Adults Parenteral Dilution Manual: Yousef Alomi

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Adults Parenteral Dilution Manual
Book · March 2015
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Yousef Alomi
Ministry of Health Saudi Arabia
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Adult Parenteral
Dilution Manual
This 1st Edition of the Parenteral Therapy Manual of Ministry of Health truly substantiates
our commitment to the general pharmaceutical care administration Mission and Vision,
dedicated to
Humanity as inspired by Allah. This story of success speaks a lot about the integrity of the
pharmacy profession. As the world of pharmacy is not excused to the constant occurrence
of changes, our pursuit to give top priority to patient care and safety prevails.
Congratulations on the success of the Task Force to imitate, Review, Update and
Standardize the IV Admixture Manual comprised of Pharmaceutical Care Services in the
different regions.
Deputy Minister of Health for Curative Service

Dr.Abdulaziz bin Muhammad Al-Hemaidi
2
We are proud to introduce the first edition of the Parenteral Therapy Manual it has been
our aim to provide staff with reliable, up-to-date drug information.
In the daily management of patients, clinicians are often faced with the need to access
drug information quickly in order to make swift therapeutic decisions. It is hoped that this
manual may be a readily accessible source of clinically important drug information for
parenteral drug therapy.
Additionally, it is meant to provide a quick and reliable
source of information for nursing staff. At a time when worldwide attention is being.
Assistant Deputy Minister for Supportive Medical Services

DR. Munira Hemdan Al-esseimi
3
I would like to thank the working committee for their tireless efforts in developing the first
edition of the ‘Manual for Sterile Preparations’. Due to the rapidly expanding sterile
pharmaceutical preparation services nationwide, it is very timely and essential that the
Pharmaceutical Services Division, Ministry of Health develops and publishes this manual
The contents of this manual will be able to serve as a standard reference for all hospital
pharmacists in handling and managing sterile preparation activities.
I am confident that this manual will also provide useful information on ensuring quality,
safety and efficacy of products.
Director of General Administration of Pharmaceutical care at Ministry of Health

DR. YOUSEF AHAMED YOUSEF ALOMI
4
Editors
DR YOUSEF AHAMED ALOMI
DR Somaiya Mohammed Aljudaibi DR Hajer Yousef Almudaiheem
DR Norah Abdulaziz Aljohany DR Samia Zaben Atallah Almurshadi
Reviewers
DR Wajed Awad AL-Shammari DR AMANI ABDULLAH BAHDEALAH

DR.Hind Kh. Al Mutairi
5
Stability of Vials Stability of
Rate of
Final Concentration Final after Premixed
Final Preparation Route Administration
Initial Diluents Reconstitution Preparation Maximum Reconstitution Solution monitoring
Generic Name with Maximum of Special Conditions
Strength Volume with Standard Conc. Parameter
Concentration Admin
IVP IVPB Concentration RT Ref RT Ref IVP IVPB
Administer dose
within
Acetamionphen 10mg/ml 24 hrs Fever
6 hours of opening
10mg/ml NA NA NA 10mg/ml 50 or 100 mL 10mg/ml 10mg/ml NA NA after NA IV inf NA 15 min reduction
vial
Y-site stability: vials spiking Pain relief
Do not refrigerate
No information
or refreeze
Acetazolamide Intraocul
250mg/ 50ml 500mg/ 50ml D5W ar
5 ml SWFI IM administration
Y-site stability: D5W D5W premixed 24 24 IVP pressure
100mg/ ml 4.64 mL dose Undiluted 5mg/ ml 10mg/ml NA 24 hrs 1 min 15-30 min is not
no information NS 250mg/ 50ml 500mg/ 50ml NS hrs hrs IV inf Serum
<500mg recommended
but likely to be NS premixed electrolyte
unstable CBC
LD:
150 mg/kg in 200 mL D5W
Dose 2:
50 mg/kg in 500 mL D5W
Dose 3:
100 mg/kg in 1000 mL D5W Allergic
-To avoid fluid overload in patients <40 Kg and fluid restricted reaction
Loading Acolor change
Acetylcystine patients -LFT
Dose 15 may occure in
2ed dose50 3ed dose100 -KFT
LD 150 mg/kg min opend vials(light
Y-site stability: mg/kg over mg/kg Serum
200mg D5W 10 ml NA over 1hr NA NA 24 hrs NA IV inf NA Dose 2 purple)and does
No information BW( 4hrs Over 16 hrs level of
/ ml 4hrs not affect the
KG) acetamino
Aceta Aceta Aceta Dose316h safety or efficacy
D5W D5W D5W phen
-dote -dote -dote rs
(ml) (ml) (ml) Serum
(ml) (ml) (ml) electolyte
30 22.5 100 7.5 250 15 500
25 18.75 100 6.25 250 12.5 500
20 15 60 5 140 10 280
15 11.25 45 3.75 105 7.5 210
10 7.5 30 2.5 70 5 140
-Rapid infusion
Acyclovir can cause renal
damage
Y-site stability: 0- 500 mg/ 100 -Do not use
Amikacin, ml NS 600-1750mg/ 250ml bacteriostatic
CBC
ampicillin, 0-500 mg/ 100 7mg/ ml D5W diluents
25mg/ml D5W 10 ml SWFI NA 5mg/ ml 12 hrs NA 24 hrs NA IV inf NA 60 min LFT
benzylpenicillin, ml D5W 600-1750mg/ 250ml -Doses less than
NS KFT
cefotaxime, NS 500mg diluted it
cefuroxime,….etc in 100 cc ,doses
greater than
500mg diluted in
250 cc
1
Rate of
Concentration Admin
Do not dilute 5%
solution.
Rapid infusion
can cause
vascular overload.
albumin 25% can
be given undiluted
or diluted in
normal saline or
Albumin
D5W
5% 2-4
infusion of large
Pre-mixed ml/mint in
amounts of
Albumin vials: pt with
albumin diluted
5%  5g/100ml [12.5 gm] [50 4 hrs normal vital sign
with D5W can
20% 20mg/ ml vial] after plasma pulmonar
result in
100ml [ 25 gm] opening volume, 5- y oedema
premixe Prem hyponatremia;
25% 25mg/ 5%,20% premix premixed NA premixed [100ml ] premixed premixed the vial. NA IV inf NA 10 ml/mint hypervole
d ixed therefore, when
100ml ed Use in pt with mia
using large
Y-Site Injection Admixture: inline hypoprotei Resp
volumes of
Compatibility: [12.5 gm] filter nemia function
albumin, dilution
Diltiazem HCL, [250ml (5%)] Albumin BP
in NS is preferred
Lorazepam [25 gm] 20% 1- Hemato
CAUTION:
[500 ml (5%)] 2ml/mint crit
Substantial
reduction in
tonicity, creating
the potential for
fatal hemolysis
and acute renal
failure, may result
from the use of
sterile water as a
diluents
Alfacalcidol 1mcg/day
(one –alpha) to be
1mcg/0.5ml 1mcg/day to be added to
1mcg/day to be - protect from
2mcg/ml added to the the Origi Electrolyt
1mcg/0.5m added to the return light
return line return nal 30 e level
l NA NA undiluted NA line from the HD NA NA NA IV NA - shake injection
Y-site from the HD line from back sec -KFTS
2mcg/ml machine at the end bolus solution well prior
compatability: No machine at the the HD ae -LFTs
of HD to use
information end of HD machine
at the end
of HD
2
Rate of
Concentration Admin
500mcg/ Undiluted
250ml NS alprostadil may
Arterial
500mcg/ interact with
Alprostadil pressure
250ml plastic volumetric
Prostaglandin E1 respirator
D5W infusion chambers
y rate
500mcg/ changing their
Y-Site Injection HR
100ml 500mcg/ appearance so, the
Compatibility: Origi 0.01- Temperat
NS 25ml infusion solution
Ampicillin D5W nal 0.1mcg/ ure
0.5mg/ml NA NA 2-10 mcg/ml 500mcg/ 20mcg/ml NA NA NA 24 hrs IV inf NA should be added
Sodium, NS back kg/ mint Degree of
100ml 500mcg/25ml to the volumetric
Cefazolin ae penile
D5W D5W chamber first
Sodium, pain
500mcg/ with the
Dobutamine -length of
50ml NS alprostadil added
HCL, Fentanyl erection
premixed into the solution
Citrate….etc -signs of
500mcg/ avoiding contact
infection
50ml with the chamber
D5W walls.
If used in
combination with
Amikacin RFT
a penicillin or
Y-site stability: Level
cephalosporin,
befor 4th
500mg/ 100ml administer at a
Aciclovir, 500mg/ 100ml NS dose and
NS premixed 5mg/ ml 48 30–60 different site. If
adrenaline, D5W NA NA 5mg/ml premixed NA NA 24 hrs IV inf NA 30-60 min
50mg/ ml 500mg/100ml hrs minutes this is not possible
calcium NS 500mg/100ml after
250mg/ ml D5W premixed then flush the line
gluconate, D5W premixed Auditory
thoroughly with a
chloramphenicol test if
compatible
sodium succinate, possible
solution between
ciprofloxacine…
drugs.
It contain benzyl
alcohol if given
(1gm/50ml
with athor drug
Aminocaproic premixed)
contain bezyl
Acid 2gm/100ml 4-5 gm over
alcohol Couse
3gm/150ml 60 mint KFT
gasping syndrome
Y-Site Injection D5W NA NA 20mg/ ml (4-5gm/ 20mg/ ml 10gm/500ml 7 then Coagulati
250mg/ ml NA NA 7 days IV inf NA symptom
Compatibility: NS 250ml) days 1gm/hr for on profile
respiratory
Fenoldopam (6-10gm 8 hrs
depression
mesylate /500ml)
Metabolic acidosis
(11-20gm
IM not
/1000 ml)
recommended
Aminophylline 500mg/ 500ml Loading

