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 1,2
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8 h RT
1
(GMP) portion
(F)(PFL)
1
no preservative 0.05-10 mg/mL NS, D5W, LR,
NS, D5W, Ringer’s, Ringer’s:
1
LR, D10W, 24 h RT
1,2
D5-NS
D10W, D5-NS:
1
(e.g., 50-250 mL*) 8 h RT
Leucovorin
3 3 3
50 mg/5 mL N/A 10 mg/mL 8h syringe 8 h RT
500 mg/50 mL
(Pfizer/Hospira)
(F)(PFL) 0.05–10 mg/mL NS, NS, D5W, LR,
3
no preservative D5W, LR, Ringer’s, Ringer’s:
3 3
D10W, D5NS 24 h RT
(e.g., 50-250 mL*) D10W, D5NS:

3
8 h RT
BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 1/45
This document may not be reproduced in any form without the express written permission of BC Cancer Provincial Pharmacy.
Activation Date: 2 March 2006
Revised Date: 16 April 2020
Status)
Leucovorin
5 6,7
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8h
5
500 mg/50 mL portion
(Teva)
(F)(PFL)
4 8
no preservative 0.4 - 4.8 mg/mL NS, 72 h F, RT
8
D5W
(e.g., 50-250 mL*)
0.06 - 0.4 mg/mL NS, NS:

