not administer if solution is cloudy or discoloured180
55/90
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 preservative181 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
5 mg/mL181
0.2-1.3 mg/mL182 1.32 mg/mL181,182 250500 mL D5W181 do NOT use NS or other chloridecontaining solution181 do NOT use aluminum-containing needle and syringe181
0.2-1.3 mg/mL: 14 d F, 48 h RT183,115,182 1.3-2 mg/mL: 48 h F, 24 h RT181
56/90
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 preservative184 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 solution184 do NOT use aluminumcontaining needle and syringe184
5 mg/mL184
24 h F184
500 mL D5W do NOT use NS or other chloridecontaining solutions (degrades)184 do NOT use aluminum-containing needle and syringe184
24 h F, 6 h RT184
PACLitaxel 30 mg/5 mL 100 mg/16.7 mL 300 mg/50 mL (Biolyse) (RT)185 no preservative186
N/A
6 mg/mL186
8 h RT186
0.3-1.2 mg/mL in NS, D5W186 (e.g., 100-1000 mL)*
Complete administration within 27 h RT187; 186
- use non-PVC (non-DEHP) bag and tubing with inline filter186
0.1 mg/mL in NS188
44 h F, RT188
57/90
0.012-0.12 mg/mL in NS189 devices with spikes (e.g., chemo dispensing pins) may be used with vials190
16 h RT187
58/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) PACLitaxel 30 mg/5 mL 100 mg/16.7 mL 300 mg/50 mL (BMS) (RT)(PFL) no preservative191 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
6 mg/mL191
30 mg/5 mL or 100 mg/16.7 mL vial: 48 h RT191; 54 300 mg/50 mL vial: 24 h RT191
0.3-1.2 mg/mL in NS, D5W, D5NS, D5LR191 (e.g., 100-1000 mL)* 0.1-1 mg/mL in NS, D5W189 devices with spikes (e.g., chemo dispensing pins) should not be used with vials191
complete administration within 27 h RT191 48 h F, RT189
PACLitaxel 30 mg/5 mL 100 mg/16.7 mL 150 mg/25 mL 300 mg/50 mL (Hospira) (RT)(PFL) preservative192
N/A
6 mg/mL193
48 h RT193; 91;194
0.3-1.2 mg/mL in NS, D5W,D5NS, D5LR193 (e.g., 100-1000 mL)*
complete administration within 27 h RT193
devices with spikes (e.g., chemo dispensing pins) should not be used with vials193
59/90
PACLitaxel, nanoparticle, albuminbound (nab) 100 mg (Abraxis BioScience Canada, Inc.) (RT)(PFL) no preservative195
20 mL NS195 - slowly direct diluent against side of vial (i.e., greater than or equal to1 min) during reconstitution195 - let stand for greater than or equal to 5 min to wet powder195 - gently swirl or invert for greater than or equal to 2 min 195
5 mg/mL195
use immediately (RT) or 8 h F195 (PFL)195
in empty sterile PVC or non-PVC infusion bag195
48 h F plus an additional 8 h RT195,196
- each vial contains 900 mg human albumin195 - to prevent foaming, do NOT inject NS directly onto the powder - some settling may occur. Use mild agitation to resuspend195 - discard if precipitation occurs195 - in-line filters are not recommended195
60/90
Pamidronate 30 mg/10 mL 60 mg/10 mL 90 mg/10 mL (Hospira) (RT) no preservative197
N/A
3 mg/mL 6 mg/mL 9 mg/mL197
0.060.36 mg/mL NS, D5W197 e.g., 250 mL NS

198
24 h F followed by 24 h 197 RT (total 48 h) **(PFL)197
- do NOT mix with calcium containing solution (e.g., Ringers)197
Pamidronate 30 mg/10 mL 60 mg/10 mL 90 mg/10 mL (Omega) (RT) no preservative199
N/A199
0.060.36 mg/mL NS, D5W199 e.g., 250 mL NS