D5W dose: 30
Y-Site Injection 1mg/ ml as 500mg/ 500ml mint HR
Compatibility: loading dose NS Maintenanc Respirato
Equivalent to
Amphotericin B, then followed (loading dose) e dose: ry rate
80% Theophylline
amikacin, D5W NA NA by [0 - 0.36 CNS
25mg/ ml 25mg/ ml 25mg/ ml NA 24 24 hrs NA IV inf NA Protect from light
aztreonam, NS maintenance 250mg]/50ml mg/kg/mint effects
hrs Do not administer
ceftazidime , dose (max (30 minutes) or Serum
as IM
esmolol cont 25 [251-500 mg]/ Not greater theophylli
mg/ml) 100 ml-(30 than : n
minutes) 25mg/
Continuous mint
3
Rate of
Concentration Admin
infusion:
500 mg/500 ml
[Titrate]
Fluid
Restricted:
500 mg/250 ml
[Titrate]
-Monitor
for
symptoms
of
ammonia
toxicity
(pallor,
-Do not freeze
sweating,
-ammonium
retching,
chloride may
bradycar
crystallize when
dia,
exposed to low
arrhythmi
temperatures. If
Ammonium 5 meq/ml as,
100 – 200 crystallization
chloride ammoniu 100 – 200 100 – 200 meq hypervent
meq / 100 – 200 meq / occurs, the
m and D5W meq / / 5 ml ilation,
NA NA 500-1000 500-1000 ml NA NA Immedi NA IV inf NA injection should
Y-Site Injection chloride NS 500-1000 ml 500-1000 ml / mint local and
ml NS ately be warmed to
Compatibility: 5mEq/ml NS NS general
NS room temperature
No information (20)ml twitching,
in a water bath
tonic
prior to use.
convulsio
-Do not exceed a
ns, coma).
concentration of
-Monitor
1–2% ammonium
serum
chloride.
bicarbona
te
-Monitor
arterial
blood
gases
-LFT
-Rotate the -vital
ampoule to signs
facilitate solution -BP
and must not be -
100 mg/ml shaken respiratio
5 ml SWFI
Amobarbital For IV - IM :a solution n
For IV use
use D5W containing 200 -cardiac
5ml SWFI IV inf 50 mg/
Y-Site Injection 100mg/ml NS NA 100mg/ml 500mg/5ml 100mg/ml 30 mint NA NA NA NA mg/mL (20%) function
For IM use 500mg/5ml SWFI IM minut
Compatibility: For IM SWFI SWFI 500 mg of the -KFT
2.5ml e
No information use sterile powder for -LFT
SWFI
200mg/ml injection should hematolog
be dissolved in 2.5 ic
mL of SWFI paramete
-IM dose should rs
not exceed 5ml at
4
Rate of
Concentration Admin
any one site

-Do not use if
solution does not
become absolutely
clear within 5 min
after
reconstitution
Amoxacillin/
Claulenic Signs and
Acid symptoms of
600mg anaphylaxis
600mg dose
1.2gm Premixed
60mg/ 10 ml Premixed Use during first dose
KFT
600mg/10ml 600mg/50ml IVP, 10 Glucose
ml NS SWFI Undiluted 12mg/ml 12mg/ml 600mg/50ml immedia NA 4hrs 8hrs 30 mint RFT
1.2gm/20ml 1.2gm/100 IV inf mint
1.2gm dose
ml
NS tly containing Hematologic
20ml SWFI solution not function
Y-Site Injection NS recommended
Compatibility Im not
Lorazepam,clarit recommend
hromycin
-Intraoeritoneal
1 hr injection
dissolve 500mg
- if D5W with 10 ml SWFI
used as a -Intrapleural
diluent Injection
the 3-5 500mg with 5-10
resulting mint ml SWFI
Ampicillin 5 ml
solution for -Intra-articular
500 mg SWFI500 CBC
stable 500m use500mg in 5
1000 mg mg vial. Premixed: LFT
NS for 2 2 IVP g ml SWFI
100mg/ ml Undiluted 20mg/ ml 1g/50ml NS 30mg/ ml 3g/100ml NS 4hrs 8 hrs 30-60 min KFT
D5W hours vs. days IV inf -NS is the diluents
Y-Site Injection 9.2ml 1g/50ml D5W Allergic
8 hours 10-15 of choice
Compatibility: SWFI1g reactio
if mint - IMdissolve
Aciclovir, vial n
prepare for 1- 500mg with 1.8
aztreonam,
d with 2g mL SWFI shake
esmolol….etc
NS vigorously to give
(D5W 250 mg/mL
has - IM ,IVP stable
limited for 1hrr
stability) -Rapid infusion
may cause seizure
Antithymocyte - Mix diluted Lymphoc
globulin solution by gently yte profile
25mg/ml inverting infusion -CBC
lymphocyte 6 hrs for bag only once or -Platelet
immune globulin) first twice. count
(ATG) Premixed: infusion - -Vital
5mg/ml NS Premixed:
(Rabbit) 5ml SWFI NA 0.5 mg/ml 25mg/50 ml NS 0.5 mg/ml 4 hrs NA Use NA IV inf NA Use(0.22micron)in signs
D5W 25mg/50 ml NS
25mg/50 ml immedi 4 hrs line filter during
25mg/50 ml D5W
Y-Site Injection D5W atly subsequent -Allow the vials of administr
Compatibility: infusion ATG and diluents ation
Heparin sodium , to warm to room -KFT
hydrocortisone temp Hypersen
sodium succinate Before sitivity
5
Rate of
Concentration Admin
reconstitution reaction
-Protected from -Signs and
light and freezing symptoms
-Should be of
prepared infection
immediately
before use
-Administer test
dose first,
injection 0.1 ml
antivenom
Antivenom 5 intradermally
(Polyvalent 3.5mg/ml 5 ampoules ampoules If positive use
5 ampoules/50 5 ampoules/50 ml
Scorpion) NS NS NA NA diluted in diluted in NA NA NA NA IV inf NA 30 mint agoat antivenom
ml 0.5 NS 0.5 NS
(Equine) (1 amp) 50ml 0.5 NS 50ml 0.5 -may repeat dose
NS up to 20 amps if
Y-site stability: necessary
No information -monitor patient
closely during and
up to 60 mint
Antivenom
(Poluvalent Urine
Combinati Dilute 40
snake) output
on of 6 Dilute 40 ml Dilute 40 ml ml Dilute 40 ml 4
(Equine) IVP, Pulse, BP,
saudi NA NA Undiluted antivenom in antivenom in 5 antiveno antivenom in 5 NA NA NA NA ml/mi 30-60 mint
IV inf heart rate
snakes 5 ml/kg NS ml/kg NS m in 5 ml/kg NS nt
Y-site stability: Urea and
venom ml/kg NS
No information electrolyte
Atenolol
5mg/10ml
Premixed: -ECG
Y-site stability: Premixed:
5mg in 50 ml Use -Blood
Meropenem, 5mg in 50 ml NS 24 IVP, 1mg/ -Protect from
0.5mg/ml NA NA Undiluted 0.5mg/ml NS 0.5mg/ml NA NA immedi 30 mint pressure
morphine sulfate 5mg in 50 ml hrs IV inf mint light
5mg in 50 ml ately -Heart
D5W
D5W rate
-Do not freeze