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

4
Ringer’s, Lactated 24 h RT
Ringer’s, D10W,
4
D10-NS D10W:
4
12 h RT
D10NS:
4
6 h RT
Status)
Lurbinectedin
9 9 9 9
4 mg 8 mL SWI 0.5 mg/mL 30 h F, RT 100–250 mL NS, 30 h F, RT - larger infusion
9
(Pharma Mar) D5W volume is
(F) recommended for
9 9
no preservative peripheral line
Melphalan
10 10
50 mg 10mL supplied 5 mg/mL 2 h RT 0.1 – 0.45 mg/mL in complete
10 10
(GSK) diluent NS only administration within
(RT)(PFL) do NOT 60 min from time of
10
no preservative immediately after refrigerate (e.g., greater than 45 initial reconstitution at
11
adding diluent, mg and less than or RT
10
shake vigorously equal to 110 mg in
250 mL NS)*
record time of
reconstitution
Mesna
12 12
400 mg/4 mL N/A 100 mg/mL discard unused greater than 1 mg/mL 24 h RT
12
1000 mg/10 mL portion in D5W, D5½-NS,
12-14
(Baxter) (use filter needle to NS, LR
(RT) withdraw from
12
no preservative ampoule)
Mesna
12 12 12
1000 mg/10 mL N/A 100 mg/mL 8 days RT greater than 1 mg/mL 24 h RT
5000 mg/50 mL in D5W, D5½-NS,
12-14
(Baxter) (vial may be NS, LR
(RT) punctured up to 4
12 12
preservative times)
Status)
Mesna
15 15,16 15
1000 mg/10mL N/A 100 mg/mL 14 d F, RT greater than or equal 48 h F, 24 h RT
(Fresenius Kabi) to 1 mg/mL in NS,
17
(RT) D5W
15
preservative
Methotrexate
18
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
18
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
18 2
1 g/40mL portion 12 g/m as a single
19-23
(Accord) dose) : use
(RT)(PFL) 500 mg or 1 g: 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
18 18 18 18 18
no preservative 8 h RT D5W initial puncture methotrexate
- do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 18
(e.g., 1-12 g/m as a initial puncture
19-23
single dose) : 1000
mL* NS **(PFL)
Status)
Methotrexate
18 2
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info
18 2
Only preservative free portion preservative free puncture - label to include
25,26
methotrexate may be NS route in full (i.e.,
administered by the INTRATHECAL
24
intrathecal route injection) attached
50 mg/2mL to both syringe and
27
(Accord) outer ziplock bag
(RT)(PFL)
18
no preservative
Methotrexate
18 2,18 2
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
18
500 mg/20mL alcohol
(Accord) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
18 high-dose
18
preservative D5W
18 regimens (e.g., 1-
2
12 g/m as a single
18
(100 mL* NS, D5W) dose)
- do NOT use for IT
18
injection
Status)
Methotrexate
28
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
28
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
28 2
1 g/40mL portion 12 g/m as a single
19-23
2.5 g/100 mL dose) : use
(Pfizer/Hospira) 500 mg, 1 g, or 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
28 28 28
(RT)(PFL) 2.5 g: D5W initial puncture methotrexate
28 28
no preservative 8 h RT - do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 28
(e.g., 1-12 g/m as a initial puncture
19-23
single dose) : 1000
mL* NS **(PFL)
Methotrexate
28 2
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info :
28 16
Only preservative free portion preservative free puncture “IT”
25,26
methotrexate may be NS - label to include
administered by the route in full (i.e.,
24
intrathecal route INTRATHECAL
50 mg/2mL injection) attached
(Pfizer/Hospira) to both syringe and
27
(RT)(PFL) outer ziplock bag
28
no preservative
Status)
Methotrexate
28 16,28 16
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
28
500 mg/20mL alcohol
(Pfizer/Hospira) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
