Chemo Stability Chart - LtoZ PDF

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)
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
BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 1/41
This document may not be reproduced in any form without the express written permission of BC Cancer Provincial Pharmacy.
Activation Date: 2 March 2006
Revised Date: 20 September 2019
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 11
400 mg/4 mL N/A 100 mg/mL discard unused greater than 1 mg/mL 24 h RT
11
1000 mg/10 mL portion in D5W, D5½NS, NS,
11-13
(Baxter) (use filter needle to LR
(RT) withdraw from
11
no preservative ampoule)
Mesna
11 11 11
1000 mg/10 mL N/A 100 mg/mL 8 days RT greater than 1 mg/mL 24 h RT
5000 mg/50 mL in D5W, D5½NS, NS,
11-13
(Baxter) (vial may be LR
(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
25 mg/12.5 mL portion
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)
Olaratumab
48 48
500 mg/50 mL N/A 10 mg/mL discard unused dilute to a final complete - do NOT shake
39,48
(Lilly) portion volume of 250 mL administration within
48
(F)(PFL) NS 24 h F, plus an
48
do not shake additional 12 h RT
48
no preservative do NOT use D5W or
other dextrose
48
containing solutions
48
gently invert to mix
Oxaliplatin
49
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-0.4 mg/mL: - do NOT use
49
100 mg/20 mL portion 24 h RT aluminum-
49
200 mg/40 mL (0.2-0.7 mg/mL or containing needle,
49
(Hospira/Pfizer) 5 d F plus an syringe or tubing
49,51
(RT) do NOT use NS or additional 8 h RT
49
no preservative other chloride-
50
containing solutions 0.5–2 mg/mL:
24 h RT
do NOT use or
aluminum-containing 14 d F plus an
50 49,51
needle and syringe additional 8 h RT
Status)
Oxaliplatin
50 39,52 50
50 mg/10 mL N/A 5 mg/mL 2 d F, RT 0.2-0.7 mg/mL 0.2-2 mg/mL:
50
100 mg/20 mL 24 h RT, 48 h F
50
150 mg/30 mL 250-500 mL D5W
200 mg/40 mL
(Sandoz) do NOT use NS or
(RT)(PFL) other chloride-
50 50
no preservative containing solution
do NOT use
aluminum-containing
50
needle and syringe
Oxaliplatin
53
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
53 53
100 mg/20 mL portion 24 h RT, 48 h F aluminum-
53
200 mg/40 mL (0.2-0.7 mg/mL) containing needle,
53
(Teva) syringe or tubing
(RT)(PFL) do NOT use NS or
53
no preservative other chloride-
53
containing solution
do NOT use
aluminum-containing
53
needle and syringe
Status)
PACLitaxel
54
30 mg/5 mL N/A 6 mg/ mL 30 mg: 0.3-1.2 mg/mL in NS, complete - use non-DEHP
39,54 54
100 mg/16.7 mL 48 h RT D5W, D5NS, D5LR administration within bag and tubing with
54
300 mg/50 mL 27 h RT 0.22 micron in-line
54
(Accord) 100 mg: (e.g., 100-1000 mL)* filter
39,54
(RT)(PFL) 48 h RT - avoid excessive
54 54
no preservative shaking
300 mg:
54
24 h RT
PACLitaxel
56 39,57
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
56
100 mg/16.7 mL D5W administration within bag and tubing with
56,58
56
(Biolyse) (e.g., 100-1000 mL)* filter
55
(RT)
56
no preservative
59 59
0.1 mg/mL in NS 44 h F, RT
58
0.012-0.12 mg/mL in 16 h RT
60
NS
devices with spikes