198
24 h F followed by 24 h 199 RT (total 48 h) **(PFL) 199
61/90
Pamidronate 30 mg/10 mL 60 mg/10 mL 90 mg/10 mL (PPC) (RT) no preservative200 Pamidronate 30 mg/10 mL 60mg/10 mL 90 mg/10 mL (Sandoz Canada) RT no preservative201 Panitumumab 100 mg/5 mL 200 mg/10 mL 400 mg/20 mL (Amgen) (F)(PFL) do not shake no preservative202
N/A200
NS; D5W200 Less than or equal to 0.36 mg/mL200
24 h RT200
- do NOT mix with calcium containing solutions200
N/A201
NS; D5W201
24 h RT201
N/A
20 mg/mL202
Less than or equal to 1000 mg: 100 mL NS202 Greater than 1000mg: 150 mL NS202 1-10mg/mL202,203
24 h F, 6 h RT202,203
- administer with 0.2 or 0.22 micron low protein binding in-line filter202 - solution may contain particulates which do not affect product quality202 - do not administer if discoloured202
62/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Pemetrexed 100 mg 500 mg (Eli Lilly) (RT) no preservative204 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
100 mg: 4.2 mL preservative-free NS 500 mg: 20 mL preservative-free NS204
25 mg/mL204
24 h F, RT204
100 mL preservative-free NS204 do NOT mix with calcium containing solution (e.g., Ringers)205 syringe206
24 h F, RT204
Porfimer 15 mg 75 mg (Axcan) (RT)(PFL) no preservative206 Raltitrexed 2 mg (Hospira) (F, RT)(PFL) no preservative208
6.6 mL D5W 31.8 mL D5W206 record time of reconstitution 4 mL SWI208
2.5 mg/mL206
24 h F (PFL)206
use within 4 h of initial reconstitution11,207 **(PFL)206
- avoid contact with skin and eyes; protect exposed area from light206
0.5 mg/mL208
24 h F, RT208
50250 mL NS, D5W208
24 h F, RT208
63/90
Reovirus Serotype 3 Dearing Strain REOLYSIN Dose (viral titre) in each shipment may vary and must be checked closely (Oncolytics Biotech) (less than or equal to -70 C)(PFL) 209 no preservative
N/A209
dose (viral titre) in each shipment may vary and must be checked closely209
time from thawing and dilution to patient administration should be less than 8 h; may be extended to 24 h if necessary209 thaw at room temperature or in fridge209 discard unused portion210
250 mL NS209
complete administration within 8 h of removal from freezer; may be extended to 24 h if necessary209 refrigerate diluted product until delivery to treatment room209
- auxiliary label: biohazard209
riTUXimab 100 mg/10 mL 500 mg/50 mL (Roche) (F)(PFL) no preservative210
N/A
10 mg/mL210
1-4 mg/mL NS, D5W210 (e.g., 250-500 mL)*
24 h F, 36 h RT210
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Streptozocin 1g (Pfizer) (F)(PFL) no preservative211 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
9.5mL NS, SWI, D5W211
100 mg/mL211
48 h F,211 24 h RT
syringe211
48 h F, 24 h RT211
50-500 mL*NS, D5W, SWI211 Temozolomide 100 mg (Schering) (F) do not dilute212 do not shake212 no preservative212 Temsirolimus 30 mg/1.2 mL (Wyeth) (F)(PFL)213,214 no preservative215 41 mL SWI212 2.5 mg/mL212 14 h F, RT212 empty 250 mL PVC bag212
48 h F, 24 h RT211
14 h RT212
1.8 mL supplied diluent213,214
10 mg/mL213,214
24 h RT213,214 (PFL)213
250 mL NS213,214
Complete administration within 6 h213,214
- use non-PVC bag and non-PVC tubing with in-line filter213,214
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Teniposide 50 mg/5 mL (BMS) (RT) preservative216 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
10 mg/mL216
discard unused portion
50 500 mL NS or D5W for a final concentration of 0.1-1 mg/mL216
0.1-0.4 mg/mL: 24 h RT216 1 mg/mL: complete administration within 4 h of preparation RT216,217
- do not refrigerate - use non-PVC (non-DEHP) bag and tubing216 - do not use if precipitates216,217 - excessive agitation may cause precipitation216 - do not use if precipitates or remains opaque218 - do not use for IT injection
Thiotepa 15 mg (Bedford) (F)(PFL) no preservative218
1.5 mL SWI218 filter through 0.22 micron filter218 record time of reconstitution
10 mg/mL218
8 h F218
50 mL* NS218
use within 4 h of initial reconstitution219,218 **(PFL)218,220
