ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
12 hrs RT 5 days RT IM not recommended
Acetazolamide SWFI 5 ml 100 mg/ml
3 days Ref
10 mg/ml 30 min. 100 mg/ml 1 minute D5W, NS
7 days Ref see IV Push guideline
Paracetamol overdose
150 mg/kg in 200 ml D5W over 15 min - - Paracetamol Antidote
Acetylcysteine 50 mg/kg in 500 ml D5W over 4 hrs
- - 200 mg/ml 96 hrs RT 100 mg/kg in 1L D5W over 16 hrs D5W 24 hrs RT
200 mg/ml
Intermittent infusion Intermittent infusion I f i Max.
Infusion M conc. see Continuous Infusion
10 mg/ml 15 min.
60 min. 50 mg/ml Drip guideline

7 mg/ml Do Not Refrigerate

Acyclovir
SWFI 5 ml 50 mg/ml 12 hrs RT 5 mg/ml 60 min Fluid restricted 60 min D5W, NS 24 hrs RT (precipitation)
250 mg/vial 10mg/ml IM must be avoided
Adenosine Dose followed by
(Adenocur) - - 3 mg/ml 24 hrs RT 3 mg/ml (undiluted) 2 - 3 sec
sec. 3 mg/ml 2 - 3 sec
sec. Undiluted 24 hrs RT rapid NS flush
3 mg/ml see IV Push guideline

Adrenaline Infusion Max. Titrate to see Continuous

Infusion conc. 24 hrs RT
(Epinephrine) - - 1 mg/ml Use immediately Titration conc. patient D5W, NS IV Drip guideline
60 mcg/ml response
24 hrs Ref
see IV Push guideline
1 mg/ml 120 mcg/ml
Alfacalcidol
Use
(Calcijex) - - 2 mcg/ml Use immediately see IV Push Protocol 2 - 3 min 2 mcg/ml 2 - 3 min Undiluted see IV Push guideline
immediately
2 mcg/ml
Albumin 50 mg/ml 2 -4 ml/min
Use NS as diluent
(5%) 4 hrs after (5%) 4 hrs after
5% - -
200 mg/ml opening
-
1 ml/min
No dilution required - -
opening
SWFI makes the sol'n
20% hypotonic
(20%) (20%)

Alprostadil - - 500 mcg/ml 1 - 10 mcg/ml 0 1 mcg/kg/min

0.1 20 mcg/ml - D5W D10W
D5W, D10W, NS
Discard unused 24 hrs RT/Ref
(Prostin VR 500 mcg/ml) Protect from freezing
portion
(Prostavasin 20 mcg/ml)
SWFI 1 ml 20 mcg/ml 20 mcg/50 ml 60 min 40 mcg/100 ml 60 min NS 24 hrs RT/Ref
Frozen TPA 2 mg/2ml
Alteplase (r-tPA) 50 8 hrs after
SWFI 50 ml 1 mg/ml 1 mg/ml over 2 hrs 1 mg/ml 30 min NS 24 hrs RT to clear occluded venous
mg/vial reconstitution
catheter
Draw Peak 30 min after
Amikacin 30 min.
completion of infusion or at
500 mg/2 ml 24 hrs after If dose >1 Gm 24 hrs RT
- - 250 mg/ml 5 mg/ml 30 -60 min 10 mg/ml D5W, NS 1 hr after IM injection.
Give 1 hr apart from opening infuse over 7 days Ref
Draw Trough immediately
other antibiotics 60 min
before next dose.
D5W is
Bolus in 100 ml Aminophylline is equivalent
preferred.
Aminophylline 24 hrs after 48 hrs RT to 80% Theophylline.
- - 25 mg/ml
opening
Infusion: 30 min. Bolus 25 mg/ml 25 mg/min Compatible with
48 hrs Ref See Continuous IV drip
250 mg/ml commonly used
1 mg/ml guideline
guideline.
IV fluid.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter ; mcg -
microgram; meq - milliequivalent; u - units; RT - room temperature; Ref - refrigerate; Conc. - concentration

67
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Amiodarone - - 50 mg/ml Discard IV Push: 15 mg/min Peripheral: 30 mg/min D5W only 24 hrs RT Conc. > 2 mg/ml infuse
50 mg/ml ampule Dose/20 - 30 ml < 2 mg/ml 24 hrs Ref thru central line using
after use Infusion: 24 hrs Central: Not compatible pump.
1 - 6 mg/ml 2 - 6 mg/ml with NS Infusion > 2 hrs use
glass or PVC free bag
Amoxicillin + SWFI 10 ml 60 mg/ml < 600 mg
g 30 min. 100 mg/ml 5 min 600 mg in 4 hrs RT Dose must be
Clavulanic Acid ( 600 mg ) Use in 50 ml IV Push 50 ml NS 8 hrs Ref based on
( Augmentin ) immediately 601 mg - 1.2 Gm Amoxicillin.
600 mg/vial 20 ml in 100 ml 1.2 Gm in
1.2 Gms/vial ( 1.2 Gm ) 100 ml NS * Late mix *
Amphotericin B SWFI 10 ml 5 mg/ml 24 hrs Ref 0.1 mg/ml 4 - 6 hrs 0.25 mg/ml 4 hrs D5W only 24 hrs RT Test Dose: 1 mg/20 ml D5W
((Fungizone)
g ) via central line 24 hrs Ref over 20 - 30 min.
50 mg/vial Flush with D5W Protect from light.
sol'n only Monitor temp., pulse, RR
and BP q30min x4 hrs
Amphotericin B, SWFI 12 ml 4 mg/ml 24 hrs Ref Infusion: 2 hrs 2 mg/ml 60 min D5W only 6 hrs after If test dose is required:
Liposomal 1 mg/ml dilution Test dose: 1 mg/10 ml
( Ambisome ) Flush with D5W at RT D5W over 10 min.
50 mg/ml sol'n only Precipitates in NS.
15 hrs Ref Use 5 micron filter in
preparation.
Use an in-line filter
of not less than
1 micron in infusion.

Ampicillin SWFI 5 ml 100 mg/ml 1 hr RT IV Push: 100 mg/ml IV Push: 3 - 5 min 100 mg/min NS is the 8 hrs RT For IM use:
500 mg/vial ( 500 mg ) Intermittent Infusion: IV Push preferred 500 mg = 1.8 ml SWFI
1 Gm/vial < 1 Gm in 50 ml NS 30 min. 100 mg/ml diluent. 3 days Ref 1 Gm = 3.5 ml SWFI
9.6 ml 100 mg/ml 15 min. 2 Gms = 6.8 ml SWFI
( 1 Gm ) 1.1 - 2 Gm in 100 ml NS 30 min. infusion IM site - intragluteal
( Thigh )
Antithymocyte - - 20 mg/ml Use 1 mg/ml 6 hrs 4 mg/ml 4 hrs NS only 12 hrs RT Test dose: 0.05 ml
Globulin ( ATG ) immediately subcutaneous or ID
( Rabbit ) 24 hrs Ref Infuse thru an in-line
20 mg/ml filter 0.22 micron.
Antithymocyte - - 50 mg/ml Use 4 mg/ml 4 hrs 4 mg/ml 4 hrs D5 1/2 NS Test dose: 0.005 mg /0.1 ml
Globulin ( ATG ) immediately D5 1/4 NS 24 hrs Ref Preparation: 0 1ml of 50mg/ml = 5 mg
0.1ml
( Horse or Equine) NS Further dilute 5 mg in 10 ml NS = 0.5mg/ml