-Administer
without further
dilution
-Slow injection
0.4 mg/ml -Cardiac
Atropine cause paradoxical
ampoule monitor
bradycardia
or -Heart
Y-site -IV atropine
0.6 mg/ml ≤1 rate
compatability: immedi sulfate should be
ampoule NA NA undiluted NA NA NA NA NA NA NA IVP mg/m NA -Blood
fentanyl, ately injected rapidly
or int pressure
hydrocortisone during
0.1 mg/ml -Pulse
sodium succinate, resuscitative
prefilled -Mental
meropenem, efforts, followed
syringe status
by a 20-mL flush
of IV fluid and
elevation of the
extremity for 10–
20 seconds in
6
Rate of
Concentration Admin
order to facilitate
drug delivery to
the central
circulation
-Intratracheal:
dilute in 10 ml of
NS or SWFI
IM not
5-10 mg/ml recommended
(Withdraw -Swirl vial gently
the dose and -Do not shake
CBC
dilute to 20 -Protect from
Azathioprine Platelet
mL with light
50mg/ 100ml 24 24 3-5 counts
D5W NaCl 0.9% NA 24 hrs IVP -Azathioprine
Y-site stability: 10mg/ ml 5 ml SWFI 0.5mg/ ml D5W 0.5mg/ ml 50mg/ 100ml D5W hrs hrs min 30-60 min Total
NS after given IV inf injection is
No information 50mg/ 100ml 50mg/ 100ml NS Bilirubin
the dose alkaline and very
NS LFT
flush irritant and it
KFT
immediately should only be
with at least used when the
50 ml NS) oral route is
impractical
Azithromycin 1 mg/ml
conce
Y-Site Injection 250 mg/250ml 500 mg/250ml rate over 3
- Not for IM or
Compatibility: NS NS hrs
D5W Bolus -LFT
Doripenem, 100 mg/ml 4.8 ml SWFI NA 1 mg/ml Or 2 mg/ml Or 24 hrs NA 24 hrs 7 day IV inf NA Or
NS -Do not mix with -CBC
HCL,Tigecycline, 250 mg/250 ml 500 mg/250 ml 2 mg/ml
other drugs
Caspofungin..etc D5W D5W conce
rate over 1
hrs
-IV bolus may

cause nausea,
vomiting, and
local reactions,
20 mg/ 50ml 20 mg/25ml including pain
Signs and
NS NS - the diluted IV
Basiliximab 24 symptoms
4mg/ml D5W 5 ml SWFI 4mg/ml 0.4 mg/ml 0.8mg/ml 4 hrs NA NA IVP 20-30 mint solution should be
hrs of acute
NS 20mg/50ml 20 mg/25ml IV inf mixed by gently
Y-Site Injection rejection
D5W D5W inverting the bag;
Compatibility:
should not be
No information
shaken to prevent
foaming
formatiom
1ml volume
NS
give
Botulinim toxin NS strength -do not shake vial
type A without 10 units -refrigerate
For IM For IM use 4 hrs NA NA NA IM NA NA
Botox preserv /0.1ml For IM use For IM use For IM use -for IM use only
use
100 units/vial ative -do not freeze
2ml volume
NS
5 units
7
Rate of
Concentration Admin
/0.1ml
4ml volume
NS
2.5units/0.1
ml
8ml volume
NS
1.25units/0.
1 ml
-serum
electrolyte
-alkaline
phosphata
Calcitonin se
100 I.U/ml -24 hrs
5-10 I.U/kg
300 I.U/ 500 urine
100 I.U/ml NS NA NA 5-10 I.U/kg In 500 ml NS 300 I.U NA NA immedi NA IV inf NA 6 hrs
Y-Site Injection ml NS collection
Hypercalcemic ately
Compatibility: acute pancreatitis for
crisis
No information hydroxyp
roline
excretion
(paget's
disease)
-dose is usually
Calcitriol administered as
-symptom
(1,25dihydroxych an IV bolus
of
olecalciferol) through the
hypercalc
1mcg/ml 2-3 catheter at the
1mcg/ NA NA 1 mcg/ml NA NA NA NA NA NA NA NA IVP NA emia
mint end of dialysis
ml -serum
Y-Site Injection -syringe stable at
electrolyte
Compatibility: room temperature
-serum
No information for 8 hrs
Albumin
-protect from
light
-Do not mix with

carbonates,
phosphates,
sulfates, or
Calcium Chloride
tartrates.
10%
Do not give by IM
1 gm/10ml BP
or Subcutaneous
ECG
-stop the infusion
Y-site 100 mg/ml 0.5g/ 100ml Serum Ca
D5W 5g/ 250ml D5W Use IVP 3–5 if patient
compatibility: 1.4 NA Undiluted 5 mg/ ml D5W 20mg/ ml NA 24 hrs NA 1 hr KFT
NS 5g/ 250ml NS fresh IV inf mint complains pain or
Adrenaline, mEq/ml 0.5g/ 100ml NS Heart rate
discomfort
lidocaine, Site of
- Small veins
milrinone, injection
should not be used
noradrenaline,
for infusion
verapamil
- 1 gm =6.8
mmol=13.6 meq
=273 mg
8
Rate of
Concentration Admin
-protect from
light
Use -The drug should
immedia be given
tely parenterally
When rather than orally
reconstit in patients with
-serum Ca
ute with GI toxicity,
Calcium Folinate -
SWFI nausea, or
Diarrhoea
vomiting and
Y-site -
Stable when individual
compatibility: Use IVP 160 Creatinin
10mg/ D5W NA 10mg/ml ≤10mg/ml ≤10mg/ml 10mg/ml 10mg/m for 7 day NA 24 2 hr doses greater than
Aztreonam, immedi IV inf mg/m e and
ml NS l when hrs 25 mg
fluconazole, ately inute methotrex
reconstit -reconstituted
furosemide, ate
ute with with bacteriostatic
granisetron, -LFT
bacterio water containing
linezolid….etc -KFT
static benzyl alcohol
-CBC
WFI should be used
containi only when
ng parenteral doses
benzyl of 10 mg/m2 or
alcohol lower are
required
-Do not
Refrigerate
-IM is not
recommended
-Small veins
should not be used
for infusion
-Should not be
infused through ECG
Calcium
an arterial Serum Ca
Gluconate 10%
100 mg/ml 1.5 catheter because KFT
D5W Premixed: Use IVP
0.465 NA Undiluted 20mg/ ml 50mg/ ml 5g/ 100ml D5W NA 24 hrs NA ml/mi 2ml/mint of the potential Blood
Y-site NS 1g/ 50ml D5W fresh IV inf
mEq/ml 5g/ 100ml NS nt for vasospasm pressure
compatability: No 1g/ 50ml NS
-IV calcium Injection
information
should be used site
cautiously in
patients receiving
cardiac glycosides
because of the
potential of
arrhythmias
-Use small needle
into large vein
9
Rate of
Concentration Admin
For IV
Dissolve in 2
ml of NS or
SWFI
For IM
adminstration
2ml NS or
SWFI
500mg/
ml conc
or
2.15 ml NS or
SWFI370m
Audiomet
g/ml
ric
Conc
measurem
Capreomycin
ents and
500mg/ml 2.63ml NS or Use Use
1gm/100ml 24 24 -can be vestibular
Y-site NS SWFI310m NA 370mg/ml 795.5mg/ 500mg/ml immedia immedi IV inf NA 60 mint
NS hrs hrs administer IM function
compatability: No 370mg/ml g/ml 100ml tely ately
-KFT
information Conc NS
-LFT
-serum K
3.3ml NS or
level
SWFI
260mg/
ml conc
4.3ml NS or
SWFI
210mg/
ml conc
And allow 2-3