syringe: reconstituted solution is hypotonic and must be further diluted with NS prior to use218 (final concentration of 0.5-1 mg/ml is nearly isotonic)221
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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 preservative218 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 SWI218 filter through 0.22 micron filter218 record time of reconstitution
10 mg/mL218
8 h F218
qs to 6 mL with preservative free NS222
- auxiliary label69 IT - label to include route in full (i.e., INTRATHECAL injection) attached to both syringe and outer ziplock bag69 - cytotoxic223 - do not use if precipitates or remains opaque218
Thyrotropin alfa 1.1 mg (Genzyme) (F)(PFL) no preservative224
1.2 mL SWI224 swirl contents224; do not shake
0.9 mg/mL224
24 h F224
syringe224
24 h F224
67/90
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 preservative225 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL225
6 h225, 18
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 drug225
24h F225; 6 h RT226
- to prevent foaming: slowly add drug to infusion bag and gently invert bag to mix225
68/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Topotecan 4 mg (Hospira) (F)(PFL) single-use no preservative227 Topotecan 4 mg (Sandoz) (RT)(PFL) no preservative228 Trastuzumab 440 mg (Roche) (F) preservative229 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A227
1 mg/mL227
6 h F, RT18
0.02 0.5 mg/mL227
24 h F, RT227
4 mL SWI228
1 mg/mL228
24 h F, RT228
20 500 mcg/mL NS, D5W228
24 h F, RT228
20 mL supplied BWI229 swirl vial gently; allow to stand undisturbed for 5 min1
21 mg/mL229
14 d F229
250 mL NS229 Do NOT use dextrose containing solutions229
24 h F, RT229
- do not shake229
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Trastuzumab Emtansine 100 mg, 160 mg (Genentech) (F)(PFL) no preservative230
100 mg vial: 5 mL SWI230 160 mg vial: 8 mL SWI230 swirl gently until completely dissolved; do NOT shake vigorously230
20 mg/mL230
8 h RT or 24 h F230
250 mL NS or 0.45% Sodium chloride230
preferred: for immediate use230 24 h F230
- vials should remain refrigerated until use230 - 0.2 micron in-line filter is required for infusions prepared in NS230 - minimum volume for dilution is 250 mL230
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Treosulfan 1g 5g (medac) (RT) no preservative231
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 min231 5 g vial: 100 mL SWI, while slightly shaking vial and syringe; continue shaking the reconstituted solution for another 2 min231
50 mg/mL231
48 h RT11,231
undiluted232 dilute with NS or D5W in empty infusion bag for final concentration = 20 mg/mL231
48 h RT11,231
- compatible with polytetrafluoroethyl ene filters231 - may require vigorous shaking to reconstitute231
VinBLAStine 10 mg/10 mL (Hospira) (F)(PFL) no preservative177
N/A
1 mg/mL177
syringe9,177
4 h F, RT233,234
- label with: WARNING: FOR INTRAVENOUS USE ONLY FATAL IF GIVEN BY OTHER ROUTES235,236
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100250 mL NS, D5W237
24 h F, RT233,234
72/90
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 preservative238 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL238
8 h F, RT238
50 mL*NS, D5W238
24 h F, 6 h RT,238 **(PFL)238
- label with: WARNING: FOR INTRAVENOUS USE ONLY FATAL IF GIVEN BY OTHER ROUTES235,236 - label with: WARNING: FOR INTRAVENOUS USE ONLY FATAL IF GIVEN BY OTHER ROUTES235,236 - label with: WARNING: FOR INTRAVENOUS USE ONLY FATAL IF GIVEN BY OTHER ROUTES235,236
VinCRIStine 1 mg/1 mL 2 mg/2 mL 5 mg/5 mL (Teva/Novopharm) (F)(PFL) preservative239
N/A
1 mg/mL239
14 d F, RT239
50 mL*NS, D5W239
72 h F, 24 h RT73 **(PFL)239
Vinorelbine 10 mg/1 mL 50 mg/5 mL (GSK) (F)(PFL) no preservative240
N/A
10 mg/mL240
syringe: 1.5 3.0 mg/mL in NS or D5W240
24 h F, RT240
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0.5 2.0 mg/mL240 50 mL*NS, D5W, NS, D5NS, Ringers, Ringers Lactate240 Vinorelbine 10 mg/1 mL 50 mg/5 mL (Hospira) (F)(PFL) no preservative241 N/A 10 mg/mL241 discard unused portion241 syringe: 1.5 3.0 mg/mL in NS or D5W241