28 high-dose
28
preservative D5W
28 regimens (e.g., 1-
2
12 g/m as a single
28
(100 mL* NS, D5W) dose)
- do NOT use for IT
28
injection
Mitomycin
29 29 29 29
20 mg 40 mL SWI 0.5 mg/mL 72 h F, 6 h RT syringe 72 h F, 6 h RT
(Accord)
29 29 29
(RT)(PFL) shake well **(PFL) **(PFL)
29
no preservative
Status)
Mitomycin
29 29 29 29
intravesical 40 mL SWI 0.5 mg/mL 72 h F, 6 h RT syringe 72 h F, 6 h RT
20 mg
29 29 29
(Accord) 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
33 33
25 mL SWI 0.8 mg/mL discard unused syringe 4 days RT - do NOT
2,33 33
portion refrigerate
2,33
shake well **(PFL)
2,33
**(PFL)
33 33
33.3 mL SWI 0.6 mg/mL discard unused syringe 4 days F, RT
2,33
portion
2,33
shake well **(PFL)
2,33
**(PFL)
Mitomycin
29 29 29 29
intraperitoneal 40 mL SWI 0.5 mg/mL 72 h F, 6 h RT 0.02-0.04 mg/mL NS:
29
20 mg 18 h F, 3 h RT
29 29 29
(Accord) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
29 29
no preservative 6 h F, 3 h RT
Status)
Mitomycin
34 34 34 34
20 mg 40 mL SWI 0.5 mg/mL 72 h F, 6 h RT syringe 72 h F, 6 h RT
(Teva/Novopharm)
34 34 34
(RT)(PFL) shake well **(PFL) **(PFL)
34
no preservative
Mitomycin
34 34 34 34
intravesical 40 mL SWI 0.5 mg/mL 72 h F, 6 h RT syringe 72 h F, 6 h RT
20 mg
34 34 34
(Teva/Novopharm) shake well **(PFL) **(PFL)
(RT)(PFL)
34
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
34 31 31,32
shake well to prevent precipitation solubility
31
precipitation - do NOT
31
refrigerate
33 33
25 mL SWI 0.8 mg/mL discard unused syringe 4 days RT - do NOT
2,33 33
portion refrigerate
2,33
shake well **(PFL)
2,33
**(PFL)
33 33
33.3 mL SWI 0.6 mg/mL discard unused syringe 4 days F, RT
2,33
portion
2,33
shake well **(PFL)
2,33
**(PFL)
Status)
Mitomycin
34 34 34 34
intraperitoneal 40 mL SWI 0.5 mg/mL 72 h F, 6 h RT 0.02-0.04 mg/mL NS:
34
20 mg 18 h F, 6 h RT
34 34 34
(Teva/Novopharm) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
34 34
no preservative 6 h F, RT
mitoXANTRONE
35 35 35
20 mg/10 mL N/A 2 mg/mL discard unused NS, D5W 24 h RT
35
(Fresenius Kabi) portion
(RT) Greater than or equal
35 35
no preservative to *50 mL
mitoXANTRONE
36 36
20 mg/10 mL N/A 2 mg/mL discard unused 0.2-0.6 mg/mL NS, 72 h F, 24 h RT
36 36
25 mg/12.5 mL portion D5W
36
30 mg/15 mL **(PFL)
(Pfizer/Hospira) Greater than or equal
36
(RT)(PFL) to *50 mL
36
no preservative
Status)
Nivolumab
37
40 mg/4 mL N/A 10 mg/mL discard unused 1-10 mg/mL NS, complete - administer with a
37 37
100 mg/10 mL portion D5W administration within 0.2 to 1.2 micron
37 37
(BMS) 24 h F, 8 h RT in-line filter
(F)(PFL) (50-100* mL) - discard if cloudy
37
do not shake **(PFL) or has pronounced
37
no preservative mix by gentle colour change
inversion; do not (should be clear to
37 37
shake pale yellow)
oBINutuzumab
38 38,40
1000 mg/40 mL N/A 25 mg/mL discard unused 100 mg: 24 h F, 48 h RT -once removed
39 38
(Hoffman-La Roche) portion in 100 mL NS from the fridge,
**
(F)(PFL) diluted product is
do not shake 900 mg: stable for an
38 38
no preservative in 250 mL NS additional 48 h
38,40
RT
38
1000 mg: - do NOT shake
38
in 250 mL NS - do NOT use
dextrose containing
38
solutions
Status)
Octreotide
41 41 41 41
50 mcg/mL N/A 50 mcg/mL use within 4 h NS 24 h RT
100 mcg/mL
41
500 mcg/mL 100 mcg/mL volume adjusted to
(Omega) ensure a continuous
41
(F)(PFL) 500 mcg/mL infusion of octreotide
41 41
no preservative at 25 mcg/hour
Octreotide
41 41 41 41
multidose vial: N/A 200 mcg/mL 15 d F NS 24 h RT
1000 mcg/5 mL
(Omega) volume adjusted to
(F)(PFL) ensure a continuous
