Chemo Stability Chart - LtoZ

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 3 3
50 mg/5 mL N/A 10 mg/mL 5 mL vial: discard syringe 7 d F,
2 3,4
500 mg/50 mL unused portion 48 h RT
(Hospira)
1
(F)(PFL) 50 mL vial: 8 h
1
no preservative 0.05-10 mg/mL 24 h RT in NS, D5W,
NS, D5W, Ringer’s, Lactated Ringer’s,
1
Lactated Ringer’s, Ringer’s
1,2
D10W, D5NS
8 h RT in D10W, D5-
1
(e.g., 50-250 mL*) NS
BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 1/38

Activation Date: 2 March 2006
Revised Date: 1 May 2018
Status)
Leucovorin
1 6,7
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8h
1
500 mg/50 mL portion
(Teva)
(F)(PFL)
5 8
no preservative 0.4 - 4.8 mg/mL NS, 72 h F, RT
8
D5W
(e.g., 50-250 mL*)
5
0.06 - 0.4 mg/mL NS, 24 h RT in NS
5
D5W
5
12 h RT in D5W
0.06 - 1 mg/mL 24 h RT in Ringer’s,

5
Ringer’s, Lactated Lactated Ringer’s
Ringer’s, D10W,
5 5
D10NS 12 h RT in D10W
5
6 h RT in D10NS

Status)
Mechlorethamine
9 9
10 mg do NOT use if 1 mg/mL use within 4 h of syringe complete
(Ovation discoloured or water reconstitution administration within
7,10
Pharmaceuticals/Merck) droplets form in vial RT 4 h of reconstitution
7,9,10
(RT,PFL) before RT
9 9
no preservative reconstitution
9
10 mL SWI or NS
record time of 9,11

reconstitution 100 mL NS complete
administration within
4 h of reconstitution
7,9,11
RT
Melphalan
12 12
50 mg 10mL supplied 5 mg/mL 2 h RT 0.1 – 0.45 mg/mL in complete
12 12
(GSK) diluent NS only administration within
(RT)(PFL) do NOT 60 min from time of
12
no preservative immediately after refrigerate (e.g., greater than 45 initial reconstitution at
10
adding diluent, mg and less than or RT
12
shake vigorously equal to 110 mg in
250 mL NS)*
record time of
reconstitution

Status)
Mesna
13 7,13 13
1000 mg/10mL N/A 100 mg/mL 14 d F, RT Greater than or equal 48 h F, 24 h RT
13
(Fresenius Kabi) to 1mg/mL
(RT)
13
preservative NS or D5W
Methotrexate
14 10,15,16
50 mg/2mL N/A 25 mg/mL 50mg: discard syringe 2 d F, RT - for high-dose
14
500 mg/20mL unused portion regimens (e.g., 1-
2
1 g/40mL 12 g/m as a single
22 22 17-21
5 g/200mL 500mg, 1 g, 5 g: 0.4–2 mg/mL 24 h RT dose) : use
14
(Hospira) 8 h F, RT 100 mL* NS, D5W preservative-free
10
(RT)(PFL) methotrexate
14
no preservative - do not use for IT
injection
2,22,23
high dose (e.g., 1-12 24 h RT
2
g/m as a single
17-21
dose) : 1000 mL*
NS
Methotrexate
14 14 26
IT Injection : N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary label :
14 25 7,10
Only preservative free portion preservative free NS puncture “IT”
methotrexate may be - label to include
administered by the route in full (i.e.,
14
intrathecal route INTRATHECAL
24
50 mg/2mL injection) attached
(Hospira) to both syringe and
26
(RT)(PFL) outer ziplock bag
14
no preservative

Status)
Methotrexate
14 27,28 4,15
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - for high-dose
500 mg/20mL regimens (e.g., 1-
2
(Hospira) 12 g/m as a single
17-21
(RT)(PFL) 0.4–2 mg/mL
22
24 h RT
27 dose) : use
14
preservative preservative-free
10
100 mL* NS, D5W
14 methotrexate
- do not use for IT
injection
Mitomycin
29 29 29 29
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Teva)
29 29 29
(RT)(PFL) shake well **(PFL) **(PFL)
29
no preservative
Mitomycin
29 29 29 29
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
29 29 29
(Teva) shake well **(PFL) **(PFL)
(RT)(PFL)
29
no preservative
30 30
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
29 31 31,32
shake well to prevent precipitation solubility
31
precipitation - do NOT
31
refrigerate