mint for
dissolution
-CBC,
Refrigerate electrolyte
-Do not mix with -Vital
dextrose signs
-Fluid restriction -Tissue,
Caspofungin 24 48
5mg/ ml NA 0.2mg/ ml 50mg/ 250ml 0.5mg/ ml Use 24 hrs IV inf NA 60 min patient: 50 mg blood and
NS 10.5 ml SWFI 50 mg/ 100ml NS hrs hrs
7mg/ ml NS fresh and 35 mg doses or sputum
Y-site
(but not 70 mg) culture
compatability: No
may be given in before
information
100 mL NaCl and after
0.9% treatment
-LFT
10
Rate of
Concentration Admin
-protect from
light
- frozen cefazolin
Cefazoline Y- injections are
stable for 48
Premixed: 69mg/ml Hypersen
site hours at room
D5W 10ml SWFI 1g /50ml NS 6.9gm/100ml sitivity
compatibility: 100mg/ml 1mg/10ml 20mg/ml 14 IVP 3-5 30 – 60 temperature or 30
NS NS NS 24 hrs 10 2 days -KFT
Acyclovir Na, (Undiluted) days IV inf mint mint days when
1g/50ml 77mg/ml 7.7mg/100ml day -LFT
alprostadil, Maximum refrigerated
D5W D5W D5W -CBC
atracurium 138mg/ml - Iv push 50-100
aztreonam….etc mg/ml
Intermetent
infusion
5-20 mg/ml
If the single
100mg/
Cefepime dose 2g( IV) CBC
mlfor 1g
amount of Hypersen
dose Premixed:
Y-site D5W 2g/ 100ml D5W 7 sitivity
NA 20mg/ ml 1g/ 50ml D5W 40mg/ ml 24 hrs 7 24 hrs IV inf NA 30 min Can be given IM
compatability: NS l SWFI 2g/ 100ml NS days Renalfunc
160mg/ml 1g/ 50ml NS days
amikacin, 1g(IV)10ml tion
for 2g
fluconazole 1g(IM) -KFT
dose
2.4ml
Refrigerate
-Do not give in
Undiluted
severe heart
200 mg/mL
failure and in
Cefotaxime via central
patients with an
catheter and
86 un-paced heart
Y-site 60 mg/mL
mg/mL in block. CBC
combatability: via
Premixed: D5W 4.3 gm / 50ml D5W -can be given deep KFT
Aciclovir, D5W 10ml SWFI peripheral 24 hrs 7 24 hrs 5 IVP 3-5 20–60
100mg/ ml 20mg/ ml 1g/ 50ml D5W 3.65gm/ 50ml NS IM LFT
aztreonam, NS vein days days IV inf min minutes
1g/ 50ml NS 73 -Rapid IV push Hypersen
granisetron,
mg/mL in (<1 minute) of a sitivity
magnesium Maximum
NS cephalosporin has
sulfate, ….etc conc for
caused potentially
IVP:
life-threatening
147 mg/ml in
arrhythmias.
SWFI
-Protect from
light
Ceftazidime
Y-site
compatability:
Aciclovir, -For IM:
aztreonam, Undiluted Add 3ml SWFI to CBC
Premixed:
dopamine, 1gm vial lead to KFT
D5W 1g/ 100ml 2g/ 100ml D5W 7 IVP 3-5
esmolol, 100mg/ ml 10ml SWFI 100–200 10mg/ ml 40mg/ ml 18 hrs NA NA 20-30 min 260mg/ml and LFT
NS D5W 2g/ 100ml NS days IV inf min
furosemide, mg/mL in administer Hypersen
1g/ 100ml NS
granisetron…etc SW without further sitivity
dilution
11
Rate of
Concentration Admin
For IM :
Ceftriaxone Add 3.6 ml
Y- lidocaine 1% to
CBC
sitecompatibility: 1gm vial to give
KFT
Aciclovir, D5W 1g/ 50ml D5W 2g/ 50ml D5W 10 10 IVP 250 mg/ml
100mg/ ml 9.6 ml SWFI 100 mg/ml 20mg/ ml 40mg/ ml 2 days 2 days 5 min 30 min LFT
amikacin, NS 1g/ 50ml NS 2g/ 50ml NS days days IV inf -IV inf preferred
Hypersen
aztreonam, over IVP
sitivity
cisatracurium, -Protect from
…etc light
Cefuroxime
CBC
Y-site (100mg/
KFT
compatibility: ml) Premixed:
For IM: LFT
Aciclovir, Undiluted 750mg/ 100ml
1.5g/ 100ml D5W 7 3-5 Add 3 ml SWFI to Hypersen
granisetron, D5W 7.2 ml SWFI 7.5mg/ ml D5W 15mg/ ml 24 hrs 48hrs 24 hrs IVP 30 min
100mg/ ml 1.5g/ 100ml NS days min 750mg vial to give sitivity
linezolid…etc NS Maximum:1 750mg/ 100ml IV inf
225mg/ml Hematolo
00mg/ NS
gic
ml
function
5 ml SWFI
CBC
Cephradine for 500 mg
D5W 1g/ 100ml 12 24 3-5 KFT
dose 2g/ 100ml D5W Use 24 hrs IVP 30 min Can be given IM
100mg/ ml NS Undiluted 10mg/ ml D5W 20mg/ ml hrs hrs min LFT
Y-site 2g/ 100ml NS fresh IV inf
1g/ 100ml NS Hypersen
compatability: No 10 ml
sitivity
information SWFI
For 1gm dose
-Do not
Chlorpromazine
refrigerate
-IM is
Y-site
25mg/ 100ml recommended BP
compatibility:
D5W 50mg/ 100ml D5W Use Use 1mg/ IV irritating ECG
Cisatracurium, 25mg/ ml D5W NA 1mg/ ml 0.5mg/ ml NA NA IVP 1mg/mint
0.25mg/ ml 25mg/ 100ml 50mg/ 100ml NS fresh fresh mint -Protect from KFT
fluconazole, NS IV inf
NS light RFT
granisetron,
Don’t use for lees
hydrocortisone
than 6 month
sodium….etc
Ciprofloxacine
-Use with caution
in G6PD
Y-site
200mg/ 100ml 200mg/ 100ml deficiency
combatability: CBC
D5W D5W -Patients must be
aztreonam, 2mg/ ml D5W NA NA 2mg/ ml 2mg/ ml NA NA NA 24hr IV inf NA 60 min KFT
400mg/ 200ml 400mg/ 200ml adequately
calcium RFT
D5W D5W hydrated
gluconate…etc
-Protect from
light
Clindamycin
300mg/ 50ml
CBC
Y-Site Injection D5W 900mg/ 50ml D5W Use 32
D5W NA NA 6mg/ ml 18mg/ ml NA 16 days IV inf NA 30-60 min Can be given IM KFT
Compatibility 150mg/ ml 300mg/ 50ml 900mg/ 50ml NS fresh days
NS RFT
Aciclovir, NS
aztreonam, …etc
12
Rate of
Concentration Admin
Clonazepam
ECG
Y-Site Injection 1mg/ NS Use IVP 0.5ml
NA 1mg/2ml 1mg/85ml 10mg/850ml NA 24hr NA 8hr Can be given IM RR
Compatibility 1ml D5W 3mg/250ml 10mg/850ml fresh IV Inf /min
BP
No information
Cloxacillin
Y-Site Injection 2.5ml SWFI 24hr 24hr

Hypersen
Compatibility : D5W of 250mg 1g/ 50ml D5W 1g/ 50ml D5W NS NS IVP 3-5 IM not
100mg/ ml 50mg/ ml 20mg/ ml 20mg/ ml 24hr 48hr 30 min sitivity
Compatibility NS 4.8ml SWFI 1g/ 50ml NS 1g/ 50ml NS 8hr 8hr IV inf min recommended
GI effects
Hydromorphon of 500mg D5W D5W
IV push (in
patients with a
totally
implantable
venous access
device [TIVAD]
only dilute
1 M units in 5 ml
SW
For continuous IV
Scr
administration:
BUN
Inject one-half the
200000u/ Urine
Colistimethate NS Use 24 IV total daily
ml 10ml SWFI 3.2 mg/ml In 50 ml 16 mg/ml 16 mg/ml 8 hr 24hr 5 min 30 min – output
sodium D5W 200000U/ml fresh hrs IV inf Dose over 3 min,
75mg/ 60 min Signs of
the remainder of
ml neurotoxi
the total daily
city
dose should be
added to a
compatible IV
fluid and
administered over
the next 22 - 23
hrs starting 1 - 2
hrs after the
initial dose.
- 1million = 80 mg
13
Rate of
Concentration Admin
Cyclosporine
6hr Bp
Y-Site Injection NS PVC Scr
250mg/5ml 50mg/ml NA 1000mg/ 50mg/20ml NA NA NA IV inf NA 2-6hr Use glass bottle
Compatibility: D5W 5000mg/ml 50mg/100ml 24hr in Blood
ml Prepare in chemo
Propofol, glass level
room
caspofungin
meropenem…etc
Dantrolene
Do not mix with
LFT
20mg/ 60ml 0.33mg/ Use other solutions
Y- 0.33mg/ ml SWFI 60 ml NA 0.33mg/ ml 20mg/ 60ml SWFI NA 6hrs NA IV inf NA 60 mint Body
SWFI ml fresh IM not
sitecompatability: weight
recommended
No information
Dexamethasone -protect from