41
preservative infusion of octreotide
41
at 25 mcg/hour
Octreotide
42 42 42
50 mcg/mL N/A 50 mcg/mL discard unused SC syringe use within 4 h
42
100 mcg/mL portion
42
500 mcg/mL 100 mcg/mL
(Teva/Novopharm)
42 42 42
(F)(PFL) 500 mcg/mL infusion: NS 24 h RT
42
no preservative
Status)
Octreotide
42 42,43 42,43
multidose vial: N/A 200 mcg/mL 14 d F SC syringe use within 14 d F
1000 mcg/5 mL
(Teva/Novopharm)
42 42
(F)(PFL) infusion: NS 24 h RT
42
preservative
Octreotide
44 11,46,47 46
(SANDOSTATIN®) N/A 200 mcg/mL discard unused 50–200 mL NS 24 h RT
45
1000 mcg/5 mL portion
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
44
preservative infusion rate of 25
46
mcg/h
Octreotide
11,47 46
(SANDOSTATIN®) N/A 50 mcg/mL discard unused 50-100 mL 24 h RT
46
50 mcg/1 mL 100 mcg/mL portion
44 46
100 mcg/1 mL 500 mcg/mL NS
500 mcg/1 mL
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
44
no preservative infusion rate of 25
46
mcg/h
Status)
Octreotide
(SANDOSTATIN LAR®) 2 mL supplied 10 mg: 5 mg/mL discard unused deep intragluteal use within 4 h of initial - do NOT shake
46 46 7,46
10 mg diluent portion administration only reconstitution
20 mg 20 mg: 10 mg/mL
30 mg gently run 2 mL
46
(Novartis) down sides of the 30 mg: 15 mg/mL
(F)(PFL) vial; do NOT disturb
45
no preservative for 2–5 min, then
46
swirl moderately
record time of
reconstitution
Olaratumab
48 48
500 mg/50 mL N/A 10 mg/mL discard unused dilute to a final complete - do NOT shake
39,48
(Lilly) portion volume of 250 mL administration within
48
(F)(PFL) NS 24 h F plus an
48
do not shake additional 12 h RT
48
no preservative do NOT use D5W or
other dextrose
48
containing solutions
48
gently invert to mix
Status)
Oxaliplatin
49
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-0.4 mg/mL: - do NOT use
49
100 mg/20 mL portion 24 h RT aluminum-
49
200 mg/40 mL (0.2-0.7 mg/mL or containing needle,
49
(Hospira/Pfizer) 5 d F plus an syringe or tubing
49,51
(RT) do NOT use NS or additional 8 h RT
49
no preservative other chloride-
50
containing solutions 0.5–2 mg/mL:
24 h RT
do NOT use or
aluminum-containing 14 d F plus an
50 49,51
needle and syringe additional 8 h RT
Oxaliplatin
50 39,52 50
50 mg/10 mL N/A 5 mg/mL 2 d F, RT 0.2-0.7 mg/mL 0.2-2 mg/mL:
50
100 mg/20 mL 48 h F, 24 h RT
50
150 mg/30 mL 250-500 mL D5W
200 mg/40 mL
(Sandoz) do NOT use NS or
(RT)(PFL) other chloride-
50 50
no preservative containing solution
do NOT use
aluminum-containing
50
needle and syringe
Status)
Oxaliplatin
53
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
53 53
100 mg/20 mL portion 48 h F, 24 h RT aluminum-
53
200 mg/40 mL (0.2-0.7 mg/mL) containing needle,
53
(Teva) syringe or tubing
(RT)(PFL) do NOT use NS or
53
no preservative other chloride-
53
containing solution
do NOT use
aluminum-containing
53
needle and syringe
PACLitaxel
54
30 mg/5 mL N/A 6 mg/ mL 30 mg: 0.3-1.2 mg/mL in NS, complete - use non-DEHP
39,54 54
100 mg/16.7 mL 48 h RT D5W, D5NS, D5LR administration within bag and tubing with
54
300 mg/50 mL 27 h RT 0.22 micron in-line
54
(Accord) 100 mg: (e.g., 100-1000 mL)* filter
39,54
(RT)(PFL) 48 h RT - avoid excessive
54 54
no preservative shaking
300 mg:
54
24 h RT
Status)
PACLitaxel
56 39,57
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
56
100 mg/16.7 mL D5W administration within bag and tubing with
56,58
300 mg/50 mL 27 h RT 0.22 micron in-line
56
(Biolyse) (e.g., 100-1000 mL)* filter
55
(RT)
56
no preservative
59 59
0.1 mg/mL in NS 44 h F, RT
58
0.012-0.12 mg/mL in 16 h RT
60
NS
devices with spikes