24 h F, RT240
24 h F, RT241
0.5 2.0 mg/mL241 50 mL* NS, D5W, NS, D5NS, Ringers, Ringers Lactate241
24 h F, RT241
74/90
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Vinorelbine 10 mg/1 mL 50 mg/5mL (PPC) (F)(PFL) no preservative242 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A242
10 mg/mL242
syringe: 1.5-3.0 mg/mL in D5W or NS242
24 h F, RT242
0.5-2.0 mg/mL242 NS, D5W, NS, D5NS, Ringers, Ringers Lactate242 Vinorelbine 10 mg/1 mL 50 mg/5mL (Pierre Fabre Pharma Canada) (F)(PFL) no preservative243 N/A243 10 mg/mL243 discard unused portion243 syringe: 1.5-3.0 mg/mL in D5W or NS243
24 h F, RT242
24 h F, RT243
75/90
0.5-2.0 mg/mL243 NS, D5W, NS, D5NS, Ringers, Ringers Lactate243
24 h F, RT243
76/90
* 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 797.18,244 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
77/90
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. Rui Paiva. Personal communication. Business Unit Director, Transplant and Oncology; 1 June 2009. 4. Bayer HealthCare Pharmaceuticals. MabCampath Package Insert. Toronto, Ontario; 1 September 2007. 5. 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. 6. Berlex Canada Inc. Campath Drug Information. San Antonio, Texas; undated. 7. Schering AG. MABCAMPATH Package Leaflet. Berlin, Germany; April 2002. 8. MedImmune Pharma B.V. Ethyol Package Insert. The Netherlands; 2003. 9. Trissel LA. Handbook on Injectable Drugs. 13th ed. Bethesda, MD: American Society of Health-System Pharmacists, Inc.; 2005. 10. Erfa Canada Inc. AMSA PD injection product monograph. Westmount, Quebec; 16 August 2005. 11. BC Cancer Agency. Pharmacy Policy Number II-20: Guiding Principles for Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer Agency; 6 January 2006. 12. Tanya Leduc. Personal communication. Acting editor, BC Cancer Agency Cancer Drug Manual; 2 June 2008. 13. Orphan Pharma International. Kidrolase Product Monograph. Limonest, France; 2005. 14. Robert Sarrazin B Pharm. Personal communication. Consultant, OPi Inc. February 2005. 15. Repchinsky C editor. Compendium of Pharmaceuticals and Specialties. 12th ed. Ottawa, Ontario: Canadian Pharmacists Association; 2004. 16. OPi SAS. Kidrolase Product Monograph. Laval, Quebec; 2003. 17. Rhone-Poulenc Rorer. Kidrolase Package Insert. Montreal, Quebec; 2004. 18. 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. 19. Orphan Pharma International. Erwinase Product Monograph. Limonest, France; 2005. 20. Enzon Pharmaceuticals Inc. Oncaspar Product Monograph. Bridgewater, New Jersey; 2003.
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61. Oryx Pharmaceuticals Inc. Clasteon Product Monograph. Mississauga, Ontario; 25 November 2004. 62. Baxter Corporation. Procytox Package Insert. Toronto, Ontario; 2004. 63. Baxter Corporation. Procytox Package Insert. Missisauga, Ontario; 1 October 2003. 64. Paul Agro. Personal communication. Medical Information, cyclophosphamide, Baxter. 12 July, 2006. 65. Novartis Pharmaceuticals Canada Inc. NEORAL & SANDIMMUNE I.V. product monograph. Dorval, Quebec; 30 September 2008. 66. Trissel LA. Handbook on Injectable Drugs. 13th ed. Bethesda, Maryland: American Society of Health-System Pharmacists, Inc; 2005. p. 418-420. 67. Mayne Pharma (Canada) Inc. Cytarabine Injection Product Monograph. Montreal, Quebec; 25 July 2003. 68. Pfizer Canada Inc. CYTOSAR Sterile Powder monograph. Kirkland, Quebec; 16 September 2010. 69. BC Cancer Agency Miscellaneous Origin Tumour Group. BCCA protocol summary for solid tumours using intrathecal methotrexate and/or thiptepa and/or cytarabine (MOIT). Vancouver, British Columbia: BC Cancer Agency; 1 July 2005. 70. BC Cancer Agency. Systemic Therapy Policy III-50: Administration of Cytotoxic Drugs by the Intrathecal Route via Lumbar Puncture or Ommaya Reservoir. Vancouver, British Columbia; 31 October 2002. 71. Pfizer Canada Inc. CYTOSAR Sterile Powder Product Monograph. Kirkland, Quebec; 17 March 2004. 