ANTIBIOTIC COMPATIBILITIES & STORAGE CONDITIONS

Name of Amikacin
Antibiotic
Formulation IV

Store intact vials at 20°C to 25°C (68°F to 77°F).

Following admixture at concentrations of 0.25-5 mg/mL,
amikacin is stable for 24 hours at room temperature, 60
Storage
days at 4°C (39°F), or 30 days at -15°C (5°F). Previously
refrigerated or thawed frozen solutions are stable for 24
hours when stored at 25°C (77°F).

Stable in dextran 75 6% in NS, D5LR, D51/4NS, D51/3NS,

D51/2NS, D5NS, D10NS, D5W, D10W, D20W, LR, mannitol
Compatibility 20%, 1/4NS, 1/2NS, NS; variable stability in peritoneal
dialysis solutions.

Name of Gentamicin
Antibiotic
Formulation IV/TOPICAL

Store at controlled room temperature of 20°C to 25°C

Storage
(68°F to 77°F).

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 Stable in dextran 40, D5W, D10W, mannitol 20%, LR,
NS; incompatible with fat emulsion 10%; variable
Compatibility
stability in peritoneal dialysis solution.

Name of Antibiotic AMOXICILLIN

Formulation IV/ORAL

Amoxicillin 250 mg and 500 mg capsules, and 125

mg/5 mL and 250 mg/5 mL unreconstituted
powder: Store at or below 20°C (68°F).

Amoxicillin 500 mg and 875 mg tablets, and 200 mg/5

mL and 400 mg/5mL unreconstituted powder:
Store at or below 25°C (77°F).
Storage
Reconstituted oral suspension remains stable for 14
days at room temperature or if refrigerated
(refrigeration preferred). Unit-dose antibiotic oral
syringes are stable at room temperature for at least
72 hours (Tu 1988).

Name of Antibiotic AMOXICILLIN + CLAVULANATE

Formulation IV/ORAL

Storage Powder for oral suspension: Store dry powder at or

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 below 25°C (77°F). Reconstituted oral suspension
should be kept in refrigerator. Discard unused
suspension after 10 days (consult manufacturer's
labeling for specific recommendations). Unit-dose
antibiotic oral syringes are stable under
refrigeration for 24 hours (Tu 1988).

Tablet: Store at or below 25°C (77°F). Dispense in

original container.

Name of Antibiotic AMPICILLIN

Formulation IV/ORAL

Incompatible in D5W, D5NS, D10W, fat emulsion 10%,

hetastarch 6%, LR; variable stability (consult detailed
Compatibility
reference) in NS.

Storage
Oral:

Capsules: Store at 20°C to 25°C (68°F to 77°F).

Oral suspension: Store dry powder at 20°C to 25°C

(68°F to 77°F). Once reconstituted, oral
suspension is stable for 14 days under
refrigeration.

IV:

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 Store intact vials at 20°C to 25°C (68°F to 77°F).

Solutions for IM or direct IV should be used within

1 hour.

Stability of parenteral admixture in NS at 25°C

(77°F) is 8 hours (concentrations up to 30
mg/mL) and at 4°C (39°F) is 24 hours
(concentration of 30 mg/mL) or 48 hours
(concentrations up to 20 mg/mL). Protect from
freezing.

Name of Antibiotic
Piperacillin + Tazobactam

Formulation IV

Stable in D5W, NS, sterile water for injection; LR

(EDTA formulated product only); variable stability
Compatibility (consult detailed reference) in peritoneal dialysis
solution.

Storage
Vials: Store intact vials at 20°C to 25°C (68°F to 77°F).
Use single-dose or bulk vials immediately after
reconstitution. Discard any unused portion after 24
hours if stored at 20°C to 25°C (68°F to 77°F) or

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 after 48 hours if stored at 2°C to 8°C (36°F to
46°F). Do not freeze vials after reconstitution.
Stability in IV bags has been demonstrated for up
to 24 hours at room temperature and up to 1 week
at refrigerated temperature. Stability in an
ambulatory IV infusion pump has been
demonstrated for a period of 12 hours at room
temperature.

Galaxy containers: Store at or below -20°C (-4°F). The

thawed solution is stable for 14 days at 2°C to 8°C
(36°F to 46°F) or 24 hours at 20°C to 25°C (68°F
to 77°F). Do not refreeze.

