Chemo Stability Chart - AtoK

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)
AGS-16C3F
1 1 1
30 mg 5.1 mL SWI 6 mg/mL discard unused ≥ 0.3 mg/mL complete - unopened vials
1
(Astellas) portion administration within may be kept at RT
2,3
(F)(PFL) swirl gently; do NOT 100 mL D5W 6 h RT of for up to 4h prior to
1 1 1
do not shake shake (PFL) reconstitution use if protected from
1 1
no preservative mix by gentle light
1
allow foam to clear inversion **(PFL)
1
before proceeding
record time of
reconstitution
Aldesleukin
4,5 4 4 4
22 million units 1.2 mL SWI 18 million unit/mL 48 h F 50 mL D5W 48 h F - do not use in-line
4,5 4,5
(1.3 mg) (1.1 mg/mL) filter
4
(Novartis) direct diluent against 30 – 70 mcg/mL - avoid bacteriostatic
(F)(PFL) side of vial during water for injection or
4 4
no preservative reconstitution Less than 30 mcg/mL: NS due to increased
4
dilute in D5W aggregation
4
do NOT shake containing human
5
albumin 0.1%
6,7 7
SC syringe 14 d F
**(PFL)
BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 1/51
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: 1 November 2019
Manufacturer,
Alemtuzumab
9 10 11
30 mg/mL N/A filter NOT required discard unused SC syringe discard at the end of - do NOT shake
8 9
(Genzyme/Bayer) portion the day F, RT
9
(F)(PFL) 30 mg/mL
do not shake
9 9 9
no preservative 100 mL NS, D5W 8 h F, RT
11
**(PFL)
Amsacrine
12 12 12 12-14
75 mg/1.5 mL glass syringes 5 mg/mL 24 h RT 500 mL D5W 7 d F, 48 h RT - contains DMA***
(Erfa Canada) preferred during
12
(RT) reconstitution; (**PFL) (plastic or glass
12 12
no preservative max. time in plastic container)
12
syringe : 15 min
13.5 mL supplied
diluent (L-lactic
1
acid)
transfer 1.5mL from

ampoule into the
12
diluent vial
Arsenic trioxide
15 15
10 mg/10 mL N/A 1 mg/mL discard unused 100-250 mL NS, 24 h RT, 48 h F
15 15
(Lundbeck/Teva) portion D5W
(RT) (use filter needle to
15
no preservative withdraw from
ampoule)
Manufacturer,
Asparaginase
16 16
(asparaginase E. coli) 4 mL SWI 2500 units/mL 72 h F, 3 h RT syringe complete
10,000 units administration within
16
(CGF/EUSA) do NOT shake; 72 h F, 3 h RT
16
(F) rotate gently
16
no preservative
50-250 mL NS or complete
17
D5W administration within
16,18
3 h RT
Erwinia asparaginase
19 19 19
(asparaginase Erwinia 1-2 mL NS 10 000-5000 15 min RT glass or 4 h RT - contact with the
chrysanthemi) units/mL polypropylene rubber stopper may
19
10,000 units do NOT shake; mix syringe denature the
(CGF/EUSA) gently to minimize (use 5 micron filter reconstituted drug,
(F) bubbles and contact needle to withdraw creating filaments of
19 19 20 19
no preservative with stopper from vial) insoluble material
- discard if
particulate matter is
20
present
- do not use sterile
water for
reconstitution as the
resulting product is
19
not isotonic
Manufacturer,
PEG-asparaginase -
see pegaspargase in
L-Z chart
(pegylated
asparaginase E. coli)
Atezolizumab
21 22
1200 mg/20 mL N/A 60 mg/mL discard unused 250 mL NS only complete - discard vial if
21
(Hoffman-La Roche) portion administration within cloudy, discoloured
21
(F)(PFL) mix by slow 24 h F, 8 h RT (should be clear to
22
do not shake inversion pale yellow), or
21 22
no preservative visible particles
22
- do NOT shake
Avelumab
23 23
200 mg/10 mL N/A 20 mg/mL discard unused 250 mL NS, complete - do NOT shake
18
(EMD) portion 0.45% sodium administration within - use 0.2 micron in-
23 23
(F)(PFL) chloride 24 h F, 8 h RT line filter to
23 23
no preservative if refrigerated, administer
bring vial to RT mix by gentle if refrigerated, bring
23 23
prior to use inversion bag to RT prior to
23
administration
Manufacturer,
azaCITIDine
24 24 24
100 mg 4 mL SWI 25 mg/mL 45 min RT, 8 h SC syringe 45 min RT (including - discard if contains
24 24
(Celgene) F preparation time), large particles
24 24
(RT) shake vigorously 8hF - re-suspend syringe
24
no preservative contents before
record time of refrigerate syringe injection by
reconstitution immediately after vigorously rolling
preparation if not to syringe between
24
be used within 45 palms
minutes of -if cold diluent
25
reconstitution reconstitution is used
to extend stability,
Refrigerated minimize exposure to
24
syringes : RT; ensure proper
 allow up to 30 min refrigeration of
prior to diluent, reconstituted
administration to vial, and final
reach a product
temperature of ~20-
25°C
discard syringe if
time elapsed at RT is
greater than 30 min
24 26,27 26,27
cold diluent 25 mg/mL 22 h F 22 h F
reconstitution:
4 mL SWI at 2-
26,27
8°C
Manufacturer,
azaCITIDine
28 28 28 28
100 mg 4 mL SWI 25 mg/mL 45 min RT, 8 h SC syringe 45 min RT (including - do not filter
28
(Dr. Reddy‘s) F preparation time), - discard if contains
28 28 28
(RT) shake vigorously 8hF large particles
28
no preservative - re-suspend syringe
refrigerate syringe contents before
immediately after injection by
preparation if not to vigorously rolling
be used within 45 syringe between
28
minutes of palms
28
reconstitution
Refrigerated
28
syringes :
 allow up to 30 min
prior to
administration to
reach a
temperature of
approximately 20-
25°C
 discard syringe if
time elapsed at RT
is greater than 30
min
Manufacturer,
BCG
8 29
(Tice substrain) 1 mL preservative- 1 to 8×10 2hF transfer from vial to use within 2 h F of - auxiliary info:
29 29 29,30 30
intravesical free NS CFU/vial 60 mL syringe, rinse reconstitution biohazard
8 29 29
50 mg = 1 to 8 x 10 **(PFL) vial with another 1 mL - do NOT filter
29 29
CFU allow to stand for a NS; add rinse to **(PFL) - do NOT shake
(Merck Canada) few minutes, then same 60 mL syringe
(F)(PFL) gently swirl to and qs to 50 mL with
29 29 29
no preservative suspend NS
record time of if a closed system