Status)
Mitomycin
29 29 29 29 29
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS: 6 h RT, 18 h F
20 mg
29 29 29
(Teva) shake well **(PFL) NS, sodium lactate sodium lactate: 6 h RT,
29
(RT)(PFL) F
29
no preservative
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
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 35
20 mg/10 mL N/A 2 mg/mL discard unused NS, D5W 24 h RT
35
(Teva/Novopharm) portion
36
(RT)(PFL) Greater than or equal **(PFL)
35 35
no preservative to *50 mL

Status)
Nivolumab
37 37
40 mg/4 mL N/A 10 mg/mL discard unused 1-10 mg/mL complete - administer with a
37
100 mg/10 mL portion administration within 8 0.2 to 1.2 micron
37 38 37
(BMS) NS, D5W h RT or 24 h F in-line filter
(F)(PFL) - discard if cloudy
do not shake mix by gentle or has pronounced
37 37
no preservative inversion colour change
(should be clear to
37
pale yellow)
oBINutuzumab
39 39,40
1000 mg/40 mL N/A 25 mg/mL discard unused 100 mg: 24 h F, 48 h RT -once removed
2 39
(Hoffman-La Roche) portion in 100 mL NS from the fridge,
**
(F)(PFL) diluted product is
do not shake 900 mg: stable for an
39 39
no preservative in 250 mL NS additional 48 h
39,40
RT
39
1000 mg: - do NOT shake
39
in 250 mL NS - do NOT use
dextrose containing
39
solutions

Status)
Octreotide
41 41 41
50 mcg/mL N/A 50 mcg/mL Use within 4 h NS 24 h RT
100 mcg/mL 100 mcg/mL
41
500 mcg/mL 500 mcg/mL volume adjusted to
(Omega) ensure a continuous
(F)(PFL) infusion of octreotide
41 41
no preservative at 25 mcg/hour
multidose vial:
41 41 41 41
1000 mcg/5 mL 200 mcg/mL 15 d F NS 24 h RT
(Omega)
(F)(PFL) volume adjusted to
41
preservative ensure a continuous
infusion of octreotide
41
at 25 mcg/hour
Octreotide
42
50 mcg/mL N/A 50 mcg/mL discard unused SC syringe single use vials: use
42
100 mcg/mL 100 mcg/mL portion within 4 h
42
500 mcg/mL 500 mcg/mL
(Teva/Novopharm) multidose vials: use
28,42
(F)(PFL) within 14 d F
42
no preservative
multidose vial: 42 28,42 42

200 mcg/mL 14 d F infusion: NS single use or multidose
1000 mcg/5 mL 42
vials: 24 h RT
(Teva/Novopharm)
(F)(PFL)
42
preservative

Status)
Octreotide
43 10,45,46 45
(SANDOSTATIN®) N/A 200 mcg/mL discard unused 50–200 mL NS 24 h RT
44
1000 mcg/5 mL portion
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
43
preservative infusion rate of 25
45
mcg/h
Octreotide
10,46 45
(SANDOSTATIN®) N/A 50 mcg/mL discard unused 50-100 mL 24 h RT
45
50 mcg/1 mL 100 mcg/mL portion
43 45
100 mcg/1 mL 500 mcg/mL NS
500 mcg/1 mL
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
43
no preservative infusion rate of 25
45
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
45 45 7,45
10 mg diluent portion administration only reconstitution
20 mg 20 mg: 10 mg/mL
30 mg gently run 2 mL
45
(Novartis) down sides of the 30 mg: 15 mg/mL
(F)(PFL) vial; do NOT disturb
44
no preservative for 2–5 min, then
45
swirl moderately
record time of
reconstitution