Sodium light
phosphate -IM administer Hemoglob
>8mg/50ml
Y-site 4mg/ml small doses in
NS D5W 2 IVP 3
Aciclovir, 4mg/ml NA (undilut >8mg/50ml 4mg/ml NA NA 24 hrs 30 mint without further -Serum K
D5W >8mg/50ml days IV inf mint
amikacin, ed) dilution -Serum
NS
aztreonam, -Dexamethasone glucose
cisatracurium Acetate injection
…etc not for IV use
-Dilution not
recommended due
to precipitation
risk
-IV slowly to
avoid venous
thrombosis and
phlebitis
- Diazepam
emulsion is the
Diazepam preferred Cardiovas
10mg/2ml preparation for cular and
IV inf because it mental
Y- 5mg/ml 5mg/ forms more stable statues
5mg/ml NS NA NA NA NA NA NA NA NA NA IVP NA
sitecompatability: Undiluted mint preparation and is Respirato
D5W
No information also less irritant to ry
veins function
- PVC containers -LFT
and giving sets
should not be used
– more than 50%
of the dose may be
adsorbed. Glass
or polyethylene
should be used in
preference
-Protect from
light
14
Rate of
Concentration Admin
- slow
administration
reduces the
Blood
antihypertensive
pressure
response, Use a
-Serum
cannula for
uric acid
Diazoxide administration,
-KFT
300mg/20ml taking care to
30 -CBC
15mg/ NA NA 15mg/ml avoid
NA NA NA NA NA NA NA NA IVP secon NA with
Y- ml undiluted extravasation
ds differenti
sitecompatability - Patients should
al AST
No information remain supine at
-Urine
least 1 hour after
glucose
IV dosing and also
and
during
ketones
administration.
-protect from
light
Diphenhydramine
50mg/ml
CNS
Y- 50mg/ 50ml -Can be given IM depressio
100mg/ 50ml D5W Use IVP 3-5
sitecompatibility: D5W NA Undiluted 1mg/ ml D5W 2mg/ ml NA 24 hrs NA 25 mg/min -Protect from n
50mg/ ml 100mg/ 50ml NS fresh IV inf min
Abciximab, NS 50mg/ 50ml NS light Drowsines
Acyclovir Na, s
Azithromycin,
Aztreonam…etc
-protect from
light
-Standard dose:
567
micrograms/kg by
IV infusion over 4
minutes (at
Dipyridamole approx 142
10mg/2ml micrograms/kg/mi -Heart
20mg/20ml 50mg/20ml
0.142mg/ nute). Thallium- rate
NS NS
Y-site 5mg/ml D5W NA NA 1mg/ml 2.5mg/ml NA NA NA NA IV inf NA kg/mint for 201 should be -Blood
20mg/20ml 50mg/20ml
compatibility: NS 4 mint injected within 3– pressure
D5W D5W
No information 5 minutes -ECG
following the 4-
minute infusion.
-Aminophylline
should be
available for
emergent use dose
of 50-100 mg IVP
over30-60 second
15
Rate of
Concentration Admin
-The patient must

be adequately
hydrated using
60 mg/hour
Disodium NaCl 0.9% before
(1mg/min) -Serum
Pamidronate dosing for ↑Ca.
30mg/100ml 90mg/250ml In impaired Ca,
15mg/5ml Use Use Infusion into a
NS NS 24 renal electrolyte
3mg/ml D5W 5ml SWFI NA 0.3mg/ml 0.36mg/ immedia NA immedi IV inf NA relatively large
30mg/100ml 90mg/250ml hrs function -CBC
Y-site NS ml tely ately vein minimizes
D5W D5W maximum -Serum
compatibility: patient discomfort
rate 20 creatinine
No information - should be
mg/hour.
infused slowly to
avoid renal
impairment
Erythromyci
n 500mg
1gm
Y-site 10ml
IM not
compatability: SWFIfor
24 recommended CBC
Aciclovir, NS 500 mg dose NO 1mg/ ml 500mg/ 500ml Premixed: 24 hrs 14 8 hrs IV inf No 60 min
50mg/ ml 5mg/ ml hrs Do not use NS for LFT
aminophylline, NS 500mg/ 100ml NS days
reconstitution Vital signs
ampicillin, 20ml SWFI
may precipitate
benzylpenicillin, for 1g dose
esmolol,
hydrocortisone
sodium succinate,
labetalol…etc
Etomidate
2mg/ml
Y-site
30–60
compatability: Use 10- 20 -infusion may lead Heart rate
NA NA NA IV inf secon
Atropine sulfate, 2mg/ml NA 2mg/ml 2mg/ml 2mg/ml fresh mcg/kg/min to adrenal -blood
IVP ds
atracurium t suppression pressure
besylate, fentanyl
citrate, lidocaine
HCL,
lorazepam…etc
Factor IX
Y-site
compatibility: No
3hr Level of
information Depe Depen Depe
Depend Depend depe Depend factor VII
500iu/ Depend on Depend on Depend on nd on d on nd on Depend on Depend on
SWFI 10 ml on Depend on product on nd on on and IX
vial product product product prod produc prod product product
product product prod product PT
uct t uct
uct PTT
16
Rate of
Concentration Admin
-SC Undiluted
-Scinf: add to a
suitable volume of
Gluc 5%,
ensuring that the
Filgrastim 300mcg/0. final
5ml concentration is
Y-Site Injection Intact 15
IV inf
Compatibility: containers micrograms/mL
intermitted
Acyclovir should be IV or more
15mg/ml 15-60 min
sodium,, refrigerate Only 600mg in 50- 15mg/40ml NA NA Unstabl bolus 15-30 -Stability is conc.
NA NA 12mg/50ml Or mcg 24 hr CBC
Allopurinol d at 2 to 8 D5W 100 ml of D5W e at RT SC min dependent: if
6mg/100ml IV inf
sodium, Amikacin °C and IV inf filgrastim
continues
sulfate, protected concentration is
over 24hr
Aminophylline, from <15
Ampicillin direct micrograms/mL
sodium sunlight then human
serum albumin
must be added to
produce a final
albumin conc. of 2
mg/mL
Intrapleural
injection
250mg
IT
powder
Flucloxacillin
250mg/100 30 min IV P 3–4 -LFT
20MG/ 5000MG/
ml NS 5 mL WFI 50MG/ 5mg/ml 1000mg/50ml Use 24 hr NA 24hr IV inf minu 30-60 min -RFT
Y-Site Injection ML 100ML
premixed ML fresh IM tes -FBC
Compatibility
500mg/
100ml
200 mg/100 mL
Fluconazole
over 10 minutes;
400 mg /200 mL
Y-Site Injection 200mg/100
over 20 minutes LFT,
Compatibility ml
D5W (600 mL/hr).In Renal
Acyclovir sodium, 400mg/200 NA NA 2mg/ml 200mg/100ml 2mg/ml 200mg/100ml NA NA 24 hr NA IV inf NA 1 -2 hrs
NA the USA, a function
Allopurinol ml 400mg/200ml 400mg/200ml
maximum test
sodium, Premixed
infusion rate of
Amifostine,
100 mL/hour is
Amikacin sulfate
recommended.
..etc
15 Max cumulative
secon dose 3mg/hr
blood
ds -For additional
pressure
(cons doses,may repeat
-Heart
cious 100-400 at 1min intervals
Flumazenil rate
sedati micrograms (Max 4 doses)
0.5mg/5ml 0.1mg/ml Continuous 0.1mg/ml IVP -Level of
0.1mg/ml D5W NA 24hrs NA 24hrs NA on) to /hour -avoid
undiluted infusion undiluted IV inf re-
NS 30 continuous extravasations,avo
sedation
(gene infusion id pain
and
ral on inj by using
conscious
anest large vein
ness
hesia) IM NOT
secon RECOMMENDE
17
Rate of
Concentration Admin
ds) D
Not
to
excee
d 0.2
mg/m
in.
-Not for rapid
injection
-The 24 mg/mL
solution may be
not to given without
Foscarnet exceed 60 dilution via a
24mg/ml mg/kg over central vein
12mg/ml
1 hour or -If a peripheral CBC
Periphera
Y-site 120 mg/kg vein is used, the Electrolyt
12mg/ml l line
compatability: Premixed Premixed Use over 2 solution must be e
24mg/ml D5W NA NA Peripheral 24 hrs NA 24hrs IV inf NA
Amikacin, 250ml bottle 250ml bottle immedi hours diluted to give a -KFT
NS line 24mg/ml
aminophylline, ately solution Ophthalm
Central
ampicillin, or containing 12 ic exam
line
aztreonam, mg/mL before
ceftazidime, …etc 1mg/kg/min administration
t -some centers
piggyback 1 L
-Use 0.22 NaCl 0.9% to run
micron in concurrently with
line filter the foscarnet dose
-The IV inf either