(e.g., chemo
dispensing pins) may
61
be used with vials
Status)
PACLitaxel
63 39,63,64
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
63
100 mg/16.7 mL D5W, D5NS, D5LR administration within bag and tubing with
63
63
300 mg/50 mL (e.g., 100-1000 mL)* filter
(Hospira)
(RT)(PFL)
62
preservative
PACLitaxel,
65 65
nanoparticle, albumin- 20 mL NS 5 mg/mL use immediately in empty sterile PVC, 48 h F plus an - each vial contains
66
bound (nab) (RT) or non-PVC, or non- additional 8 h RT 900 mg human
65 65 65
100 mg - slowly direct 8hF DEHP infusion bag albumin
(Celgene) diluent against side - to prevent
65
(RT)(PFL) of vial (i.e., greater **(PFL) foaming, do NOT
65
no preservative than or equal to 1 inject NS directly
65
min) during onto the powder
65
reconstitution - some settling may
occur; use mild
- let stand for agitation to
65
greater than or resuspend
equal to 5 min to wet - administer using
65
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
65
min cause filter
67,68
blockage)
Status)
Pamidronate
69 69
30 mg/10 mL N/A 3 mg/mL discard unused Less than or equal to 24 h RT - do NOT mix with
69 69
60 mg/10 mL portion 0.36 mg/mL NS, calcium containing
69 69
90 mg/10 mL D5W solutions
69
(Fresenius Kabi) 6 mg/mL
(RT)
69
no preservative
69
9 mg/mL
Pamidronate
70
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
70 70 70
60 mg/10 mL portion NS, D5W RT (total 48 h) calcium containing
90 mg/10 mL solution (e.g.,
70 70 70
(Hospira) 6 mg/mL **(PFL) Ringer’s)
(RT)
70
no preservative
70
9 mg/mL
Pamidronate
71 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
71 71 71
(Omega) 6 mg/mL **(PFL) Ringer’s)
(RT)
71
no preservative
71
9 mg/mL
Status)
Pamidronate
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
(Pfizer) 6 mg/mL **(PFL) Ringer’s)
(RT)
72
no preservative
72
9 mg/mL
Pamidronate
73 73 73
30 mg/10 mL N/A 3 mg/mL discard unused NS; D5W 24 h RT - do NOT mix with
43,73
60mg/10 mL portion calcium containing
73 73
(Sandoz Canada) 6 mg/mL Ringer’s)
RT
73
no preservative
73
9 mg/mL
PANitumumab
74 74,75
100 mg/5 mL N/A 20 mg/mL discard unused Less than or equal to 24 h F, 6 h RT - administer with
74
400 mg/20 mL portion 1000 mg: 0.2 or 0.22 micron
74 74
(Amgen) 100 mL NS in-line filter
(F)(PFL) - solution may
do not shake Greater than 1000mg: contain particulates
74 74
no preservative 150 mL NS which do not affect
74
product quality
74,75
1-10mg/mL - do not administer
74
if discoloured
Status)
pegaspargase
76 76
(pegylated N/A 750 units/mL discard unused IM: syringe: - do NOT shake
76
asparaginase E. coli) portion max volume: use within 4 h of vial
39,76
3750 units/5 mL 2 mL in children and puncture
(Shire) adolescents;
(F)(PFL) 3 mL in adults
do not shake
76
no preservative if volume greater than
above, use multiple
76
sites
IV: bag:
76
100 mL NS, D5W use within 4 h of vial
39,76
puncture
Pembrolizumab
77
100 mg/4 mL N/A 25 mg/mL discard unused 1-10 mg/mL complete - use a 0.2 to 5
39,77 77
(Merck) portion NS, D5W administration within micron in-line
77 77
(F)(PFL) 6 h RT, 24 h F filter
do not shake mix by gentle - allow vials and
77 77
no preservatives inversion diluted solutions to
come to RT prior to
77
use
- vials contain 0.25
77
mL overfill
