BCCA - Chemotherapy Protocols & Stability Chart - July - 2019

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART
DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special
(Storage Prior to Use, With: Stability Precautions/Notes
Manufacturer,
Preservative Status)
AGS-16C3F
1 1 1
30 mg 5.1 mL SWI 6 mg/mL discard unused ≥ 0.3 mg/mL complete - unopened vials
1
(Astellas) portion administration within may be kept at RT
2,3
(F)(PFL) swirl gently; do NOT 100 mL D5W 6 h RT of for up to 4h prior to
1 1 1
do not shake shake (PFL) reconstitution use if protected from
1 1
no preservative mix by gentle light
1
allow foam to clear inversion **(PFL)
1
before proceeding
record time of
reconstitution
Aldesleukin
4,5 4 4 4
22 million units 1.2 mL SWI 18 million unit/mL 48 h F 50 mL D5W 48 h F - do not use in-line
4,5 4,5
(1.3 mg) (1.1 mg/mL) filter
4
(Novartis) direct diluent against 30 – 70 mcg/mL - avoid bacteriostatic
(F)(PFL) side of vial during water for injection or
4 4
no preservative reconstitution Less than 30 mcg/mL: NS due to increased
4
dilute in D5W aggregation
4
do NOT shake containing human
5
albumin 0.1%
6,7 7
SC syringe 14 d F
**(PFL)
BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 1/49

Activation Date: 2 March 2006
Revised Date: 1 July 2019
Manufacturer,
Alemtuzumab
9 10 11
30 mg/mL N/A filter NOT required discard unused SC syringe discard at the end of - do NOT shake
8 9
(Genzyme/Bayer) portion the day F, RT
9
(F)(PFL) 30 mg/mL
9 9
do not shake 100 mL NS, D5W 8 h F, RT
9
no preservative
11
**(PFL)
Amsacrine
12 12 12 12-14
75 mg/1.5 mL glass syringes 5 mg/mL 24 h RT 500 mL D5W 7 d F, 48 h RT - contains DMA***
(Erfa Canada) preferred during
12
(RT) reconstitution; (**PFL) (plastic or glass
12 12
no preservative max. time in plastic container)
12
syringe : 15 min
13.5 mL supplied
diluent (L-lactic
1
acid)
transfer 1.5mL from

ampoule into the
12
diluent vial
Arsenic
15 15
10 mg/10 mL N/A 1 mg/mL discard unused 100-250 mL NS, 24 h RT, 48 h F
15 15
(Lundbeck/Teva) portion D5W
(RT) (use filter needle to
15
no preservative withdraw from
ampoule)

Manufacturer,
Asparaginase
16 16
(asparaginase E. coli) 4 mL SWI 2500 units/mL 72 h F, 3 h RT syringe complete
10,000 units administration within
16
(CGF/EUSA) do NOT shake; 72 h F, 3 h RT
16
(F) rotate gently
16
no preservative
50-250 mL NS or complete
17
D5W administration within
16,18
3 h RT
Erwinia asparaginase
19 19 19
(asparaginase Erwinia 1-2 mL NS 10 000-5000 15 min RT glass or 4 h RT - contact with the
chrysanthemi) units/mL polypropylene rubber stopper may
19
10,000 units do NOT shake; mix syringe denature the
(CGF/EUSA) gently to minimize (use 5 micron filter reconstituted drug,
(F) bubbles and contact needle to withdraw creating filaments of
19 19 20 19
no preservative with stopper from vial) insoluble material
- discard if
particulate matter is
20
present
- do not use sterile
water for
reconstitution as the
resulting product is
19
not isotonic
PEG-asparaginase -
see pegaspargase in
L-Z chart
(pegylated
asparaginase E. coli)

Manufacturer,
Atezolizumab
21 22
1200 mg/20 mL N/A 60 mg/mL discard unused 250 mL NS only complete - discard vial if
21
(Hoffman-La Roche) portion administration within cloudy, discoloured
21
(F)(PFL) mix by slow 24 h F, 8 h RT (should be clear to
22
do not shake inversion pale yellow), or
21 22
no preservative visible particles
22
- do NOT shake
Avelumab
23 23
200 mg/10 mL N/A 20 mg/mL discard unused 250 mL NS, complete - do NOT shake
18
(EMD) portion 0.45% sodium administration within - use 0.2 micron in-
23 23
(F)(PFL) chloride 24 h F, 8 h RT line filter to
23 23
no preservative if refrigerated, administer
bring vial to RT mix by gentle if refrigerated, bring
23 23
prior to use inversion bag to RT prior to
23
administration

Manufacturer,
azaCITIDine
24 24 24
100 mg 4 mL SWI 25 mg/mL 45 min RT, 8 h SC syringe 45 min RT (including - discard if contains
24 24
(Celgene) F preparation time), 8 h large particles
24 24
(RT) shake vigorously F - re-suspend syringe
24
no preservative contents before
record time of refrigerate syringe injection by
reconstitution immediately after vigorously rolling
preparation if not to syringe between
24
be used within 45 palms
minutes of -if cold diluent
25
reconstitution reconstitution is used
to extend stability,
minimize exposure to
24 26,27 26,27
cold diluent 25 mg/mL 22 h F 22 h F RT; ensure proper
reconstitution: refrigeration of
4 mL SWI at 2- diluent, reconstituted
26,27
8°C vial, and final
product
Refrigerated
24
syringes :
 allow up to 30 min
prior to
administration to
reach a
temperature of ~20-
25°C
 discard syringe if
time elapsed at RT
is greater than 30
min

Manufacturer,
azaCITIDine
28 28 28 28
100 mg 4 mL SWI 25 mg/mL 45 min RT, 8 h SC syringe 45 min RT (including - do not filter
28
(Dr. Reddy‘s) F preparation time), 8 h - discard if contains
28 28 28
(RT) shake vigorously F large particles
28
no preservative - re-suspend syringe
refrigerate syringe contents before
immediately after injection by
preparation if not to vigorously rolling
be used within 45 syringe between
28
minutes of palms
28
reconstitution
Refrigerated
28
syringes :
 allow up to 30 min
prior to
administration to
reach a
temperature of
approximately 20-
25°C
 discard syringe if
time elapsed at RT
is greater than 30
min

Manufacturer,
BCG
8 29
(Tice substrain) 1 mL preservative- 1 to 8×10 2hF transfer from vial to use within 2 h F of - auxiliary info:
29 29 29,30 30
intravesical free NS CFU/vial 60 mL syringe, rinse reconstitution biohazard
8 29 29
50 mg = 1 to 8 x 10 **(PFL) vial with another 1 mL - do NOT filter
29 29
CFU allow to stand for a NS; add rinse to **(PFL) - do NOT shake
(Merck Canada) few minutes, then same 60 mL syringe
(F)(PFL) gently swirl to and qs to 50 mL with
29 29 29
no preservative suspend NS
record time of if a closed system

reconstitution transfer device is
used:
transfer from vial to
60 mL syringe and qs
to 50 mL with NS; do
29
NOT rinse vial
BCG
8 31
(Tice substrain) 1 mL preservative 1 to 8×10 2hF transfer from vial to use within 2 h F of - auxiliary info:
31 31 30,31 30
intravesical free NS CFU/vial 60 mL syringe and qs reconstitution biohazard
8 31 31 31
50 mg = 1 to 8 x 10 (PFL to 50 mL with NS - do NOT filter
31 31
CFU allow to stand for a **(PFL) - do NOT shake
(Merck USA) few minutes, then
(F)(PFL) gently swirl to
31 31
no preservative suspend
record time of
reconstitution

Manufacturer,
BCG
32 32
intravesical do NOT shake; roll 10.5 ± 8.7×108 2 h F, RT 50 mL NS 2 h F or RT after - auxiliary info:
32 32 18
81 mg to reconstitute CFU/vial reconstitution biohazard
(Sanofi Pasteur) (Connaught
32 32
(F)(PFL) 3 mL supplied strain) **(PFL)
32 32
preservative diluent
record time of
reconstitution
Belinostat
33 33 33 33
500 mg 9 mL SWI 50 mg/mL 12 h RT 250 mL NS complete - use 0.22 micron
(Spectrum) administration within inline filter to
33 33
(RT) 36 h RT administer
33
no preservative
Bendamustine
34 34
25 mg 25 mg vial: 5 mg/mL 30 minutes 0.2-0.6 mg/mL NS, complete
34 34
100 mg add 5 mL SWI D2.5-½NS administration within
35
(Lundbeck/Teva) 24 h F, 3 h RT
34
(RT,F)(PFL) 100 mg vial: 250* - 500 mL
34 34
no preservative add 20 mL SW
shake well;
dissolves completely
34
in 5 minutes

Manufacturer,
Bevacizumab
36 37 36-38 36
100 mg/4 mL N/A 25 mg/mL discard unused 1.4-16.5 mg/mL 48 h F, RT - do NOT shake
36
400 mg/16 mL portion
(Roche) 100-250 mL NS
36,37
(F)(PFL) only
do not shake
36
no preservative
Bleomycin
39 39 39 39
15 units 6 mL* NS 2.5 units/mL 48 h F 50 mL* NS 24 h RT
(NB: dose in units only)
(Fresenius Kabi)
(F)(PFL)
39
no preservative
Bleomycin
40 40 41
15 units 6 mL* NS, SWI 2.5 units/mL 48 h F, 24 h RT 50 mL* NS{14216}} 4 h RT
(NB: dose in units only)
(Pfizer/Hospira)
(F)(PFL)
40
no preservative

Manufacturer,
Blinatumomab
42 42 42 42
38.5 mcg 3 mL SWI 12.5 mcg/mL 24 h F, 4 h RT 250 mL NS complete - use non-DEHP bag
(Amgen) administration within and IV administration
42 42
(F)(PFL) do NOT use add supplied IV 10 d F, 96 h RT set
do not shake supplied IV solution solution stabilizer to - use 0.2 or 0.22
42 42
no preservative stabilizer to NS bag and gently micron in-line filter
42
reconstitute vials mix to avoid - prime lines with
42
foaming blinatumomab
direct diluent against solution; do NOT use
side of vial during add reconstituted NS
42
reconstitution drug to bag following
addition of IV solution
42
gently swirl to avoid stabilizer
42
excess foaming
Bortezomib
43 43 44,45 43 44,45
SC injection 1.4 mL NS 2.5 mg/mL 2 d F, RT SC syringe 14 d F, 48 h RT - auxiliary info:
3.5 mg WARNING:
(Actavis) SUBCUTANEOUS
(RT)(PFL) use only. Fatal if
43
no preservative given by other
routes.
Bortezomib
43 43 44,45 43 44,45
3.5 mg 3.5 mL NS 1 mg/mL 2 d F, RT IV syringe 14 d F, 48 h RT - auxiliary info:
(Actavis) WARNING:
(RT)(PFL) INTRAVENOUS use
43
no preservative only. Fatal if given by
other routes.

Manufacturer,
Bortezomib
46 46 30,47 46 30,47
SC injection 1.4 mL NS 2.5 mg/mL 2d F, RT SC syringe 14 d F, 48 h RT - auxiliary info:
3.5 mg WARNING:
(Apotex) SUBCUTANEOUS
46
routes.
Bortezomib
46 46 30,47 46 30,47
3.5 mg 3.5 mL NS 1 mg/mL 2d F, RT IV syringe 14 d F, 48 h RT - auxiliary info:
(Apotex) WARNING:
46
other routes.
Bortezomib
48 48 44,45 48 44,45
3.5 mg WARNING:
(Janssen) SUBCUTANEOUS
48
routes.
Bortezomib
48 48 44,45 48 44,45
(Janssen) WARNING:
48
other routes.