50 mg/ml Further dilute 0.5 mg in 10 ml NS = 0.05mg/ml

Get 0.1ml from final dilution = 0.005mg

Arginine - - 100 mg/ml 24 hrs RT 100 mg/ml 30 min. 100 mg/ml 30 min. No further Discard Administer by central
100 mg/ml dilution unused line only.
needed. portion.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter 68
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Atenolol - - 0.5 mg/ml Use 0.5 mg/ml 1 mg/min 0.5 mg/ml 1 mg/min No further Discard see IV push guieline.
(Tenormin) immediately undiluted dilution unused
0.5 mg/ml needed. portion.
Atosiban - - 7.5 mg/ml Use 0.75 mg/ml as per 0.75 mg/ml as per NS, D5W 24 hrs RT Initial dose: 6.75mg in
( Tractocile ) immediately Protocol Protocol or RL 24 hrs Ref 0.9 ml over 1 min.
Remove 10 ml Followed by 18 mg/hr
from 100 ml IV for 3 hrs then
sol'n then add continuous infusion of
10 ml of drug 6 mg/hr up to 45 hrs
Atropine - - 0.6 mg/ml Use 0.6 mg/ml 1 mg or less 0.6 mg/ml 1 mg or less Undiluted Use see IV Push
Sulfate immediately over 1 min over 1 min immediately guideline.
0.6 mg/ml
Azathioprine SWFI 10 ml 5 mg/ml 24 hrs Ref 10 mg/ml 5 min 10 mg/ml 5 min D5W or NS 24 hrs RT IM not
( Imuran ) IV Push IV Push IV Push 24 hrs Ref recommended.
50 mg/vial Infusion: Infusion: Infusion:
2 mg/ml 15-60 min 15-60 min
Azithromycin SWFI 5 ml 100 mg/ml 24 hrs RT 1 mg/ml 3 hrs 2 mg/ml 60 min D5W or NS 24 hrs RT After the 3rd dose,
( Zithromax ) please check w/ MD
500 mg/vial
/ i l 7 days Ref if ok to shift to oral
Aztreonam SWFI 5 ml 100 mg/ml 24 hrs RT IV Push: 100 mg/ml IV Push: 3 -5 min 100 mg/ml IV Push: 3 -5 min NS 48 hrs RT -
500 mg/vial Intermittent Infusion: Intermittent Infusion: Infusion:
20 mg/ml 60 min 20 mg/ml 30 min. 7 days Ref.
Bacillus-Calmette NS 1 ml 5x108 2 hrs 1 ml BCG - - - NS 2 hrs RT Prepare under the
Guerin ( BCG ) CFU/ml after use in 50 ml NS Chemo hood (BSC).
( Onco
Onco-TICE
TICE ) opening
i ( ttotal
t l) Di
Dispense iin a
5x108 Colony Forming catheter tip 50 ml
Units ( CFU ) syringe with cover
Bretylium - - 50 mg/ml Discard 4 mg/ml 1 - 2 mg/min 10 mg/ml 4 mg/min D5W or NS 24 hrs RT see Continuous IV
500 mg ampule drip guideline
after use
Calcium Chloride - - g
100 mg/ml Discard g
IV Push: 100 mg/ml g
IV Push: 100 mg/min g
IV Push: 100 mg/ml g
100 mg/min D5W or NS 24 hrs RT see IV Push g
guideline
100 mg/ml unused IV Push see Calcium administration
portion. Infusion: 20 mg/ml Infusion: over 1 hr Infusion: 20 mg/ml Infusion over 1 hr guideline
Calcium Gluconate - - 100 mg/ml Discard IV Push: 100 mg/ml IV Push: 150 mg/min IV Push: 100 mg/ml 150 mg/min D5W or NS 24 hrs RT see IV Push guideline
100 mg/ml unused IV Push see Calcium administration
portion. Infusion: 20 mg/ml Infusion: 30-60 min Infusion: 20 mg/ml Infusion: 30-60 min guideline
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
i
mcg - microgram; illi i l t u - units;
meq - milliequivalent; it RT - Room
R ttemperature;
t R f - Refrigerate;
Ref R fi t Conc.
C t ti
- concentration

69
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Carnitine - - 200 mg/ml Discard 200 mg/ml 2 - 3 min 8 mg/ml 2 - 3 min NS 24 hrs RT Protect from light.
200 mg/ml unused IV Push IV Push
portion. Infusion: Infusion:
0.5 mg/ml 30 min
Caspofungin SWFI 10.5 ml 5 mgml Use 0.2 mg/ml 60 min 0.5 mg/ml 60 min NS 24 hrs RT Do not use any
50 mg/vial immediately 50 mg/250 ml 48 hrs Ref diluent containing
glucose - not stable
Cefazolin SWFI 9.6 ml 100 mg/ml 24 hrs RT 20 mg/ml 30 min 125 mg/ml 3 - 5 min D5W or NS 48 hrs RT IM dilution:
1 Gm/vial 10 days Ref 1 Gm dilute with 2.5 ml
10 days Ref SWFI will yield (3ml)
= 330 mg/ml
Cefepime
p SWFI 10 ml 100 mg/ml
g 24 hrs RT 20 mg/ml
g 30 min 40 mg/ml
g 30 min D5W or NS 24 hrs RT IM dilution:
1 Gm/vial 7 days Ref 1 Gm dilute with 2.4ml
7 days Ref SWFI will yield (3.6ml)
= 280 mg/ml
Cefotaxime SWFI 10 ml 100 mg/ml 24 hrs RT 20 mg/ml 30 min 40 mg/ml 30 min D5W or NS 24 hrs RT IM dilution:
1 Gm/vial 7 days Ref 5 days Ref 1 Gm dilute with 3 ml
SWFI will yield (3.4ml)
= 300 mg/ml
Ceftazidime SWFI 9.2 ml 100 mg/ml 24 hrs RT 20 mg/ml 30 min 40 mg/ml 3 - 5 min D5W or NS 24 hrs RT IM dilution:
1 Gm/vial 7 days Ref 1 Gm dilute with 2.4ml
7 days Ref SWFI will yield (3.6ml)
= 280 mg/ml
Ceftriaxone SWFI 9.6 ml 100 mg/ml 24 hrs RT 20 mg/ml 30 min 40 mg/ml 3 - 5 min D5W or NS 24hrs RT IM dilution: 1 Gm dilute with
1G
Gm/vial
/ i l 10 days Ref 3.5 ml Lidocaine 1% will yield
10 days Ref 250 mg/ml; Do not mix with

Calcium containing sol'n

Cefuroxime SWFI 7.2 ml 100 mg/ml 48 hrs Ref 15 mg/ml 30 min 137 mg/ml 3-5 min D5W or NS 24 hrs RT IM dilution:
750 mg/vial 750 mg dilute with 3 ml
7 days Ref SWFI will yield
215 mg/ml
Chlorpheniramine - - 10 mg/ml Discard 10 mg/ml 1 min 10 mg/ml 1 min Undiluted - see IV Push
10 mg/ml ampule guideline
100 mg/ml after use
Ciprofloxacin - - 2 mg/ml Discard 2 mg/ml 60 min 2 mg/ml 60 min Undiluted 48 hrs RT Protect from light upon
200 mg/100 ml unused after opening dispensing. Do not remove
portion from box or put syringe in
after 24 hrs RT Full bottle use a brown zip-lock bag.
product exp. date

Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration

70
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Cisatracurium - - 2 mg/ml Discard 2 mg/ml 5 - 10 sec 2 mg/ml 5 - 10 sec D5W or NS 24 hrs RT Not for IM
2 mg/ml ampule IV Push IV Push IV Push or 24 hrs Ref injection too much
after use Infusion: Infusion: Infusion: Undiluted tissue irritation.
0.1 - 2 mg/ml 0.5-10 mcg/kg 0.5-10 mcg/kg
per minute per minute
Clindamycin - - 150 mg/ml Discard 6 mg/ml 30 - 60 min 18 mg/ml 30 mg/min D5W or NS 48 hrsRT Can be given IM
150 mg/ml ampule 7 days Ref without further
after use dilution.
Colistimethate SWFI 2 ml 20 mg/ml 24 hrs Ref Dose/50 ml 30 min 2 million units 30 min D5W or NS 24 hrs Ref For nebuliser:
( Colomycin ) or in 50 ml Dilute 500,000 u/vial
( Colistin ) 1 - 5 mg/ml or with 1 - 2 ml SWFI
500,000 units/vial 5 mg/ml or NS then pour sol'n
( 40 mg/vial ) into nebuliser.
Cosyntropin - - 250 mcg/ml Discard 250 mcg/ml 2 min. 250 mcg/ml 2 min Undiluted Use see IV Push
( Tetracosactidum ) ampule immediately guideline
( Synacthen ) after use
250 mcg/ml
Cotrimoxazole - - 16 mg/ml Discard 1 ml of drug 60 - 90 min 1 ml of drug 60 min D5W only 1:25 - 6 hrs RT Flush with D5W only.
( Septrin ) TMP unused in 25 ml D5W in 15 ml D5W
( Bactrim ) 80 mg/ml portion. 1:20 - 4 hrs RT IM not indicated.
16 mg/ml TMP SMX
80 mg/ml SMX 1:15 - 2 hrs RT Do not Refrigerate.
(Sulfamethoxasole)
Cyclosporin - - 50 mg/ml Discard 0.5mg/ml 6 hrs 2.5 mg/ml 2 hrs D5W or NS 24 hrs RT
50 mg/ml unused i glass
in l b
bottle
ttl Do not Refrigerate.
Refrigerate
portion. & PVC free bag

Deferoxamine SWFI 2 ml 250 mg/ml 7 days Ref 10 mg/ml <15 mg/kg/hr 25 mg/ml 15 mg/kg/hr NS 24 hrs RT Do not Refrigerate.
( Desferal ) Can be given IM or SC
0.5 Gms/vial without further dilution.
Desmopressin - - 4 mcg/ml Discard Doses 10 min. 4 mcg/ml 10 min. NS Use see IV Push
4 mcg/ml unused > 4 mcg Undiluted immediately guideline
portion. dilute with
10 - 50 ml NS
Dexamethasone - - 4 mg/ml Discard IV Push: <10 mg 30 min. 4 mg/ml 1-5 min. D5W or NS 24 hrs RT Acetate injection
4 mg/ml unused 11 - 50 mg in 50 ml Undiluted is not for IV use.
portion. 51 - 100 mg in 100 ml see IV Push
or : 1 mg/ml
g guideline
g
Dexmedetomidine - - 100 mcg/ml Discard 200 mcg/48 ml Loading: 1 mcg/kg NS only 24 hrs RT Monitor blood pressure,
200 mcg/vial unused total vol. 50 ml over 10 min. - - heart rate, especially in
portion. ( 4 mcg/ml) Maintenance hypovolemia and elderly.
0.2 - 0.7 mcg/kg/hr
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration
71

Dextose 50 % - - 500 mg/ml 24 hrs RT 500 mg/ml 30 min 500 mg/ml 3 ml/min Undiluted 24 hrs RT see IV Push
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
24 hrs Ref Undiluted Undiluted 24 hrs Ref guideline
Diazepam - - 5 mg/ml Discard 5 mg/ml 5 min 5 mg/ml 5 mg/min Undiluted Use Can precipitate once
5 mg/ml unused immediately diluted.
portion. see IV Push guideline
Diazoxide - - 15 mg/ml Discard 15 mg/ml 30 seconds 15 mg/ml 30 seconds Undiluted Use see IV Push
( Eudemine ) unused or less or less immediately guideline
15 mg/ml portion. Do not give
IM or SC
Digoxin - - 0.25 mg/ml Discard 1 ml of drug in 30 min 0.25 mg/ml at least D5W or NS Use see IV Push
0.25 mg/ml unused 4 ml IV sol'n Undiluted 5 minutes immediately guideline
portion. (1:4 dilution) Less than fourfold
dilution mayy cause
precipitation.
Diltiazem SWFI 5 ml 5 mg/ml Discard 1 mg/ml 5 - 15 mg/hr 5 mg/ml 2 min. D5W or NS 24 hrs RT see IV Push
25 mg/vial unused Undiluted IV Push 24 hrs Ref guideline.
portion. IM not recommended.
Dimenhydrinate - - 50 mg/ml Discard 5 mg/ml 5 min 5 mg/ml 5 min D5W or NS 24 hrs RT May also be given
( Dramamine ) unused IM or SC without
50 mg/ml portion. further dilution.
Diphenhydramine - - 50 mg/ml Discard 50 mg/ml 25 mg/min 50 mg/ml 25 mg/min Undiluted Use see IV Push
50 mg/ml unused immediately guideline
portion.
Dipyridamole - - 5 mg/ml Discard Dose/20 - 50 ml 0.14 2.5 mg/ml 0.14 mg/kg/min D5W or NS Use Protect from light
5 mg/ml unused Ratio: 1 : 2 mg/kg/min immediately
portion.
Dobutamine SWFI 10 ml 25 mg/ml 6 hrs RT 4 mg/ml 2.5 - 20 5 mg/ml 2.5 - 20 D5W or NS 48 rs RT see Continuous
250 mg/vial 48 hrs Ref. mcg/kg/min mcg/kg/min 7 days Ref IV drip guideline
Dopamine - - 40 mg/ml Discard 4 mg/ml 1 - 20 6.4 mg/ml 20 D5W or NS 24 hrs RT see Continuous
200 mg/ampule unused mcg/kg/min mcg/kg/min IV drip guideline
portion.
Doxapram - - 20 mg/ml Discard 1 mg/ml 1 - 2 mg/min 20 mg/ml 5 mg/min D5W or NS 24 hrs RT see IV Push
20 mg/ml unused guideline
portion. Rapid infusion may
cause hemolysis.
Doxycyxline SWFI 10 ml 10 mg/ml 24 hrs RT 0.1 mg/ml 4 hrs 1 mg/ml 1 hr D5W or NS 24 hrs RT Protect from light
100 mg/vial 72 hrs Ref 72 hrs Ref
Drotrecogin Alfa SWFI 2 5 ml
2.5 2 mg/ml 3 hrs RT 0 1 mg/ml
0.1 24 mcg/kg/hr 0 2 mg/ml
0.2 24 mcg/kg/hr NS onl
only 14 hrs RT inf sion is interrupted
If the infusion interr pted
(Xigris) infusion for a for any reason, it should be
5 mg/vial total of 96 hrs restarted at 24 mcg/kg/hr.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration

72
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Edrophonium - - 10 mg/ml Discard 10 mg/ml 30-45 sec 10 mg/ml 30-45 sec Undiluted Use see IV Push
10 mg/ml unused immediately guideline
portion.
Ephedrine - - 50 mg/ml Discard 50 mg/ml 3 - 5 min 50 mg/ml 3 - 5 min Undiluted Use see IV Push
50 mg/ml unused immediately guideline
portion.
Ertapenem SWFI 10 ml 100 mg/ml Discard unused 20 mg/ml 30 min. 20 mg/ml 30 min. NS only 6 hrs RT IM Dilution: 1 Gm dilute in 3.2 ml
portion. 24 hrs Ref Lidocaine 1% to yield 250 mg/ml