(e.g., chemo
dispensing pins) may
61
be used with vials
PACLitaxel
63 39,63,64
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
100 mg/16.7 mL D5W, D5-NS, administration within bag and tubing with
63 63
150 mg/25 mL D5-LR 27 h RT 0.22 micron in-line
63
300 mg/50 mL filter
(Hospira) (e.g., 100-1000 mL)*
(RT)(PFL)
62
preservative
Status)
PACLitaxel,
65 65
nanoparticle, albumin- 20 mL NS 5 mg/mL use immediately in empty sterile PVC, 48 h F plus an - each vial contains
66
bound (nab) (RT) or non-PVC, or non- additional 8 h RT 900 mg human
65 65 65
100 mg - slowly direct 8hF DEHP infusion bag albumin
(Celgene) diluent against side - to prevent
65
(RT)(PFL) of vial (i.e., greater **(PFL) foaming, do NOT
65
no preservative than or equal to 1 inject NS directly
65
min) during onto the powder
65
reconstitution - some settling may
occur; use mild
- let stand for agitation to
65
greater than or resuspend
equal to 5 min to wet - administer using
65
powder a 15 micron filter
ONLY
- gently swirl or (NOTE:filters with a
invert for greater pore size less than
than or equal to 2 15 microns may
65
min cause filter
67,68
blockage)
Pamidronate
69 69
30 mg/10 mL N/A 3 mg/mL discard unused Less than or equal to 24 h RT - do NOT mix with
69 69
60 mg/10 mL portion 0.36 mg/mL NS, calcium containing
69 69
90 mg/10 mL D5W solutions
69
(Fresenius Kabi) 6 mg/mL
(RT)
69
no preservative
69
9 mg/mL
Status)
Pamidronate
70
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F plus an - do NOT mix with
70 70
60 mg/10 mL portion NS, D5W additional 24 h RT calcium containing
70
90 mg/10 mL (total 48 h) solution (e.g.,
70 70
(Hospira) 6 mg/mL Ringer’s)
70
(RT) **(PFL)
70
no preservative
70
9 mg/mL
Pamidronate
71 71
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F plus an - do NOT mix with
71 71
71
71 71
(Omega) 6 mg/mL Ringer’s)
71
(RT) **(PFL)
71
no preservative
71
9 mg/mL
Pamidronate
72
30 mg/10 mL N/A 3 mg/mL discard unused 0.06-0.36 mg/mL in 24 h F plus an - do NOT mix with
72 72
72
72 72
(Pfizer) 6 mg/mL Ringer’s)
72
(RT) **(PFL)
72
no preservative
72
9 mg/mL
Status)
Pamidronate
73 73 73
30 mg/10 mL N/A 3 mg/mL discard unused NS; D5W 24 h RT - do NOT mix with
43,73
60mg/10 mL portion calcium containing
90 mg/10 mL solution (e.g.,
73 73
(Sandoz Canada) 6 mg/mL Ringer’s)
RT
73
no preservative
73
9 mg/mL
PANitumumab
74 74 74-77
100 mg/5 mL N/A 20 mg/mL discard unused 1-10mg/mL 24 h F, 6 h RT - administer with
74
400 mg/20 mL portion 0.2 or 0.22 micron
74 74
(Amgen) 100 mL* NS in-line filter
(F)(PFL) - solution may
do not shake contain particulates
74
no preservative which do not affect
74
product quality
- do not administer
74
if discoloured
Status)
pegaspargase
78 78
(pegylated N/A 750 units/mL discard unused IM: syringe: - do NOT shake
78
asparaginase E. coli) portion max volume: use within 4 h of vial
39,78
3750 units/5 mL 2 mL in children and puncture
(Shire) adolescents;
(F)(PFL) 3 mL in adults
do not shake
78
no preservative if volume greater than
above, use multiple
78
sites
IV: bag:
78
100 mL NS, D5W use within 4 h of vial
39,78
puncture
Pembrolizumab
79
100 mg/4 mL N/A 25 mg/mL discard unused 1-10 mg/mL complete - use a 0.2 to 5
2,79 79
(Merck) portion NS, D5W administration within micron in-line
79 79
(F)(PFL) 96 h F, 6 h RT filter
do not shake mix by gentle - allow vials and
79 79
no preservatives inversion diluted solutions to
come to RT prior to
79
use
- vials contain 0.25
79
mL overfill
Status)
Pembrolizumab
80 80 80
50 mg 2.3 mL SWI 25 mg/mL 24 h F, 6 h RT 1-10 mg/mL NS, complete - use 0.2 to 5
80
(Merck) D5W administration within micron in-line
80 81
(F) direct diluent against 24 h F, 6 h RT filter
80
no preservative side of vial during mix by gentle - allow
80
reconstitution to inversion reconstituted vials
80
avoid foaming and diluted
solutions to come
80
allow up to 5 to RT prior to use
minutes for bubbles - vials can be at RT
80
to clear for up to 24 h prior
80
to use
80
do NOT shake - vials contain 20%
80
overfill
Pemetrexed
82 82 82
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
82 82
500 mg 4.2 mL NS NS calcium containing
(Accord) solution (e.g.,
82
(RT) 500 mg: Ringer’s)
82 82
no preservative 20 mL NS
Pemetrexed
83 83 83
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
83 83
500 mg 4.2 mL NS NS calcium containing
(Eli Lilly) solution (e.g.,
84
(RT) 500 mg: Ringer’s)
83
no preservative 20 mL preservative-
83
free NS
Status)
PERTuzumab
85 85 85
420 mg/14 mL N/A 30 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT use
39,85
(Roche) portion dextrose containing
85 85
(F)(PFL) do NOT shake mix by gentle solutions
85
no preservative inversion to avoid
85
foaming
Plerixafor
86 86 43,87
24 mg/1.2 mL N/A 20 mg/mL discard unused SC syringe 48 hours RT
86
(sanofi-aventis) portion
(RT)
86
no preservative
Polatuzumab vedotin
88 88 88 88 88
140 mg 7.2 mL SWI 20 mg/mL ** 48 h F, 8 h RT 0.72-2.7 mg/mL NS, in NS : - do NOT shake
88
(Genentech) D5W, ½NS 24 h F, 4h RT - use 0.2-0.22
88
(F)(PFL) direct diluent against (PFL) micron in-line
88 88
do not shake side of vial during (dilute to a minimum in D5W : filter
88 88 88
no preservative reconstitution volume of 50 mL) 36 h F, 4 h RT
88
gently invert bag to in ½NS :
88
mix 18 h F, 4 h RT
Pralatrexate
89 89 90 89
20 mg/1 mL N/A 20 mg/mL discard unused syringe 24 h F, RT - do NOT dilute
2
40 mg/2 mL portion
90
(Servier) **(PFL)
(F)(PFL)
89
no preservative
Status)
Raltitrexed
91 91 91
2 mg 4 mL SWI 0.5 mg/mL 24 h F, RT 50-250 mL NS, complete
91
(Pfizer) D5W administration within
91
(F,RT)(PFL) 24 h F, RT
91
(no preservative)
Ramucirumab
92 92 92
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL* NS 24 h F, 4 h RT - 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
100 mg/10 mL N/A 10 mg/mL discard unused 1-4 mg/mL NS, NS: - once removed
2,94 94 94
500 mg/50 mL portion D5W 14 d F, 24 h RT from the fridge,
(Roche) product
(F)(PFL) (e.g., 250-500 mL)* D5W: compounded in NS
94 94
no preservative 24 h F, 12 h RT is stable for 24h
94
RT
- once removed
from the fridge,
product
compounded in
D5W is stable for
94
12h RT
Status)
riTUXimab
95 95 95
subcutaneous N/A 120 mg/mL discard unused SC syringe 48 h F plus 8 h RT - contains
95 95
1400 mg/11.7 mL portion hyaluronidase
1600 mg/13.4 mL - formulations are
(Roche) NOT
95
(F)(PFL) interchangeable
95
no preservative
romiDEPsin
96 96 96 96
10 mg 2.2 mL of supplied 5 mg/mL 8 h RT 500 mL NS 24 h RT - reconstituted
96,97
(Celgene Inc.) diluent solution will be
96 98
(RT) slightly viscous
39 96
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
96
diluent)
Status)
Siltuximab
99 99 99
100 mg 100 mg: 20 mg/mL 2 h RT 250 mL D5W complete - use 0.2 micron in-
99 99
400 mg 5.2 mL SWI administration within line filter
99
(Janssen) dilute to 250 mL final 6 h RT
(F)(PFL) 400 mg: volume by
99 99
no preservative 20 mL SWI withdrawing volume
from bag equal to
allow vial to come to volume of drug to be
99
room temperature added
prior to use (~30
99
minutes)
gently swirl, do NOT