Manufacturer,
Bortezomib
49 49 44,45 49 44,45
3.5 mg WARNING:
(Teva) SUBCUTANEOUS
49
routes.
Bortezomib
49 49 44,45 49 44,45
(Teva) WARNING:
49
other routes.
Brentuximab vedotin
50 50 50 50
50 mg 10.5 mL SWI 5 mg/mL 24 h F 0.4-1.8 mg/mL in NS, 24 h F - solution should be
(GMD/Seattle Genetics) D5W, Lactated clear to slightly
(F)(PFL) direct diluent against Ringer’s opalescent,
50
no preservative side of vial during colorless, and free of
50 50 50
reconstitution 100-250 mL visible particulates
50
do NOT shake

Manufacturer,
Busulfan
51
60 mg/10 mL N/A 6 mg/mL discard unused NS, D5W complete - contains DMA***
30,51
(PMS) portion (dilute to volume 10 administration within - always add
51
(F) times drug volume to 12 h F, 8 h RT busulfan to diluent to
51
no preservative achieve final mix; do not add
51
concentration of ~0.5 diluent to busulfan
51
mg/mL)
Busulfan
52
60 mg/10 mL N/A 6 mg/mL discard unused NS, D5W in NS: complete - contains DMA***
18,52
(SteriMax) portion (dilute to volume 10 administration within - always add
52
(F) times drug volume to 12 h F, 8 h RT busulfan to diluent to
52
no preservative achieve final mix; do not add
52
concentration of ~0.5 in D5W: complete diluent to busulfan
52
mg/mL) administration within
52
8 h RT

Manufacturer,
Cabazitaxel
53 53
60 mg/1.5 mL supplied diluent: 10 mg/mL 1 h RT 0.10 – 0.26 mg/mL complete - concentrate and
53
(sanofi-aventis) withdraw entire NS, D5W administration within diluent vials contain
53 53
(RT) contents of diluent 48 h F, 8 h RT overfill
53
no preservative vial and inject into (e.g., 250 mL*) - use non-DEHP bag
53
the concentrate and tubing
53
vial - use 0.22 micron in-
53
line filter
slowly direct diluent - diluent contains
against inside of vial 13% (w/w) ethanol in
53 53
to limit foaming water
- discard if
mix by repeated crystallization
53
inversions for 45 occurs
53
sec
53
do NOT shake
53
let sit for 5 min
CARBOplatin
54 54 54
50 mg/5 mL N/A 10 mg/mL discard unused 0.5-10 mg/mL 24 h F, 8 h RT - do NOT use
54
150 mg/15 mL portion aluminum-containing
54
450 mg/45 mL NS, D5W needle, syringe, or
54
600 mg/60 mL tubing
(Accord)
(RT)(PFL)
54
no preservative

Manufacturer,
CARBOplatin
55 55 55 56
50 mg/5 mL N/A 10 mg/mL discard unused 0.3-10 mg/mL 48 h F , 24 h RT - do NOT use
55
55
450 mg/45 mL NS, D5W needle, syringe or
55
600 mg/60 mL tubing
(Omega)
(RT)(PFL)
55
no preservative
CARBOplatin
57 57 57
50 mg/5 mL N/A 10 mg/mL discard unused 0.3-10 mg/mL 48 h F - do NOT use
57
57
57
600 mg/60 mL tubing
(Pfizer/Hospira)
(RT)(PFL)
57
no preservative
CARBOplatin
58 59 58
50 mg/5 mL N/A 10 mg/mL discard unused 0.5-10 mg/mL 8 h RT - do NOT use
58
150 mg/15 mL portion RT aluminum-containing
58,60,61
58
(Teva/Novopharm) tubing
(RT)(PFL)
58
no preservative

Manufacturer,
Carfilzomib
62 62
10 mg 10 mg: 2 mg/mL 24 h F, 4 h RT 50-100 mL D5W complete - if a closed system
62 62
30 mg 5 mL SWI only administration within transfer device is not
60 mg 24 h F, 4 h RT after used for
62 62
(Amgen) 30 mg: do NOT dilute in NS reconstitution compounding, a 21
62
(F)(PFL) 15 mL SWI gauge (or larger
62
no preservative gauge) needle is
60 mg: recommended to
62
29 mL SWI prevent coring of the
62-64
vial stopper
direct diluent against
side of vial during
62
reconstitution
swirl gently; do NOT

62
shake
if foaming occurs,
allow to settle until
clear (about 5
62
minutes)
record time of
reconstitution

Manufacturer,
Carmustine
65 65 65
100 mg 3 mL diluent 3.3 mg/mL in 10% 24 h F, 8 h RT glass or polyolefin 24 h F: in glass or - do not use if
65 65 60 60
(Bristol Labs) (supplied) ethanol container polyolefin container product has oily
65
(F) droplets
65 65
no preservative diluent to reach RT, 500 mL NS or D5W use within 4 h of
65
then dissolve drug reconstitution RT
with 3 mL diluent;
65
add 27 mL SWI
record time of
reconstitution
Cemiplimab
66
250 mg/5 mL N/A 50 mg/mL discard unused 50 or 100 mL NS, complete
66 66
(Regeneron) portion D5W administration within
66
(F)(PFL) 24 h F, 6 h RT
do not shake dilute to final volume
66
no preservative by withdrawing
volume from bag
equal to volume of
66
drug to be added
mix by gentle
inversion

Manufacturer,
Cetuximab
67 67 67 67
100 mg/50 mL N/A 2 mg/mL 12 h F, 8 h RT syringe 12 h F, 8 h RT - administer using
67
200 mg/100 mL 0.22 micron filter
(Imclone/Lilly)
(F) evacuated container
67
do not shake or bag
67
no preservative
CISplatin
68 68
10 mg/10 mL N/A 1 mg/mL discard unused Less than or equal to 24 h RT - do NOT use
30
50 mg/50 mL portion 60 mg: 100 mL* NS aluminum-containing
100 mg/100mL needle, syringe or
68
(Accord) Greater than 60 mg: tubing
(RT)(PFL) 250 mL* NS
68
no preservative
2 L of D5 in one-half
or one-third NS
containing 37.5 g of
68
mannitol
CISplatin
69 69
30
100 mg/100mL portion 60 mg: 100 mL* NS aluminum-containing
(Pfizer/Hospira) needle, syringe or
69
(RT)(PFL) Greater than 60 mg: tubing
69
no preservative 250 mL* NS
or one-third NS
69
mannitol

Manufacturer,
CISplatin
70 70,71 70
10 mg/10 mL N/A 1 mg/mL 48 h RT Less than or equal to 24 h RT - do NOT use
50 mg/50 mL 60 mg: 100 mL NS* aluminum-containing
70
(Sandoz) Greater than 60 mg: tubing
(RT)(PFL) 250 mL NS*
70
no preservative
NS, 0.45% sodium
chloride with or
72
without mannitol
or one-third NS
70
mannitol
CISplatin
73 73
18
50 mg/50 mL portion 60 mg: 100 mL* NS aluminum-containing
73
(Teva) Greater than 60 mg: tubing
(RT)(PFL) 250 mL* NS
73
no preservative
or one-third NS
73
mannitol

Manufacturer,
Cladribine
74 75
10 mg/10 mL N/A 1 mg/mL discard unused SC syringe discard end of
74 13,74,76
(Fresenius Kabi) potion day
(F)(PFL)
74
no preservative
500 mL NS only 24 h RT
do NOT use D5W
74
Cassette: at least 7 days
qs to 100 mL with
bacteriostatic NS
only via SIMS
DELTEC INC.
MEDICATION
74
CASSETTES® filter
drug and diluent
through 0.22 micron
filter as each solution
is being introduced
into the cassette

Manufacturer,
Cyclophosphamide
77 71,77,79 77,79
200 mg 200 mg: 20 mg/mL 48 h F, Less than or equal to 72 h F,
77 77
500 mg 10 mL NS 24 h RT 1 g: 100 mL NS* 24 h RT
1000 mg
2000 mg 500 mg: Greater than 1 g:
(Baxter) 25 mL NS 250 mL NS*
(RT)(PFL)
77
no preservative 1000 mg: high dose in BMT:
50 mL NS may need 500 NS*
77
2000 mg: NS, D5W, D5NS
77,78
100 mL NS
Cytarabine
80 80
1000 mg/10mL N/A 100 mg/mL discard unused 0.1-37.5 mg/mL NS, 10 d F, 48 h RT
30,80 80
2000 mg/20mL portion D5W, SWI
(Pfizer/Hospira) **(PFL)
(RT)(PFL) 100 mL* NS, D5W,
80
no preservative SWI
Cytarabine
80
IT injection N/A 100 mg/mL use within 4 h of diluents containing use within 4 h of - auxiliary info: IT
30 30
1000 mg/10mL initial vial preservatives should initial vial puncture injection
30
2000 mg/20mL record time of puncture NOT be used for - label to include
(Pfizer/Hospira) puncture intrathecal **(PFL) route in full (i.e.,
80
(RT)(PFL) administration INTRATHECAL
80
no preservative injection) attached to
qs to 6 mL with both syringe and
41
preservative free outer ziplock bag
81,82
NS

Manufacturer,
Cytarabine
80 80
SC injection N/A 100 mg/mL discard unused syringe 10 d F, 48 h RT
30,80
1000 mg/10mL portion
2000 mg/20mL **(PFL)
(Pfizer/Hospira)
(RT)(PFL)
83
no preservative
Cytarabine
84 84
1000 mg/10mL N/A 100 mg/mL discard unused 0.1-37.5 mg/mL NS, 10 d F, 48 h RT
30,84 84
2000 mg/20mL portion D5W, SWI
(PMS) **(PFL)
(RT)(PFL) 100 mL* NS, D5W,
84
no preservative SWI
Cytarabine
84
IT injection N/A 100 mg/mL use within 4 h of diluents containing use within 4 h of - auxiliary info: IT
30 30
1000 mg/10mL initial vial preservatives should initial vial puncture injection
30
2000 mg/20mL record time of puncture NOT be used for - label to include
(PMS) puncture intrathecal **(PFL) route in full (i.e.,
84
(RT)(PFL) administration INTRATHECAL
84
no preservative injection) attached to
qs to 6 mL with both syringe and
41
preservative free outer ziplock bag
81,82
NS