reconstitution transfer device is
used:
transfer from vial to
60 mL syringe and qs
to 50 mL with NS; do
29
NOT rinse vial
BCG
8 31
(Tice substrain) 1 mL preservative 1 to 8×10 2hF transfer from vial to use within 2 h F of - auxiliary info:
31 31 30,31 30
intravesical free NS CFU/vial 60 mL syringe and qs reconstitution biohazard
8 31 31 31
50 mg = 1 to 8 x 10 (PFL to 50 mL with NS - do NOT filter
31 31
CFU allow to stand for a **(PFL) - do NOT shake
(Merck USA) few minutes, then
(F)(PFL) gently swirl to
31 31
no preservative suspend
record time of
reconstitution
Manufacturer,
BCG
32 32
intravesical do NOT shake; roll 10.5 ± 8.7×108 2 h F, RT 50 mL NS 2 h F or RT after - auxiliary info:
32 32 18
81 mg to reconstitute CFU/vial reconstitution biohazard
(Sanofi Pasteur) (Connaught
32 32
(F)(PFL) 3 mL supplied strain) **(PFL)
32 32
preservative diluent
record time of
reconstitution
Belinostat
33 33 33 33
500 mg 9 mL SWI 50 mg/mL 12 h RT 250 mL NS complete - use 0.22 micron
(Spectrum) administration within inline filter to
33 33
(RT) 36 h RT administer
33
no preservative
Bendamustine
34 34
25 mg 25 mg vial: 5 mg/mL 30 minutes 0.2-0.6 mg/mL NS, complete
34 34
100 mg add 5 mL SWI D2.5-½NS administration within
35
(Lundbeck/Teva) 24 h F, 3 h RT
34
(RT,F)(PFL) 100 mg vial: 250* - 500 mL
34 34
no preservative add 20 mL SW
shake well;
dissolves completely
34
in 5 minutes
Manufacturer,
Bevacizumab
36 36 36 36
(AVASTIN®) N/A 25 mg/mL discard unused 1.4-16.5 mg/mL 48 h F, RT - do NOT shake
36
100 mg/4 mL portion
36
400 mg/16 mL in NS only
(Roche)
(F)(PFL)
do not shake
36
no preservative
Bevacizumab
37 37 37 37
(MVASI®) N/A 25 mg/mL discard unused 1.4-16.5 mg/mL 48 h F, RT - do NOT shake
37
100 mg/4 mL portion
37
(Amgen)
(F)(PFL)
do not shake
37
no preservative
Bevacizumab
38 38 38 38
(ZIRABEV®) N/A 25 mg/mL discard unused 1.4-16.5 mg/mL 48 h F, RT - do NOT shake
38
100 mg/4 mL portion
38
(Pfizer)
(F)(PFL)
do not shake
38
no preservative
Manufacturer,
Bleomycin
39 39 39 39
15 units 6 mL* NS 2.5 units/mL 48 h F 50 mL* NS 24 h RT
(NB: dose in units only)
(Fresenius Kabi)
(F)(PFL)
39
no preservative
Bleomycin
40 40 41
15 units 6 mL* NS, SWI 2.5 units/mL 48 h F, 24 h RT 50 mL* NS{14216}} 4 h RT
(NB: dose in units only)
(Pfizer/Hospira)
(F)(PFL)
40
no preservative
Blinatumomab
42 42 42 42
38.5 mcg 3 mL SWI 12.5 mcg/mL 24 h F, 4 h RT 250 mL NS complete - use non-DEHP bag
(Amgen) administration within and IV administration
42 42
(F)(PFL) do NOT use add supplied IV 10 d F, 96 h RT set
do not shake supplied IV solution solution stabilizer to - use 0.2 or 0.22
42 42
no preservative stabilizer to NS bag and gently micron in-line filter
42
reconstitute vials mix to avoid - prime lines with
42
foaming blinatumomab
direct diluent against solution; do NOT use
side of vial during add reconstituted NS
42
reconstitution drug to bag following
addition of IV solution
42
gently swirl to avoid stabilizer
42
excess foaming
Manufacturer,
Bortezomib
43 43 44,45 43 44,45
SC injection 1.4 mL NS 2.5 mg/mL 2 d F, RT SC syringe 14 d F, 48 h RT - auxiliary info:
3.5 mg WARNING:
(Actavis) SUBCUTANEOUS
(RT)(PFL) use only. Fatal if
43
no preservative given by other
routes.
Bortezomib
43 43 44,45 43 44,45
3.5 mg 3.5 mL NS 1 mg/mL 2 d F, RT IV syringe 14 d F, 48 h RT - auxiliary info:
(Actavis) WARNING:
(RT)(PFL) INTRAVENOUS use
43
no preservative only. Fatal if given by
other routes.
Bortezomib
46 46 30,47 46 30,47
SC injection 1.4 mL NS 2.5 mg/mL 2d F, RT SC syringe 14 d F, 48 h RT - auxiliary info:
3.5 mg WARNING:
(Apotex) SUBCUTANEOUS
46
routes.