99
shake
Streptozocin
100 100 100 100
1g 9.5mL NS, SWI, 100 mg/mL 48 h F, 24 h RT syringe 48 h F, 24 h RT
100
(Pfizer) D5W
(F)(PFL)
100 100
no preservative 50-500 mL* NS, 48 h F, 24 h RT
100
D5W, SWI
Temsirolimus
101,102 101,102 101,102
30 mg/1.2 mL 1.8 mL supplied 10 mg/mL 24 h RT 250 mL NS complete - use non-DEHP
101,102
(Wyeth) diluent administration within 6 bag and tubing with
101,102 101 101,102 101,102
(F)(PFL) **(PFL) h in-line filter
103
no preservative
Status)
Teniposide
104
50 mg/5 mL N/A 10 mg/mL discard unused 50 – 500 mL NS, 0.1-0.4 mg/mL: - do not refrigerate
104
(BMS) portion D5W for a final 24 h RT - use non-DEHP
104
(RT) concentration of 0.1-1 bag and tubing
104 104
preservative mg/mL 1 mg/mL: - do not use if
104,105
complete precipitates
administration within - contains DMA***
4 h of preparation - excessive
104,105
RT agitation may
cause
104
precipitation
Thiotepa
106 106 106
15 mg 15 mg: 10 mg/mL 8hF reconstituted solution 24 h F, 4 h RT - do not use if
106
100 mg 1.5 mL SWI is hypotonic and must precipitates are
106
(Adienne/Methapharm) be further diluted with present
106
(F) 100 mg: NS prior to use - reconstituted
106 106
no preservative 10 mL SWI solution may be
doses ≤ 500 mg: used if
106
to remove haze, 500 mL NS or with an opalescent
filter through 0.22 appropriate volume to - administer with
micron filter after achieve 0.5-1 mg/mL 0.2 micron inline
107 106 106
reconstitution concentration filter
record time of doses > 500 mg:

106
reconstitution 1000 mL NS
Status)
Thiotepa
106 106 27
IT injection diluents containing 10 mg/mL 8hF qs to 6 mL with use within 4 h of initial - auxiliary info :
26 2
15 mg preservatives should preservative free NS reconstitution “IT”
100mg NOT be used for - label to include
(Adienne/Methapharm) intrathecal route in full (i.e.,
108
(F) administration INTRATHECAL
106
no preservative injection) attached
15 mg: to both syringe and
106 27
1.5 mL SWI outer ziplock bag
- do not use if
100 mg: precipitates are
106 106
10 mL SWI present
- reconstituted
to remove haze, solution may be
filter through 0.22 used if
106
micron filter after opalescent
107
reconstitution
record time of
reconstitution
Thyrotropin alfa
109 109 109 109 109
1.1 mg 1.2 mL SWI 0.9 mg/mL 24 h F syringe 24 h F
(Genzyme)
109
(F)(PFL) swirl contents
109
no preservative
do NOT shake
Status)
Tocilizumab
110 110
80 mg/4 mL N/A 20 mg/mL discard unused 100 mL NS complete - to prevent
110
200 mg/10 mL portion administration within foaming: slowly
110
400 mg/20 mL dilute to final volume 24 h F, RT add drug to
(Roche) by withdrawing infusion bag and
(F)(PFL) volume from bag bring to room gently invert bag to
110 110
no preservative equal to volume of temperature prior to mix
110 110
drug to be added administration
110
gently invert to mix
Topotecan
111 2,111
4 mg/4 mL N/A 1 mg/mL discard unused 0.025-0.5 mg/mL 14 d F, 48 h RT
2,111
(Accord) portion
(RT)(PFL) 50-100 mL NS,
111 111
no preservative D5W
Topotecan
112 112 112
1 mg 1 mg: 1 mg/mL 24 h F, RT 0.02-0.5 mg/mL 24 F, RT
112
4 mg 1.1 mL SWI
(Actavis) 50-100 mL NS,
112
(RT)(PFL) 4 mg: D5W
112 112
no preservative 4 mL SWI
Topotecan
113 113
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F, RT
2,113
(Pfizer/Hospira) portion
(F)(PFL) 50-100 mL NS,
113 113
no preservative D5W
Status)
Topotecan
114 114
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F
114
(Sandoz) portion
114
(F)(PFL) 50-100 mL NS, **(PFL)
114 114
no preservative D5W
Trastuzumab
115 39 115 115 115
(HERCEPTIN®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
115
440 mg BWI
(Roche) do NOT use dextrose
115
(F) swirl vial gently; containing solutions
115
no preservative allow to stand
undisturbed for 5
115
min
Trastuzumab
116 2,116 116 116 116
(HERZUMA®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
116
440 mg BWI - supplied BWI
(Celltrion/Teva) do NOT use dextrose contains benzyl
116 116
(F) swirl vial gently; containing solutions alcohol
116
no preservative allow to stand
undisturbed for 5
116
min
Status)
Trastuzumab
117 117 117 117
(OGIVRI®) 150 mg vial: 21 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT shake
117 117
150 mg 7.2 mL SWI portion - supplied BWI
440 mg do NOT use dextrose contains benzyl
117 117
(BGP) containing solutions alcohol
(F)
117 2,117
no preservative 440 mg vial: 14 d F
20 mL supplied
117
BWI
swirl vial gently;