Status)
oFAtumumab
47 47 47
100 mg/ 5 mL N/A 20 mg/mL discard unused 1000 mL NS 48 h RT - administer with
2
1000 mg/50 mL portion 0.2 micron in-line
47
(GlaxoSmithKline) or filter
(F)(PFL) - do NOT shake;
47
no preservative alternatively, 2000 mg mix by slow
doses may be inversion to avoid
47
supplied in formation of foam
47
2 x 500 mL NS - solution may
contain a small
withdraw volume quantity of drug
from bag equal to particles; do not
volume of drug to be administer if
47
added solution is cloudy
47
or discoloured
Olaratumab
48 48
500 mg/50 mL N/A 10 mg/mL discard unused dilute to a final complete - do NOT shake
2,48
(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

Status)
Oxaliplatin
49
50 mg 50 mg: 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
49 49 49 49
100 mg 10 mL SWI, D5W portion (0.2-0.7 mg/mL) 24 h F aluminum-
(Actavis) containing needle,
49
(RT)(PFL) 100 mg: do NOT use NS or syringe or tubing
49 49
no preservative 20 mL SWI, D5W other chloride-
49
containing solutions
do NOT use
aluminum-containing
49
needle and syringe
Oxaliplatin
50
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-0.4 mg/mL: - do NOT use
50 50
100 mg/20 mL portion (0.2-0.7 mg/mL 24 h RT aluminum-
200 mg/40 mL or containing needle,
50
(Hospira/Pfizer) do NOT use NS or 5 d F plus an syringe or tubing
50,52
(RT) other chloride- additional 8 h RT
50 51
no preservative containing solutions
0.5–2 mg/mL:
do NOT use 24 h RT
aluminum-containing or
51
needle and syringe 14 d F plus an
50,52
additional 8 h RT

Status)
Oxaliplatin
53 53
50 mg/10 mL N/A 5 mg/mL discard unused 250–500 mL D5W 0.2-1.3 mg/mL: - do NOT use
53 53,54 4,54,55
100 mg/20 mL portion (0.2-2 mg/mL) 48 h RT, 14 d F aluminum-
200 mg/40 mL containing needle,
53
(sanofi-aventis) do NOT use NS or 1.3-2 mg/mL: syringe or tubing
53
(RT)(PFL) other chloride- 24 h RT, 48 h F
53 53
no preservative containing solutions
do NOT use
aluminum-containing
53
needle and syringe
Oxaliplatin
51 2,56 51
50 mg/10 mL N/A 5 mg/mL 2 d F, RT 0.2-0.7 mg/mL 0.2-2 mg/mL:
51
100 mg/20 mL 24 h RT, 48 h F
51
150 mg/30 mL 250-500 mL D5W
200 mg/40 mL
(Sandoz) do NOT use NS or
(RT)(PFL) other chloride-
51 51
no preservative containing solution
do NOT use
aluminum-containing
51
needle and syringe

Status)
Oxaliplatin
57
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
57 57 57
100 mg/20 mL portion (0.2-0.7 mg/mL) 24 h RT, 48 h F aluminum-
200 mg/40 mL containing needle,
57
(Teva) do NOT use NS or syringe or tubing
(RT)(PFL) other chloride-
57 57
no preservative containing solution
do NOT use
aluminum-containing
57
needle and syringe
PACLitaxel
58
30 mg/5 mL N/A 6 mg/ mL 30 mg/5 mL or 0.3-1.2 mg/mL in NS, complete - use non-DEHP
58
100 mg/16.7 mL 100 mg/16.7 mL D5W, D5NS, D5LR administration within bag and tubing with
58
300 mg/50 mL vial: 27 h RT 0.22 micron in-line
2,58 58
(Accord) 48 h RT (e.g., 100-1000 mL)* filter
(RT)(PFL) - avoid excessive
58 58
no preservative 300 mg/50 mL shaking
vial:
58
24 h RT

Status)
PACLitaxel
60 2,61
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
60
100 mg/16.7 mL D5W administration within bag and tubing with
60,62
300 mg/50 mL 27 h RT 0.22 micron in-line
60
(Biolyse) (e.g., 100-1000 mL)* filter
59
(RT)
60
no preservative
63 63
0.1 mg/mL in NS 44 h F, RT
62
0.012-0.12 mg/mL in 16 h RT
64
NS
devices with spikes