Bortezomib
46 46 30,47 46 30,47
3.5 mg 3.5 mL NS 1 mg/mL 2d F, RT IV syringe 14 d F, 48 h RT - auxiliary info:
(Apotex) WARNING:
46
other routes.
Manufacturer,
Bortezomib
48 48 44,45 48 44,45
3.5 mg WARNING:
(Janssen) SUBCUTANEOUS
48
routes.
Bortezomib
48 48 44,45 48 44,45
(Janssen) WARNING:
48
other routes.
Bortezomib
49 49 44,45 49 44,45
3.5 mg WARNING:
(Teva) SUBCUTANEOUS
49
routes.
Bortezomib
49 49 44,45 49 44,45
(Teva) WARNING:
49
other routes.
Manufacturer,
Brentuximab vedotin
50 50 50 50
50 mg 10.5 mL SWI 5 mg/mL 24 h F 0.4-1.8 mg/mL in NS, 24 h F - solution should be
(GMD/Seattle Genetics) D5W, Lactated clear to slightly
(F)(PFL) direct diluent against Ringer’s opalescent,
50
no preservative side of vial during colorless, and free of
50 50 50
reconstitution 100-250 mL visible particulates
50
do NOT shake
Busulfan
51
60 mg/10 mL N/A 6 mg/mL discard unused NS, D5W complete - contains DMA***
30,51
(PMS) portion (dilute to volume 10 administration within - always add
51
(F) times drug volume to 12 h F, 8 h RT busulfan to diluent to
51
no preservative achieve final mix; do not add
51
concentration of ~0.5 diluent to busulfan
51
mg/mL)
Busulfan
52
60 mg/10 mL N/A 6 mg/mL discard unused NS, D5W in NS: complete - contains DMA***
18,52
(SteriMax) portion (dilute to volume 10 administration within - always add
52
(F) times drug volume to 12 h F, 8 h RT busulfan to diluent to
52
no preservative achieve final mix; do not add
52
concentration of ~0.5 in D5W: complete diluent to busulfan
52
mg/mL) administration within
52
8 h RT
Manufacturer,
Cabazitaxel
53 53
60 mg/1.5 mL supplied diluent: 10 mg/mL 1 h RT 0.10 – 0.26 mg/mL complete - concentrate and
53
(sanofi-aventis) withdraw entire NS, D5W administration within diluent vials contain
53 53
(RT) contents of diluent 48 h F, 8 h RT overfill
53
no preservative vial and inject into (e.g., 250 mL*) - use non-DEHP bag
53
the concentrate and tubing
53
vial - use 0.22 micron in-
53
line filter
slowly direct diluent - diluent contains
against inside of vial 13% (w/w) ethanol in
53 53
to limit foaming water
- discard if
mix by repeated crystallization
53
inversions for 45 occurs
53
sec
53
do NOT shake
53
let sit for 5 min
CARBOplatin
54 54 54
50 mg/5 mL N/A 10 mg/mL discard unused 0.5-10 mg/mL 24 h F, 8 h RT - do NOT use
54
150 mg/15 mL portion aluminum-containing
54
450 mg/45 mL NS, D5W needle, syringe, or
54
600 mg/60 mL tubing
(Accord)
(RT)(PFL)
54
no preservative
Manufacturer,
CARBOplatin
55 55 55 56
50 mg/5 mL N/A 10 mg/mL discard unused 0.3-10 mg/mL 48 h F , 24 h RT - do NOT use
55
55
450 mg/45 mL NS, D5W needle, syringe or
55
600 mg/60 mL tubing
(Omega)
(RT)(PFL)
55
no preservative
CARBOplatin
57 57 57
50 mg/5 mL N/A 10 mg/mL discard unused 0.3-10 mg/mL 48 h F - do NOT use
57
57
57
600 mg/60 mL tubing
(Pfizer/Hospira)
(RT)(PFL)
57
no preservative
CARBOplatin
58 59 58
50 mg/5 mL N/A 10 mg/mL discard unused 0.5-10 mg/mL 8 h RT - do NOT use
58
150 mg/15 mL portion RT aluminum-containing
58,60,61
58
(Teva/Novopharm) tubing
(RT)(PFL)
58
no preservative
Manufacturer,
Carfilzomib
62 62
10 mg 10 mg: 2 mg/mL 24 h F, 4 h RT 50-100 mL D5W complete - if a closed system
62 62
30 mg 5 mL SWI only administration within transfer device is not
60 mg 24 h F, 4 h RT after used for
62 62
(Amgen) 30 mg: do NOT dilute in NS reconstitution compounding, a 21
62
(F)(PFL) 15 mL SWI gauge (or larger
62
no preservative gauge) needle is
60 mg: recommended to
62
29 mL SWI prevent coring of the
62-64
vial stopper
direct diluent against
side of vial during
62
reconstitution
swirl gently; do NOT