allow to stand
undisturbed for 5
117
min
Trastuzumab
118 118 118 118
(TRAZIMERA®) 150 mg vial: 21 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT shake
118 118
150 mg 7.2 mL SWI portion - supplied BWI
440 mg do NOT use dextrose contains benzyl
118 118
(Pfizer) containing solutions alcohol
(F)
118 2,118
no preservative 440 mg vial: 14 d F
20 mL supplied
118
BWI
swirl vial gently;

allow to stand
undisturbed for 5
118
min
Status)
Trastuzumab
119 119 119
Emtansine 100 mg vial: 20 mg/mL 24 h F 250 mL NS or ½NS 24 h F - do not use if
119 119
(KADCYLA®) 5 mL SWI only reconstituted
119 119
100 mg do NOT freeze do NOT freeze solution contains
119
160 mg 160 mg vial: do NOT shake visible particulates
119
(Roche) 8 mL SWI 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
39
200 mg/8 mL portion within 24 h F, 8 h in-line filter for
120,121 120
400 mg/16 mL invert gently to mix RT administration
(Tracon)
(F)(PFL)
120
no preservative
Treosulfan
122,123 2,122,124 125 2,122,124
1g pre-heat diluent to 50 mg/mL 48 h RT undiluted 48 h RT - compatible with
5g 25-30°C (max) polytetrafluoroethyl
126
(medac) or ene filters
(RT) shake vial carefully - may sometimes
122,123
no preservative to loosen powder dilute with NS or D5W require vigorous
before adding the in empty infusion bag shaking to
122,123
warmed diluent for final concentration reconstitute
124
= 20 mg/mL - do NOT
1 g vial: refrigerate as may
20 mL SWI or ½NS cause
122,123
gently shake while precipitation
122,123
adding diluent
5 g vial:
100 mL SWI or ½NS
gently shake while
122,123
adding diluent
(takes ~2 min to
reconstititute)
Status)
vinBLAStine
127 128
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W use within 4 h of initial - auxiliary info:
2,127 2,127
(Pfizer) portion vial puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
127
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
129,130
ROUTES
vinBLAStine
131 128
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W use within 4 h of initial - auxiliary info:
2,131 2,131
(Teva) portion vial puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
131
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
129,130
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 info:
5 mg/5 mL WARNING: FOR
132
(Hospira) **(PFL) INTRAVENOUS
(F)(PFL) USE ONLY –
132
no preservative FATAL IF GIVEN
BY OTHER
133,134
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Status)
vinCRIStine
135 135 135
1 mg/1 mL N/A 1 mg/mL 8 h F, RT 0.01-0.1 mg/mL NS, 24 h F, RT - auxiliary info:
135
2 mg/2 mL D5W WARNING: FOR
5 mg/5 mL INTRAVENOUS
(Teva) 25-50 mL NS, D5W
136
USE ONLY –
(F)(PFL) FATAL IF GIVEN
135
no preservative BY OTHER
133,134
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
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 info:
137
50 mg/5mL portion WARNING: FOR
(Fresenius Kabi) NS, D5W, ½NS, INTRAVENOUS
(F)(PFL) D5-½NS, Ringer’s, USE ONLY –
137 137
no preservative Ringer’s Lactate FATAL IF GIVEN
BY OTHER
130,133
ROUTES
Status)
Vinorelbine
138 138 138
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary info:
2
50 mg/5 mL portion WARNING: FOR
(GMP) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5-½NS, USE ONLY –
138
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
138
Lactate BY OTHER
130,133
ROUTES
Vinorelbine
139 139 139
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
139
(Pfizer/Hospira) 50 mL* NS, D5W, INTRAVENOUS
139
139
Lactate BY OTHER
130,133
ROUTES
Vinorelbine
140 140 140
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
140
(Teva) 50 mL* NS, D5W, INTRAVENOUS
140
140
Lactate BY OTHER
130,133
ROUTES
Status)
Zoledronic acid
141 141
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
141
(Dr Reddy’s) portion within 24 h of calcium containing
141 141
(RT) preparation solutions
141
no preservative
refrigerate diluted
product if not used
immediately after
preparation; bring to
RT prior to
141
administration
Zoledronic acid
142 142
142
(Marcan) portion within 24 h of calcium containing
142
(RT) preparation solutions (e.g.,
142
no preservative Lactated
142
refrigerate diluted Ringer’s)
product if not used
immediately after
RT prior to
142
administration
Status)
Zoledronic acid
143 143
143
(MDA) portion within 24 h of calcium containing
143 143
(RT) preparation solutions
143
no preservative
refrigerate diluted
product if not used
immediately after
RT prior to
143
administration
Zoledronic acid
144 144
(ZOMETA) N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
39
4 mg/ 5 mL portion within 24 h of calcium containing
144 144
(Novartis) preparation solutions
(RT)
144
no preservative refrigerate diluted
product if not used
immediately after
RT prior to
144
administration
Status)
Zoledronic acid
145 145
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 ml NS, D5W complete infusion - do NOT mix with
145
(Sandoz) portion within 24 h of calcium- or other
145
(RT) preparation divalent cation-
145
no preservative containing infusion
refrigerate diluted solutions (e.g.,
product if not used Lactated
145
immediately after Ringer’s)
RT prior to
145
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 content locally. All suggestions for change are to forwarded to the Cancer Drug Manual editor.
Explanatory Notes:
Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the classification
146,147
outlined in USP 797.
Vial stability: Stability of solution after first puncture or reconstituted solution.
Storage temperature: If information states same stability with refrigerator and room temperature storage, then fridge stability is bolded as preferred (ie, to
minimize growth of micro-organisms).
Discard unused portion: Unused portion from single use vials should be discarded at the end of the day.
“overfill known” is stated if the manufacturer states overfill that is present is within acceptable limits.
“Complete administration within __” is stated if the manufacturer specifies that the infusion must be completed in a specific time frame following preparation,
usually including entire time required for preparation (from first puncture), storage, and administration of infusion.
Abbreviations:
BWI = bacteriostatic water for injection

CIVI: ambulatory pump = Continuous Intravenous Infusion (e.g., elastomeric infusor)
D5W = dextrose 5% in water
DMA = N,N dimethylacetamide
F = refrigerate
Non-DEHP = not containing Di(2-ethylhexyl) phthalate (DEHP)
NS = normal saline
PFL = protect from light
RT = room temperature
SWI = sterile water for injection
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Chemo Stability Chart - LtoZ

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Chemo Stability Chart - LtoZ

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BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART

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

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

0.06 - 0.4 mg/mL NS, NS:

0.06 - 1 mg/mL Ringer’s, LR:

high dose use within 24 h RT of

high dose use within 24 h RT of

devices with spikes

gently swirl, do NOT

record time of doses > 500 mg:

swirl vial gently;

swirl vial gently;

BWI = bacteriostatic water for injection

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