Manufacturer,
Cytarabine
84 84
SC injection N/A 100 mg/mL discard unused syringe 10 d F, 48 h RT
30,84
1000 mg/10mL portion
2000 mg/20mL **(PFL)
(PMS)
(RT)(PFL)
84
no preservative
Dacarbazine
85 85 85
100 mg 100 mg: 10 mg/mL 72 h F, 8 h RT 250-1000 mL* NS, 24 h F, 8 h RT - protect container
85
200 mg 9.9 mL SWI D5W from light during
60,85
(Abraxis) **(PFL) storage and
86
(F)(PFL) 200 mg: administration
85 85
no preservative 19.7 mL SWI - overfill unknown
Dacarbazine
87 87 13,87 87
200 mg 200 mg: 10 mg/mL 8 h RT, 48 h F 0.19–3.0 mg/mL 24 h F - protect container
87
600 mg 19.7 mL SWI from light during
88 86
(Hospira) (PFL) 250-1000 mL* NS, **(PFL) storage and
86
(F)(PFL) 600 mg: D5W administration
87 87 88,89
no preservative 59.1 mL SWI - no overfill
Dacarbazine
90 90 90 90
600 mg 59.1 mL SWI 10 mg/mL 24 h F, 8 h RT 0.19-3.0 mg/mL in 24 h F - protect container
90
(Pfizer) D5W or NS from light during
86
(F)(PFL) **(PFL) storage and
90 86
no preservative administration
DACTINomycin
91
0.5 mg 1.1 mL SWI 0.5 mg/mL discard unused syringe use within 4 h of - drug loss reported
91 91 71 71
(GMD Pharma for (preservative-free) (500 mcg/mL) portion initial vial puncture with some cellulose

Manufacturer,
Recordati) ester membrane in-
91
(RT)(PFL) do NOT use SWI 10 mcg/mL or line filters
91 91
no preservative with preservative greater
(may form
91 91,92
precipitate) NS, D5W
Daratumumab
93
100 mg/5mL N/A 20 mg/mL discard unused 500-1000 mL NS 24 h F, followed by - administer with a
93
400 mg/20mL portion 15 h infusion (total 39 0.22 or 0.2 micron in-
93 93
(Janssen) dilute to final volume h) line filter
(F)(PFL) by withdrawing - discard if visible
do not shake volume from bag allow bag to come to particles are
93 93
no preservative equal to volume of room temperature, observed
93
drug to be added then use - complete infusion
93 93
immediately within 15 hours
mix by gentle
93
inversion **(PFL)
DAUNOrubicin
94 94,97 96 94
20 mg 4 mL SWI 5 mg/mL 48 h F, 24 h RT 100-250 mL in 48 h F, 24 h RT
94
(Erfa Canada Inc.) isotonic solution e.g.,
95 94
(RT)(PFL) NS
96
no preservative
96
no data for D5W
DAUNOrubicin
98 98 98 98
20 mg 4 mL SWI 5 mg/mL 48 h F, 24 h RT 100-250 mL 48 h F, 24 h RT
60
(Teva/Novopharm) NS or D5W
98 98
(RT)(PFL) **(PFL) **(PFL)
98
no preservative

Manufacturer,
Degarelix
99 99 99 99
80 mg 80 mg: 20 mg/mL 2 h RT SC syringe 2 h RT
120 mg 4.2 mL SWI
99
(Ferring) (supplied diluent)
(RT)
99
do not shake
100 99
no preservative 120 mg: 40 mg/mL
3 mL SWI (supplied
99
diluent)
swirl gently; avoid

shaking to prevent
99
foam formation
reconstitution may
99
take up to 15 min

Manufacturer,
Denosumab
101 101
(XGEVA) N/A 71 mg/mL discard unused SC syringe use within 4 h of - not interchangeable
71,101 71 101
120 mg/1.7 mL portion initial puncture with PROLIA
(Amgen) - do not use if
(F)(PFL) solution is cloudy;
do not shake trace amounts of
101
no preservative translucent to white
proteinaceous
particles are
101
acceptable
- avoid vigorous
101
shaking
- bring to room
temperature 15-30
minutes prior to
101
administration
Dexrazoxane
102 102
250 mg 250 mg: 10 mg/mL 3 h F, 30 min MUST BE FURTHER 4 h F, 1 h RT
102 103
500 mg 25 mL SWI RT DILUTED With
(Pfizer) Lactated Ringers
(RT) 500 mg: Injection to 1.3 – 3.0
102 102 102
no preservative 50 mL SWI mg/mL

Manufacturer,
DOCEtaxel
104 104
20 mg/2 mL N/A 10 mg/mL 20mg/2 mL vial: 0.3-0.74 mg/mL complete - use non-DEHP bag
80 mg/8 mL discard unused administration within and IV administration
18,104 104 104
160 mg/16 mL portion 250 mL* NS, D5W 14 d F, 48 h set
18,105,106
(Pfizer/Hospira) RT
(F, RT)(PFL)
104
preservative 80 mg/8 mL or
160 mg/16 mL
104
vial (maximum
number of
punctures: up to 3
doses can be
removed when a
venting needle is
also inserted, i.e.,
6 punctures
106
total)
18,104
14 d F
104
**(PFL)
DOCEtaxel
107 18,108 107
20 mg/2 mL N/A 10 mg/mL 14 d F, RT 0.3-0.74 mg/mL complete - use non-DEHP bag
80 mg/8 mL administration within and IV administration
107 107,109 107
160 mg/16 mL 250 mL* NS, D5W 24 h F, 4 h RT set
(Sandoz)
(F,RT)(PFL)
107
preservative

Manufacturer,
DOCEtaxel
110 18,110,111 110
20 mg/0.5 mL supplied diluent : 10 mg/mL 14 d F, RT 0.3-0.74 mg/mL complete - use non-DEHP
80 mg/2 mL - if vials were administration within bag and IV
110 110 110
(sanofi-aventis) refrigerated, allow to 250 mL NS, D5W 4 h F, administration set
18,111
(F, RT)(PFL) warm for 5 min at 48 h RT
110
no preservative 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
110
sec
110
do NOT shake
Let sit for 5

110
minutes
DOXOrubicin
112 112 112
10 mg/5 mL N/A 2 mg/mL 8h syringe 24 h F, RT from initial - for ULYEPOCHR
112
20 mg/10 mL vial puncture protocol, see entry
50 mg/25 mL for EPOCHR
200 mg/100 mL (3-in-1solution
(Accord) containing
(F)(PFL) etoposide,
112
no preservative DOXOrubicin,
vinCRIStine)

Manufacturer,
DOXOrubicin
113 113 13,114
10 mg 10 mg: 2 mg/mL 48 h F, 24 h syringe 48 h F, 24 h RT - for ULYEPOCHR
13,113
50 mg 5 mL NS, SWI, RT protocol, see entry
113
150 mg D5W for EPOCHR
(Hospira) (3-in-1solution
(RT)(PFL) 50 mg: containing
113
no preservative 25 mL NS, SWI, etoposide,
113
D5W DOXOrubicin,
vinCRIStine)
150 mg:
75 mL NS, SWI,
113
D5W
(NS reconstitution
113
takes longer)
DOXOrubicin
115 115 115 115
10 mg/5 mL N/A 2 mg/mL 8h syringe 48 h F, 24 h RT - for ULYEPOCHR
20 mg/10 mL from initial vial protocol, see entry
50 mg/25 mL record time of puncture for EPOCHR
200 mg/100 mL puncture (3-in-1solution
(Teva/Novopharm) containing
(F)(PFL) etoposide,
115
no preservative DOXOrubicin,
vinCRIStine)

Manufacturer,
DOXOrubicin
116 116 116
10 mg/5 mL N/A 2 mg/mL discard unused syringe 48 h F, 24 h RT - for ULYEPOCHR
71,116
50 mg/25 mL portion protocol, see entry
200 mg/100 mL for EPOCHR
(Pfizer) (3-in-1solution
(F) containing
116
no preservative etoposide,
DOXOrubicin,
vinCRIStine)
DOXOrubicin
117 117 117
Pegylated Liposomal N/A 2 mg/mL discard unused Less than 90 mg: 250 24 h F - do not filter
117 117
20 mg/10 mL portion mL D5W only
(Janssen)
(F) Greater than or equal
117
no preservative to 90 mg: 500mL
117
D5W only
Durvalumab
118 118 118
120 mg/2.4 mL N/A 50 mg/mL discard unused 1-15 mg/mL NS, 24 h F, 4 h RT - do NOT shake
118 118
500 mg/10 mL portion D5W - use 0.2-0.22 micron
(AstraZeneca) in-line filter to
118
(F)(PFL) (e.g., 100 mL* NS, administer
do not shake D5W)
118
no preservative
mix by gentle
118
inversion

Manufacturer,
Epirubicin
119 119 119
10 mg/5 mL N/A 2 mg/mL 8 h F, RT syringe 48 h F, 24 h RT
20 mg/10 mL from initial vial
119
50 mg/25 mL puncture
150 mg/75 mL
200 mg/100 mL
(Teva/Novopharm)
(F)(PFL)
119
no preservative
Epirubicin
120 120 120
10 mg/5 mL N/A 2 mg/mL 8h syringe 48 h F, 24 h RT
50 mg/25 mL from initial vial
120
200 mg/100 mL record time of puncture
(Fresenius Kabi) puncture
(F)(PFL)
120 18,120
no preservative 100 mL* NS, D5W 2 d F, RT
Epirubicin
121 121 121
10 mg/5 mL N/A 2 mg/mL 8h syringe 48 h F, 24 h RT from
121
50 mg/25 mL initial vial puncture
200 mg/100 mL record time of
(Pfizer) puncture
60 122
(F)(PFL) 100 mL* NS, D5W 2 d F, RT
121
no preservative

Manufacturer,
EPOCHR
(ULYEPOCHR protocol) see brand specific see brand specific see brand etoposide dose etoposide - final product is a
(RT) entries for: entries for: specific entries ≤125 mg/24 h: concentration 3-in-1 solution
18,123-126
no preservative DOXOrubicin as DOXOrubicin, for: DOXOrubicin, in 500 mL NS ≤0.25 mg/mL: containing
applicable etoposide, etoposide, complete etoposide,
vinCRIStine vinCRIStine etoposide dose administration within DOXOrubicin,
>125 mg/24 h: 72 h RT vinCRIStine (refer to
in 1000 mL NS ULYEPOCHR
precipitation occurs protocol)
at etoposide - use non-DEHP bag
concentrations and tubing only
>0.25 mg/mL - use 0.22 micron
inline filter
eriBULin
127 127 127
1 mg/2 mL N/A 0.5 mg/mL discard unused IV syringe 24 h F, 6 h RT - do not administer
18,127
(Eisai Limited) portion through dextrose
127 127
(RT)(PFL) containing lines
18
no preservative - vials contain
dehydrated alcohol
127
USP (5% v/v)

Manufacturer,
Etoposide
128 128
100 mg/5 mL N/A 20 mg/mL 14 d RT 0.2-0.4 mg/mL NS, 0.2 mg/mL: - use non-DEHP bag
128 128
200 mg/10 mL D5W 7 d F, RT and tubing only
500 mg/25 mL - use 0.22 micron in-
129
1000 mg/50 mL 500 mL* NS, D5W 0.4 mg/mL: line filter
128
(Sandoz) 12 h F, RT - for ULYEPOCHR
(RT)(PFL) protocol, see entry
128
preservative for EPOCHR
(3-in-1solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)

Manufacturer,
Etoposide
130
100 mg/5 mL N/A 20 mg/mL discard unused NS 0.2-0.3 mg/mL: - use non-DEHP bag
130 131 131,132
200 mg/10 mL portion 7 d F, 2 d RT and tubing only
500 mg/25 mL Stability is - use 0.22 micron in-
129
1000 mg/50 mL concentration 0.4-0.5 mg/mL: line filter
131 131
(Teva/Novopharm) dependent 1 d F, 1d RT - for ULYEPOCHR
(RT)(PFL) protocol, see entry
130
no preservative 0.6-9.0mg/mL: for EPOCHR
generally unstable (3-in-1solution
containing
9.5 mg/mL: etoposide,
131 131
2 d F, 1d RT DOXOrubicin,
vinCRIStine)
10-12 mg/mL:
131 131,132
7 d F, 2 d RT
130 130,133
D5W 4 h RT
Etoposide phosphate
134,135 18,134,135 134,135
(ETOPOPHOS®) 5 mL NS, D5W, 20 mg/mL 48 h F , 24 500 mL* NS, 24 h F, RT
134,135 134,135 134,135
100 mg SWI, BWI h RT , D5W
(BMS)
(F)(PFL) (do not dilute to less
134 134,135 134,135
no preservative 10 mL NS, D5W, 10 mg/mL than 0.1 mg/mL)
134,135
SWI, BWI