Name of Antibiotic
Penicillin G

Formulation IV

Inactivated in acidic or alkaline solutions.

Penicillin G potassium: Stable in dextran 6% in

dextrose, dextran 6% in NS, D5LR, D51/4NS,
D51/2NS, D5NS, D5W, D10W, LR, 1
/2NS, NS,
Compatibility
hetastarch 6%; incompatible with dextran 70 6%
in dextrose, dextran 40 10% in dextrose; variable
stability (consult detailed reference) in fat
emulsion 10%, peritoneal dialysis solutions.

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 Penicillin G sodium: Stable in dextran 40 10%;
incompatible with fat emulsion 10%; variable
stability (consult detailed reference) in D5W, NS,
peritoneal dialysis solution.

Storage
Penicillin G potassium powder for injection should be
stored below 86°F (30°C). Following
reconstitution, solution may be stored for up to 7
days under refrigeration. Premixed bags for
infusion should be stored in the freezer (-20°C or -
4°F); frozen bags may be thawed at room
temperature or in refrigerator. Once thawed,
solution is stable for 14 days if stored in
refrigerator or for 24 hours when stored at room
temperature. Do not refreeze once thawed.

Penicillin G sodium powder for injection should be

stored at controlled room temperature.
Reconstituted solution may be stored under
refrigeration for up to 3 days.

Name of Antibiotic PENICILLIN V

Formulation ORAL
Storage
Refrigerate suspension after reconstitution; discard

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 after 14 days.

Name of Antibiotic AZTREONAM

Formulation IV
Compatibility
Solution for infusion: Stable in D5LR, D51/4NS,
D51/2NS, D5NS, D5W, D10W, mannitol 5%, mannitol
10%, LR, NS; variable stability (consult detailed
reference) in peritoneal dialysis solution.

Storage
Vials: Prior to reconstitution, store at room
temperature; avoid excessive heat. After
reconstitution, solutions for infusion with a final
concentration of ≤20 mg/mL should be used within
48 hours if stored at room temperature or within 7
days if refrigerated. Solutions for infusion with a
final concentration of >20 mg/mL (if prepared with
SWFI or NS only) should also be used within 48
hours if stored at room temperature or within 7
days if refrigerated; all other solutions for infusion
with a final concentration >20 mg/mL must be
used immediately after preparation (unless
prepared with SWFI or NS).

Premixed frozen containers: Store unused container

frozen at ≤-20°C (-4°F). Frozen container can be

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 thawed at room temperature of 25°C (77°F) or in a
refrigerator, 2°C to 8°C (36°F to 46°F). Thawed
solution should be used within 48 hours if stored at
room temperature or within 14 days if stored under
refrigeration. Do not freeze.

Name of Antibiotic
Meropenem

Formulation IV
Compatibility
Stable in NS for 1 hour at controlled room temperature
and up to 15 hours refrigerated. Duplex container: Do
not admix with other drugs. Variable stability (consult
detailed reference) in D5LR, D51/4NS, D5NS, D5W,
D10W, LR, 1/2NS, mannitol 2.5%, mannitol 10%,
sodium bicarbonate 5%. Note: Meropenem stability
(admixed with NS at a concentration of 20 mg/mL) at
room temperature for >1 hour or under refrigeration for
>15 hours is not supported by the manufacturer. Data
exist supporting stability (admixed with NS at a
concentration of 20 mg/mL) at room temperature for ≤4
hours and under refrigeration ≤24 hours

Storage
Freshly prepared solutions should be used. However,

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 constituted solutions maintain satisfactory potency
under the conditions described below. Solutions should
not be frozen.

Store intact vials and unactivated Duplex containers at

20°C to 25°C (68°F to 77°F). Unactivated duplex
units with foil strip removed from the drug
chamber must be protected from light and used
within 7 days at room temperature. Once activated,
must be used within 1 hour if stored at room
temperature or within 15 hours if stored under
refrigeration. Do not freeze.

Dry powder should be stored at controlled room

temperature 20°C to 25°C (68°F to 77°F).