72. BPharm Yamina Chikhaoui PhD. Personal communication. Medical Information, Pfizer Canada. February 2005. 73. Novopharm Limited. Vincristine product monograph. Scarbough, Canada; 1999. 74. Abraxis Pharmaceutical Products. Dacarbazine product information package. Schaumburh, IL; December 2006. 75. Trissel L. Handbook on injectable drugs. 13th ed. Bethesda, Maryland: American Society of Health-System Pharmacists; 2005. p. 428-431. 76. Mayne Pharma (Canada) Inc. DACARBAZINE FOR INJECTION product monograph. Montreal, Quebec; 25 July 2003. 77. John Korontzis. Personal communication. Regulatory Affairs Associate, Dacarbazine, Mayne Pharma Canada; #FEB-14-2005 (february 8, 2005). 78. Lundback. Cosmegen product monograph. Deerfield, IL; 7 November 2011. 79. Jane Stachura. Personal communication. Ovation Pharmaceuticals Inc; 12 January 2009. 80. Ovation Pharmaceuticals Inc. COSMEGEN product monograph. Deerfield, Illinois; 19 August 2008.
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81. Patricia Hamelin-Dandridge RN. Personal communication. Medical Information Research Associate, Ovation Pharmaceuticals; 24 October, 2008. 82. Trissel LA. Handbook on Injectable Drugs. 13th ed. Bethesda, Maryland: American Society of Health-System Pharmacists, Inc; 2005. p. 431. 83. Erfa Canada Inc. Daunorubicin injection product monograph. Westmount, Quebec; 6 December 2002. 84. Erfa Canada Inc. Material Safety Data Sheet. Montreal, Quebec; 3 October 2007. 85. Henri Knafo MD. Personal communication. Medical Director, Erfa Canada Inc; 14 July 2008. 86. Henri Knafo MD. Personal communication. Medical director, Erfa Canada Inc; 09 July 2008. 87. Novopharm Limited. Daunorubicin Package Insert. Toronto, Canada; Undated. 88. Ferring Pharmaceuticals. FIRMAGON product monograph. North York, Ontario; 06 November 2009. 89. B.C. Cancer Agency - Pharmacy. Pharmacy Provincial Policy II-30: Guiding principles for chemotherapy preparation chart. Vancouver, British Columbia: BC Cancer Agency; 24 March 2004. 90. Amgen Canada Inc. XGEVA product monograph. Mississauga, Ontario; 14 October 2011. 91. BC Cancer Agency. Pharmacy Policy Number II-20: Guiding Principles for Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer Agency; 19 September 2007. 92. Pharmacia & Upjohn Inc. Zinecard Package Insert. Mississauga, Ontario; 2004. 93. Pharmacia & Upjohn Company. Zinecard: US Prescribing Information. Kalamazoo, Michigan; September 2003. 94. Pfizer Canada Inc. ZINECARD product monograph. Kirkland, Quebec; 12 August 2010. 95. Hospira Healthcare Corporation. DOCETAXEL FOR INJECTION product monograph. Saint-Laurent, Quebec; 21 February 2011. 96. Josee Lloyd, Senior Clinical Specialist. Subject : Docetaxel Injection 160mg/16mL and 80 mg/8mL multidosing and venting needles. Hospira Clinical Support Team; 13 July 2011. 97. Josse Lloyd Senior Clinical Specialist. Email received March 12, 2013. Hospira Healthcare Corporation; 12 March 2013;. 98. sanofi-aventis Canada Inc. TAXOTERE product monograph. Laval, Quebec; 15 April 2011. 99. Walker S. Stability of docetaxel solution after Dilution in Ethanol and Storage in vials and after Dilution in Normal Saline and Storage in Bags. Can J Hosp Pharm 2007;60(4):231237. 100. Mayne Pharma (Canada) Inc. Doxorubicin Package Insert. Montreal, QC; Undated.
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121. John Korontzis. Personal communication. Regulatory Affairs Associate, Fluorouracil, Mayne Pharma Canada; reference # FEB-43-2005.February 16, 2005. 122. Stiles ML, Allen Jr LV, Tu YH. Stability of fluorouracil administered through four portable infusion pumps. American Journal of Hospital Pharmacy 1989;46(10):2036-2040. 123. Sandoz Canada Inc. Fluorouracil Injection product monograph. Boucherville, Quebec; 3 April 2012. 124. Accord Healthcare. Gemcitabine for Injection product monograph. Markham, Ontario; 5 July 2011. 125. Astron Research LTD. UK. Gemcitabine for Injection (STBRG/ACGEM/01) Stability Study Report (Dilution Study) 2001 . 