(e.g., chemo
dispensing pins) may
65
be used with vials
PACLitaxel
67 2,67,68
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
67
100 mg/16.7 mL D5W, D5NS, D5LR administration within bag and tubing with
67
150 mg/25 mL 27 h RT 0.22 micron in-line
67
300 mg/50 mL (e.g., 100-1000 mL)* filter
(Hospira)
(RT)(PFL)
66
preservative

Status)
PACLitaxel,
69 69
nanoparticle, albumin- 20 mL NS 5 mg/mL use immediately in empty sterile PVC, 48 h F plus an - each vial contains
70
bound (nab) (RT) or non-PVC, or non- additional 8 h RT 900 mg human
69 69 69
100 mg - slowly direct 8hF DEHP infusion bag albumin
(Celgene) diluent against side - to prevent
69
(RT)(PFL) of vial (i.e., greater **(PFL) foaming, do NOT
69
no preservative than or equal to 1 inject NS directly
69
min) during onto the powder
69
reconstitution - some settling may
occur; use mild
- let stand for agitation to
69
greater than or resuspend
equal to 5 min to wet - administer using
69
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
69
min cause filter
71,72
blockage)
Pamidronate
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL NS, 24 h F followed by 24 h - do NOT mix with
73 73 73
60 mg/10 mL portion D5W RT (total 48 h) calcium containing
90 mg/10 mL 6 mg/mL solution (e.g.,
73 73
(Hospira) **(PFL) Ringer’s)
73 74
(RT) 9 mg/mL (e.g., 250 mL* NS)
73
no preservative

Status)
Pamidronate
75
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL NS, 24 h F followed by 24 h - do NOT mix with
75 75 75
60 mg/10 mL portion D5W RT (total 48 h) calcium containing
75 75
(Omega) **(PFL) Ringer’s)
75 74
(RT) 9 mg/mL (e.g., 250 mL* NS)
75
no preservative
Pamidronate
76 76 76
30 mg/10 mL N/A 3 mg/mL discard unused NS; D5W 24 h RT - do NOT mix with
76
60 mg/10 mL portion calcium containing
76
90 mg/10 mL 6 mg/mL Less than or equal to solutions
76
(Fresenius Kabi) 0.36 mg/mL
76
(RT) 9 mg/mL
76
no preservative
Pamidronate
77 77 77
30 mg/10 mL N/A 3 mg/mL discard unused NS; D5W 24 h RT - do NOT mix with
77,28
60mg/10 mL portion calcium containing
77
(Sandoz Canada) Ringer’s)
77
RT 9 mg/mL
77
no preservative

Status)
PANitumumab
78 78,79
100 mg/5 mL N/A 20 mg/mL discard unused Less than or equal to 24 h F, 6 h RT - administer with
78
400 mg/20 mL portion 1000 mg: 100 mL 0.2 or 0.22 micron
78 78
(Amgen) NS in-line filter
(F)(PFL) - solution may
do not shake Greater than 1000mg: contain particulates
78 78
no preservative 150 mL NS which do not affect
78
product quality
78,79
1-10mg/mL - do not administer
78
if discoloured
pegaspargase
80
(PEG-asparaginase) N/A 750 units/mL discard unused IM: syringe: - discard cloudy
80 80
(pegylated portion max volume: discard at end of solution
2,80 80
asparaginase E. coli) 2 mL in children and day - do not shake
3750 units/5 mL adolescents; - do not use if
(Baxalta) 3 mL in adults stored out of
(F)(PFL) refrigerator for
80 81
no preservative if volume greater than greater than 48 h
above, use multiple - do not use if
80 81
sites previously frozen
IV: bag:
80
100 mL NS, D5W complete
administration within
81
48 h F
protect bag from direct

sunlight during
81
infusion

Status)
Pembrolizumab
82
100 mg/4 mL N/A 25 mg/mL discard unused 1-10 mg/mL complete - use a 0.2 to 5
2,82 82
(Merck) portion NS, D5W administration within micron in-line
82 82
(F)(PFL) 6 h RT, 24 h F filter
do not shake mix by gentle - allow vials and
82 82
no preservatives inversion diluted solutions to
come to RT prior to
82
use
- vials contain 0.25
82
mL overfill
Pembrolizumab
82 82 82
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
82
(Merck) D5W administration within 6 micron in-line
82 83
(F) direct diluent against h RT, 24 h F filter
82
no preservative side of vial during mix by gentle - allow
82
reconstitution to inversion reconstituted vials
82
avoid foaming and diluted
solutions to come
82
allow up to 5 to RT prior to use
minutes for bubbles - vials can be at RT
82
to clear for up to 24 h prior
82
to use
82
do NOT shake - vials contain 20%
82
overfill