Reconstitution Infusion admixture (1 to 20 mg/mL): Solution is stable

when diluted in NS for 1 hour at up to 25°C (77°F) or
15 hours at up to 5°C (41°F). Solutions constituted with
dextrose injection 5% should be used immediately.
Note: Meropenem stability (admixed with NS at a
concentration of 20 mg/mL) at room temperature for >1
hour or under refrigeration for >15 hours is not
supported by the manufacturer. Data exist supporting
stability (admixed with NS at a concentration of 20
mg/mL) at room temperature for ≤4 hours and under
refrigeration ≤24 hours

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Name of Antibiotic Ertapenem
Formulation IV
Compatibility
Stable in NS; per manufacturer do not mix with other
medications or use diluents containing dextrose.

Storage
Prior to reconstitution, store vials at ≤25°C (77°F). The
reconstituted IM solution should be used within 1 hour
after preparation. The reconstituted IV solution may be
stored at room temperature (25°C [77°F]) and used
within 6 hours, or stored for 24 hours under
refrigeration (5°C [41°F]) and used within 4 hours after
removal from refrigeration. Do not freeze.

Name of Antibiotic CEFAZOLIN

Formulation IV
Compatibility
Stable in D5W, D5LR, D51/4NS, D51/2NS, D5NS,
D10W,LR, NS; variable stability (consult detailed
reference) in peritoneal dialysis solutions.

Storage
Store intact vials at room temperature and protect from
temperatures exceeding 40°C. Reconstituted solutions
of cefazolin are light yellow to yellow. Protection from

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 light is recommended for the powder and for the
reconstituted solutions. Reconstituted solutions are
stable for 24 hours at room temperature and for 10 days
under refrigeration. Stability of parenteral admixture at
room temperature (25°C) is 48 hours. Stability of
parenteral admixture at refrigeration temperature (4°C)
is 14 days.

Name of Antibiotic CEFIXIME

Formulation ORAL
Storage
Capsule, chewable tablet, tablet: Store at 20°C to 25°C
(68°F to 77°F).

Powder for suspension: Prior to reconstitution, store at

20°C to 25°C (68°F to 77°F). After reconstitution,
suspension may be stored for 14 days at room
temperature or under refrigeration.

Name of Antibiotic CEFUROXIME

Formulation IV/ORAL
Compatibility
Stable in D51/4NS, D51/2NS, D5NS, D5W, D10W, LR,
NS.

Storage
Injection: Store intact vials at 15°C to 30°C (59°F to

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 86°F); protect from light. Reconstituted solution is
stable for 24 hours at room temperature and 48
hours when refrigerated. IV infusion in NS or D5W
solution is stable for 24 hours at room temperature,
7 days when refrigerated, or 26 weeks when frozen.
After freezing, thawed solution is stable for 24
hours at room temperature or 21 days when
refrigerated.

Oral suspension: Prior to reconstitution, store at 2°C to

30°C (36°F to 86°F). Reconstituted suspension is
stable for 10 days at 2°C to 8°C (36°F to 46°F).

Tablet: Store at 15°C to 30°C (59°F to 86°F).

Name of Antibiotic CEFTRIAXONE

Formulation IV
Compatibility
Stable in D5W with KCl 10 mEq, D51/4NS with KCl 20
mEq, D51/2NS, D5W, D10W, NS, mannitol 5%, mannitol
10%, sodium bicarbonate 5%, bacteriostatic water,
sterile water for injection. Incompatible with calcium-
containing solutions (eg, LR, D5LR, D5R, Hartmann’s
solution, parenteral nutrition solutions). Variable
stability (consult detailed reference) in peritoneal
dialysis solutions.

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Storage
Powder for injection: Prior to reconstitution, store at
≤25°C (≤77°F). Protect from light.

Premixed solution (manufacturer premixed): Store at -

20°C; once thawed, solutions are stable for 3 days
at 25°C (77°F) or for 21 days at 5°C (41°F). Do not
refreeze.

Name of Antibiotic CEPHALEXIN

Formulation ORAL
Storage
Capsule: Store at 15°C to 30°C (59°F to 86°F).

Powder for oral suspension: Refrigerate suspension

after reconstitution; discard after 14 days.

Tablet: Store at 20°C to 25°C (68°F to 77°F).

Name of Antibiotic Ciprofloxacin

Formulation IV/ORAL
Compatibility
Stable in D51/4NS, D51/2NS, D5W, D10W, LR, NS,
SWFI; variable stability (consult detailed reference)
in peritoneal dialysis solution.