126. Eli Lilly Canada Inc. Gemzar Package Insert. Toronto, Ontario; 16 January 2002. 127. Marilyn Bain BSc N. Personal communication. Sr Therapeutic Area Specialist Medical Information, Gemzar. September 2004. 128. Hospira Healthcare Corporation. Gemcitabine for injection, USP product monograph. Montreal, Quebec; 3 November 2008. 129. Rose Toussaint. Personal communication. Clinical Specialist, Hospira Canada Healthcare Corporation; 26 May2009. 130. Hospira Canada Clinical Support Team. Personal communication. Hospira Healthcare Corporation; 13 March 2009. 131. B.C. Cancer Agency - Pharmacy. Pharmacy Provincial Policy II-30: Guiding principles for chemotherapy preparation chart. Vancouver, British Columbia: BC Cancer Agency; 24 March 2004. 132. Novopharm Limited. Gemcitabine product monograph. Toronto, Ontario; 08 February 2008. 133. Sandoz Standard. Gemcitabine for injection product monograph. Boucherville, Quebec; 13 November 2007.2007. 134. Amelie Fontaine B.Sc (N). Personal communication. Drug Information Specialist, Sandoz (vial); 9 April 2009. 135. Stephane Jean B. Pharm. Personal communication. Sandoz Canada Drug Information; 7 May 2008. 136. Stephane Jean. Personal communication. Drug Information Specialist; 25 September 2009. 137. Amelie Fontaine B.Sc (N). Personal communication. Drug Information Specialist, Sandoz (infusion); 9 April 2009. 138. Pfizer Canada Inc. IDAMYCIN product monograph. Kirkland, Quebec; 19 February 2009. 139. Pharmaceutical Partners of Canada, Inc. IDARUBICIN HYDROCHLORIDE INJECTION product monograph. Richmond Hill, Ontario; 12 November 2009. 140. Baxter Corporation. Ifex Package Insert. Toronto, Ontario; Undated.
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141. Pharmaceutical Partners of Canada, Inc. Ifosfamide for Injection product monograph. Richmond Hill, Ontario; 17 January 2008. 142. sanofi-aventis Canada. Iniparib (BSI-201;SAR240550) Special Access Program Guidance for the Physician. Laval, Quebec; 15December2010. 143. Schering Canada Inc. Intron A Package Insert. Pointe-Claire, Quebec; January 2003. 144. Judy Sutherland MD. Personal communication. BC Cancer Agency Genitourinary Tumour Group; 11 June 2007. 145. Julie Lacasse BScN RN. Personal communication. Associate Medical Information, Schering. February 2005. 146. Schering Canada. Intron A Product Monograph. Pointe Claire Quebec; December 2004. 147. Edward Kavalec. Intron A (interferon alpha-2b). Schering Canada - Medical Services. 2006. 148. Bristol Myers Squibb Canada. YERVOY product monograph. Montreal, Quebec; 1 February 2012. 149. Mayne Pharma (Canada) Inc. Irinotecan Package Insert. Montreal, Quebec; 28 April 2005. 150. Beryl Chan. Personal communication. Mayne Pharma (Canada) Inc. Scientific Affairs Manager, Irinotecan. 2 February 2006. 151. Walker S, Iazzetta J, Law S. Irinotecan stability in vials following puncture when stored at 23c or 4c. Can J Hosp Pharm 2006;59 (Suppl 2):36. 152. Pharmacia Canada Inc. Camptosar Package Insert. Mississauga, Ontario; May 2002. 153. Sandoz Canada Inc. Irinotecan injection package insert. Boucherville, Quebec; April 2008. 154. Bristol-Myers Squibb. IXEMPRA product monograph. Princeton, New Jersey; 01 October 2007. 155. Faulding (Canada) Inc. Leucovorin Package Insert. Montreal, QC; Undated. 156. John Korontzis. Personal communication. Regulatory Affairs Associate, Leucovorin Calcium, Mayne Pharma Canada; February 2005. 157. Novopharm Limited (Teva). LEUCOVORIN CALCIUM Injection product information package. Toronto, Ontario; undated. 158. Ovation Pharmaceuticals Inc. MUSTARGEN Package Insert. Deerfield, Illinois; October 2005. 159. GlaxoSmithKline Inc. Alkeran Package Insert. Mississauga, Ontario; Montreal, Quebec; 2004. 160. Pharmaceutical Partners of Canada Inc. Mesna Package Insert. Richmond Hill, Ontario; November 2001. 161. Mayne Pharma Canada. Methotrexate Product Monograph. Montreal, Quebec; December 2003.
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative

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

Alemtuzumab 30 mg/mL (Genzyme previously Bayer)3 (F)(PFL) do not shake no preservative4

filter NOT required4 30 mg/mL4

discard unused portion4

discard at the end of the day F or RT

2550 mL*NS only8

540 mg/mL: 24 h F,8 5 h RT

- discard cloudy solution9

500 mL D5W10 (plastic or glass container)10

do not shake; roll to reconstitute19 1-2 mL NS19

15 min in original container; 8 h in a glass or polypropylene syringe19

glass or polypropylene syringe19

8 h in a glass or polypropylene syringe19

discard unused portion20

IM: maximum volume 2 mL; if greater than 2 mL use multiple sites20

IV: 100 mL NS or D5W20

4 mL SWI22 shake vigorously22

BCG 81 mg (Sanofi Pasteur) (F)(PFL) preservative24

do not shake; roll to reconstitute24 3 mL supplied diluent24 record time of reconstitution

10.5 8.7108 CFU/vial (Connaught strain)24

2 h F or RT after reconstitution24 **(PFL)24

- overfill unknown - protect from light25 - do not filter25

500 mL NS26 0.2-0.6 mg/mL26

complete administration within 24 h F, 3 h RT26

discard unused portion27

1.4-16.5 mg/mL28 100-250 mL NS only27,28

Bortezomib 3.5 mg (Ortho Biotech formally Millennium) (RT)(PFL) no preservative35

24 h F38 Do NOT freeze38

discard unused portion40

NS or D5W (dilute in volume 10 times the busulfan volume to ~ 0.5 mg/mL)40

complete administration within 12 h F: NS40 8 h RT: NS, D5W

Cabazitaxel 60 mg/1.5 mL (sanofi-aventis canada Inc.) (RT)41

NS or D5W{41 (e.g. 250 mL) 0.10 0.26 mg/mL41

complete administration within 8 h RT41

discard unused portion42

0.3-10 mg/mL43 NS, D5W9,42 do NOT use aluminum-containing needle or syringe43

- do NOT use aluminumcontaining needle, syringe or tubing43

discard unused portion RT45

0.5-10 mg/mL46 NS, D5W9,45,47 do NOT use aluminum-containing needle or syringe45

- do NOT use aluminumcontaining needle, syringe or tubing45

3.3 mg/mL in 10% ethanol48

glass48 or polyolefin container9 500 mL NS or D5W48

24 h F: in glass,48 or polyolefin container9 use within 4 h of reconstitution RT48

- do not use if product has oily droplets48

discard unused portion after 12 h F, 8 h RT49

- do NOT use aluminumcontaining needle, syringe or tubing50

- do NOT use aluminumcontaining needle, syringe or tubing53

Cladribine 10 mg/10 mL (Janssen-Ortho) (F)(PFL) no preservative56

discard unused portion56

48h F, end of day RT11,56,58,59

- shake vigorously to dissolve any precipitates from refrigeration56

500 mL NS only56 Do NOT use D5W56

Cassette: qs to 100 mL with bacteriostatic NS only via SIMS

Cassette: qs to 100 mL with bacteriostatic NS only via SIMS

discard unused portion65

NS, D5W65 dilute to concentration between 1:20 and 1:10065

dilute immediately prior to use65

N/A record time of puncture

100 mL*NS, Water for Injection, D5W, Lactated Ringers67

72 h F, 24 h RT from initial vial puncture67

- do not use for IT injection

Cytarabine 100 mg (Pfizer) (RT)(PFL) no preservative68

NS, D5W, SWI or BWI68 100 mg: 5 mL68