62
shake
if foaming occurs,
allow to settle until
clear (about 5
62
minutes)
record time of
reconstitution
Manufacturer,
Carmustine
65 65 65
100 mg 3 mL diluent 3.3 mg/mL in 10% 24 h F, 8 h RT glass or polyolefin 24 h F: in glass or - do not use if
65 65 60 60
(Bristol Labs) (supplied) ethanol container polyolefin container product has oily
65
(F) droplets
65 65
no preservative diluent to reach RT, 500 mL NS or D5W use within 4 h of
65
then dissolve drug reconstitution RT
with 3 mL diluent;
65
add 27 mL SWI
record time of
reconstitution
Cemiplimab
66
250 mg/5 mL N/A 50 mg/mL discard unused 1-20 mg/mL complete - administer using
30,66 66 66
350 mg/7 mL portion NS, D5W administration within 0.2-5 micron filter
66
(sanofi) 8 h RT, 24 h F
67
(F)(PFL) 50-100* mL
do not shake
66
no preservative mix by gentle
inversion
Cetuximab
68 68 68 68
100 mg/50 mL N/A 2 mg/mL 12 h F, 8 h RT syringe 12 h F, 8 h RT - administer using
68
200 mg/100 mL 0.22 micron filter
(Imclone/Lilly)
(F) evacuated container
68
do not shake or bag
68
no preservative
Manufacturer,
CISplatin
69 69
10 mg/10 mL N/A 1 mg/mL discard unused Less than or equal to 24 h RT - do NOT use
30
50 mg/50 mL portion 60 mg: 100 mL* NS aluminum-containing
100 mg/100mL needle, syringe or
69
(Accord) Greater than 60 mg: tubing
(RT)(PFL) 250 mL* NS
69
no preservative
2 L of D5 in one-half
or one-third NS
containing 37.5 g of
69
mannitol
CISplatin
70 70
30
100 mg/100mL portion 60 mg: 100 mL* NS aluminum-containing
(Pfizer/Hospira) needle, syringe or
70
(RT)(PFL) Greater than 60 mg: tubing
70
no preservative 250 mL* NS
or one-third NS
70
mannitol
Manufacturer,
CISplatin
71 71,72 71
10 mg/10 mL N/A 1 mg/mL 48 h RT Less than or equal to 24 h RT - do NOT use
50 mg/50 mL 60 mg: 100 mL NS* aluminum-containing
71
(Sandoz) Greater than 60 mg: tubing
(RT)(PFL) 250 mL NS*
71
no preservative
NS, 0.45% sodium
chloride with or
73
without mannitol
or one-third NS
71
mannitol
CISplatin
74 74
18
50 mg/50 mL portion 60 mg: 100 mL* NS aluminum-containing
74
(Teva) Greater than 60 mg: tubing
(RT)(PFL) 250 mL* NS
74
no preservative
or one-third NS
74
mannitol
Manufacturer,
Cladribine
75 76
10 mg/10 mL N/A 1 mg/mL discard unused SC syringe discard end of
75 13,75,77
(Fresenius Kabi) potion day
(F)(PFL)
75
no preservative
500 mL NS only 24 h RT
do NOT use D5W
75
Cassette: at least 7 days
qs to 100 mL with
bacteriostatic NS
only via SIMS
DELTEC INC.
MEDICATION
75
CASSETTES® filter
drug and diluent
through 0.22 micron
filter as each solution
is being introduced
into the cassette
Manufacturer,
Cyclophosphamide
78 72,78,80 78,80
200 mg 200 mg: 20 mg/mL 48 h F, Less than or equal to 72 h F,
78 78
500 mg 10 mL NS 24 h RT 1 g: 100 mL NS* 24 h RT
1000 mg
2000 mg 500 mg: Greater than 1 g:
(Baxter) 25 mL NS 250 mL NS*
(RT)(PFL)
78
no preservative 1000 mg: high dose in BMT:
50 mL NS may need 500 NS*
78
2000 mg: NS, D5W, D5NS
78,79
100 mL NS
Cytarabine
81 81
1000 mg/10mL N/A 100 mg/mL discard unused 0.1-37.5 mg/mL NS, 10 d F, 48 h RT
30,81 81
2000 mg/20mL portion D5W, SWI
(Pfizer/Hospira) **(PFL)
(RT)(PFL) 100 mL* NS, D5W,
81
no preservative SWI
Cytarabine
81
IT injection N/A 100 mg/mL use within 4 h of diluents containing use within 4 h of - auxiliary info: IT
30 30
1000 mg/10mL initial vial preservatives should initial vial puncture injection
30
2000 mg/20mL record time of puncture NOT be used for - label to include
(Pfizer/Hospira) puncture intrathecal **(PFL) route in full (i.e.,
81
(RT)(PFL) administration INTRATHECAL
81
no preservative injection) attached to
qs to 6 mL with both syringe and
41
preservative free outer ziplock bag
82,83
NS
Manufacturer,
Cytarabine
81 81
SC injection N/A 100 mg/mL discard unused syringe 10 d F, 48 h RT
30,81
1000 mg/10mL portion
2000 mg/20mL **(PFL)
(Pfizer/Hospira)
(RT)(PFL)
84
no preservative
Cytarabine
85 85
1000 mg/10mL N/A 100 mg/mL discard unused 0.1-37.5 mg/mL NS, 10 d F, 48 h RT
30,85 85
2000 mg/20mL portion D5W, SWI
(PMS) **(PFL)
(RT)(PFL) 100 mL* NS, D5W,
85
no preservative SWI
Cytarabine
85
IT injection N/A 100 mg/mL use within 4 h of diluents containing use within 4 h of - auxiliary info: IT
30 30
1000 mg/10mL initial vial preservatives should initial vial puncture injection
30
2000 mg/20mL record time of puncture NOT be used for - label to include
(PMS) puncture intrathecal **(PFL) route in full (i.e.,
85
(RT)(PFL) administration INTRATHECAL
85
no preservative injection) attached to
qs to 6 mL with both syringe and
41
preservative free outer ziplock bag
82,83
NS
Manufacturer,
Cytarabine
85 85
SC injection N/A 100 mg/mL discard unused syringe 10 d F, 48 h RT
30,85
1000 mg/10mL portion
2000 mg/20mL **(PFL)
(PMS)
(RT)(PFL)
85
no preservative
Dacarbazine
86 86 86
100 mg 100 mg: 10 mg/mL 72 h F, 8 h RT 250-1000 mL* NS, 24 h F, 8 h RT - protect container
86
200 mg 9.9 mL SWI D5W from light during
60,86
(Abraxis) **(PFL) storage and
87
(F)(PFL) 200 mg: administration
86 86
no preservative 19.7 mL SWI - overfill unknown
Dacarbazine
88 88 13,88 88
200 mg 200 mg: 10 mg/mL 8 h RT, 48 h F 0.19–3.0 mg/mL 24 h F - protect container
88
600 mg 19.7 mL SWI from light during
89 87
(Hospira) (PFL) 250-1000 mL* NS, **(PFL) storage and
87
(F)(PFL) 600 mg: D5W administration
88 88 89,90
no preservative 59.1 mL SWI - no overfill
Dacarbazine
91 91 91 91
600 mg 59.1 mL SWI 10 mg/mL 24 h F, 8 h RT 0.19-3.0 mg/mL in 24 h F - protect container
91
(Pfizer) D5W or NS from light during
87
(F)(PFL) **(PFL) storage and
91 87
no preservative administration
Manufacturer,
DACTINomycin
92
0.5 mg 1.1 mL SWI 0.5 mg/mL discard unused syringe use within 4 h of - drug loss reported
92 92 72 72
(GMD Pharma for (preservative-free) (500 mcg/mL) portion initial vial puncture with some cellulose
Recordati) ester membrane in-
92
(RT)(PFL) do NOT use SWI 10 mcg/mL or line filters
92 92
no preservative with preservative greater
(may form
92 92,93
precipitate) NS, D5W
Daratumumab
94
100 mg/5mL N/A 20 mg/mL discard unused 500-1000 mL NS 24 h F, followed by - administer with a
94
400 mg/20mL portion 15 h infusion (total 39 0.22 or 0.2 micron in-
94 94
(Janssen) dilute to final volume h) line filter
(F)(PFL) by withdrawing - discard if visible
do not shake volume from bag allow bag to come to particles are
94 94
no preservative equal to volume of room temperature, observed
94
drug to be added then use - complete infusion
94 94
immediately within 15 hours
mix by gentle
94
inversion **(PFL)
DAUNOrubicin
95 95,98 97 95
20 mg 4 mL SWI 5 mg/mL 48 h F, 24 h RT 100-250 mL in 48 h F, 24 h RT
95
(Erfa Canada Inc.) isotonic solution e.g.,
96 95
(RT)(PFL) NS
97
no preservative
97
no data for D5W
Manufacturer,
DAUNOrubicin
99 99 99 99
20 mg 4 mL SWI 5 mg/mL 48 h F, 24 h RT 100-250 mL 48 h F, 24 h RT
60
(Teva/Novopharm) NS or D5W
99 99
(RT)(PFL) **(PFL) **(PFL)
99
no preservative
Degarelix
100 100 100 100
80 mg 80 mg: 20 mg/mL 2 h RT SC syringe 2 h RT
120 mg 4.2 mL SWI
100
(Ferring) (supplied diluent)
(RT)
100
do not shake
101 100
no preservative 120 mg: 40 mg/mL
3 mL SWI (supplied
100
diluent)
swirl gently; avoid