Erythromycin SWFI 10 ml 50 mg/ml 24 hrs RT < 250 mg in 100 ml 1 - 2 hrs 5 mg/ml 60 min NS only 24 hrs RT Do not use D5W as
500 mg/vial 14 days Ref > 500 mg in 250 ml 24 hrs Ref diluent; If needed to
or use D5W add 0.5 ml
1 - 5 mg/ml
g NaHCO3 8.4% as
buffer to each 100 ml
D5W
Erythropoeitin - - 2000 u/0.2ml Discard 1:20 30 min 1:10 30 min. D10W or Can be given SC or IM
( Eprex ) unused 1 part of Eprex then flush 1 part of Eprex Bacteriostatic 24 hrs RT without further dilution.
2000 units/0.2 ml portion. 19 parts of with 20 ml 9 parts of 0.9% NaCl Dispense with 250 ml D10W
D10W D10W D10W (with preservative) for Day Case Unit.
Esmolol - - 10 mg/ml Discard 10 mg/ml 50 - 250 10 mg/ml 1 - 2 min D5W or NS 24 hrs RT see IV Push
10 mg/ml unused mcg/kg/min guideline
portion. see Continuous
IV Drip guideline
Etomidate - - 2 mg/ml Discard 2 mg/ml 1 min 2 mg/ml 30 sec. Undiluted Use see IV Push
2 mg/ml unused immediately guideline
portion.
Fentanyl - - 50 mcg/ml Discard 10 mcg/ml 1 - 20 mcg/kg/hr 50 mcg/ml 1 - 3 min IVPush D5W or NS 48 hrs RT see IV Push
50 mcg/ml unused Undiluted 48 hrs Ref guideline
portion.
Flucloxacillin SWFI 2.5 ml 100 mg/ml Discard < 1 Gm in 50 ml NS 30 min 50 mg/ml 5 min D5W or NS 24 hrs RT IM dilution
250 mg/vial ( 250 mg ) unused < 2 Gms in 100 ml NS 72 hrs Ref 500 mg vial dilute with
500 mg/vial
/ i l 5 mll portion.
ti or 2 mll SWFI will
ill yield
i ld
( 500 mg ) 20 mg/ml 250 mg/ml
Fluconazole - - 2 mg/ml Discard 2 mg/ml 60 min 2 mg/ml 60 min Premixed 48 hrs RT Protect from light upon
200 mg/100 ml unused in syringe dispensing. Do not remove
portion. from box or put syringe in
Full bottle use a brown zip-lock bag.
exp date
product exp.

Flumazenil - - 0.1 mg/ml Discard 0.1 mg/ml 30 sec. 0.1 mg/ml 15 sec Undiluted Use see IV Push
0.1 mg/ml unused portion. immediately guideline
Folic Acid - - 5 mg/ml Discard 0.1 mg/ml 30 min. 0.1 mg/ml 20 min. D5W or NS 24 hrs RT Protect from light.
5 mg/ml unused Not recommended
portion. for direct IV push.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration 73
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Folinic Acid - - 10 mg/ml 24 hrs RT 0.5 mg/ml 15 - 30 min 0.5 mg/ml 160 mg/min D5W or NS 24 hrs RT Can be given IM
( Leucovorin Ca ) 24 hrs Ref 4 days Ref
10 mg/ml
Fosphenytoin - - 75 mg/ml 24 hrs Ref < 6 mg/ml 100 mg/min 6 mg/ml 150 mg/min NS 8 hrs RT Fosphenytoin 1.5 mg=
75 mg/ml 24 hrs Ref 1 mg Phenytoin.
Can be given IM
Furosemide - - 10 mg/ml Discard IV Push: < 80 mg not more than 10 mg/ml 4 mg/min D5W or NS 24 hrs RT Do not Refrigerate.
10 mg/ml unused Undiluted 40 mg/min IV Push Undiluted
portion. 81 - 250 mg Infusion:
in 50 ml not more than
> 251 mg in 4 mg/min
100 ml
Ganciclovir SWFI 10 ml 50 mg/ml 12 hrs RT 5 mg/ml 60 min. 10 mg/ml 60 min. D5W or NS 24 hrs Ref. To be mixed in
500 mg/vial (Cymevene) Chemo hood (BSC).
5 days Ref Handle like other
(Cytovene) chemo meds.
Gentamicin - - 10 mg/ml 24 hrs RT < 100 mg in 50 ml < 100 ml 4 mg/ml < 100 ml D5W or NS 24 hrs RT Peak level drawn
10 mg/ml Pedia use over 30 min over 15 min 7 days Ref 30 min after end of
40 mg/ml 40 mg/ml < 200 mg in 100 ml > 100 ml > 100 ml infusion or 1 hr
Adult use or over 60 min over 60 min following IM injection.
Give 1 hr apart from 2 mg/ml Trough level drawn
other antibiotics. 30 min before next
dose.
Glucagon - - 1 mg/ml Discard 1 mg/ml 1 mg/min 1 mg/ml 1 mg/min Undiluted Use see IV Push
1 mg/ml unused May use undiluted immediately guideline
1 mg = 1 unit portion. sol'n for infusion
1 mg/ml for
Beta-blocker
overdose
Glycopyrrolate - - 0.2 mg/ml Discard 0.2 mg/ml 1 min. 0.2 mg/ml 1 min Undiluted Use Can be given IM
g
0.2 mg/ml unused immediatelyy see IV Push
portion. guideline
Granisetron - - 1 mg/ml 24 hrs RT Dose in 30 min. 3 mg/15 ml 5 min D5W or NS 24 hrs RT Do not refrigerate.
( Kytril ) 1 mg/ml 50 ml
Granulocyte - - 300 mcg/ml 24 hrs RT 15 mcg/ml 30 min. 300 mcg/ml 30 min. D5W only 24 hrs Ref. Conc. 5 - 15 mcg/ml
Colonies add 2 mg/ml
Stimulating SC preferred Albumin to prevent
Factor ( GCSF ) absorption of drug
300 mcg/ml to the plastic
Haloperidol - - 5 mg/ml Discard Dose in 30 min. 5 mg/ml 5 mg/min D5W only Use see IV Push
Lactate unused 25 - 50 ml Undiluted immediately guideline
5 mg/ml portion.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram;
microgram meq - milliequivalent;
millieq i alent u - units;
nits RT - Room temperat
temperature;
re Ref - Refrigerate;
Refrigerate Conc.
Conc - concentration
74
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Heparin - - 5000 u/ml 24 hrs RT 25,000 units Titrate 100 units/ml Titrate D5W or NS 24 hrs RT see IV Push
5000 units/ml in 500 ml according infusion. according 24 hrs Ref guideline
( 50 u/ml ) to PTT 5000 units/ml to PTT see Continuous
results bolus or results IV drip guideline
loading dose
Hepatitis B - - 500 u/10 ml Discard 5000 units less than 5000 units less than Undiluted Use Use clear sol
sol'n
n
Immuneglobulin unused in 100 ml 1 ml/min in 100 ml 1 ml/min immediately
( Hepatect ) portion. Undiluted Undiluted
Hydralazine SWFI 1 ml 20 mg/ml Discard 1 mg/ml > 5 mg/min 1 mg/ml 5 min NS only 4 days RT see IV Push
( Apresoline ) unused Do not use guideline
20 mg/ampule portion. D5W as diluent
Hydrocortisone
y SWFI 2 ml 50 mg/ml
g Discard IV Push: < 100 mg/ml 30 min. IV Push: 50 mg/ml
g 10 min. D5W or NS 24 hrs RT see IV Push
100 mg/vial ( 100 mg ) unused 101 - 150 mg in 50 ml Intermittent infusion: guideline.
250 mg/vial 5 ml portion. > 151 mg in 100 ml 3 mg/ml
( 250 mg ) or 1 - 3 mg/ml
Hydromorphone - - 10 mg/ml Discard 0.2 mg/ml 0.2 - 2 mg/hr 10 mg/ml No max.dose D5W or NS 48 hrs RT Monitor BP, HR, RR,
10 mg/ml unused Titrate to effect terminal patient 48 hrs Ref GI effects, CNS effects.
may require
portion. > 20 mg/hr See Narcotic infusion
Hyoscine - - 20 mg/ml Discard 1 mg/ml 30 min. 20 mg/ml 2 - 3 min D5W or NS 8 hrs RT see IV Push
( Buscopan ) unused guideline
20 mg/ml portion.
Ibandronic Acid - - 2 mg/ml Discard 0.012 mg/ml 2 hrs 0.06 mg/ml 15 min. D5W or NS 24 hrs RT Non - Formulary
(Brondonate) unused or or 24 hrs Ref Restricted drug
2 mg/ampule
/ portion. Dose/500 ml Dose/100 ml
Imipenem NS 100 ml 5 mg/ml 10 hrs RT 5 mg/ml 500 mg over 5 mg/ml 500 mg over NS only 10 hrs RT Less stable with
500 mg/vial 48 hrs Ref 30 min. 30 min. 48 hrs Ref D5W
1 Gm over 1 Gm over 4 hrs RT
60 min. 60 min. 24 hrs Ref
Indomethacin NS 1 ml 1 mg/ml 24 hrs Ref 1 mg/ml 5 - 10 sec. 1 mg/ml 5 sec. NS only 24 hrs Ref IM not recommended
( Indocid
I d id ) Do
D nott use if pinlk
i lk or
1 mg/vial in brown color
Infliximab SWFI 10 ml 10 mg/ml Use 0.4 - 4 mg/ml 2 hrs 4 mg/ml 2 ml/min NS only Infuse Restricted drugs.
( Remicade ) immediately immediately
100 mg/vial
Insulin, Actrapid - - 100 u/ml 30 days Ref 1 unit/ml Titrate according 100 u/ml 1 min NS only 24 hrs RT see IV Push
100 units/ml to Blood sugar 24 hrs Ref guideline
Iron Saccharate - - 20 mg/ml Discard 0.4 mg/ml 1 - 6 hrs 1 mg/ml 1 hr NS only 24 hrs RT Test dose 10 mg in
( Ferosac ) unused 25 ml over a period
100 mg/5 ml portion of 15 min.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration

75
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Iron Sucrose Discard 1 mg/ml 100 ml over 15 min No test dose required.
(Venofer) - - 20 mg/ml unused 1 mg/ml 30 min. For stability reasons NS only 24 hrs RT If a test dose is desired:
100 mg/5 ml portion to lower concentration 200 ml over 30 min 20mg (1ml) in 25ml NS over 30min

is not permissible.

Isoniazid - - 25 mg/ml Discard 25 mg/ml 5 - 10 min 25 mg/ml IV Push Undiluted Use Dilution not
50 mg/2 ml unused portion. Undiluted 5 min immediately recommended.
Isoproterenol - - 0.2 mg/ml Discard 2 mcg/ml 2-10mcg/min 16 mcg/ml 2-10mcg/min D5W or NS 24 hrs RT Do not use if sol'n
( Isoprenaline) unused ( 1 mg in turns pink or brown
( Isuprel ) portion 500 ml ) 0.05 - 0.2 0.05 - 0.2
2 mg/10 ml mcg/kg/min mcg/kg/min
Ketamine - - 50 mg/ml Discard 1 mg/ml 5 to 20 2 mg/ml 20 - 40 D5W or NS 24 hrs RT Protect from light
50 mg/ml
g unused mcg/kg/min
g g mcg/kg/min
g g 24 hrs Ref see IV Push
portion guideline
see Continuous
IV drip guideline
Ketorolac Discard not less than Undiluted not less than Use see IV Push
Tromethamine - - 30 mg/ml unused 30 mg/ml 15 seconds 30 mg/ml 15 seconds - immediately guideline
30 mg/ml portion
Labetalol - - 5 mg/ml Discard 1 mg/ml 0.25 - 2 5 mg/ml 3 mg/kg/hr D5W or NS 24n hrs RT see IV Push
5 mg/ml unused mg/kg/hr Undiluted guideline
portion see Continuous
IV drip guideline
Levofloxacin - - 5 mg/ml Discard 5 mg/ml < 250 mg 5 mg/ml 60 min Premixed 48 hrs RT Protect from light upon
500 mg/100 ml unused over 30 min Doses of in syringe dispensing. Do not remove
portion > 250 mg 750 mg must from box or put syringe in
after 24 hrs RT over 60 min be infused Full bottle use a brown zip-lock bag.
over 90 min. product exp. date Incompatible with Mannitol,
and Sod. Bicarbonate.
Levothyroxine SWFI 5 ml 100 mcg/ml Discard 100 mcg/ml 100 mcg/min 100 mcg/ml 100 mcg/min Undiluted Use see IV Push
500 mcg/vial unused immediately guideline
portion
ti
Lidocaine - - 20 mg/ml 24 hrs RT 4 mg/ml 20 mcg/kg/min 20 mg/ml 25-50 mg/min Undiluted 24 hrs RT see IV Push
20 mg/ml IV bolus IV Push guideline
50 mcg/kg/min D5W or NS see Continuous
Infusion Infusion IV drip guideline
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcgg - microgram;
g ; meq
q - milliequivalent;
q ; u - units;; RT - Room temperature;
p ; Ref - Refrigerate;
g ; Conc. - concentration

76
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Linezolid - - 2 mg/ml Discard 2 mg/ml 60 min 2 mg/ml 60 min Premixed 48 hrs RT Protect from light upon
600 mg/300 ml unused in syringe dispensing. Do not remove
portion from overwrap or put syringe
after 24 hrs RT Full bag, use in a brown zip-lock bag.
product exp. date

Lorazepam - - 2 mg/ml Discard 0.5 mg/ml 0.01 - 0.05 1 mg/ml 2 mg/min D5W only 24 hrs RT see IV Push
2 mg/ml unused mg/kg/hr in glass bottle guideline
portion container
Magnesium - - 500 mg/ml 24 hrs RT 1 - 2 Gm/50 ml 1 - 4 hrs 40 mg/ml 150 mg/min D5W or NS 24 hrs RT see IV Push
Sulfate 50% Magnesium SO4 2.1 - 4 Gm/100ml guideline
500 mg/ml 50 mg/ml > 4.1 Gm in see Continuous
Elem. Mg++ 250 ml IV drip guideline
4 meq/ml see L&D Magnesium
Elem. Mg++ Protocol
Mannitol 20% - - 200 mg/ml Discard unused 200 mg/ml 30 - 60 min 200 mg/ml 30 min. Premixed 24 hrs RT Do not Refrigerate.
200 mg/ml portion after Undiluted Do not use if crystals
24 hrs RT are present.
Meperidine - - 100 mg/ml Discard 5 mg/ml 15 - 35 mg/hr 10 mg/ml 5 min D5W or NS 48 hrs RT see IV Push
( Pethidine ) unused IV Push 48 hrs Ref guideline
100 mg/ml portion. Unidluted
Meropenem SWFI 9.6 ml 50 mg/ml 8 hrs RT 500 mg - 1 Gm 30 min 50 mg/ml 30 min. NS only 8 hrs RT Less stable in
500 mg/vial ( 500 mg ) in 50 ml D5W : 1 hr at RT
1 Gm/vial 19.1 ml 48 hrs Ref 48 hrs Ref 6 hrs Ref
(1G
Gm )
Methylprednisolone SWFI 2 ml 62.5 mg/ml 48 hrs RT < 125 mg 3 - 5 min Undiluted 3 - 5 min D5W, NS 48 hrs RT see IV Push
( Solu-Medrol ) ( 125 mg ) IV Push IV Push IV Push IV Push guideline
125 mg/vial 10 ml 100 mg/ml 126 - 250 mg in 50 ml 30 min see High Dose
1 Gm/vial ( 1 Gm ) 251 - 500 mg in 100 ml 60 min. 20 mg/ml 60 min. Methylprednisolone guideline
501 - 1250 mg in 250 ml 1 - 2 hrs
Metaraminol - - 10 mg/ml Discard 0.06
0 06 mg/ml Titrate 0.2
0 2 mg/ml Titrate D5W or NS 24 hrs RT Can be given IM or
10 mg/ml unused to response to response SC without further
portion. dilution.
Metoclopramide - - 5 mg/ml Discard < 10 mg 1 - 2 min 10 mg/ml 1-2 min D5W, NS, RL 24 hrs RT see IV Push
10 mg/ampule unused IV Push IV Push guideline
portion. Infusion:
1 mg/ml
g
Metoprolol - - 1 mg/ml Discard 1 mg/ml 3 - 5 min. 1 mg/ml over 1 min. Undiluted Use see IV Push
1 mg/ml unused immediately guideline
portion.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration

77
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Metronidazole - - 5 mg/ml Discard 5 mg/ml 60 min. 5 mg/ml 60 min. Premixed 48 hrs RT Protect from light upon
500 mg/100 ml unused after opening dispensing. Do not remove
portion from overwrap or put syringe
after 24 hrs RT Full bottle use in a brown zip-lock bag.
product exp date

Midazolam - - 5 mg/ml 1 mg/ml 1 - 7 mg/hr 5 mg/ml 2 - 5 min D5W or NS 24 hrs RT Deep IM injection
( Dormicum ) Titrate to effect Undiluted IV Push is recommended.
5 mg/ml
Milrinone - - 1 mg/ml Discard 200 mcg/ml 0.5mcg/kg/min 400 mcg/ml 0.75 mcg/kg/min D5W or NS 72 hrs RT see Continuous
1 mg/ml unused IV drip guideline
portion.
Morphine
p - - 10 mg/ml
g Discard 1 mg/ml
g 0.8 - 80 mg/hr
g 10 mg/ml
g 80 mg/hr
g D5W or NS 48 rs RT see IV Push
10 mg/ml unused Titrate to effect (Undiluted) 48 hrs Ref guideline
portion.

Moxifloxacin - - 1.6 mg/ml 24 hrs RT 1.6 mg/ml 60 min. 1.6 mg/ml 60 min. Premixed 48 hrs RT Protect from light upon
400 mg/250 ml after opening after opening dispensing. Do not remove
bottle from box or put syringe in
Full bottle use a brown zip-lock bag.
product exp date Avoid rapid or bolus
IV infusion.
Nalbuphine - - 10 mg/ml Discard 1 mg/ml 1 mg/min 10 mg/ml 1 mg/min D5W or NS 24 hrs RT see IV Push
10 mg/ml unused Undiluted guideline
portion.
N l
Naloxone - - 0.02 mg/ml Discard Dose in 15 min 1 mg/ml 5 - 10 min D5W or NS 48 hrs RT see IV Push
0.02 mg/ml 0.4 mg/ml unused 10 ml NS or Undiluted guideline
0.4 mg/ml portion.
Neostigmine - - 0.25 mg/ml Discard Undiluted slow Undiluted Slow IV Push Undiluted Use Preferred route is
0.25 mg/ml unused IV Push immediately IM or SC.
0.5 mg/ml 0.5 mg/ml portion.
Nimodipine - - 200 mcg/ml
/ l Discard
Di d 200 mcg/ml
/ l 1 mg/hr
/h 200 mcg/ml
/ l 2 mg/hr
/h Premixed
P i d 24 h
hrs RT
200 mcg/ml unused -
portion.
Nitroglycerine - - 5 mg/ml Discard 0.2 mg/ml 5 mcg/min 0.4 mg/ml 200 mcg/min Premixed 24 hrs RT see Continuous
50 mg/10 ml unused 50 mg/250 ml IV drip guideline
portion. D5W
Nitroprusside - - 10 mg/ml Discard 0 2 mg/ml
0.2 05-1
0.5 0 4 mg/ml
0.4 12 mcg/kg/min D5W 24 hrs RT Protect from light
light.
50 mg/5 ml unused mcg/kg/min see Continuous
portion. IV drip guideline
Norepinephrine - - 1mg/ml Discard 60 mcg/ml 0.05 - 0.1 120 mcg/ml 0.1 - 2 D5W 24 hrs RT Protect from light.
( Noradrenaline ) unused mcg/kg/min mcg/kg/min see Continuous
4 mg/4 ml portion. IV drip guideline
j ; NS - Normal Saline;; Gm - Gram;; IM - Intramuscular;; IV - Intravenous;; SC - Subcutaneous;; min - minute;; sec - seconds;; mg
Abbreviations: SWFI - Sterile Water for Injection; g - milligram;
g ; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration 78
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Octreotide - - 100 mcg/ml Discard 1 - 2 mcg/ml 1 mcg/kg/hr 10 mcg/ml 1 mcg/kg/hr NS (preferred) 24 hrs RT see IV Push
( Sandostatin ) unused compatible with guideline
100 mcg/ml portion. D5W 24 hrs Ref
see Continuous
IV drip guideline
Omeprazole - - 8 mg/ml 12 hrs Ref 0.4 mg/ml 30 min 0.4 mg/ml 20 min. NS only 24 hrs RT Less stable with
8 mg/ml 24 hrs Ref D5W - 6 hrs RT
Ondansetron - - 2 mg/ml Discard 2 mg/ml 2 - 5 min D5W or NS 48 hrs RT see IV Push
2 mg/ml unused Dose in 50 ml 30 min 48 hrs Ref guideline
portion.
Pamidronate SWFI 10 ml 9 mg/ml 24 hrs RT 0.12 mg/ml 4 hrs 0.24 mg/ml 2 hrs D5W or NS 24 hrs RT Should not be
90 mg/vial
g 24 hrs Ref mixed with Calcium
containing sol'n
Pancuronium - - 2 mg/ml Discard 0.4 mg/ml 0.1 mg/kg/hr 2 mg/ml 2 mg/min D5W or NS 24 hrs RT see IV Push
2 mg/ml unused Undiluted IV Push 24 hrs Ref guideline
portion. see Continuous
IV drip guideline
Pantoprazole SWFI 5 ml 8 mg/ml 2 hrs RT 0.4 mg/ml 30 min. 0.8 mg/ml 30 min. NS (preferred) 12 hrs RT Do not Refrigerate.
40 mg/vial D5W Late Mix
Penicillin G Sod. SWFI 4.6 ml 200,000 7 days Ref 40,000 u/ml 30 min 100,000 u/ml 15 min. D5W or NS 24 hrs RT Give 1 hr apart
600 mg/vial = units/ml <2.5 mil u in 50 ml 3 days Ref from Aminoglycosides
1 million units/vial <5 mil u in 100 ml
Pentamidine SWFI 5 ml 60 mg/ml 48 hrs RT 1 mg/ml 60 min. 2.5 mg/ml 60 min. D5W 24 hrs RT Incompatible with
60 mg/ml NS.
Can be given IM.
Phenobarbital - - 65 mg/ml Discard 4 mg/ml 30 mg/min 65 mg/ml 60 mg/min D5W or NS 24 hrs RT see IV Push
65 mg/ml unused guideline
portion. see Continuous
IV drip guideline
Phentolamine - - 10 mg/ml Discard 5 - 10 mg in rapid IV Push 5 - 10 mg in rapid IV Push NS only Use For extravasation
10 mg/ml unusedd 10 mll NS 10 mll NS immediately
i di t l
portion.
Phenylephrine - - 10 mg/ml Discard 0.1 mg/ml 40 - 80 1 mg/ml 1 - 2 min D5W or NS 48 hrs RT see IV Push
10 mg/ml unused mcg/min guideline
portion.
Phenytoin - - 50 mg/ml Discard < 100 mg Not more than 50 mg/ml 50 mg/min NS only Use see IV Push
250 mg/5 ml unused Undiluted 50 mg/min within 4 hrs guideline
portion. 101- 500 mg at room temp see Continuous
in 50 ml IV drip guideline
501 mg - 1 Gm
in 100 ml
Up to 2 Gms
in 250 ml
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter 79
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Phytomenadione - - 10 mg/ml Discard Dose in 50 ml 30 min. 0.2 - 5 mg/ml 1 mg/min D5W or NS 24 hrs RT Protect from light.
( Vitamin K ) unused Can be given
10 mg/ml portion. IM or SC.
Piperacillin/ SWFI 17.5 ml 200 mg/ml 24 hrs RT 45 mg/ml 30 min 90 mg/ml 30 min. D5W or NS 24 hrs RT Give 1 hr
Tazobactam 48 hrs Ref. 7 days Ref. apart from
( Tazocin ) Aminoglycoides
4.5 Gms/vial
Piracetam - - 200 mg/ml Discard 200 mg/ml 60 min 200 mg/ml 60 min Undiluted Use -
( Nootropil ) unused immediately
200 mg/ml portion.
Potassium - - 2 meq/ml Discard 0.1 meq/ml see KCL 0.4 meq/ml see KCL D5W or NS 24 hrs RT see Potassium
Chloride unused ((Peripheral
p line)) Protocol ( central line ) Protocol 7 days
y Ref. Chloride g
guideline
2 meq/ml portion.
1 meq = 1 mmol
Potassium - - 3 mmol/ml Discard Dose in see K2PO4 Dose in see K2PO4 D5W or NS 24 hrs RT see Potassium
Phosphate unused 250 ml Protocol 100 ml Protocol 24 hrs Ref. Phosphate
3 mmol/ml portion. guideline.
Pralidoxime SWFI 20 ml 50 mg/ml Discard 20 mg/ml 15 - 30 min. 50 mg/ml 200 mg/min NS Use May be administered
( Protopam ) unused immediately by IM or SC.
50 mg/ml portion.
Procainamide - - 100 mg/ml 24 hrs RT 4 mg/ml 2 - 6 mg/min 100 mg/ml 50 mg/min D5W or NS 24 hrs RT see Continuous
( Pronestyl ) after opening IV drip guideline
1 Gm/vial
Prochloperazine - - 5 mg/ml Discard 5 mg/ml 5 mg/min 5 mg/ml 5 mg/min Undiluted Use see IV Push
5 mg/ml unused immediately guideline
portion.
Procyclidine - - 5 mg/ml Discard 5 mg/ml 1 mg/min 5 mg/ml 1 mg/min Undiluted Use see IV Push
5 mg/ml unused immediately guideline
portion.
Promethazine - - 25 mg/ml Discard 25 mg/ml 25 mg/min 25 mg/ml 25 mg/min Undiluted 24 hrs RT IM is the preferred
25 mg/ml
/ l unused
d route.
t
portion. see IV Push
guideline
Propofol - - 10 mg/ml Discard 10 mg/ml 0.3 - 3 mg/kg/hr 10 mg/ml 12 mg/kg/hr may be further 12 hrs(undiluted) Monitor blood pressure &
10 mg/ml unused Titrate to effect diluted to a conc. heart rate during infusion.
portion. > 2 mg/ml in D5W 8 hrs (Diluted)
Propranolol - - 1 mg/ml Discard 1 mg/ml 1 mg/min 1 mg/ml 1 mg/min Undiluted Use see IV Push
1 mg/ml unused immediately guideline
portion. Not for infusion.
Protamine - - 10 mg/ml Discard 10 mg/ml 50 mg in 10 mg/ml 50 mg in Undiluted Use see IV Push
Sulfate unused 10 minutes 10 minutes immediately guideline
10 mg/ml portion.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration 80
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Qunidine Gluconate - - 80 mg/ml Discard 16 mg/ml 0.02 - 0.3 16 mg/ml 0.3 mg/kg/min D5W only 24 hrs RT Use bottle or PVC
800 mg/10 ml unused (800 mg/50ml) mg/kg/min (800 mg/50ml) free bag.