Manufacturer,
Filgrastim
136 136 18,137
(NEUPOGEN®) N/A 300 mcg/mL discard unused SC syringe 14 d F - albumin is added to
18
300 mcg/1 mL portion D5W to prevent
480 mcg/1.6 mL filgrastim adsorption
18,137 136
(Amgen) 50-100 mL D5W 7 d F, 48 h RT to plastic
138
(F)(PFL) only - incompatible with
136,138
do not shake saline
136
no preservative in PVC, polyolefin, or - do NOT dilute to
136
glass less than 5
136
mcg/mL
(for filgrastim
concentrations of 5-
15 mcg/mL in D5W,
add albumin 2
136
mg/mL)
Fludarabine
139 139 13,122 13,122
50 mg 2 mL SWI 25 mg/mL 48 h F, RT dilute to maximum of 48 h F, RT
139,140
(Berlex) 1 mg/mL
(F)
139
no preservative 50-100 mL NS,
139
D5W
Fludarabine
141 141
50 mg N/A 25 mg/mL discard unused dilute to maximum of 48 h F, 24 h RT
141 141
(Teva/Novopharm) portion 1 mg/mL
(F)
141
no preservative (e.g., 50-100 mL* NS,
D5W)

Manufacturer,
Fluorouracil
142 18,143 142 18,143
5000 mg/100 mL N/A 50 mg/mL 48 h RT syringe 48 h RT
(Accord)
(RT)(PFL)
142 143 18,143
no preservative 0.5-10 mg/mL 48 h RT
(e.g., 50-1000 mL*

D5W)
CIVI: ambulatory complete within 8

144 143
pump d
Fluorouracil
145 145 145 30,145
(Pfizer/Hospira)
(RT)(PFL)
145 146 145
no preservative 0.5-10 mg/mL 24 h RT
(e.g., 50-1000 mL*

D5W)
CIVI: ambulatory complete within

144 13,60,147,148
pump 8d

Manufacturer,
Fluorouracil
149 30,150 30,149
5000 mg/100 mL
(Sandoz)
150 30,150
(RT)(PFL) 0.35 – 15 mg/mL 48 h RT
149
no preservative
149
(300-500 mL D5W)
CIVI: ambulatory complete within

144 13,60,147,148
pump 8d
Gemcitabine
151 151 151 151
1000 mg 200 mg: 38 mg/mL 24 h RT syringe 24 h RT
151
2000 mg 5 mL NS
(Accord)
151 18,152,153
(RT) 1000 mg: 0.1-10 mg/mL NS 48 h RT
151 151
no preservative 25 mL NS
2000 mg:
151
50 mL NS
Gemcitabine
154 154 154
200 mg/5.3 mL N/A 38 mg/mL discard unused syringe 24 h RT
18
1000 mg/26.3 mL portion
2000 mg/52.6 mL
(Hospira) 0.1 – 38 mg/mL NS,
154
(F) D5W
154
no preservative

Manufacturer,
Gemcitabine
155 155 155
200 mg/5.3 mL N/A 38 mg/mL discard unused syringe 24 h RT
18
2000 mg/52.6 mL
(Pfizer) 0.1 – 38 mg/mL NS,
155
(F) D5W
155
no preservative
IDArubicin
156 156 156
5 mg 5 mg: 1 mg/mL 48 h F, syringe 48 h F, 24 h RT - avoid alkaline
156 156 156
10mg 5 mL SWI 24 h RT solutions
(Pfizer)
156
(RT)(PFL) 10 mg: **(PFL)
156 156
no preservative 10 mL SWI
vial contents under

156
negative pressure
do NOT use BWI to

156
reconstitute
IDArubicin PFS
156 156
5 mg/5 mL N/A 1 mg/mL 48 h F, 24 h RT, syringe 4 h from initial - avoid alkaline
18 156
10 mg/10 mL puncture solutions
156
20 mg/20 mL **(PFL)
(Pfizer)
(F)(PFL)
156
no preservative

Manufacturer,
IDArubicin
157 157
5 mg/5 mL N/A 1 mg/mL discard unused syringe 4 h from initial - avoid alkaline
157 18 157
10 mg/10 mL solution puncture solutions
20 mg/20 mL
(Fresenius Kabi)
(F)(PFL)
157
no preservative
Ifosfamide
158 158 158
1000 mg 1000 mg: 50 mg/mL 48 h F, 24 h 0.6–20 mg/mL 72 h F, 24 h RT
158 18,158
3000 mg 20 mL SWI RT
(Baxter) 500–1000 mL* NS, 24 h F, RT when
60
(RT) 3000 mg: D5W, Lactated mixed with mesna
158 158 158
no preservative 60 mL SWI Ringer’s
shake well
Ifosfamide
159 159 159
1000 mg 1000 mg: 50 mg/mL 48 h F, 24 h 0.6-20 mg/mL 72 h F, 24 h RT
159 18,159
3000 mg 20 mL SWI RT
(Fresenius Kabi) 24 h F, RT when
60
(RT) 3000 mg: 500-1000 mL* NS mixed with mesna
159 159
no preservative 60 mL SWI D5W, Lactated
159
Ringer’s
shake well

Manufacturer,
Iniparib
160 160
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL NS, D5W 24 h RT - *may also use
160
(sanofi-aventis) portion empty IV bag and qs
(F) dilute to 250 mL final to final volume of
160
no preservative volume by 250 mL with NS,
160
withdrawing volume D5W
from bag equal to
volume of drug to be
160
added*
Inotuzumab
161 161 161 161
ozogamicin 4 mL SWI 0.25 mg/mL 4hF 0.01 – 0.1 mg/mL complete - do NOT shake
161
0.9 mg NS administration within - protect container
(Pfizer) gently swirl vial to record time of dilute dose within 8 h of reconstitution from UV and
161 161 161
(F)(PFL) mix reconstitution 4 hours of (50 mL NS) RT,F fluorescent light
161 161
no preservative reconstitution during storage and
161 161,162
(PFL) administration
protect from light mix by gentle - protect
161
if not used inversion if refrigerated, bring administration line
162
immediately bag to RT over 1 h from light ONLY if
prior to hang time will be
161 161,162
administration longer than 1 h
Interferon Alfa -2b

163 163 18
10 million units/1 mL N/A 10 million 7dF syringe 7dF - vials can be kept at
163
(Merck) units/mL RT for up to 7 days
(F) before use; discard if
163,164 163
preservative final concentration 24 h F, RT not used within this
163 163
≥ 0.3 million IU/mL time
163
50 mL NS

Manufacturer,
Interferon Alfa -2b
18,163 163 18,164
18 million units/3 mL N/A 6 million 14 d F syringe 14 d F - vials can be kept at
163
163,164 163
163 163
163
50 mL NS
Interferon Alfa -2b

18,163 163 18,164
25 million units/2.5 mL N/A 10 million 14 d F syringe 14 d F - vials can be kept at
163
163,164 163
163 163
163
50 mL NS

Manufacturer,
Interferon Alfa -2b
163 163 18,164
10 million units 1 mL supplied 10 million 24 h F syringe 24 h F - after reconstitution,
163 163
(Merck) diluent (SWI) units/mL provides an isotonic
(F) solution which may
no preservative (unless do NOT shake; roll be used for
163 164
reconstituted with to reconstitute final concentration 24 h F, RT intralesional
163 163 163
BWI) ≥ 0.1 million IU/mL injection
- non-reconstituted
163
100 mL NS vials can be kept at
RT for up to 4 weeks
before use; discard if
163 18,163 163 18,163
1 mL BWI 14 d F syringe 14 d F not reconstituted for
use within this
163
do NOT shake; roll time
163 164
to reconstitute final concentration 24 h F, RT
163
≥ 0.1 million IU/mL
163
100 mL NS

Manufacturer,
Ipilimumab
165 165 165 165
50 mg/10 mL N/A 5 mg/mL 24 h F,RT 1 – 4 mg/mL NS, 24 h F,RT - do NOT shake
165
200 mg/40 mL D5W - administer with 0.2
165
(BMS Canada) or 0.22 in-line filter
(F)(PFL) OR - vials may contain
165
no preservative undiluted in empty translucent-to-white
viaflex bag or glass amorphous
165
bottle particles
- discard if cloudy or
(allow vials to stand at has pronounced
RT for ~5 min prior to colour change
withdrawal of (should be clear to
165 165
contents) pale yellow)
Irinotecan
166
40 mg/2 mL N/A 20 mg/mL discard unused 0.12–3 mg/mL D5W 48 h F, 24 h RT
166 166
100 mg/5 mL portion (preferred), NS
166
500 mg/25 mL **(PFL)
60
(Accord) 500* mL
(RT)(PFL)
166
no preservative
Irinotecan
167,168
40 mg/2 mL N/A 20 mg/mL discard unused 0.12-3 mg/mL 14 d F, 48 h
167,168 30,167,168
100 mg/5 mL portion D5W (preferred), RT
167,168
300 mg/15 mL NS
500 mg/25 mL
60 167,168
(Pfizer/Hospira) 500* mL **(PFL)
(RT)(PFL)
167,168
no preservative

Manufacturer,
Irinotecan Liposome
169 169
43 mg/10 mL N/A 4.3 mg/mL discard unused to a final volume of 24 h F, 4 h RT - do not use in-line
169 169
(Servier) portion 500 mL with NS, filter
169
(F)(PFL) D5W **(PFL) - expressed as
169
no preservative irinotecan free base
mix by gentle (allow product to
169
inversion come to RT prior to
administration if
169
stored in F)
Ixabepilone
170 170 170
15 mg 15 mg: 2 mg/mL 1 h RT 0.2 – 0.6 mg/mL in 6 h RT - use 0.2-1.2 micron
170
(contains 16 mg) 8 mL supplied Lactated Ringer’s in-line filter
170
45 mg diluent Injection USP (use - use non-DEHP bag
(contains 47 mg) non-DEHP infusion and administration
170 170
(BMS) 45 mg: container) set
(F)(PFL) 23.5 mL supplied
170 170
no preservative diluent
* 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 Special Precautions/Notes column.
*** Contains DMA (N,N dimethylacetamide). Product may be incompatible with closed system transfer devices such as ChemoLock.
Centres are not to change the content locally but should forward suggestions to the Cancer Drug Manual staff.