Storage
Injection:

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 Premixed infusion: Store between 5°C to 25°C
(41°F to 77°F); avoid freezing. Protect from
light.

Vial: Store between 5°C to 30°C (41°F to 86°F);

avoid freezing. Protect from light. Diluted
solutions of 0.5-2 mg/mL are stable for up to
14 days refrigerated or at room temperature.

Microcapsules for oral suspension: Prior to

reconstitution, store below 25°C (77°F). Protect
from freezing. Following reconstitution, store
below 30°C (86°F) for up to 14 days. Protect from
freezing.

Tablet:

Immediate release: Store between 20°C to 25°C

(68°F to 77°F); excursions are permitted
between 15°C and 30°C (59°F and 86°F).

Extended release: Store at 25°C (77°F); excursions

are permitted between 15°C and 30°C (59°F
and 86°F).

Name of Antibiotic
Levofloxacin

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Formulation IV/ORAL
Compatibility
Stable in D5LR, D5NS, D51/2NS with 20 mEq/L KCl,
D5W, NS, Plasma-Lyte® 56 in 5% dextrose, sodium
lactate (M/6); incompatible with mannitol 20%,
sodium bicarbonate 5%.

Storage
Stable in D5LR, D5NS, D51/2NS with 20 mEq/L KCl,
D5W, NS, Plasma-Lyte® 56 in 5% dextrose, sodium
lactate (M/6); incompatible with mannitol 20%,
sodium bicarbonate 5%.

Name of Antibiotic OFLOXACIN

Formulation IV/ORAL
Storage
Store at 25°C (77°F); excursions permitted to 15°C to
30°C (59°F to 86°F).

Name of Antibiotic Tetracycline

Formulation ORAL
Storage
Store at 20°C to 25°C (68°F to 77°F); protect from
light. Use of outdated tetracyclines has caused a
Fanconi-like syndrome (nausea, vomiting, acidosis,

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 proteinuria, glycosuria, aminoaciduria, polydipsia,
polyuria, hypokalemia).

Name of Antibiotic
Doxycycline

Formulation IV
Compatibility
Solutions for IV infusion are stable in NS, D5W,
Ringer's injection, LR, D5LR.

Storage
IV infusion: Protect from light. Stability varies based
on solution.

Name of Antibiotic Trimethoprim-sulfamethoxazole (co-trimoxazole):

Formulation IV/ORAL
Compatibility
Stable in D5W, D51/2NS, LR, 1/2NS; variable stability
(consult detailed reference) in NS.

Storage Injection: Store at room temperature; do not refrigerate.

Less soluble in more alkaline pH. Protect from
light. Solution must be diluted prior to
administration. Following dilution, store at room
temperature; do not refrigerate. Manufacturer

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 recommended dilutions and stability of parenteral
admixture at room temperature (25°C):

5 mL/125 mL D5W; stable for 6 hours.

5 mL/100 mL D5W; stable for 4 hours.

5 mL/75 mL D5W; stable for 2 hours.

Suspension, tablet: Store at controlled room

temperature of 15°C to 25°C (59°F to 77°F).
Protect from light.

Name of Antibiotic AZITHROMYCIN

Formulation
Compatibility
Stable in D5W, D5LR, D51/4NS, D51/3NS, D51/2NS (with
or without 20 mEq/L KCl), Normosol®-M in D5,
Normosol®-R in D5, LR, NS, 1/2NS.

Storage
Injection: Store intact vials of injection at room
temperature. Reconstituted solution is stable for 24
hours when stored below 30°C (86°F). The diluted
solution is stable for 24 hours at or below room
temperature (30°C [86°F]) and for 7 days if stored
under refrigeration (5°C [41°F]).

Suspension, immediate release: Store dry powder

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 below 30°C (86°F). Store reconstituted suspension
at 5°C to 30°C (41°F to 86°F) and use within 10
days.

Suspension, extended release : Store dry powder ≤30°C

(86°F). Following reconstitution, store at 25°C
(77°F); excursions permitted to 15°C to 30°C
(59°F to 86°F); do not refrigerate or freeze. Should
be consumed within 12 hours following
reconstitution.

Tablet : Store between 15°C to 30°C (59°F to 86°F).