Status)
Pembrolizumab
77 77 77
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
77
(Merck) D5W administration within 6 micron in-line
77 78
(F) direct diluent against h RT, 24 h F filter
77
no preservative side of vial during mix by gentle - allow
77
reconstitution to inversion reconstituted vials
77
avoid foaming and diluted
solutions to come
77
allow up to 5 to RT prior to use
minutes for bubbles - vials can be at RT
77
to clear for up to 24 h prior
77
to use
77
do NOT shake - vials contain 20%
77
overfill
Pemetrexed
79 79 79
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
79 79
500 mg 4.2 mL NS NS calcium containing
(Accord) solution (e.g.,
79
(RT) 500 mg: Ringer’s)
79 79
no preservative 20 mL NS
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
(Eli Lilly) solution (e.g.,
81
(RT) 500 mg: Ringer’s)
80
no preservative 20 mL preservative-
80
free NS
Status)
PERTuzumab
82 82 82
420 mg/14 mL N/A 30 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT use
39,82
(Roche) portion dextrose containing
82 82
(F)(PFL) do NOT shake mix by gentle solutions
82
no preservative inversion to avoid
82
foaming
Plerixafor
83 83 43,84
24 mg/1.2 mL N/A 20 mg/mL discard unused SC syringe 48 hours RT
83
(sanofi-aventis) portion
(RT)
83
no preservative
Porfimer
85 85
15 mg 15 mg: 2.5 mg/mL 24 h F syringe use within 4 h of initial - avoid contact with
85 7,86
75 mg 6.6 mL D5W reconstitution skin and eyes;
85
(Axcan) **(PFL) protect exposed
85 85
(RT)(PFL) 75 mg: **(PFL) area from light
85 85
no preservative 31.8 mL D5W
record time of
reconstitution
Raltitrexed
87 87 87
2 mg 4 mL SWI 0.5 mg/mL 24 h F, RT 50-250 mL NS, complete
87
(Pfizer) D5W administration within
87
(F,RT)(PFL) 24 h F, RT
87
(no preservative)
Status)
Ramucirumab
88 88 88
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL* NS 4 h RT, 24 h F - use 0.22 micron
88 88
500 mg/50 mL portion filter
89
(Eli Lilly) (0.4 – 4 mg/mL) - do NOT use
(F)(PFL) dextrose containing
88 88
(do not shake) gently invert to mix solutions
88
no preservative
88
do NOT shake
riTUXimab
90 91,92
100 mg/10 mL N/A 10 mg/mL discard unused 1-4 mg/mL NS, 24 h F, 12 h RT - once removed
90 90
500 mg/50 mL portion D5W from the fridge,
(Roche) compounded
(F)(PFL) (e.g., 250-500 mL)* product is stable
90 91,92
no preservative for 12h RT
riTUXimab
93 93 93
subcutaneous N/A 120 mg/mL discard unused SC syringe 48 h F plus 8 h RT - contains
93 93
1400 mg/11.7 mL portion hyaluronidase
1600 mg/13.4 mL - formulations are
(Roche) NOT
93
(F)(PFL) interchangeable
93
no preservative
Status)
romiDEPsin
94 94 94 94
10 mg 2.2 mL of supplied 5 mg/mL 8 h RT 500 mL NS 24 h RT - reconstituted
94,95
(Celgene Inc.) diluent solution will be
94 96
(RT) slightly viscous
39 94
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
94
diluent)
Siltuximab
97 97 97
100 mg 100 mg: 20 mg/mL 2 h RT 250 mL D5W complete - use 0.2 micron in-
97 97
400 mg 5.2 mL SWI administration within line filter
97
(Janssen) dilute to 250 mL final 6 h RT
(F)(PFL) 400 mg: volume by
97 97
no preservative 20 mL SWI withdrawing volume
from bag equal to
allow vial to come to volume of drug to be
97
room temperature added
prior to use (~30
97
minutes)
gently swirl, do NOT