give undiluted
using a syringe
pump or add to a
convenient
Weight
≤4mg/ volume of NaCl
-I & O
minute 0.9%
daily
3-5 In severe -Can be
Furosemide -BP
mint renal administer IM
10mg/ml suitable for Orthostas
Or impairment only for doses ≤50
250mg/25ml doses ≤80 mg is
10mg/ NS NA 40mg the rate mg where neither
(10mg/ml) 1mg/ml 100mg/ 2mg/ml Use NA 24hrs NA IVP Electrolyt
ml D5W 100mg/50ml /mint may be the oral or IV
Y-site undiluted 100ml immedia IV inf e
NS over reduced to routes are
compatability: NS tly -KFT
1-2 2.5 available
aztreonam, -In high
mint mg/minute - IM use is not
calcium doses
to reduce suitable for the
gluconate, Monitor
ototoxicity treatment of acute
ceftazidime, hearing
conditions such as
cefuroxime..etc
pulmonary
oedema
-Protect from
light
18
Rate of
Concentration Admin
Do not give in
Gentamicin
Premixed: myasthenia
80mg/ 100ml gravis.
Y-site:
NS Ensure good
Aciclovir, Audiogra
60mg/50ml hydration status
atracurium, 10mg/ ml 400mg/ 100ml 24 m if
D5W NA NA 0.8mg/ ml NS 4mg/ ml Use NA 24 hrs IV inf NA 30-120 min -obese patients
ciprofloxacin, 40mg D5W hrs longterm
NS Or fresh dosage should be
cisatracurium, /ml 400mg/ 100ml NS CBC
80mg/100ml based on the
esmolol, KFT
D5W following
fluconazole,
60mg/50ml equation:Dosing
foscarnet,
D5W weight = IBW +
granisetron….etc
0.4 (TBW – IBW)
-1 unit=1mg
-Gently roll vial to
dissolve glucagon
-Continuous
infusion may be
used in beta-
blocker
toxicity/over dose
5–10 mg by slow
IV injection over -Blood
10 minutes (to pressure
Glucagon
reduce the -ECG
1mg
Use likelihood of -Blood
2 IVP 1mg/ 1–5
1mg/ml D5W 1ml SWFI 1mg/ml 0.1mg/ml 1mg/ml immedia NA NA vomiting); glucose
Y-site days IV inf mint mg/hour
tely followed by an IV -Heart
compatibility: No
infusion of 1–5 rate
information
mg/hour (50 -
micrograms/kg/ho Mentation
ur) titrated to
clinical response
- If the solution
shows signs of
fibril formation
(↑viscosity) or
insoluble matter it
should be
discarded
-IM administer
-Heart
undiluted
rate
-Glycopyrrolate
anticholin
may be mixed
ergic
with neostigmine
effects
or pyridostigmine
0.2mg/100ml 0.2mg/100ml -Bowel
Glycopyrrolate Use 60sec to minimize
NS NS IVP 15–20 sounds
Bromide 0.2mg/ml D5W NA 0.2mg/ml 2mcg/ml 2mcg/ml immedia NA 24 hrs NA - cardiac side
0.2mg/100ml 0.2mg/100ml IV inf minutes
0.2mg/ml NS (undiluted) tely 3mint effects 5–10
D5W D5W
mcg/kg (0.2 mg of
glycopyrrolate for
every 1 mg of
neostigmine or 5
mg of
pyridostigmine
19
Rate of
Concentration Admin
Granisetron
30
Y-site 0.2mg/ml
sec -Protect from
compatibility:
(undi light
amikacin, dilute each 1
1mg/ 50ml luted) -40 mcg/kg is the Clinical
aminophylline, mg (1 mL) to 0.2mg/ ml 1mg/ 5ml D5W 24 IVP
1mg/ ml D5W NA 0.02mg/ ml D5W 24 hrs NA 24 hrs or 5 -30 mint usual maximum improvem
ampicillin, 5 mL with 1mg/ 5 ml NS hrs IV inf
NS 1mg/ 50ml NS over dose ent
aztreonam, NaCl 0.9%
2–5 -Multidose vial
bumetanide, in the
minu stability 30 days
calcium syringe
tes
gluconate,
cefotaxime..etc
ECG
Haloperidol -Can be given IM Electrolyt
Y-site 50mg/ 50ml Use IVP 3-5 -Protect from es: Serum
5mg/ ml D5W NA Undiluted 1mg/ ml 1mg/ ml 50mg/ 50ml D5W NA NA 7 day 30 min
compatibility: D5W fresh IV inf min light during K, Ca,
No information storage Mg LFTs
KFT
Hydralazine
20mg/ ml
20mg
Withdraw 2-3
Y-site BP
the required mint
compatibility: Use IVP 0.05mg – No Special Pulse
20mg/ ml NS 1 ml SWFI dose and 40mg/ 1000ml 0.1mg/ ml 40mg/ 200ml NS NA 24 hrs NA (5
Hydrocortisone 0.04mg/ ml fresh Iv inf 0.2mg/mint Conditions KFT
further NS mg/m
sodium succinate, LFT
dilute to 10 in)
verapamil
mL with
NaCl 0.9%
1–10
Hydrocortisone
minu
Sodium Succinate
tes
100mg
500mg
1
0.1 -1
mint
Y-site Premixed: mg/ ml
100mg/ 3000mg/ 50ml for
compatibility: 100mg/ 100ml 24 hrs
2ml D5W 2 ml SWFI D5W 72 24 IVP doses Serum K,
Aciclovir, Undiluted 1mg/ ml D5W 60mg/ ml NA 2-10 30 min Can be given IM
500mg/ NS 4ml SWFI 3000mg/ 50 ml NS hrs hrs IV inf < 200 Ca, Na
adrenaline 100mg/ 100ml mg/ml
4ml (4 hrs stability) mg
(epinephrine), NS 4 hrs
10
aminophylline,
mint
atracurium,
for
aztreonam,
doses
benzylpenicillin..e
≥200
tc
mg
Hyoscine
Butylbromide Premixed: Premixed:
-IOP
20mg 20mg/50ml 20mg/50ml 1
20mg/ NS IVP Can be given IM -HR
NA Undiluted 0.4mg/ml D5W 0.4mg/ml D5W NA NA 8 hrs NA mg/m 30 mint
ml D5W IV inf undiluted -Urine
Y-site 20mg/50ml 20mg/50ml int
output
compatibility: No NS NS
information
20
Rate of
Concentration Admin
Can be given IM
Suspension for IM
Imipenem-
50mg/ ml (500mg- administration
cilastatin sodium CBC
vial NS 500mg/ 100ml 500mg/ 100ml NS Use 24 30 min) should be
10 ml SWFI NA 5mg/ ml 5mg/ ml NA 4 hrs IV inf NA KFT
500mg/100 D5W NS or D5W or D5W fresh hrs (1g- reconstituted with
Y-Site Injection RFT
ml premix 60 min) 1% lidocaineHCl
Compatibility
without
Acyclovir, …etc
epinephrine
24 hrs
Do not -Avoid
Indomethacin
1-2ml NS or dilute extravasations
SWFI further IV inf 3-5 -IM not -KFT
Y-site 1mg/ml NS 1mg/ml 1mg/ml 1mg/ml 1mg/ml 1mg/ml 24 hrs NA NA 20-60 mint
(Preservative Do not IVP mint recommended -LFT
compatibility: No
free) use -Protect from
information
dextros light
e
Vital sign
2 hr Sign of
patients on infection,
maintenanc LFT
e therapy
who have
tolerated at IV infusion
least three through a low-
Infliximab prior 2- protein-binding
10mg/ 24 24
Y-Site Injection NS 10 ml SWFI NA 0.4mg/ml 4mg/ml 3hr 3 hrs IVinf NA hour filter (pore size
ml dose/250ml NS dose/250ml NS hrs hrs
NA infusions, a 1.2 micron or less)
shorter over at least 2
infusion hours
time of a
minimum
of 1 hour
may be
considered
Iron Dextran -IV push not Body