Status)
Pemetrexed
84 84 84
100 mg 100 mg: 4.2 mL 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
500 mg preservative-free NS preservative-free calcium containing
84
(Eli Lilly) NS solution (e.g.,
85
(RT) 500 mg: 20 mL Ringer’s)
84
no preservative preservative-free
84
NS
PERTuzumab
86 86 86
420 mg/14 mL N/A 30 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT use
2,86
(Roche) portion dextrose containing
86 86
(F)(PFL) do NOT shake mix by gentle solutions
86
no preservative inversion to avoid
86
foaming
Plerixafor
87 87 28,88
24 mg/1.2 mL N/A 20 mg/mL discard unused SC syringe 48 hours RT
87
(sanofi-aventis) portion
(RT)
87
no preservative
Porfimer
89 89
15 mg 15 mg: 6.6 mL D5W 2.5 mg/mL 24 h F syringe use within 4 h of initial - avoid contact with
7,90
75 mg reconstitution skin and eyes;
89
(Axcan) 75 mg: 31.8 mL **(PFL) protect exposed
89 89 89
(RT)(PFL) D5W **(PFL) area from light
89
no preservative
record time of
reconstitution

Status)
Raltitrexed
91 91 91 91
2 mg 4 mL SWI 0.5 mg/mL 24 h F, RT 50–250 mL NS, 24 h F, RT
91
(Hospira) D5W
(F, RT)(PFL)
91
no preservative
Ramucirumab
92 92 92
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL* NS 4 h RT, 24 h F - use 0.22 micron
92 92
500 mg/50 mL portion filter
93
(Eli Lilly) (0.4 – 4 mg/mL) - do NOT use
(F)(PFL) dextrose containing
92 92
(do not shake) gently invert to mix solutions
92
no preservative
92
do NOT shake
riTUXimab
94 95,96
100 mg/10 mL N/A 10 mg/mL discard unused 1-4 mg/mL NS, 24 h F, 12 h RT - once removed
94 94
500 mg/50 mL portion D5W from the fridge,
(Roche) compounded
(F)(PFL) (e.g., 250-500 mL)* product is stable
94 95,96
no preservative for 12h RT
riTUXimab
97 97 97
subcutaneous N/A 120 mg/mL discard unused SC syringe 48 h F plus 8 h RT - contains
97 97
1400 mg/11.7 mL portion hyaluronidase
(Roche)
(F)(PFL)
97
no preservative

Status)
romiDEPsin
98 98 98 98
10 mg 2.2 mL of supplied 5 mg/mL 8 h RT 500 mL NS 24 h RT - reconstituted
98,99
(Celgene Inc.) diluent solution will be
98 100
(RT) slightly viscous
2 98
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
98
diluent)
Siltuximab
101 101 101
100 mg 100 mg: 20 mg/mL 2 h RT 250 mL D5W complete - use 0.2 micron in-
101 101
400 mg 5.2 mL SWI administration within line filter
101
(Janssen) dilute to 250 mL final 6 h RT
(F)(PFL) 400 mg: volume by
101 101
no preservative 20 mL SWI withdrawing volume
from bag equal to
allow vial to come to volume of drug to be
101
room temperature added
prior to use (~30
101
minutes)
gently swirl, do not

101
shake

Status)
Streptozocin
102 102 102 102
1g 9.5mL NS, SWI, 100 mg/mL 48 h F, 24 h RT syringe 48 h F, 24 h RT
102
(Pfizer) D5W
(F)(PFL)
102 102
no preservative 50-500 mL* NS, 48 h F, 24 h RT
102
D5W, SWI
Temsirolimus
103,104 103,104 103,104
30 mg/1.2 mL 1.8 mL supplied 10 mg/mL 24 h RT 250 mL NS complete - use non-DEHP
103,104
(Wyeth) diluent administration within 6 bag and tubing with
103,104 103 103,104 103,104
(F)(PFL) **(PFL) h in-line filter
105
no preservative
Teniposide
106
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
106
(BMS) portion D5W for a final RT - use non-DEHP
106
(RT) concentration of 0.1-1 bag and tubing
106 106
preservative mg/mL 1 mg/mL: complete - do not use if
106,107
administration within 4 precipitates
h of preparation - contains DMA***
106,107
RT - excessive
agitation may
cause
106
precipitation