shaking to prevent
100
foam formation
reconstitution may
100
take up to 15 min
Manufacturer,
Denosumab
102 102
(XGEVA®) N/A 71 mg/mL discard unused SC syringe use within 4 h of - not interchangeable
72,102 72 102
120 mg/1.7 mL portion initial puncture with PROLIA
(Amgen) - do not use if
(F)(PFL) solution is cloudy;
do not shake trace amounts of
102
no preservative translucent to white
proteinaceous
particles are
102
acceptable
- avoid vigorous
102
shaking
- bring to room
temperature 15-30
minutes prior to
102
administration
Dexrazoxane
103 103
250 mg 250 mg: 10 mg/mL 3 h F, 30 min MUST BE FURTHER 4 h F, 1 h RT
103 104
500 mg 25 mL SWI RT DILUTED With
(Pfizer) Lactated Ringers
(RT) 500 mg: Injection to 1.3 – 3.0
103 103 103
no preservative 50 mL SWI mg/mL
Manufacturer,
Dinutuximab
105 105 105
17.5 mg/5 mL N/A 3.5 mg/mL discard unused 100 mL NS initiate infusion within - do NOT shake
30
(Unither/United portion 4 h of dilution;
Therapies) mix by gentle refrigerate bag if not
105 105
(F)(PFL) inversion hung immediately
do not shake
105
no preservative complete
administration within
105
24 h of dilution
Manufacturer,
DOCEtaxel
106 106
20 mg/2 mL N/A 10 mg/mL 20mg/2 mL vial: 0.3-0.74 mg/mL complete - use non-DEHP bag
80 mg/8 mL discard unused administration within and IV administration
18,106 106 106
160 mg/16 mL portion 250 mL* NS, D5W 14 d F, 48 h set
18,107,108
(Pfizer/Hospira) RT
(F, RT)(PFL)
106
preservative 80 mg/8 mL or
160 mg/16 mL
106
vial (maximum
number of
punctures: up to 3
doses can be
removed when a
venting needle is
also inserted, i.e.,
6 punctures
108
total)
18,106
14 d F
106
**(PFL)
DOCEtaxel
109 18,110 109
20 mg/2 mL N/A 10 mg/mL 14 d F, RT 0.3-0.74 mg/mL complete - use non-DEHP bag
80 mg/8 mL administration within and IV administration
109 109,111 109
160 mg/16 mL 250 mL* NS, D5W 24 h F, 4 h RT set
(Sandoz)
(F,RT)(PFL)
109
preservative
Manufacturer,
DOCEtaxel
112 18,112,113 112
20 mg/0.5 mL supplied diluent : 10 mg/mL 14 d F, RT 0.3-0.74 mg/mL complete - use non-DEHP
80 mg/2 mL - if vials were administration within bag and IV
112 112 112
(sanofi-aventis) refrigerated, allow to 250 mL NS, D5W 4 h F, administration set
18,113
(F, RT)(PFL) warm for 5 min at 48 h RT
112
no preservative RT. Withdraw entire
contents of the
diluent and inject the
entire contents of
the syringe into the
corresponding
concentrate vial. Mix
by repeated
inversions for 45
112
sec
112
do NOT shake
Let sit for 5