97
shake
Status)
Streptozocin
98 98 98 98
1g 9.5mL NS, SWI, 100 mg/mL 48 h F, 24 h RT syringe 48 h F, 24 h RT
98
(Pfizer) D5W
(F)(PFL)
98 98
no preservative 50-500 mL* NS, 48 h F, 24 h RT
98
D5W, SWI
Temsirolimus
99,100 99,100 99,100
30 mg/1.2 mL 1.8 mL supplied 10 mg/mL 24 h RT 250 mL NS complete - use non-DEHP
99,100
(Wyeth) diluent administration within 6 bag and tubing with
99,100 99 99,100 99,100
(F)(PFL) **(PFL) h in-line filter
101
no preservative
Teniposide
102
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
102
(BMS) portion D5W for a final RT - use non-DEHP
102
(RT) concentration of 0.1-1 bag and tubing
102 102
preservative mg/mL 1 mg/mL: complete - do not use if
102,103
administration within 4 precipitates
h of preparation - contains DMA***
102,103
RT - excessive
agitation may
cause
102
precipitation
Status)
Thiotepa
104 104 104
15 mg 15 mg: 10 mg/mL 8hF reconstituted solution 4 h RT, 24 h F - do not use if
104
100 mg 1.5 mL SWI is hypotonic and must precipitates are
104
(Adienne/Methapharm) be further diluted with present
104
(F) 100 mg: NS prior to use - reconstituted
104 104
no preservative 10 mL SWI solution may be
doses ≤ 500 mg: used if
104
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
105 104 104
reconstitution concentration filter
record time of doses > 500 mg:

104
reconstitution 1000 mL NS
Status)
Thiotepa
104 104 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.,
106
(F) administration INTRATHECAL
104
no preservative injection) attached
15 mg: to both syringe and
104 26
1.5 mL SWI outer ziplock bag
- do not use if
100 mg: precipitates are
104 104
10 mL SWI present
- reconstituted
to remove haze, solution may be
filter through 0.22 used if
104
micron filter after opalescent
105
reconstitution
record time of
reconstitution
Thyrotropin alfa
107 107 107 107 107
1.1 mg 1.2 mL SWI 0.9 mg/mL 24 h F syringe 24 h F
(Genzyme)
107
(F)(PFL) swirl contents
107
no preservative
do NOT shake
Status)
Tocilizumab
108 108
80 mg/4 mL N/A 20 mg/mL discard unused 100 mL NS complete - to prevent
108
200 mg/10 mL portion administration within foaming: slowly
108
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
108 108
no preservative equal to volume of temperature prior to mix
108 108
drug to be added administration
108
gently invert to mix
Topotecan
109 2,109
4 mg/4 mL N/A 1 mg/mL discard unused 0.025-0.5 mg/mL 14 d F, 48 h RT
2,109
(Accord) portion
(RT)(PFL) 50-100 mL NS,
109 109
no preservative D5W
Topotecan
110 110 110
1 mg 1 mg: 1 mg/mL 24 h F,RT 0.02-0.5 mg/mL 24 F, RT
110
4 mg 1.1 mL SWI
(Actavis) 50-100 mL NS,
110
(RT)(PFL) 4 mg: D5W
110 110
no preservative 4 mL SWI
Topotecan
111 111
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F, RT
2,111
(Pfizer/Hospira) portion
(F)(PFL) 50-100 mL NS,
111 111
no preservative D5W
Status)
Topotecan
112 112
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F
112
(Sandoz) portion
112
(F)(PFL) 50-100 mL NS, **(PFL)
112 112
no preservative D5W
Trastuzumab
113 39 113 113 113
(HERCEPTIN®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
113
440 mg BWI
(Roche) do NOT use dextrose
113
(F) swirl vial gently; containing solutions
113
preservative allow to stand
undisturbed for 5
113
min
Status)
Trastuzumab
114 114 114
Emtansine 100 mg vial: 20 mg/mL 24 h F 250 mL NS or 0.45% 24 h F - do not use if
114
(KADCYLA®) 5 mL SWI sodium chloride only reconstituted
114 114 114
100 mg do NOT freeze do NOT freeze solution contains
160 mg 160 mg vial: visible particulates
114 114
(Roche) 8 mL SWI do NOT shake or is cloudy or
114
(F)(PFL) discolored
114
no preservative swirl gently until - dextrose 5%
completely dissolved solutions cause
aggregation of the
114
do NOT shake protein; do not
dilute with dextrose
containing
114
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%
114
NS
Status)
TRC105 (Carotuximab)
115 116
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
115,116 115
400 mg/16 mL invert gently to mix F administration
(Tracon)
(F)(PFL)
115
no preservative
Treosulfan
117 7,117 118 7,117
1g pre-heat SWI to 50 mg/mL 48 h RT undiluted 48 h RT - compatible with
5g 30°C (not higher) polytetrafluoroethyl
117
(medac) shake vial carefully dilute with NS or D5W ene filters
(RT) before adding the in empty infusion bag - may require
117
no preservative warmed SWI for final concentration vigorous shaking to
117 117
1 g vial: 20 mL SWI, = 20 mg/mL reconstitute
while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
117
2 min
5 g vial: 100 mL
SWI, while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
117
2 min
Status)
vinBLAStine
119 120 121,122
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W 24 h F, RT - auxiliary info:
119
(Hospira) portion WARNING: FOR
(F)(PFL) INTRAVENOUS
119
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
123,124
ROUTES
vinBLAStine
125
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, use within 4 h of initial - auxiliary info:
125 120,126 39
(Teva) portion D5W puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
125
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
123,124
ROUTES
Status)
vinCRIStine
127 127 127 127
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
127
(Hospira) **(PFL) INTRAVENOUS
(F)(PFL) USE ONLY –
127
no preservative FATAL IF GIVEN
BY OTHER
123,124
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Status)
vinCRIStine
128 128 128
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:
128
2 mg/2 mL D5W WARNING: FOR
5 mg/5 mL INTRAVENOUS
129
(Teva) 25-50 mL NS, D5W USE ONLY –
(F)(PFL) FATAL IF GIVEN
128
no preservative BY OTHER
123,124
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Vinorelbine
130 130 130
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary info:
130
50 mg/5mL portion WARNING: FOR
(Fresenius Kabi) NS, D5W, ½NS, INTRAVENOUS
(F)(PFL) D5½NS, Ringer’s, USE ONLY –
130 130
no preservative Ringer’s Lactate FATAL IF GIVEN
BY OTHER
123,131
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:
2
50 mg/5 mL portion WARNING: FOR
(GMP) 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
123,131
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
(Pfizer/Hospira) 50 mL* NS, D5W, INTRAVENOUS
133
133
Lactate BY OTHER
123,131
ROUTES
Vinorelbine
134 134 134
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
134
(Teva) 50 mL* NS, D5W, INTRAVENOUS
134
134
Lactate BY OTHER
123,131
ROUTES
Status)
Zoledronic acid
135 135
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
135
(Dr Reddy’s) portion within 24 h of calcium containing
135 135
(RT) preparation solutions
135
no preservative
Refrigerate diluted
product if not used
immediately after
preparation; bring to
RT prior to
135
administration
Zoledronic acid
136 136
136
(Marcan) portion within 24 h of calcium containing
136
(RT) preparation solutions (e.g.,
136
no preservative Lactated
136
Refrigerate diluted Ringer’s)
product if not used
immediately after
RT prior to
136
administration
Status)
Zoledronic acid
137 137
137
(MDA) portion within 24 h of calcium containing
137 137
(RT) preparation solutions
137
no preservative
Refrigerate diluted
product if not used
immediately after
RT prior to
137
administration
Zoledronic acid
138 138
(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
138 138
(Novartis) preparation solutions
(RT)
138
no preservative Refrigerate diluted
product if not used
immediately after
RT prior to
138
administration
Status)
Zoledronic acid
139 139
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 ml NS, D5W complete infusion - do NOT mix with
139
(Sandoz) portion within 24 h of calcium- or other
139
(RT) preparation divalent cation-
139
no preservative containing infusion
Refrigerate diluted solutions (e.g.,
product if not used Lactated
139
immediately after Ringer’s)
RT prior to
139
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
140,141
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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Chemo Stability Chart - LtoZ PDF

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BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART

(e.g., 50-250 mL*) D10W, D5-NS:

(e.g., 50-250 mL*) D10W, D5NS:

(e.g., 50-250 mL*)

0.06 - 0.4 mg/mL NS, NS:

0.06 - 1 mg/mL Ringer’s, LR:

high dose use within 24 h RT of

high dose use within 24 h RT of

devices with spikes

gently swirl, do NOT

record time of doses > 500 mg:

BWI = bacteriostatic water for injection

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