Status)
Thiotepa
108 108 108 108
15 mg 1.5 mL SWI 10 mg/mL 8hF 50 mL* NS use within 4 h of initial - do not use if
108,109
(Bedford) reconstitution precipitates or
108
(F)(PFL) filter through 0.22 remains opaque
108 108 108,110
no preservative micron filter **(PFL) - do not use for IT
injection
record time of
reconstitution syringe: reconstituted use within 4 h of initial
108,109
solution is hypotonic reconstitution
and must be further
108,110
diluted with NS prior **(PFL)
108
to use
(final concentration of
0.5-1 mg/ml is nearly
111
isotonic)
Thiotepa
108 108 25
IT injection diluents containing 10 mg/mL 8hF qs to 6 mL with use within 4 h of initial - auxiliary label :
108,109
15 mg preservatives should preservative free reconstitution “IT”
112
(Bedford) NOT be used for NS - label to include
108,110
(F)(PFL) intrathecal **(PFL) route in full (i.e.,
108
no preservative administration INTRATHECAL
injection) attached
108
1.5 mL SWI to both syringe and
25
outer ziplock bag
filter through 0.22 - do not use if
108
micron filter precipitates or
108
remains opaque
record time of
reconstitution

Status)
Thyrotropin alfa
113 113 113 113 113
1.1 mg 1.2 mL SWI 0.9 mg/mL 24 h F syringe 24 h F
(Genzyme)
113
(F)(PFL) swirl contents
113
no preservative
do not shake
Topotecan
114 114 114 114
4 mg N/A 1 mg/mL discard unused 0.02–0.5 mg/mL 24 h F, RT
115
(Hospira) portion
(F)(PFL) 50-100 mL NS,
114 115
no preservative D5W
Topotecan
116 116 116 116 116
4 mg 4 mL SWI 1 mg/mL 24 h F, RT 0.02 – 0.5 mg/mL 24 h F, RT
(Mylan)
(RT)(PFL) 50-100 mL NS,
116 116
no preservative D5W
Topotecan
117 117
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F
117
(Sandoz) portion
117
(F)(PFL) 50-100 mL NS, **(PFL)
117 117
no preservative D5W

Status)
Trastuzumab
118 2 118 118 118
(HERCEPTIN®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
118
440 mg BWI
(Roche) do NOT use dextrose
118
(F) swirl vial gently; containing solutions
118
preservative allow to stand
undisturbed for 5
118
min

Status)
Trastuzumab
119 119 119
Emtansine 100 mg vial: 5 mL 20 mg/mL 24 h F 250 mL NS or 0.45% 24 h F - do not use if
119
(KADCYLA®) SWI sodium chloride reconstituted
119 119 119
100 mg do NOT freeze only do NOT freeze solution contains
160 mg 160 mg vial: 8 mL visible particulates
119 119
(Hoffmann-La Roche) SWI do NOT shake or is cloudy or
119
(F)(PFL) discolored
119
no preservative swirl gently until - dextrose 5%
completely dissolved solutions cause
aggregation of the
119
do NOT shake protein; do not
dilute with dextrose
containing
119
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%
119
NS

Status)
TRC105 (Carotuximab)
120 121
100 mg/4 mL N/A 25 mg/mL discard unused 0.6 – 10 mg/mL NS complete infusion - use a 0.2 micron
2
200 mg/8 mL portion within 8 h RT, 24 h in-line filter for
120,121 120
400 mg/16 mL invert gently to mix F administration
(Tracon)
(F)(PFL)
120
no preservative