112
minutes
DOXOrubicin
114 114 114
10 mg/5 mL N/A 2 mg/mL 8h syringe 24 h F, RT from initial - for ULYEPOCHR
114
20 mg/10 mL vial puncture protocol, see entry
50 mg/25 mL for EPOCHR
200 mg/100 mL (3-in-1solution
(Accord) containing
(F)(PFL) etoposide,
114
no preservative DOXOrubicin,
vinCRIStine)
Manufacturer,
DOXOrubicin
115 115 13,116
10 mg 10 mg: 2 mg/mL 48 h F, 24 h syringe 48 h F, 24 h RT - for ULYEPOCHR
13,115
50 mg 5 mL NS, SWI, RT protocol, see entry
115
150 mg D5W for EPOCHR
(Hospira) (3-in-1solution
(RT)(PFL) 50 mg: containing
115
no preservative 25 mL NS, SWI, etoposide,
115
D5W DOXOrubicin,
vinCRIStine)
150 mg:
75 mL NS, SWI,
115
D5W
(NS reconstitution
115
takes longer)
DOXOrubicin
117 117 117 117
10 mg/5 mL N/A 2 mg/mL 8h syringe 48 h F, 24 h RT - for ULYEPOCHR
20 mg/10 mL from initial vial protocol, see entry
50 mg/25 mL record time of puncture for EPOCHR
200 mg/100 mL puncture (3-in-1solution
(Teva/Novopharm) containing
(F)(PFL) etoposide,
117
no preservative DOXOrubicin,
vinCRIStine)
Manufacturer,
DOXOrubicin
118 118 118
10 mg/5 mL N/A 2 mg/mL discard unused syringe 48 h F, 24 h RT - for ULYEPOCHR
72,118
50 mg/25 mL portion protocol, see entry
200 mg/100 mL for EPOCHR
(Pfizer) (3-in-1solution
(F) containing
118
no preservative etoposide,
DOXOrubicin,
vinCRIStine)
DOXOrubicin
119 119 119
Pegylated Liposomal N/A 2 mg/mL discard unused Less than 90 mg: 250 24 h F - do not filter
119 119
20 mg/10 mL portion mL D5W only
(Janssen)
(F) Greater than or equal
119
no preservative to 90 mg: 500mL
119
D5W only
Durvalumab
120 120 120
120 mg/2.4 mL N/A 50 mg/mL discard unused 1-15 mg/mL NS, 24 h F, 4 h RT - do NOT shake
120 120
500 mg/10 mL portion D5W - use 0.2-0.22 micron
(AstraZeneca) in-line filter to
120
(F)(PFL) (e.g., 100 mL* NS, administer
do not shake D5W)
120
no preservative
mix by gentle
120
inversion
Manufacturer,
Epirubicin
121 121 121
10 mg/5 mL N/A 2 mg/mL 8 h F, RT syringe 48 h F, 24 h RT
20 mg/10 mL from initial vial
121
50 mg/25 mL puncture
150 mg/75 mL
200 mg/100 mL
(Teva/Novopharm)
(F)(PFL)
121
no preservative
Epirubicin
122 122 122
10 mg/5 mL N/A 2 mg/mL 8h syringe 48 h F, 24 h RT
50 mg/25 mL from initial vial
122
200 mg/100 mL record time of puncture
(Fresenius Kabi) puncture
(F)(PFL)
122 18,122
no preservative 100 mL* NS, D5W 2 d F, RT
Epirubicin
123 123 123
10 mg/5 mL N/A 2 mg/mL 8h syringe 48 h F, 24 h RT from
123
50 mg/25 mL initial vial puncture
200 mg/100 mL record time of
(Pfizer) puncture
60 124
(F)(PFL) 100 mL* NS, D5W 2 d F, RT
123
no preservative
Manufacturer,
EPOCHR
(ULYEPOCHR protocol) see brand specific see brand specific see brand etoposide dose etoposide - final product is a
(RT) entries for: entries for: specific entries ≤125 mg/24 h: concentration 3-in-1 solution
18,125-128
no preservative DOXOrubicin as DOXOrubicin, for: DOXOrubicin, in 500 mL NS ≤0.25 mg/mL: containing
applicable etoposide, etoposide, complete etoposide,
vinCRIStine vinCRIStine etoposide dose administration within DOXOrubicin,
>125 mg/24 h: 72 h RT vinCRIStine (refer to
in 1000 mL NS ULYEPOCHR
precipitation occurs protocol)
at etoposide - use non-DEHP bag
concentrations and tubing only
>0.25 mg/mL - use 0.22 micron
inline filter
eriBULin
129 129 129
1 mg/2 mL N/A 0.5 mg/mL discard unused IV syringe 24 h F, 6 h RT - do not administer
18,129
(Eisai Limited) portion through dextrose
129 129
(RT)(PFL) containing lines
18
no preservative - vials contain
dehydrated alcohol
129
USP (5% v/v)
Manufacturer,
Etoposide
130 130
100 mg/5 mL N/A 20 mg/mL 14 d RT 0.2-0.4 mg/mL NS, 0.2 mg/mL: - use non-DEHP bag
130 130
200 mg/10 mL D5W 7 d F, RT and tubing only
500 mg/25 mL - use 0.22 micron in-
131
1000 mg/50 mL 500 mL* NS, D5W 0.4 mg/mL: line filter
130
(Sandoz) 12 h F, RT - for ULYEPOCHR
(RT)(PFL) protocol, see entry
130
preservative for EPOCHR
(3-in-1solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Manufacturer,
Etoposide
132
100 mg/5 mL N/A 20 mg/mL discard unused NS 0.2-0.3 mg/mL: - use non-DEHP bag
132 133 133,134
200 mg/10 mL portion 7 d F, 2 d RT and tubing only
500 mg/25 mL Stability is - use 0.22 micron in-
131
1000 mg/50 mL concentration 0.4-0.5 mg/mL: line filter
133 133
(Teva/Novopharm) dependent 1 d F, 1d RT - for ULYEPOCHR
(RT)(PFL) protocol, see entry
132
no preservative 0.6-9.0mg/mL: for EPOCHR
generally unstable (3-in-1solution
containing
9.5 mg/mL: etoposide,
133 133
2 d F, 1d RT DOXOrubicin,
vinCRIStine)
10-12 mg/mL:
133 133,134
7 d F, 2 d RT
132 132,135
D5W 4 h RT
Etoposide phosphate
136,137 18,136,137 136,137
(ETOPOPHOS®) 5 mL NS, D5W, 20 mg/mL 48 h F , 24 500 mL* NS, 24 h F, RT
136,137 136,137 136,137
100 mg SWI, BWI h RT , D5W
(BMS)
(F)(PFL) (do not dilute to less
136 136,137 136,137
no preservative 10 mL NS, D5W, 10 mg/mL than 0.1 mg/mL)
136,137
SWI, BWI
Manufacturer,
Filgrastim
138 138 18,139
(NEUPOGEN®) N/A 300 mcg/mL discard unused SC syringe 14 d F - albumin is added to
18
300 mcg/1 mL portion D5W to prevent
480 mcg/1.6 mL filgrastim adsorption
18,139 138
(Amgen) 50-100 mL D5W 7 d F, 48 h RT to plastic
140
(F)(PFL) only - incompatible with
138,140
do not shake saline
138
no preservative in PVC, polyolefin, or - do NOT dilute to
138
glass less than 5
138
mcg/mL
(for filgrastim
concentrations of 5-
15 mcg/mL in D5W,
add albumin 2
138
mg/mL)
Fludarabine
141 141 13,124 13,124
50 mg 2 mL SWI 25 mg/mL 48 h F, RT dilute to maximum of 48 h F, RT
141,142
(Berlex) 1 mg/mL
(F)
141
no preservative 50-100 mL NS,
141
D5W
Fludarabine
143 143
50 mg N/A 25 mg/mL discard unused dilute to maximum of 48 h F, 24 h RT
143 143
(Teva/Novopharm) portion 1 mg/mL
(F)
143
no preservative (e.g., 50-100 mL* NS,
D5W)
Manufacturer,
Fluorouracil
144 18,145 144 18,145
5000 mg/100 mL N/A 50 mg/mL 48 h RT syringe 48 h RT
(Accord)
(RT)(PFL)
144 145 18,145
no preservative 0.5-10 mg/mL 48 h RT
(e.g., 50-1000 mL*