Explanatory Notes
Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to
38,171
the classification outlined in USP 797.
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 fridge stability is bolded as preferred
(ie, to minimize growth of micro-organisms).
Discard unused portion: Unused portion from single use vials should be discarded at the end of the day.
“overfill known” is stated if the manufacturer states overfill that is present is within acceptable limits.
“Complete administration within __” is stated if the manufacturer specifies that the infusion must be completed in a specific time frame following
preparation, usually including entire time required for preparation (from first puncture), storage, and administration of infusion.
Abbreviations
BWI = bacteriostatic water for injection
CIVI: ambulatory pump = Continuous Intravenous Infusion (e.g., elastomeric infusor)
D5W = dextrose 5% in water
DMA = N,N dimethylacetamide
F = refrigerate
Non-DEHP = not containing Di(2-ethylhexyl) phthalate (DEHP)
NS = normal saline
PFL = protect from light
RT = room temperature
SWI = sterile water for injection
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55. Omega Laboratories Ltd. Carboplatin injection product monograph. Montreal, Quebec; 24 March 2011.
56. Nayla El Zir. Personal communication. Associate, Regulatory Affairs, Omega Laboratories Limited; 12 April 2017.
57. Pfizer Canada ULC. Carboplatin injection product monograph. Kirkland, Quebec; 31 December 2018.
58. Novopharm Limited. Carboplatin Package Insert. Toronto, Canada; Undated.
59. Manjinder S Kang. Personal communication. Regulatory Affairs Drug Information Pharmacist, Novopharm Canada. 14 March 2005.
60. Trissel LA. Handbook on Injectable Drugs. 13th ed. Bethesda, MD: American Society of Health-System Pharmacists, Inc.; 2005.
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63. Luis Simao. Personal communication. Area Manager, ICU Medical Canada; 11 May 2018.
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65. Bristol Laboratories of Canada. BiCNU Package Insert. Montreal, Canada; 2002.
66. Regeneron Pharmaceuticals Inc. Pharmacy Manual Protocol R2810-ONC-1676: An open-label, randomized, phase 3 clinical trial of REGN2810 versus therapy of investigator's
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68. Accord Healthcare Inc. Cisplatin injection product monograph. Kirkland, Quebec; 15 February 2019.
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72. Trissel LA. Handbook on Injectable Drugs. 16th ed. Bethesda, Maryland: American Society of Health-System Pharmacists, Inc; 2011. p. 378.
73. Teva Canada Limited. Cisplatin injection® product monograph. Toronto, Ontario; 6 March 2013.
74. Pharmaceutical Partners of Canada, Inc. Cladribine For Injection product monograph. Richmond Hill, Ontario; 27 November 2008.
75. BC Cancer Agency Lymphoma Tumour Group. (LYCDA) BCCA Protocol Summary for Treatment of Hairy Cell Leukemia with Cladribine. Vancouver, British Columbia: BC Cancer
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76. de Lemos ML, Hamata L. Stability issues of parenteral chemotherapy drugs. J Oncol Pharm Pract 2007;13(1):27-31.
77. Baxter Corporation. Procytox Package Insert. Toronto, Ontario; 2004.
78. Baxter Corporation. Procytox Package Insert. Missisauga, Ontario; 1 October 2003.
79. Paul Agro. Personal communication. Medical Information, cyclophosphamide, Baxter. 12 July, 2006.
80. Pfizer Canada Inc. Cytarabine Solution for Injection product monograph. Kirkland, Quebec; 3 November 2015.
81. BC Cancer Lymphoma Tumour Group. (LYIT) BC Cancer Protocol Summary for Treatment of Lymphoma using Intrathecal Methotrexate and Cytarabine. Vancouver, British
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82. BC Cancer Miscellaneous Origin Tumour Group. (MOIT) BC Cancer Protocol Summary for Solid Tumours using Intrathecal Methotrexate and/or Thiotepa and/or Cytarabine.
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83. Hospira Healthcare Corporation. Cytarabine Injection® product monograph. Saint-Laurent, Quebec; 25 November 2013.
84. Pharmascience Inc. Cytarabine Solution for Injection product monograph. Montreal, Quebec; 14 February 2017.
85. Abraxis Pharmaceutical Products. Dacarbazine product information package. Schaumburh, IL; December 2006.
86. Trissel L. Handbook on injectable drugs. 13th ed. Bethesda, Maryland: American Society of Health-System Pharmacists; 2005. p. 428-431.
87. Mayne Pharma (Canada) Inc. DACARBAZINE FOR INJECTION product monograph. Montreal, Quebec; 25 July 2003.
88. John Korontzis. Personal communication. Regulatory Affairs Associate, Dacarbazine, Mayne Pharma Canada; #FEB-14-2005 (february 8, 2005).
89. Robert Caunce. Personal communication. Quality System Manager, Hospira Australia; 12 March 2008.
90. Pfizer Canada Inc. Dacarbazine for Injection product monograph. Kirkland, Quebec; 31 May 2018.
91. Recordati Rare Diseases Inc. COSMEGEN® product monograph. Lebanon, New Jersey USA; 24 July 2014.

92. Andy Harbrow. Personal communication. Global Medical Services Manager, Primevigilance (for Recordati Rare Diseases Inc.); 15 July 2014.
93. Janssen Inc. DARZALEX® product monograph. Toronto, Ontario; 29 June 2016.
94. Erfa Canada Inc. Daunorubicin injection product monograph. Westmount, Quebec; 6 December 2002.
95. Erfa Canada Inc. Material Safety Data Sheet. Montreal, Quebec; 3 October 2007.
96. Henri Knafo MD. Personal communication. Medical Director, Erfa Canada Inc; 14 July 2008.
97. Henri Knafo MD. Personal communication. Medical director, Erfa Canada Inc; 09 July 2008.
98. Novopharm Limited. Daunorubicin Package Insert. Toronto, Canada; Undated.
99. Ferring Pharmaceuticals. FIRMAGON® product monograph. North York, Ontario; 20 March 2013.
100. Ferring Pharmaceuticals. FIRMAGON® product monograph. North York, Ontario; 06 November 2009.
101. Amgen Canada Inc. XGEVA® product monograph. Mississauga, Ontario; 14 October 2011.
102. Pfizer Canada Inc. ZINECARD® product monograph. Kirkland, Quebec; 12 August 2010.
103. Pfizer Canada Inc. ZINECARD® product monograph. Kirkland, Quebec; 30 March 2015.
104. Pfizer Canada Inc. Docetaxel injection product monograph. Kirkland, Quebec; 1 June 2018.
105. Hospira Canada Clinical Support Team. Personal communication. Hospira Canada Healthcare Corporation; 21 March 2011.
106. Josee Lloyd, Senior Clinical Specialist. Subject : Docetaxel Injection 160mg/16mL and 80 mg/8mL multidosing and venting needles. Hospira Clinical Support Team, Hospira
Healthcare Corporation; 13 July 2011.
107. Sandoz Canada Inc. Docetaxel injection product monograph. Boucherville, Quebec; 24 January 2018.
108. Bazundama Bazuta Feza Sandrine. Personal communication - regarding in-house vial stability for docetaxel injection. Medical Information Intern, Sandoz Canada Inc.; 14 August
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109. Bazundama Bazuta Feza Sandrine. Personal communication - regarding in-house product stability of diluted docetaxel injection. Medical Information Intern, Sandoz Canada Inc.;
14 August 2018.
110. sanofi-aventis Canada Inc. TAXOTERE® product monograph. Laval, Quebec; 15 April 2011.
111. Walker SE, Charbonneau F, Law 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
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112. Accord Healthcare Inc. Doxorubicin injection® product monograph. Montreal, Quebec; 9 April 2014.
113. Mayne Pharma (Canada) Inc. Doxorubicin Package Insert. Montreal, QC; Undated.
114. Mayne Pharma (Canada) Inc. Doxorubicin Product Monograph. Montreal, Quebec; 2002.
115. Novopharm Limited. Doxorubicin Product Monograph. Scarborough, Ontario; 8 November 1996.
116. Pfizer Canada Inc. ADRIAMYCIN® injection product monograph. Kirkland, Quebec; 28 August 2007.
117. Janssen Inc. CAELYX® product monograph. Toronto, Ontario; 10 October 2013.
118. AstraZeneca Canada Inc. IMFINZI® product monograph. Mississauga, Ontario; 4 May 2018.
119. Novopharm. Epirubicin for Injection product monograph. Toronto, Ontario; 16 March 2009.
120. Pharmaceutical Partners of Canada, Inc. Epirubicin Hydrochloride Injection product monograph. Richmond Hill, Ontario; 6 July 2010.
121. Pharmacia Canada Inc. Pharmorubicin PFS Package Insert. Mississauga, Ontario; May 2003.
123. BC Cancer Agency Lymphoma Tumour Group. (ULYEPOCHR) Interim BCCA Protocol Summary for Treatment of Lymphoma with Dose-Adjusted Etoposide, DOXOrubicin,
VinCRIStine, Cyclophosphamide, PredniSONE, and riTUXimab (LYEPOCHR) with Intrathecal Methotrexate. Vancouver, British Columbia: BC Cancer Agency; 1 July 2015.
124. Barry Goldspiel. Personal communication. NIH Clinical Centre; 14 April 2015.
125. Wolfe JL, Thoma LA, Du C, et al. Compatibility and stability of vincristine sulfate, doxorubicin hydrochloride, and etoposide in 0.9% sodium chloride injection. Am J Health-Syst
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126. Dunleavy K, Pittaluga S, Shovlin M, et al. Low-intensity therapy in adults with Burkitt's lymphoma. N Engl J Med 2013;369:1915-1925.
127. Eisai Limited. HALAVEN® product monograph. Mississauga, Ontario; 17 January 2013.
128. Sandoz Canada Inc. Etoposide injection® product monograph. Kirkland, Quebec; 27 February 2012.
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130. Novopharm Limited. Etoposide Product Monograph. Toronto, Ontario; 2000.

131. Lepage R, Walker S, Godin J. Stability and compatibility of etoposide in normal saline. Canadian Journal of Hospital Pharmacy 2000;53(5):338-345.
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133. Angie Chan. Personal communication. Drug Information Pharmacist, Novopharm. 29 September 2006.
134. Bristol-Myers Squibb Company. ETOPOPHOS® product monograph. Princeton, New Jersey, USA; March 2011.
135. Bristol-Myers Squibb Company. ETOPOPHOS® product monograph. Princeton, New Jersey, USA; September 2013.
136. Amgen Canada Inc. NEUPOGEN® product monograph. MIssissauga, Ontario; 21 March 2014.
137. Amgen Medical Information. Personal communication. Amgen Canada Inc.; 8 July 2014.
138. Trissel LA. Handbook on Injectable Drugs. 13th ed. Bethesda, Maryland: American Society of Health-System Pharmacists, Inc; 2005. p. 648-655.
139. Berlex Canada Inc. Fludara Package Insert. Lachine, Quebec; December 1998.
140. Trissel's™2 Clinical Pharmaceutics Database (Parenteral Compatibility) [database on the internet]. Fludarabine. Thomson MICROMEDEX®, Available at:
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Manufacturer, Preservative
Status)
Leucovorin
1 1,2
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8 h RT
1
(GMP) portion
(F)(PFL)
1
no preservative 0.05-10 mg/mL NS, D5W, LR,
NS, D5W, Ringer’s, Ringer’s:
1,2 1
LR, D10W, D5NS 24 h RT
(e.g., 50-250 mL*) D10W, D5-NS:

1
8 h RT
Leucovorin
3 3 3
50 mg/5 mL N/A 10 mg/mL 8h syringe 8 h RT
500 mg/50 mL
(Pfizer/Hospira)
(F)(PFL) 0.05 – 10 mg/mL NS, NS, D5W, LR,
3
no preservative D5W, LR, Ringer’s, Ringer’s:
3 3
D10W, D5NS 24 h RT
(e.g., 50-250 mL*) D10W, D5NS:

3
8 h RT

Status)
Leucovorin
5 6,7
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8h
5
500 mg/50 mL portion
(Teva)
(F)(PFL)
4 8
no preservative 0.4 - 4.8 mg/mL NS, 72 h F, RT
8
D5W
(e.g., 50-250 mL*)
0.06 - 0.4 mg/mL NS, NS:

4 4
D5W 24 h RT
D5W:
4
12 h RT
0.06 - 1 mg/mL Ringer’s, LR:

4
Ringer’s, Lactated 24 h RT
Ringer’s, D10W,
4
D10NS D10W:
4
12 h RT
D10NS:
4
6 h RT

Status)
Melphalan
9 9
50 mg 10mL supplied 5 mg/mL 2 h RT 0.1 – 0.45 mg/mL in complete
9 9
(GSK) diluent NS only administration within
(RT)(PFL) do NOT 60 min from time of
9
no preservative immediately after refrigerate (e.g., greater than 45 initial reconstitution at
10
adding diluent, mg and less than or RT
9
shake vigorously equal to 110 mg in
250 mL NS)*
record time of
reconstitution
Mesna
11
400 mg/4 mL N/A 100 mg/mL discard unused greater than 1 mg/mL complete
11
1000 mg/10 mL portion in D5W, D5½NS, NS, administration within
11-13 11
(Baxter) (use filter needle to LR 24 h RT
(RT) withdraw from
11
no preservative ampoule)
Mesna
11 11
1000 mg/10 mL N/A 100 mg/mL 8 days RT greater than 1 mg/mL complete
5000 mg/50 mL in D5W, D5½NS, NS, administration within
11-13 11
(Baxter) (vial may be LR 24 h RT
(RT) punctured up to 4
11 11
preservative times)
Mesna
14 14,15 14
1000 mg/10mL N/A 100 mg/mL 14 d RT,F greater than or equal 24 h RT, 48 h F
(Fresenius Kabi) to 1 mg/mL in NS or
16
(RT) D5W
14
preservative

Status)
Methotrexate
17
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
17
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
17 2
1 g/40mL portion 12 g/m as a single
18-22
(Accord) dose) : use
(RT)(PFL) 500 mg or 1 g: 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
17 17 17 17 17
no preservative 8 h RT D5W initial puncture methotrexate
- do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 17
(e.g., 1-12 g/m as a initial puncture
18-22
single dose) : 1000
mL* NS **(PFL)
Methotrexate
17 2
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info
17 2
Only preservative free portion preservative free puncture - label to include
24,25
methotrexate may be NS route in full (i.e.,
administered by the INTRATHECAL
23
intrathecal route injection) attached
50 mg/2mL to both syringe and
26
(Accord) outer ziplock bag
(RT)(PFL)
17
no preservative

Status)
Methotrexate
17 2,17 2
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
17
500 mg/20mL alcohol
(Accord) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
17 high-dose
17
preservative D5W
17 regimens (e.g., 1-
2
12 g/m as a single
17
(100 mL* NS, D5W) dose)
- do NOT use for IT
17
injection
Methotrexate
27
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
27
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
27 2
1 g/40mL portion 12 g/m as a single
18-22
2.5 g/100 mL dose) : use
(Pfizer/Hospira) 500 mg, 1 g, or 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
27 27 27
(RT)(PFL) 2.5 g: D5W initial puncture methotrexate
27 27
no preservative 8 h RT - do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 27
(e.g., 1-12 g/m as a initial puncture
18-22
single dose) : 1000
mL* NS **(PFL)

Status)
Methotrexate
27 2
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info :
27 15
Only preservative free portion preservative free puncture “IT”
24,25
methotrexate may be NS - label to include
administered by the route in full (i.e.,
23
intrathecal route INTRATHECAL
50 mg/2mL injection) attached
(Pfizer/Hospira) to both syringe and
26
(RT)(PFL) outer ziplock bag
27
no preservative
Methotrexate
27 15,27 15
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
27
500 mg/20mL alcohol
(Pfizer/Hospira) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
27 high-dose
27
preservative D5W
27 regimens (e.g., 1-
2
12 g/m as a single
27
(100 mL* NS, D5W) dose)
- do NOT use for IT
27
injection
Mitomycin
28 28 28 28
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Accord)
28 28 28
(RT)(PFL) shake well **(PFL) **(PFL)
28
no preservative

Status)
Mitomycin
28 28 28 28
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
28 28 28
(Accord) shake well **(PFL) **(PFL)
(RT)(PFL)
28
no preservative
29 29
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
28 30 30,31
shake well to prevent precipitation solubility
30
precipitation - do NOT
30
refrigerate
Mitomycin
28 28 28 28
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS:
28
20 mg 3 h RT, 18 h F
28 28 28
(Accord) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
28 28
no preservative 3 h RT, 6 h F
Mitomycin
32 32 32 32
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Teva/Novopharm)
32 32 32
(RT)(PFL) shake well **(PFL) **(PFL)
32
no preservative

Status)
Mitomycin
32 32 32 32
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
32 32 32
(Teva/Novopharm) shake well **(PFL) **(PFL)
(RT)(PFL)
32
no preservative
29 29
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
32 30 30,31
shake well to prevent precipitation solubility
30
precipitation - do NOT
30
refrigerate
Mitomycin
32 32 32 32
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS:
32
20 mg 6 h RT, 18 h F
32 32 32
(Teva/Novopharm) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
32 32
no preservative 6 h RT, F
mitoXANTRONE
33 33 33
20 mg/10 mL N/A 2 mg/mL discard unused NS, D5W 24 h RT
33
(Fresenius Kabi) portion
(RT) Greater than or equal
33 33
no preservative to *50 mL

Status)
mitoXANTRONE
34 34 34
20 mg/10 mL N/A 2 mg/mL discard unused 0.2-0.6 mg/mL NS: 24 h F, RT
34
34 34
(Hospira) NS, D5W **(PFL)
(RT)(PFL)
34
no preservative Greater than or equal
34
to *50 mL
mitoXANTRONE
35 35
20 mg/10 mL N/A 2 mg/mL discard unused Greater than or equal 24 h RT
35 35
(Teva/Novopharm) portion to *50 mL NS, D5W
36
(RT)(PFL) **(PFL)
35
no preservative
Nivolumab
37
40 mg/4 mL N/A 10 mg/mL discard unused 1-10 mg/mL NS, complete - administer with a
37 37
100 mg/10 mL portion D5W administration within 0.2 to 1.2 micron
37 37
(BMS) 8 h RT or 24 h F in-line filter
(F)(PFL) (50-100* mL) - discard if cloudy
37
do not shake **(PFL) or has pronounced
37
no preservative mix by gentle colour change
inversion; do not (should be clear to
37 37
shake pale yellow)

Status)
oBINutuzumab
38 38,40
1000 mg/40 mL N/A 25 mg/mL discard unused 100 mg: 24 h F, 48 h RT -once removed
39 38
(Hoffman-La Roche) portion in 100 mL NS from the fridge,
**
(F)(PFL) diluted product is
do not shake 900 mg: stable for an
38 38
no preservative in 250 mL NS additional 48 h
38,40
RT
38
1000 mg: - do NOT shake
38
in 250 mL NS - do NOT use
dextrose containing
38
solutions
Octreotide
41 41 41 41
50 mcg/mL N/A 50 mcg/mL Use within 4 h NS 24 h RT
100 mcg/mL
41
500 mcg/mL 100 mcg/mL volume adjusted to
(Omega) ensure a continuous
41
(F)(PFL) 500 mcg/mL infusion of octreotide
41 41
no preservative at 25 mcg/hour
Octreotide
41 41 41 41
multidose vial: N/A 200 mcg/mL 15 d F NS 24 h RT
1000 mcg/5 mL
(Omega) volume adjusted to
(F)(PFL) ensure a continuous
41
preservative infusion of octreotide
41
at 25 mcg/hour

Status)
Octreotide
42 42 42
50 mcg/mL N/A 50 mcg/mL discard unused SC syringe use within 4 h
42
100 mcg/mL portion
42
500 mcg/mL 100 mcg/mL
(Teva/Novopharm)
42 42 42
(F)(PFL) 500 mcg/mL infusion: NS 24 h RT
42
no preservative
Octreotide
42 42,43 42,43
multidose vial: N/A 200 mcg/mL 14 d F SC syringe use within 14 d F
1000 mcg/5 mL
(Teva/Novopharm)
42 42
(F)(PFL) infusion: NS 24 h RT
42
preservative
Octreotide
44 10,46,47 46
(SANDOSTATIN®) N/A 200 mcg/mL discard unused 50–200 mL NS 24 h RT
45
1000 mcg/5 mL portion
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
44
preservative infusion rate of 25
46
mcg/h

Status)
Octreotide
10,47 46
(SANDOSTATIN®) N/A 50 mcg/mL discard unused 50-100 mL 24 h RT
46
50 mcg/1 mL 100 mcg/mL portion
44 46
100 mcg/1 mL 500 mcg/mL NS
500 mcg/1 mL
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
44
no preservative infusion rate of 25
46
mcg/h
Octreotide
(SANDOSTATIN LAR®) 2 mL supplied 10 mg: 5 mg/mL discard unused deep intragluteal use within 4 h of initial - do NOT shake
46 46 7,46
10 mg diluent portion administration only reconstitution
20 mg 20 mg: 10 mg/mL
30 mg gently run 2 mL
46
(Novartis) down sides of the 30 mg: 15 mg/mL
(F)(PFL) vial; do NOT disturb
45
no preservative for 2–5 min, then
46
swirl moderately
record time of
reconstitution

Status)
oFAtumumab
48 48 48
100 mg/ 5 mL N/A 20 mg/mL discard unused 1000 mL NS 48 h RT - administer with
39
1000 mg/50 mL portion 0.2 micron in-line
48
(GlaxoSmithKline) or filter
(F)(PFL) - do NOT shake;
48
no preservative alternatively, 2000 mg mix by slow
doses may be inversion to avoid
48
supplied in formation of foam
48
2 x 500 mL NS - solution may
contain a small
withdraw volume quantity of drug
from bag equal to particles; do not
volume of drug to be administer if
48
added solution is cloudy
48
or discoloured
Olaratumab
49 49
500 mg/50 mL N/A 10 mg/mL discard unused dilute to a final complete - do NOT shake
39,49
(Lilly) portion volume of 250 mL administration within
49
(F)(PFL) NS 24 h F, plus an
49
do not shake additional 12 h RT
49
no preservative do NOT use D5W or
other dextrose
49
containing solutions
49
gently invert to mix

Status)
Oxaliplatin
50
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-0.4 mg/mL: - do NOT use
50
100 mg/20 mL portion 24 h RT aluminum-
50
200 mg/40 mL (0.2-0.7 mg/mL or containing needle,
50
(Hospira/Pfizer) 5 d F plus an syringe or tubing
50,52
(RT) do NOT use NS or additional 8 h RT
50
no preservative other chloride-
51
containing solutions 0.5–2 mg/mL:
24 h RT
do NOT use or
aluminum-containing 14 d F plus an
51 50,52
needle and syringe additional 8 h RT
Oxaliplatin
51 39,53 51
50 mg/10 mL N/A 5 mg/mL 2 d F, RT 0.2-0.7 mg/mL 0.2-2 mg/mL:
51
100 mg/20 mL 24 h RT, 48 h F
51
150 mg/30 mL 250-500 mL D5W
200 mg/40 mL
(Sandoz) do NOT use NS or
(RT)(PFL) other chloride-
51 51
no preservative containing solution
do NOT use
aluminum-containing
51
needle and syringe