Quinine Discard 1 ml/kg or Dose in 500 ml D5W preferred IV Push or bolus injection
Dihydrochloride - - 300 mg/ml unused 1 mg/ml over 4 hrs D5W or NS over 4 hrs diluent 24 hrs RT not recommended may
300 mg/ml
g portion. compatible with be fatal.
NS
Ranitidine - - 25 mg/ml Discard 1 mg/ml 30 min. 2.5 mg/ml 4 ml/min D5W or NS 2 days RT IM injection is
( Zantac ) unused 10 days Ref. given undiluted.
50 mg/ampule portion.
Rasburicase SWFI 1 ml 1.5 mg/ml Discard Non - Formulary
1.5 mg/vial unused Dose/50 ml 30 min. Dose/50 ml 30 min. NS 24 hrs Ref. Restricted
7.5 mg/vial 7.5 mg/ml portion.
Remifentanil SWFI 1 ml 1 mg/ml Discard 25 mcg/ml 0.05 - 1 mcg/kg/min 250 mcg/ml 0.6 - 15 mcg/kg/hr D5W or NS 24 hrs RT Monitor respiratory &
1 mg/ampule unused cardiovascular status,
portion. blood pressure & heart rate
Rifampicin SWFI 10 ml 60 mg/ml 24 hrs RT 6 mg/ml 30 min. 6 mg/ml 30 min. NS 24 hrs RT Do not refrigerate.
300 mg/vial ( NS )
4 hrs RT IM or SC not
( D5W ) indicated.
Ritodrine - - 10 mg/ml Discard 0.3 mg/ml 0.05 - 0.35 0.3 mg/ml 0.35 mg/min D5W or NS 48 hrs RT Not for IM use.
( Yutopar ) unused mg/min
50 mg/ampule portion.
Rocuronium - - 10 mg/ml Discard 10 mg/ml 0.01 - 0.125 10 mg/ml 4 - 16 Undiluted 24 hrs RT see Continuous
10 mg/ml
/ l unused
d mg/kg/min
/k / i mcg/kg/min
/k / i 24 h
hrs R
Ref.
f IV d
drip
i guideline
id li
portion.
Salbutamol - - 0.5 mg/ml Discard 60 mcg/ml 25 - 50 500 mcg/ml 50 mcg/min D5W or NS 24 hrs RT May be given
( Ventolin ) unused mcg/min Undiluted IM or SC.
500 mcg/ml portion.
Sodium - - 1 meq/ml Discard 0.5 meq/ml 1 meq/kg/hr 1 meq/ml 2 meq/kg/hr D5W or NS 24 hrs RT Incompatible with
Bicarbonate 8.4%
8 4% unused ( 1: 1 Dilution ) Undiluted Calcium containing
1 meq/ml portion. solution.
1 meq = 1 mmol
Somatostatin - - 3 mg/ml Discard 60 mcg/ml 3.5 mcg/kg/hr 60 mcg/ml 3.5 mcg/kg/hr D5W or NS 48 hrs Ref Use PVC free bag
3 mg/ampule unused (3 mg in 50 ml) Renal pt.: Renal pt.: or evac. bottle if
portion. 1.75 mcg/kg/hr 1.75 mcg/kg/hr NS is used.
Streptomycin SWFI 5 ml 200 mg/ml 24 hrs RT 1 Gm/100 ml 60 min - 30 min D5W or NS 24 hrs RT IM dilution: Dilute 1 Gm in 3 2 ml
3.2
1 Gm/vial SWFI to yield 250 mg/ml