D5W)
CIVI: ambulatory complete within 8

146 145
pump d
Fluorouracil
147 147 147 30,147
(Pfizer/Hospira)
(RT)(PFL)
147 148 147
no preservative 0.5-10 mg/mL 24 h RT
(e.g., 50-1000 mL*

D5W)
CIVI: ambulatory complete within

146 13,60,149,150
pump 8d
Manufacturer,
Fluorouracil
151 30,152 30,151
5000 mg/100 mL
(Sandoz)
152 30,152
(RT)(PFL) 0.35 – 15 mg/mL 48 h RT
151
no preservative
151
(300-500 mL D5W)
CIVI: ambulatory complete within

146 13,60,149,150
pump 8d
Gemcitabine
153 153 153 153
200 mg 200 mg: 38 mg/mL 24 h RT syringe 24 h RT
153
1000 mg 5 mL NS
2000 mg
153 18,154,155
(Accord) 1000 mg: 0.1-38 mg/mL NS 48 h RT
153
(RT) 25 mL NS
153
no preservative
2000 mg:
153
50 mL NS
Gemcitabine
157 157 156
200 mg/5.3 mL N/A 38 mg/mL discard unused syringe 24 h RT
156
1000 mg/26.3 mL portion
2000 mg/52.6 mL
(Pfizer/Hospira) 0.1–38 mg/mL NS,
156
(F) D5W
156
no preservative
Manufacturer,
Gemcitabine
158 158 158
(NOTE: concentration) N/A 40 mg/mL discard unused syringe 24 h RT CAUTION:
158
200 mg/5 mL portion alternative
1000 mg/25 mL concentration
2000 mg/50 mL 0.1–40 mg/mL NS,
(Sandoz) D5W
158
(F)
158
no preservative
IDArubicin
159 159 159
5 mg 5 mg: 1 mg/mL 48 h F, syringe 48 h F, 24 h RT - avoid alkaline
159 159 159
10mg 5 mL SWI 24 h RT solutions
(Pfizer)
159
(RT)(PFL) 10 mg: **(PFL)
159 159
no preservative 10 mL SWI
vial contents under

159
negative pressure
do NOT use BWI to

159
reconstitute
IDArubicin PFS
159 159
5 mg/5 mL N/A 1 mg/mL 48 h F, 24 h RT, syringe 4 h from initial - avoid alkaline
18 159
10 mg/10 mL puncture solutions
159
20 mg/20 mL **(PFL)
(Pfizer)
(F)(PFL)
159
no preservative
Manufacturer,
IDArubicin
160 160
5 mg/5 mL N/A 1 mg/mL discard unused syringe 4 h from initial - avoid alkaline
160 18 160
10 mg/10 mL solution puncture solutions
20 mg/20 mL
(Fresenius Kabi)
(F)(PFL)
160
no preservative
Ifosfamide
161 161 161
1000 mg 1000 mg: 50 mg/mL 48 h F, 24 h 0.6–20 mg/mL 72 h F, 24 h RT
161 18,161
3000 mg 20 mL SWI RT
(Baxter) 500–1000 mL* NS, 24 h F, RT when
60
(RT) 3000 mg: D5W, Lactated mixed with mesna
161 161 161
no preservative 60 mL SWI Ringer’s
shake well
Ifosfamide
162 162 162
1000 mg 1000 mg: 50 mg/mL 48 h F, 24 h 0.6-20 mg/mL 72 h F, 24 h RT
162 18,162
3000 mg 20 mL SWI RT
(Fresenius Kabi) 24 h F, RT when
60
(RT) 3000 mg: 500-1000 mL* NS mixed with mesna
162 162
no preservative 60 mL SWI D5W, Lactated
162
Ringer’s
shake well
Manufacturer,
Iniparib
163 163
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL NS, D5W 24 h RT - *may also use
163
(sanofi-aventis) portion empty IV bag and qs
(F) dilute to 250 mL final to final volume of
163
no preservative volume by 250 mL with NS,
163
withdrawing volume D5W
from bag equal to
volume of drug to be
163
added*
Inotuzumab
164 164 164 164
ozogamicin 4 mL SWI 0.25 mg/mL 4hF 0.01 – 0.1 mg/mL complete - do NOT shake
164
0.9 mg NS administration within - protect container
(Pfizer) gently swirl vial to record time of dilute dose within 8 h of reconstitution from UV and
164 164 164
(F)(PFL) mix reconstitution 4 hours of (50 mL NS) RT,F fluorescent light
164 164
no preservative reconstitution during storage and
164 164,165
(PFL) administration
protect from light mix by gentle - protect
164
if not used inversion if refrigerated, bring administration line
165
immediately bag to RT over 1 h from light ONLY if
prior to hang time will be
164 164,165
administration longer than 1 h
Manufacturer,
Interferon Alfa -2b
166 166 18
10 million units/1 mL N/A 10 million 7dF syringe 7dF - vials can be kept at
166
(Merck) units/mL RT for up to 7 days
(F) before use; discard if
166,167 166
preservative final concentration 24 h F, RT not used within this
166 166
≥ 0.3 million IU/mL time
166
50 mL NS
Interferon Alfa -2b