Status)
Oxaliplatin
54
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
54 54
100 mg/20 mL portion 24 h RT, 48 h F aluminum-
54
200 mg/40 mL (0.2-0.7 mg/mL) containing needle,
54
(Teva) syringe or tubing
(RT)(PFL) do NOT use NS or
54
no preservative other chloride-
54
containing solution
do NOT use
aluminum-containing
54
needle and syringe
PACLitaxel
55
30 mg/5 mL N/A 6 mg/ mL 30 mg: 0.3-1.2 mg/mL in NS, complete - use non-DEHP
39,55 55
100 mg/16.7 mL 48 h RT D5W, D5NS, D5LR administration within bag and tubing with
55
300 mg/50 mL 27 h RT 0.22 micron in-line
55
(Accord) 100 mg: (e.g., 100-1000 mL)* filter
39,55
(RT)(PFL) 48 h RT - avoid excessive
55 55
no preservative shaking
300 mg:
55
24 h RT

Status)
PACLitaxel
57 39,58
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
57
100 mg/16.7 mL D5W administration within bag and tubing with
57,59
57
(Biolyse) (e.g., 100-1000 mL)* filter
56
(RT)
57
no preservative
60 60
0.1 mg/mL in NS 44 h F, RT
59
0.012-0.12 mg/mL in 16 h RT
61
NS
devices with spikes

(e.g., chemo
dispensing pins) may
62
be used with vials
PACLitaxel
64 39,64,65
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
64
100 mg/16.7 mL D5W, D5NS, D5LR administration within bag and tubing with
64
64
300 mg/50 mL (e.g., 100-1000 mL)* filter
(Hospira)
(RT)(PFL)
63
preservative

Status)
PACLitaxel,
66 66
nanoparticle, albumin- 20 mL NS 5 mg/mL use immediately in empty sterile PVC, 48 h F plus an - each vial contains
67
bound (nab) (RT) or non-PVC, or non- additional 8 h RT 900 mg human
66 66 66
100 mg - slowly direct 8hF DEHP infusion bag albumin
(Celgene) diluent against side - to prevent
66
(RT)(PFL) of vial (i.e., greater **(PFL) foaming, do NOT
66
no preservative than or equal to 1 inject NS directly
66
min) during onto the powder
66
reconstitution - some settling may
occur; use mild
- let stand for agitation to
66
greater than or resuspend
equal to 5 min to wet - administer using
66
powder a 15 micron filter
ONLY
- gently swirl or (NOTE:filters with a
invert for greater pore size less than
than or equal to 2 15 microns may
66
min cause filter
68,69
blockage)
Pamidronate
70 70
30 mg/10 mL N/A 3 mg/mL discard unused Less than or equal to 24 h RT - do NOT mix with
70 70
60 mg/10 mL portion 0.36 mg/mL NS, calcium containing
70 70
90 mg/10 mL D5W solutions
70
(Fresenius Kabi) 6 mg/mL
(RT)
70
no preservative
70
9 mg/mL

Status)
Pamidronate
71
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
71 71 71
60 mg/10 mL portion NS, D5W RT (total 48 h) calcium containing
90 mg/10 mL solution (e.g.,
71 71 71
(Hospira) 6 mg/mL **(PFL) Ringer’s)
(RT)
71
no preservative
71
9 mg/mL
Pamidronate
72 72
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
72 72 72
72 72 72
(Omega) 6 mg/mL **(PFL) Ringer’s)
(RT)
72
no preservative
72
9 mg/mL
Pamidronate
73
30 mg/10 mL N/A 3 mg/mL discard unused 0.06-0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
73 73 73
73 73 73
(Pfizer) 6 mg/mL **(PFL) Ringer’s)
(RT)
73
no preservative
73
9 mg/mL

Status)
Pamidronate
74 74 74
30 mg/10 mL N/A 3 mg/mL discard unused NS; D5W 24 h RT - do NOT mix with
43,74
60mg/10 mL portion calcium containing
74 74
(Sandoz Canada) 6 mg/mL Ringer’s)
RT
74
no preservative
74
9 mg/mL
PANitumumab
75 75,76
100 mg/5 mL N/A 20 mg/mL discard unused Less than or equal to 24 h F, 6 h RT - administer with
75
400 mg/20 mL portion 1000 mg: 0.2 or 0.22 micron
75 75
(Amgen) 100 mL NS in-line filter
(F)(PFL) - solution may
do not shake Greater than 1000mg: contain particulates
75 75
no preservative 150 mL NS which do not affect
75
product quality
75,76
1-10mg/mL - do not administer
75
if discoloured

Status)
pegaspargase
77 77
(pegylated N/A 750 units/mL discard unused IM: syringe: - do NOT shake
77
asparaginase E. coli) portion max volume: use within 4 h of vial
39,77
3750 units/5 mL 2 mL in children and puncture
(Shire) adolescents;
(F)(PFL) 3 mL in adults
do not shake
77
no preservative if volume greater than
above, use multiple
77
sites
IV: bag:
77
100 mL NS, D5W use within 4 h of vial
39,77
puncture
Pembrolizumab
78
100 mg/4 mL N/A 25 mg/mL discard unused 1-10 mg/mL complete - use a 0.2 to 5
39,78 78
(Merck) portion NS, D5W administration within micron in-line
78 78
(F)(PFL) 6 h RT, 24 h F filter
do not shake mix by gentle - allow vials and
78 78
no preservatives inversion diluted solutions to
come to RT prior to
78
use
- vials contain 0.25
78
mL overfill

Status)
Pembrolizumab
78 78 78
50 mg 2.3 mL SWI 25 mg/mL 6 h RT, 24 h F 1-10 mg/mL NS, complete - use 0.2 to 5
78
(Merck) D5W administration within 6 micron in-line
78 79
(F) direct diluent against h RT, 24 h F filter
78
no preservative side of vial during mix by gentle - allow
78
reconstitution to inversion reconstituted vials
78
avoid foaming and diluted
solutions to come
78
allow up to 5 to RT prior to use
minutes for bubbles - vials can be at RT
78
to clear for up to 24 h prior
78
to use
78
do NOT shake - vials contain 20%
78
overfill
Pemetrexed
80 80 80
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
80 80
500 mg 4.2 mL NS NS calcium containing
(Accord) solution (e.g.,
80
(RT) 500 mg: Ringer’s)
80 80
no preservative 20 mL NS
Pemetrexed
81 81 81
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
81 81
500 mg 4.2 mL NS NS calcium containing
(Eli Lilly) solution (e.g.,
82
(RT) 500 mg: Ringer’s)
81
no preservative 20 mL preservative-
81
free NS

Status)
PERTuzumab
83 83 83
420 mg/14 mL N/A 30 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT use
39,83
(Roche) portion dextrose containing
83 83
(F)(PFL) do NOT shake mix by gentle solutions
83
no preservative inversion to avoid
83
foaming
Plerixafor
84 84 43,85
24 mg/1.2 mL N/A 20 mg/mL discard unused SC syringe 48 hours RT
84
(sanofi-aventis) portion
(RT)
84
no preservative
Porfimer
86 86
15 mg 15 mg: 2.5 mg/mL 24 h F syringe use within 4 h of initial - avoid contact with
86 7,87
75 mg 6.6 mL D5W reconstitution skin and eyes;
86
(Axcan) **(PFL) protect exposed
86 86
(RT)(PFL) 75 mg: **(PFL) area from light
86 86
no preservative 31.8 mL D5W
record time of
reconstitution
Raltitrexed
88 88 88
2 mg 4 mL SWI 0.5 mg/mL 24 h F, RT 50-250 mL NS, complete
88
(Pfizer) D5W administration within
88
(F,RT)(PFL) 24 h F, RT
88
(no preservative)

Status)
Ramucirumab
89 89 89
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL* NS 4 h RT, 24 h F - use 0.22 micron
89 89
500 mg/50 mL portion filter
90
(Eli Lilly) (0.4 – 4 mg/mL) - do NOT use
(F)(PFL) dextrose containing
89 89
(do not shake) gently invert to mix solutions
89
no preservative
89
do NOT shake
riTUXimab
91 92,93
100 mg/10 mL N/A 10 mg/mL discard unused 1-4 mg/mL NS, 24 h F, 12 h RT - once removed
91 91
500 mg/50 mL portion D5W from the fridge,
(Roche) compounded
(F)(PFL) (e.g., 250-500 mL)* product is stable
91 92,93
no preservative for 12h RT
riTUXimab
94 94 94
subcutaneous N/A 120 mg/mL discard unused SC syringe 48 h F plus 8 h RT - contains
94 94
1400 mg/11.7 mL portion hyaluronidase
1600 mg/13.4 mL - formulations are
(Roche) NOT
94
(F)(PFL) interchangeable
94
no preservative

Status)
romiDEPsin
95 95 95 95
10 mg 2.2 mL of supplied 5 mg/mL 8 h RT 500 mL NS 24 h RT - reconstituted
95,96
(Celgene Inc.) diluent solution will be
95 97
(RT) slightly viscous
39 95
no preservative swirl gently to mix - vials contain
overfill to allow for
full drug recovery
(drug vial contains
11 mg romidepsin;
diluent vial
contains 2.4 mL
95
diluent)
Siltuximab
98 98 98
100 mg 100 mg: 20 mg/mL 2 h RT 250 mL D5W complete - use 0.2 micron in-
98 98
400 mg 5.2 mL SWI administration within line filter
98
(Janssen) dilute to 250 mL final 6 h RT
(F)(PFL) 400 mg: volume by
98 98
no preservative 20 mL SWI withdrawing volume
from bag equal to
allow vial to come to volume of drug to be
98
room temperature added
prior to use (~30
98
minutes)
gently swirl, do NOT

98
shake

Status)
Streptozocin
99 99 99 99
1g 9.5mL NS, SWI, 100 mg/mL 48 h F, 24 h RT syringe 48 h F, 24 h RT
99
(Pfizer) D5W
(F)(PFL)
99 99
no preservative 50-500 mL* NS, 48 h F, 24 h RT
99
D5W, SWI
Temsirolimus
100,101 100,101 100,101
30 mg/1.2 mL 1.8 mL supplied 10 mg/mL 24 h RT 250 mL NS complete - use non-DEHP
100,101
(Wyeth) diluent administration within 6 bag and tubing with
100,101 100 100,101 100,101
(F)(PFL) **(PFL) h in-line filter
102
no preservative
Teniposide
103
50 mg/5 mL N/A 10 mg/mL discard unused 50 – 500 mL NS or 0.1-0.4 mg/mL: 24 h - do not refrigerate
103
(BMS) portion D5W for a final RT - use non-DEHP
103
(RT) concentration of 0.1-1 bag and tubing
103 103
preservative mg/mL 1 mg/mL: complete - do not use if
103,104
administration within 4 precipitates
h of preparation - contains DMA***
103,104
RT - excessive
agitation may
cause
103
precipitation