1
recommended weight
100mg/ 250ml Use 24 IVP mL/
Y-site NS NA 10mg/ ml 0.4mg/ ml 1mg/ ml 100mg/ 100ml NS NA 24 hrs 2-6 hrs - Initial test dose CBC
50mg/ ml NS fresh hrs IV inf minu
compatibility: No (prior to first dose KFT
te
information only) LFT
Initial test dose
Use
1 (prior to first dose
volumetric
mL/ only) Hemoglob
infusion
minu -Infusion: dilute in
Iron Saccharate Undiluted device as
Premixed Premixed te 300mg/250ml NS Hematocr
injection into follows:
20mg/ NS NA 100mg/ 100mg/ Use 24 IVP (i.e. 5 infuse at least 1.5 it
Y-site the venous 1mg/1ml 1mg/1ml NA 24 hrs give 100 mg
ml 100ml 100ml fresh hrs IV inf minu hrs, -Serum
compatibility: limb of a over at least
NS NS tes 400mg/250ml Ferritin
No information dialyser 15 minutes;
per infuse at least 2.5 Transferr
give 200 mg
ampo hrs, 500mg/250ml in
over at least
ule) infuse at least 3.5
30 minutes
hrs
Isoproterenol 0.2mg/ml 1mg/ 500ml 0.004mg/ Premixed Use 24 IV inf -Can be given IM ECG
NA 0.002mg/ ml NA 24 hrs Bolus infusion
200mcg/ml 0.2mg/ ml D5W prepared by D5W ml 2mg/ 500ml D5W fresh hrs IVP And Hemodyn
21
Rate of
Concentration Admin
NS diluting 1 1mg/ 500ml NS 2mg/ 500ml NS Subcutaneous amic

Y-site mL of the -Protect from -Heart
compatibility: injection light and air rate
Na,famotidine, containing Respirato
Bivalirudin,atracr 0.2 mg/mL ry rate
ium (1:5000) to a -Arterial
…etc volume of 10 blood gas
mL with -Arterial
0.9% sodium blood
chloride pressure
injection or -CVP
5% dextrose -Serum
injection electrolyte
-Serum
glucose
500mg/
500mg/ KFT
100ml
Kanamycin 200ml -Every 2-3
NS
1gm NS days peak
500mg/ Can be given IM
D5W 500mg/ Use and
NA NA 2.5mg/ml 5mg/ml 100ml NA 24 hrs NA IV inf NA 30-60 mint -Dose should be
Y-site NS 200ml fresh trough
D5W depend in IBW
compatibility: D5W concentra
1gm/
No information 1g/400ml NS tion
200ml NS
1g/400ml D5W -Hearing
1gm/200ml D5W
Carnitine
levels
(acyl and
free) in
L-carintine 30 minutes Intermittent plasma
24
200mg/ml (loading intravenous and urine
hours
Use IVP 2-3 dose) or 10– infusion -Blood
NS NA Undiluted 0.5mg/ml 0.5mg/ml 8mg/ml 8mg/ml NA in PVC NA
Y-site 200mg/ml fresh IV inf mint 30 minutes (unlicensed use glucose
plastic
compatibility: No (subsequent for valproate -
bags
information doses) toxicity) Symptom
s of
deficiency
-BP
-KFT
-LFT
Levofloxacin
-Signs of
Premixed - Levofloxacin
tendon
500mg/100ml 250 mg = 255 mg
30 minutes damage
levofloxacin
for 250 mg -Signs of
Y-site hemihydrate (1)
(at least 60 CNS
compatibility: Premixed -Patients should
Premixed Use Use minutes for disorders
Adrenaline, 5mg/ml NS NA NA 5mg/ml 500mg/ 5mg/ml NA NA IV inf NA be well hydrated
500mg/100ml fresh fresh 500 mg) -
amikacin, D5W 100ml and asked to
750 mg Symptom
aminophylline, drink fluids
over 90 s of
clindamycin, liberally to
mint neuropath
dexamethasone, prevent
y
dobutamine, crystalluria
-Blood
dopamine..etc
glucose
concentra
tion-Signs
22
Rate of
Concentration Admin
of
infection
-T4
-TSH
-Blood
pressure
-Large, sudden -Heart
200mcg
Levothyroxine doses of IV rate
dose
200 mcg levothyroxine may
40 Mcg/ml 40–100 2–3
500 mcg Use Use have
NS 5ml NS mcg/mL in NA NA NA NA NA NA IVP minu NA
fresh fresh cardiovascular
500mcg NS tes
Y-site risks
dose
compatibility: No -Protect from
100mcg/ml
information light
Check for minute

FBC
leaks by squeezing
(including
the bag firmly if
haemoglo
the bag leaks, do
bin,
not use
platelets,
-Spike the bag
total and
using the blue-
differenti
coloured port only
Linezolid ated
(the white port
Premixed leucocyte
should not be
600mg/300ml bag counts)
used)
Premixed Premixed -Signs of
Use 30–120 -Protect from
Y-site: 2mg/ml NS NA NA 2mg/ml 600mg/300ml 2mg/ml 600mg/300ml NA NA NA IV inf NA metabolic
fresh minutes light and freezing
Aciclovir, D5W D5W D5W acidosis
-Keep bags in foli
alfentanil, -Signs of
laminate
amikacin, supra-
overwrap until
aminophylline, infection
used
aztreonam, or
-The solution is a
calcium superinfec
yellow color that
gluconate…etc tion
can intensify with
impairme
no affect on
nt
potency
- U&Es
-LFT
Lorazepam 2 Intravenous Respirato

4mg/ml mg/m injection ry and
Premixed
2mg/ml Discard in 0.2 mg/mL (preferred route) cardiovas
4mg/ml D5W 4mg/50ml NA 24 hrs NA IVP
NA Dilute 1:1 0.04mg/ 2mg/50ml 0.08mg/ After or Continuous -IV injection cular
2mg/ml NS NS IV inf
Y-site ml NS ml use 0.05 infusion should be status
4mg/50ml
compatibility: 2mg/50 mg/k performed with -Signs of
D5W
Aciclovir, D5W g extreme care to propylene
23
Rate of
Concentration Admin
adrenaline, over avoid inadvertent glycol