Succinylcholine SWFI 10 ml 50 mg/ml 24 hrs RT 1 - 2 mg/ml 0.5 - 10 100 mg/ml 10 - 30 sec. D5W or NS 24 hrs RT see IV Push
500 mg/vial mg/min guideline
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration

81
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GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Sufentanil - - 50 mcg/ml Discard 1 mcg/ml 1 mcg/kg/hr 2 mcg/ml Titrate to D5W or NS 24 hrs RT Rapid IV infusion may result
50 mcg/ml unused effect. in skeletal muscle & chest
portion. wall rigidity, respiratory
distress/arrest.
Teicoplanin SWFI 5 ml 40 mg/ml 24 hrs RT Dose in 50 ml 30 min 40 mg/ml 1 minute D5W or NS 24 hrs RT IM dilution:
200 mg/vial Dissolve 200 mg in
3 ml SWFI to yield
67 mg/ml
Tenecteplase SWFI 10 ml 5 mg/ml 8 hrs Ref 5 mg/ml 5 sec. 5 mg/ml 5 sec. Undiluted Use Incompatible with
50 mg/vial immediately D5W.
Thiamine - - 100 mg/ml Discard after Dose in 50 ml 30 min Dose in 10 ml 20 min D5W or NS 24 hrs RT Can be given IM.
100 mg/vial
g opening
p g 24 hrs Ref
Thiopental SWFI 10 ml 50 mg/ml 24 hrs RT 25 mg/ml 3 -5 min 25 mg/ml 3 -5 min D5W or NS 24 hrs RT see IV Push
500 mg/vial IV Push IV Push IV Push IV Push guideline
Infusion: Infusion: see Continuous
2 mg/ml Titrate 50 mg/ml 25 mg/min IV drip guideline
Tigecycline NS 5.3 ml 10 mg/ml Discard unused 1 mg/ml 30 - 60 min 1 mg/ml 30 min D5W or NS 6 hrs RT
50 mg/vial portion. 24 hrs Ref
Tirofiban - - 0.25 mg/ml 24 hrs Ref 12.5 mg in 0.4 mcg/kg/min 12.5 mg in 0.4 mcg/kg/min D5W or NS 24 hrs Ref see Continuous
( Aggrastat ) 200 ml for 30 min 200 ml for 30 min IV drip guideline
12.5 mg/50 ml (Total vol. is should be (Total vol. is should be
250 ml ) continued at 250 ml ) continued at
0.1 mcg/kg/min 0.1 mcg/kg/min
Tobramycin - - 40 mg/ml 24 hrs RT <100 mg in 50 ml 30 min D5W or NS 48 hrs RT Draw Peak 30 min after
80 mg/vial 101 - 200 mg 48 hrs Ref completion of infusion or
in 100 ml 30 min 2 mg/ml 30 min at 1 hr after IM injection.
Give 1 hr apart from 201 - 500 mg DrawTrough immediately
other antibiotics. in 250 ml 60 min before next dose.
TPA or r-tPA SWFI 50 ml 1 mg/ml 8 hrs RT 1 mg/ml Varies 1 mg/ml 2 hrs D5W or NS 8 hrs RT Frozen TPA
( Tissue minimal conc. with 2 mg/2ml
Plasminogen 0.5
0 5 mg/ml indication to clear occluded
Activator ) venous catheter
30 days frozen
Tramadol - - 50 mg/ml Discard 50 mg/ml over 1 min. 50 mg/ml 1 min. Undiluted Use Can be given IM
( Tramal ) unused immediately see IV Push
50 mg/ml portion. guideline
Tranexamic Acid - - 100 mg/ml
g Discard Dose in 50 ml 15-30 minutes 100 mg/ml
g 100 mg/min
g D5W or NS 24 hrs RT see IV Push
( Cyclokapron) unused 24 hrs Ref guideline
100 mg/ml portion. 501 - 1 Gm (Preferred)
in 100 ml
Tromethamine - - 36 mg/ml Discard 36 mg/ml 3 -6 hrs 36 mg/ml 500 mg/kg/hr Undiluted Use Single use only.
( THAM ) unused immediately
18 Gms/500 ml portion.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter 82
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc. - concentration
 ADULT INTRAVENOUS DILUTION GUIDELINE

GENERIC DRUG RECONSTITUTION IV ADMINISTRATION GUIDELINE

Maximum Diluent Stability Comment
NAME Diluent Volume Initial Conc. Vial Stability Standard Conc. Standard Rate Maximum Conc.
Rate
Valproate Sodium - - 100 mg/ml Discard Dose / 50 ml 60 min. Dose/50 ml < 20 mg/min D5W or NS 24 hrs RT Rapid infusion will
( Depakene ) unused increase side effects.
100 mg/ml portion.
Vancomycin SWFI 10 ml 50 mg/ml 24 hrs RT 5 mg/ml 60 min. 10 mg/ml 10 mg/min D5W or NS 7 days RT Draw Trough just
500 mg/vial 96 hrs Ref 7 days Ref before next dose.

Vasopressin - - 20 units/ml Discard 0.1 - 1 u/ml 20 -30 min 1 unit/ml 1 unit/min D5W or NS 24 hrs RT Central line is
20 units/ml unused preferred due to risk
portion. of tissue necrosis.
Verapamil
p - - 2.5 mg/ml
g Discard 2.5 mg/ml
g 2 - 3 min 2.5 mg/ml
g 2 min Undiluted Use see IV Push
2.5 mg/ml unused immediately guideline
portion.
Voriconazole SWFI 19 ml 10 mg/ml 24 hrsRef 2 mg/ml 1 -2 hrs 5 mg/ml 3 mg/kg/hr D5W or NS 24 hrs Ref Incompatible with
( V-Fend ) Sodium Bicarbonate
200 mg/vial
Zidovudine - - 10 mg/ml Discard 2 mg/ml 60 min. 4 mg/ml 60 min. D5W only 24 hrs RT -
10 mg/ml unused 48 hrs Ref
portion.
Zoledronic Acid SWFI 5 ml 0.8 mg/ml Discard 4 mg/100 ml 15 min 4 mg/ml Not less than D5W or NS 24 hrs Ref Single dose only.
4 mg/vial unused 15 min
portion.
Abbreviations: SWFI - Sterile Water for Injection; NS - Normal Saline; Gm - Gram; IM - Intramuscular; IV - Intravenous; SC - Subcutaneous; min - minute; sec - seconds; mg - milligram; ml - milliliter
mcg - microgram; meq - milliequivalent; u - units; RT - Room temperature; Ref - Refrigerate; Conc.
Conc - concentration

References: 1. Lawrence A. Trissel, Handbook on Injectable Drugs, 14th ed., ASHP, Bethesda, 2007.
2. Micromedex, Drug Information System
3. Stephanie J. Phelps, Pediatric Injectable Drugs, The Teddy Bear Book, 18th ed, ASHP, Bethesda, 2007
4. Thomas, E. Young, Neofax 2006, 19th ed., Raleigh, North Carolina, USA, 2006
5. Charles F. Lacy, Drug Information Handbook International, 14th ed., APhA Lexicomp, Hudson, Ohio, USA, 2006
g p
6. www.globalrph.com
7. www.edsorangebook.com
Reviewed by: Issam Hamadeh, PharmD, Clinical Pharmacist Drug Information Center Prepared by: Cecile V. Palad, Pharmacist 1, IV Admixture Supervisor T

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