Status)
Thiotepa
105 105 105
15 mg 15 mg: 10 mg/mL 8hF reconstituted solution 4 h RT, 24 h F - do not use if
105
100 mg 1.5 mL SWI is hypotonic and must precipitates are
105
(Adienne/Methapharm) be further diluted with present
105
(F) 100 mg: NS prior to use - reconstituted
105 105
no preservative 10 mL SWI solution may be
doses ≤ 500 mg: used if
105
to remove haze, 500 mL NS or with an opalescent
filter through 0.22 appropriate volume to - administer with
micron filter after achieve 0.5-1 mg/mL 0.2 micron inline
106 105 105
reconstitution concentration filter
record time of doses > 500 mg:

105
reconstitution 1000 mL NS

Status)
Thiotepa
105 105 26
IT injection diluents containing 10 mg/mL 8hF qs to 6 mL with use within 4 h of initial - auxiliary info :
25 2
15 mg preservatives should preservative free NS reconstitution “IT”
100mg NOT be used for - label to include
(Adienne/Methapharm) intrathecal route in full (i.e.,
107
(F) administration INTRATHECAL
105
no preservative injection) attached
15 mg: to both syringe and
105 26
1.5 mL SWI outer ziplock bag
- do not use if
100 mg: precipitates are
105 105
10 mL SWI present
- reconstituted
to remove haze, solution may be
filter through 0.22 used if
105
micron filter after opalescent
106
reconstitution
record time of
reconstitution
Thyrotropin alfa
108 108 108 108 108
1.1 mg 1.2 mL SWI 0.9 mg/mL 24 h F syringe 24 h F
(Genzyme)
108
(F)(PFL) swirl contents
108
no preservative
do NOT shake

Status)
Tocilizumab
109 109
80 mg/4 mL N/A 20 mg/mL discard unused 100 mL NS complete - to prevent
109
200 mg/10 mL portion administration within foaming: slowly
109
400 mg/20 mL dilute to final volume 24 h F, RT add drug to
(Roche) by withdrawing infusion bag and
(F)(PFL) volume from bag bring to room gently invert bag to
109 109
no preservative equal to volume of temperature prior to mix
109 109
drug to be added administration
109
gently invert to mix
Topotecan
110 2,110
4 mg/4 mL N/A 1 mg/mL discard unused 0.025-0.5 mg/mL 14 d F, 48 h RT
2,110
(Accord) portion
(RT)(PFL) 50-100 mL NS,
110 110
no preservative D5W
Topotecan
111 111 111
1 mg 1 mg: 1 mg/mL 24 h F,RT 0.02-0.5 mg/mL 24 F,RT
111
4 mg 1.1 mL SWI
(Actavis) 50-100 mL NS,
111
(RT)(PFL) 4 mg: D5W
111 111
no preservative 4 mL SWI
Topotecan
112 112
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F, RT
2,112
(Pfizer/Hospira) portion
(F)(PFL) 50-100 mL NS,
112 112
no preservative D5W

Status)
Topotecan
113 113
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F
113
(Sandoz) portion
113
(F)(PFL) 50-100 mL NS, **(PFL)
113 113
no preservative D5W
Trastuzumab
114 39 114 114 114
(HERCEPTIN®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
114
440 mg BWI
(Roche) do NOT use dextrose
114
(F) swirl vial gently; containing solutions
114
preservative allow to stand
undisturbed for 5
114
min

Status)
Trastuzumab
115 115 115
Emtansine 100 mg vial: 20 mg/mL 24 h F 250 mL NS or 0.45% 24 h F - do not use if
115
(KADCYLA®) 5 mL SWI sodium chloride only reconstituted
115 115 115
100 mg do NOT freeze do NOT freeze solution contains
160 mg 160 mg vial: visible particulates
115 115
(Roche) 8 mL SWI do NOT shake or is cloudy or
115
(F)(PFL) discolored
115
no preservative swirl gently until - dextrose 5%
completely dissolved solutions cause
aggregation of the
115
do NOT shake protein; do not
dilute with dextrose
containing
115
solutions
- use a 0.2 micron
in-line filter or 0.22
micron
polyethersulfane
(PES) filter to
administer
infusions prepared
in NS; filter is
optional for
solutions in 0.45%
115
NS

Status)
TRC105 (Carotuximab)
116 117
100 mg/4 mL N/A 25 mg/mL discard unused 0.6 – 10 mg/mL NS complete infusion - use a 0.2 micron
39
200 mg/8 mL portion within 8 h RT, 24 h in-line filter for
116,117 116
400 mg/16 mL invert gently to mix F administration
(Tracon)
(F)(PFL)
116
no preservative
Treosulfan
118 7,118 119 7,118
1g pre-heat SWI to 50 mg/mL 48 h RT undiluted 48 h RT - compatible with
5g 30°C (not higher) polytetrafluoroethyl
118
(medac) shake vial carefully dilute with NS or D5W ene filters
(RT) before adding the in empty infusion bag - may require
118
no preservative warmed SWI for final concentration vigorous shaking to
118 118
1 g vial: 20 mL SWI, = 20 mg/mL reconstitute
while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
118
2 min
5 g vial: 100 mL
SWI, while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
118
2 min

Status)
vinBLAStine
120 121 122,123
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W 24 h F, RT - auxiliary info:
120
(Hospira) portion WARNING: FOR
(F)(PFL) INTRAVENOUS
120
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
124,125
ROUTES
vinBLAStine
126
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, use within 4 h of initial - auxiliary info:
126 121,127 39
(Teva) portion D5W puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
126
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
124,125
ROUTES

Status)
vinCRIStine
128 128 128 128
2 mg/2 mL N/A 1 mg/mL 8 h F, RT 50 mL* NS, D5W 24 h F, 6 h RT - auxiliary info:
5 mg/5 mL WARNING: FOR
128
(Hospira) **(PFL) INTRAVENOUS
(F)(PFL) USE ONLY –
128
no preservative FATAL IF GIVEN
BY OTHER
124,125
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)

Status)
vinCRIStine
129 129 129
1 mg/1 mL N/A 1 mg/mL 8 h F, RT 0.01-0.1 mg/mL NS, 24 h F, RT - auxiliary info:
129
2 mg/2 mL D5W WARNING: FOR
5 mg/5 mL INTRAVENOUS
(Teva) 25-50 mL NS, D5W
130
USE ONLY –
(F)(PFL) FATAL IF GIVEN
129
no preservative BY OTHER
124,125
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Vinorelbine
131 131 131
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary info:
131
50 mg/5mL portion WARNING: FOR
(Fresenius Kabi) NS, D5W, ½NS, INTRAVENOUS
(F)(PFL) D5½NS, Ringer’s, USE ONLY –
131 131
no preservative Ringer’s Lactate FATAL IF GIVEN
BY OTHER
124,125
ROUTES

Status)
Vinorelbine
132 132 132
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
132
50 mg/5 mL portion WARNING: FOR
(Hospira) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5½NS, USE ONLY –
132
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
132
Lactate BY OTHER
124,125
ROUTES
Vinorelbine
133 133 133
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
133
50 mg/5 mL portion WARNING: FOR
(Teva) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5½NS, USE ONLY –
133
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
133
Lactate BY OTHER
124,125
ROUTES
Zoledronic acid
134 134
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
134
(Dr Reddy’s) portion within 24 h of calcium containing
134 134
(RT) preparation solutions
134
no preservative
Refrigerate diluted
product if not used
immediately after
preparation; bring to
RT prior to
134
administration

Status)
Zoledronic acid
135 135
135
(Marcan) portion within 24 h of calcium containing
135
(RT) preparation solutions (e.g.,
135
no preservative Lactated
135
Refrigerate diluted Ringer’s)
product if not used
immediately after
RT prior to
135
administration
Zoledronic acid
136 136
136
(MDA) portion within 24 h of calcium containing
136 136
(RT) preparation solutions
136
no preservative
Refrigerate diluted
product if not used
immediately after
RT prior to
136
administration

Status)
Zoledronic acid
137 137
(ZOMETA) N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
39
4 mg/ 5 mL portion within 24 h of calcium containing
137 137
(Novartis) preparation solutions
(RT)
137
no preservative Refrigerate diluted
product if not used
immediately after
RT prior to
137
administration
Zoledronic acid
138 138
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 ml NS, D5W complete infusion - do NOT mix with
138
(Sandoz) portion within 24 h of calcium- or other
138
(RT) preparation divalent cation-
138
no preservative containing infusion
Refrigerate diluted solutions (e.g.,
product if not used Lactated
138
immediately after Ringer’s)
RT prior to
138
administration
* 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.
*** Contains DMA (N,N dimethylacetamide). Product may be incompatible with closed system transfer devices such as ChemoLock.
Centres are not to change the content locally but should forward suggestions to the Cancer Drug Manual staff.

Explanatory Notes
Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the classification
139,140
outlined in USP 797.
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 fridge stability is bolded as preferred (ie, to minimize
growth of micro-organisms).
Discard unused portion: Unused portion from single use vials should be discarded at the end of the day.
“overfill known” is stated if the manufacturer states overfill that is present is within acceptable limits.
“Complete administration within __” is stated if the manufacturer specifies that the infusion must be completed in a specific time frame following preparation,
usually including entire time required for preparation (from first puncture), storage, and administration of infusion.
Abbreviations
BWI = bacteriostatic water for injection
CIVI: ambulatory pump = Continuous Intravenous Infusion (e.g., elastomeric infusor)
D5W = dextrose 5% in water
DMA = N,N dimethylacetamide
F = refrigerate
Non-DEHP = not containing Di(2-ethylhexyl) phthalate (DEHP)
NS = normal saline
PFL = protect from light
RT = room temperature
SWI = sterile water for injection
References
1. Generic Medical Partners Inc. Leucovorin calcium injection product monograph. Toronto, Ontario; 13 August 2018.
2. BC Cancer. Provincial Pharmacy Directive Number II-20: Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer; 5 December 2018.
3. Pfizer Canada Inc. Leucovorin calcium injection product monograph. Kirkland, Quebec; 21 June 2018.
4. Teva Canada Limited. Leucovorin calcium injection® product monograph. Toronto, Ontario; 5 May 2014.
5. Hospira Healthcare Corporation. LEUCOVORIN CALCIUM INJECTION® product monograph. Saint-Laurent, Quebec; 7 June 2007.
6. Novopharm Limited (Teva). LEUCOVORIN CALCIUM® Injection product information package. Toronto, Ontario; undated.
7. BC Cancer Agency. Pharmacy Policy Number II-20: Guiding Principles for Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer Agency; 6 January 2006.
8. Jenny Yeung. Personal communication. Medical Information Specialist, Teva Canada; 12 April 2017.
9. GlaxoSmithKline Inc. Alkeran Package Insert. Mississauga, Ontario; Montreal, Quebec; 2004.
11. Baxter Corporation. UROMITEXAN® product monograph. Mississauga, Ontario; 6 August 2013.
12. Mona Ghobros BPharm MSc. Personal communication. Medical Information, Baxter Corporation; 29 November 2018.
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BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 1/49

transfer 1.5mL from

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 2/49

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 3/49

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 4/49

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 5/49

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record time of if a closed system

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 7/49

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swirl gently; do NOT

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do NOT use D5W

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swirl gently; avoid

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Let sit for 5

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(e.g., 50-1000 mL*

CIVI: ambulatory complete within 8

(e.g., 50-1000 mL*

CIVI: ambulatory complete within

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CIVI: ambulatory complete within

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vial contents under

do NOT use BWI to

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Interferon Alfa -2b

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Interferon Alfa -2b

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