Name of Antibiotic Metronidazole

Formulation IV/ORAL
Compatibility Stable in D5W, LR, NS.
Storage
Oral:

Extended release: Store at 25°C (77°F); excursions

are permitted between 15°C and 30°C (59°F
and 86°F).

Immediate release: Store at 15°C to 25°C (59°F to

77°F). Protect the tablets from light.

Injection: Store at 20°C to 25°C (68°F to 77°F). Protect

from light. Avoid excessive heat. Do not refrigerate. Do
not remove unit from overwrap until ready for use.

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 Discard unused solution.

Name of Antibiotic LINEZOLID

Formulation IV/ORAL
Compatibility
Stable in D51/2 NS, D5W, LR, NS

Storage
Infusion: Store at 25°C (77°F). Protect from light and
freezing. Keep infusion bags in overwrap until
ready for use.

Oral suspension: Store at 25°C (77°F); following

reconstitution store at room temperature and use
suspension within 21 days. Protect from light.

Tablet: Store at 25°C (77°F). Protect from light and

moisture.

Name of Antibiotic VANCOMYCIN

Formulation IV
Compatibility
Stable in D5NS, D5W, D10W, LR, NS; variable
stability in peritoneal dialysis solutions, TPN.

Storage
Vials: Store at 20°C to 25°C (68°F to 77°F). After

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 initial reconstitution with sterile water for injection,
D5W or NS, solutions are stable for 14 days if
refrigerated. After further dilution with D5W or
NS, the solution may be stored in a refrigerator for
14 days without significant loss of potency.
Solutions diluted with D5W and NS, LR, D5LR, or
Normosol-M and dextrose 5% may be stored in a
refrigerator for 96 hours.

Name of Antibiotic
Imipenem + Cilastatin

Formulation IV
Compatibility Variable stability in D5W, D5LR, D51/4NS, D51/2NS,
D5NS, D10W, mannitol 2.5%, mannitol 5%, mannitol
10%, NS, TPN.
Storage
Imipenem/cilastatin powder for injection should be
stored at <25°C (77°F).

IV: Reconstituted IV solutions are stable for 4 hours at

room temperature and 24 hours when refrigerated.
Do not freeze.

Name of Antibiotic RIFAMPICIN

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Formulation ORAL
Compatibility
Variable stability in D5W, NS.

Storage
Store capsules and intact vials at 25°C (77°F);
excursions permitted to 15°C to 30°C (59°F to 86°F);
avoid excessive heat (>40°C [104°F]). Protect the intact
vials from light. Reconstituted vials are stable for 24
hours at room temperature.

Name of Antibiotic Colistin (colistimethate)

Formulation IV
Compatibility
Stable in D51/4NS, D51/2NS, D5NS, D5W, LR, NS.

Storage Store intact vials (prior to reconstitution) at 20°C to

25°C (68°F to 77°F); excursions permitted to 15°C to
30°C (59°F to 86°F). Reconstituted vials may be
refrigerated at 2°C to 8°C (36°F to 46°F) or stored at
20°C to 25°C (68°F to 77°F) for up to 7 days. Solutions
for infusion should be freshly prepared; do not use
beyond 24 hours.

Name of Antibiotic Tigecycline

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Formulation IV
Compatibility
Stable in NS, D5W, or LR.

Storage
Prior to reconstitution, store at 20°C to 25°C (68°F to
77°F); excursions are permitted between 15°C and
30°C (59°F and 86°F). Reconstituted solution may be
stored at room temperature (not to exceed 25°C [77°F])
for up to 6 hours in the vial or up to 24 hours if further
diluted in a compatible IV solution. Alternatively, may
be stored refrigerated at 2°C to 8°C (36°F to 46°F) for
up to 48 hours following immediate transfer of the
reconstituted solution into NS or D5W.

Name of Antibiotic Chloramphenicol

Formulation IV/ORAL
Compatibility Stable in dextran 6% in dextrose, dextran 6% in NS,
D5LR, D51/4NS, D51/2NS, D5NS, D5W, D10W, fat
emulsion 10%, LR, 1/2NS, NS.
Storage
Store at room temperature prior to reconstitution.
Reconstituted solutions remain stable for 30 days. Use
only clear solutions. Frozen solutions remain stable for
6 months.

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