18,166 166 18,167
18 million units/3 mL N/A 6 million 14 d F syringe 14 d F - vials can be kept at
166
166,167 166
166 166
166
50 mL NS
Interferon Alfa -2b

18,166 166 18,167
25 million units/2.5 mL N/A 10 million 14 d F syringe 14 d F - vials can be kept at
166
166,167 166
166 166
166
50 mL NS
Manufacturer,
Interferon Alfa -2b
166 166 18,167
10 million units 1 mL supplied 10 million 24 h F syringe 24 h F - after reconstitution,
166 166
(Merck) diluent (SWI) units/mL provides an isotonic
(F) solution which may
no preservative (unless do NOT shake; roll be used for
166 167
reconstituted with to reconstitute final concentration 24 h F, RT intralesional
166 166 166
BWI) ≥ 0.1 million IU/mL injection
- non-reconstituted
166
100 mL NS vials can be kept at
RT for up to 4 weeks
before use; discard if
166 18,166 166 18,166
1 mL BWI 14 d F syringe 14 d F not reconstituted for
use within this
166
do NOT shake; roll time
166 167
to reconstitute final concentration 24 h F, RT
166
≥ 0.1 million IU/mL
166
100 mL NS
Manufacturer,
Ipilimumab
168 168 168 168
50 mg/10 mL N/A 5 mg/mL 24 h F,RT 1 – 4 mg/mL NS, 24 h F,RT - do NOT shake
168
200 mg/40 mL D5W - administer with 0.2
168
(BMS Canada) or 0.22 in-line filter
(F)(PFL) OR - vials may contain
168
no preservative undiluted in empty translucent-to-white
viaflex bag or glass amorphous
168
bottle particles
- discard if cloudy or
(allow vials to stand at has pronounced
RT for ~5 min prior to colour change
withdrawal of (should be clear to
168 168
contents) pale yellow)
Irinotecan
169
40 mg/2 mL N/A 20 mg/mL discard unused 0.12–3 mg/mL D5W 48 h F, 24 h RT
169 169
100 mg/5 mL portion (preferred), NS
169
500 mg/25 mL **(PFL)
60
(Accord) 500* mL
(RT)(PFL)
169
no preservative
Irinotecan
170,171
40 mg/2 mL N/A 20 mg/mL discard unused 0.12-3 mg/mL 14 d F, 48 h
170,171 30,170,171
100 mg/5 mL portion D5W (preferred), RT
170,171
300 mg/15 mL NS
500 mg/25 mL
60 170,171
(Pfizer/Hospira) 500* mL **(PFL)
(RT)(PFL)
170,171
no preservative
Manufacturer,
Irinotecan Liposome
172 172
43 mg/10 mL N/A 4.3 mg/mL discard unused to a final volume of 24 h F, 4 h RT - do not use in-line
172 172
(Servier) portion 500 mL with NS, filter
172
(F)(PFL) D5W **(PFL) - expressed as
172
no preservative irinotecan free base
mix by gentle (allow product to
172
inversion come to RT prior to
administration if
172
stored in F)
Ixabepilone
173 173 173
15 mg 15 mg: 2 mg/mL 1 h RT 0.2 – 0.6 mg/mL in 6 h RT - use 0.2-1.2 micron
173
(contains 16 mg) 8 mL supplied Lactated Ringer’s in-line filter
173
45 mg diluent Injection USP (use - use non-DEHP bag
(contains 47 mg) non-DEHP infusion and administration
173 173
(BMS) 45 mg: container) set
(F)(PFL) 23.5 mL supplied
173 173
no preservative diluent
* 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 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 be forwarded 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
174,175
the classification outlined in USP 797.
Vial stability: Stability of solution after first puncture or reconstituted solution.
Storage temperature: If information states same stability with refrigerator and room temperature storage, then fridge stability is bolded as preferred
(ie, to minimize growth of micro-organisms).
Discard unused portion: Unused portion from single use vials should be discarded at the end of the day.
“overfill known” is stated if the manufacturer states overfill that is present is within acceptable limits.
“Complete administration within __” is stated if the manufacturer specifies that the infusion must be completed in a specific time frame following
preparation, usually including entire time required for preparation (from first puncture), storage, and administration of infusion.
Abbreviations:
BWI = bacteriostatic water for injection

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

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BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART

transfer 1.5mL from

record time of if a closed system

swirl gently; do NOT

do NOT use D5W

swirl gently; avoid

Let sit for 5

(e.g., 50-1000 mL*

CIVI: ambulatory complete within 8

(e.g., 50-1000 mL*

CIVI: ambulatory complete within

CIVI: ambulatory complete within

vial contents under

do NOT use BWI to

Interferon Alfa -2b

Interferon Alfa -2b

BWI = bacteriostatic water for injection

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