Status)
Treosulfan
122 7,122 123 7,122
1g pre-heat SWI to 50 mg/mL 48 h RT undiluted 48 h RT - compatible with
5g 30°C (not higher) polytetrafluoroethyl
122
(medac) shake vial carefully dilute with NS or D5W ene filters
(RT) before adding the in empty infusion bag - may require
122
no preservative warmed SWI for final concentration vigorous shaking to
122 122
1 g vial: 20 mL SWI, = 20 mg/mL reconstitute
while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
122
2 min
5 g vial: 100 mL
SWI, while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
122
2 min

Status)
vinBLAStine
124 125 126,127
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W 24 h F, RT - auxiliary label:
124
(Hospira) portion WARNING: FOR
(F)(PFL) INTRAVENOUS
124
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
128,129
ROUTES
vinBLAStine
130
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, use within 4 h of initial - auxiliary label:
130 125,131 2
(Teva) portion D5W puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
130
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
128,129
ROUTES

Status)
vinCRIStine
132 132 132 132
2 mg/2 mL N/A 1 mg/mL 8 h F, RT 50 mL* NS, D5W 24 h F, 6 h RT - auxiliary label:
5 mg/5 mL WARNING: FOR
132
(Hospira) **(PFL) INTRAVENOUS
(F)(PFL) USE ONLY –
132
no preservative FATAL IF GIVEN
BY OTHER
128,129
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)

Status)
vinCRIStine
133 133 133
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 label:
133
2 mg/2 mL D5W WARNING: FOR
5 mg/5 mL INTRAVENOUS
(Teva) 25-50 mL NS, D5W
134
USE ONLY –
(F)(PFL) FATAL IF GIVEN
133
no preservative BY OTHER
128,129
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Vinorelbine
135 135 135
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary label:
135
50 mg/5mL portion WARNING: FOR
(Fresenius Kabi) NS, D5W, ½NS, INTRAVENOUS
(F)(PFL) D5½NS, Ringer’s, USE ONLY –
135 135
no preservative Ringer’s Lactate FATAL IF GIVEN
BY OTHER
128,129
ROUTES

Status)
Vinorelbine
136 136 136
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary label:
136
50 mg/5 mL portion WARNING: FOR
(Hospira) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5½NS, USE ONLY –
136
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
136
Lactate BY OTHER
128,129
ROUTES
Vinorelbine
137 137 137
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary label:
137
50 mg/5 mL portion WARNING: FOR
(Teva) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5½NS, USE ONLY –
137
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
137
Lactate BY OTHER
128,129
ROUTES

Status)
Zoledronic acid
138 138
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
138
(Dr Reddy’s) portion within 24 h of calcium containing
138 138
(RT) preparation solutions
138
no preservative
Refrigerate diluted
product if not used
immediately after
preparation; bring to
RT prior to
138
administration
Zoledronic acid
139 139 139
(ZOMETA) N/A 0.8 mg/ mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
2
4 mg/ 5 mL portion within 24 h of calcium containing
139 139
(Novartis) preparation solutions
(RT)
139
no preservative Refrigerate diluted
product if not used
immediately after
RT prior to
139
administration

Status)
Zoledronic acid
140 140
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 ml NS, D5W complete infusion - do NOT mix with
140
(Sandoz) portion within 24 h of calcium- or other
140
(RT) preparation divalent cation-
140
no preservative containing infusion
Refrigerate diluted solutions (e.g.,
product if not used Lactated
140
immediately after Ringer’s)
RT prior to
140
administration
* Suggested volume based on usual dose range and any concentration range of stability data
** Protect from light means minimizing exposure to direct sunlight over a storage period. More specific information on protection from light (eg, protecting container and tubing during
administration) will be indicated in the Under the Special Precautions/Notes column.
*** Contains DMA (N,N dimethylacetamide). Product may be incompatible with closed system transfer devices such as ChemoLock.
Centres are not to change the content locally but should forward suggestions to the Cancer Drug Manual staff.
Explanatory Notes
Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the classification
141,142
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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BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 1/38

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

0.06 - 1 mg/mL 24 h RT in Ringer’s,

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 2/38

record time of 9,11

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 3/38

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 4/38

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 5/38

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 6/38

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 7/38

multidose vial: 42 28,42 42

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 8/38

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 9/38

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 10/38

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devices with spikes

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protect bag from direct

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