amikacin, 2–5 intra-arterial toxicity
atracurium, minu injection, which for
bumetanide, tes can cause continuou
cefotaxime..etc arteriospasm s infusion
possibly resulting or
in gangrene prolonged
-Can be given IM use
-protect from -KFT
light -BP
-HR
-Symptom
of anxiety
Do not
Refrigerate
-Infusion via a
central venous
catheter is
preferable
Mannitol Respirato
because of the risk
20%(20g/100ml) 30–60 ry
of damage to veins
in 250 ml bottle minutes function
-Do not use
using a Cardiovas
solution that
Y-site Test dose (to giving set cular
contain crystals,
compatibility: assess with an in- status
heating in hot
Aztreonam, adequate line filter -serum
3-5 water bath and
cisatracurium, 100mg/ ml renal 50g/ 500ml 200mg/ 24 hrs NA 24 hrs NA IV inf for cerebral electrolyte
D5W NA 100mg/ ml 100g/ 500ml D5W mint vigorous shaking
linezolid, 200mg/ ml function) for D5W ml edema, s and
may be utilized
ondansetron, oliguria elevated urine
for
piperacillin with 0.2 g/kg ICP, or output
resolubilization.
tazobactam, preoperativ -KFT
cool solution to
remifentanil e in Observati
body temperature
neurosurge on of
before use
ry infusion
-from age 1–73
site
were given a
continuous
infusion over 6–
100 hours
(total dose 2–20
g/kg)
Meropenem Immedi
1g/ 100ml 1g/ 100ml NS -CBC
500mg ately -IM
D5W D5W immedia 24hrs -KFT
with NS administration
D5W tely 12 IVP 5 -LFT
Y-site 50mg/ ml 10 ml SWFI 50mg/ ml 10mg/ ml 10mg/ ml 4hrs 15-30 mint has been used in
NS Premixed Premixed within 2 hrs D5W IV inf mint -Signs of
compatibility: the treatment of
1g/ 100ml 1g/ 100ml hour  anaphylax
Aminophylline, D5W urinary tract
NS NS 4hrs is
dexamethasone, 1hrs infections and
24
Rate of
Concentration Admin
fluconazole, pneumonia in
furosemide, adults
gentamicin, - Meropenem has
metoclopramide, been administered
…etc as a 3-hour
infusion for the
treatment of CNS
infections
-Laboratory
interference:
Positive direct
and indirect
Coombs' tests
have been
reported
-
Methylprednisoln
e Acetate for deep
IM only
-Dose should be
base on the lesser
or ideal body
weight or actual
body weight
-Rapid IV
administration of
Dose large doses is
≥2mg/kg or associated with
250 cardiovascular
Methylprednisoln collapse
mg/doseo
e
ver -
Sodium succinate 40mg dose
40 mg dose 15-30 mint Methylprednisoln
40mg 1ml of
 e -Blood
500mg supplied
40mg/ 100mg/ 50ml Dose 15 Sodium succinate pressure
Y-site diluents 2 mg/ ml 500mg/ 100ml
ml D5W D5W 48 IVP 3-5 mg/kg or Can be given IM -blood
compatibility: 125mg/ml Or D5W 48 hrs NA 48 hrs
NS 1500mg/ 50ml 5mg/ ml hrs IV inf mint ≥ 500 -Protect from glucose
Aciclovir, , 500mg dose in 50-250 ml 500mg/ 100ml NS
500mg NS mg/dose light Electrolyt
ceftazidime, 8ml
dose Over ≥ 30 -Avoid IM es
dopamine, bacteriostatic
62.5mg/ml mint injection
linezolid, SWFI
of
metronidazole
Dose >15 Methylprednisoln
..etc
mg/kg or e
≤1gover acetate into the
1 hrs deltoid muscle
due to
high incidence of
subcutaneous
atrophy
-Can be given by
continuous
infusion
-don’t give iv push
if the dos >250 mg
- loading dose in
100 ml fluid
25
Rate of
Concentration Admin
-May be given IM
-degradation is
indicated by
yellow
discoloration
discard if present
-Therapy with
metoclopramide
should not
Metoclopramide
continue beyond
10mg/2ml
12 weeks, unless
benefits of -Blood
Y site
continued therapy pressure
compatibility: 20mg/50ml
Undiluted 10mg/ 50ml Use clearly outweigh -Irregular
Aciclovir, 5mg/ ml D5W NA 0.2mg/ ml 0.4mg/ml D5W NA 24 hrs NA IVP 2 min ≥15 minutes
Doses ≤ D5W fresh the risk of tardive pulse
aztreonam, NS 20mg/50ml IV inf
10mg 10mg/ 50ml NS dyskinesia -Altered
ciprofloxacin, NS
-Protect from conscious
cisatracurium,
light during ness
fentanyl,
storage
fluconazole,
-Can be given by
foscarnet…etc
continuous
infusion
(Withdraw the
required dose
and add to 500
mL of infusion
fluid)
infusion over 8–12
hours
LFT
-
-Protect from Symptom
light s of
-US boxed periphera
Metronidazole
warning: Known l
500mg/100ml
to be carcinogenic neuropath
in mice and rats y or
Y-site Premixed Premixed Use
5mg/ml NA NA NA 5mg/ ml 5mg/ ml NA NA NA IV inf NA 30-60 min -Do not remove transient
compatibility: 500mg/ 100ml 500mg/ 100ml fresh
unit from seizures
Aciclovir,
overwrap until -Signs of
(in the samebag),
ready for use supra-
cefuroxime, etc
infection
or
superinfec
tion
-FBC
Micafungin Reconstitute 50mg/100ml -Protect from -U&Es

sodium with 5 mL NS NS light - FBC
150mg/100ml
50mg or D5W 50mg/100ml -Flush line with -LFT
10mg/ NS NS
Y-site injected the NA 0.5mg/ml D5W 1.5mg/ml 24 hrs NA 24 hrs NA IV inf NA 60 mint NS prior - Candida
ml D5W 150mg/100ml
compatibility: fluid slowly administration blood
D5W
Aminophylline, against the Gently invert -Do not use cultures
bumetanide, side of the orswirl to diluents
26
Rate of
Concentration Admin
calcium inner wall of disperse the containing a

gluconate, the vial to diluted bacteriostatic
dopamine, minimize solution but do agent for
furosemide, foaming not agitate in reconstitution
glyceryl order to avoid -Phlebitis and
trinitrate…etc foaming thrombophlebitis
occur more
frequently with
administration via
a peripheral line
-Rapid infusions
may result in
histamine
mediated
reactions
Do not Pulse
0.8% Use
Moxifloxacin 1.6mg/ ml NA NA 1.6mg/ ml 400mg/ 250ml 1.6mg/ ml 400mg/ 250ml NA NA NA IV inf NA 60 min Refrigerate Serum K
saline fresh
LFT
Body
2mg/ 500ml weight
D5W 0.016mg/ 4mg/ 250ml D5W Use 24 IVP
Naloxone 0.4mg/ ml NA Undiluted 0.004mg/ ml D5W NA NA 1 min infusion Can be given IM Pulse
NS ml 4mg/ 250ml NS fresh hrs IV inf
2mg/ 500ml NS RR
BP
Cardiac
monitorin
50mg/ 250ml 100mg/ 250ml 7 Use glass and non-
Nitroglycerin 5mg/ ml D5W NA NA 0.2mg/ ml 0.4mg/ ml NA NA 48 hrs IV inf NA infusion g
D5W D5W days PVC bottle only
hemodyna
mics
0.5mg/ 100ml
Refrigerate Blood
D5W D5W 0.005mg/ 0.5mg/ 100ml D5W 24 IVP 3-5
Octerotide 0.5mg/ ml NA 0.5mg/ ml 0.005mg/ ml NA NA 24 hrs 30 min Can be given Glucose
NS 0.5mg/ 100ml ml 0.5mg/ 100ml NS hrs IV inf min
Subcutaneous LFT
NS
In NS :
8 hrs May mask
40mg/ 100ml
Omeprazole 8mg/ ml NS 5 ml NA 0.4mg./ ml 0.8mg/ ml 40mg/ 50ml NS 4 hrs NA In d5w NA IV inf NA 30 min symptoms of LFT
NS
: gastric cancer
6 hrs
4mg/ 50ml 32mg/ 50ml D5W
D5W 0.64mg/ Use 24 IVP 2-3 IM not
Ondansetron 2mg/ ml NA Undiluted 0.08mg/ ml D5W 32mg/ 50ml NS NA 24 hrs 15 min LFT
NS ml fresh hrs IV inf min recommended
4mg/ 50ml NS (premixed)
1MU/ 50ml Hypersen
Penicillin G 200000U/ D5W 80000U/ 4MU/ 50ml D5W Use 3 7
4.6 ml SWFI NA 20000U/ ml D5W 24 hrs IV inf NA 30 min Refrigerate sitivity
sodium ml NS ml 4MU/ 50ml NS fresh days days
1MU/ 50ml NS
Dilute the
20mg/ 50ml LFT
Phytomenadione 2mg/ ml D5W 0.4mg/ ml dose at Use Use IVP 3-5 Protect from light
NA NA D5W - NA NA 30 min PT
10mg/ ml NS Or in 50 ml least in 10 fresh fresh IV inf min Can be given IM
20mg/ 50ml NS INR
ml
CBC
4.5g/ 100ml
Piperacillin/ D5W 10 ml SWFI 4.5g/ 50ml D5W Use 24 7 IVP Refrigerate KFT
225mg/ ml NO 45mg/ ml D5W 90 mg/ ml 24 hrs - 30 min
Tazobactam NS 20 ml SWFI 4.5g/ 50ml NS fresh hrs days IV inf Do not give IM LFT
4.5g/ 100ml NS
Serum K
50mg/ 50ml Maximum 50mg
D5W 50mg/ 25ml D5W Use Use IVP 1-3
Protamine Sulfate 10mg/ ml 5ml SWFI Undiluted 1mg/ ml D5W 2mg/ ml NA NA 20 min in any 10 minute aPTT
NS 50mg/ 25ml NS fresh fresh IV inf min
50mg/ 50ml NS period
27
Rate of
Concentration Admin
2.5mg/ ml
50mg/ 50ml Body
D5W 50mg/ 50ml D5W Use Use 24 IVP 2-5
Ranitine 25mg/ ml NA 1mg/ ml D5W 1mg/ ml NA 30 min Can be given IM weight
NS (50 mg/20 ml 50mg/ 50ml NS fresh fresh hrs IV inf min
50mg/ 50ml NS KFT
)
CBC
Do not KFT
600mg/ 500ml Use 30 min to 3
Rifampicin 60mg/ ml NS 10 ml SWFI NA 1.2mg/ ml 6mg/ ml 600mg/ 100ml NS 6 hrs NA NA IV inf NA Refrigerate LFT
NS fresh hrs
Do not give IM Serum K,
Na
Blood
glucose
5mg/ 500ml Can be given IM
0.5mg/ ml D5W 10mcg/ 5 mg/ 500ml D5W Use 24 IVP 3-5 BP
Salbutamol NA 50mcg/ ml 10mcg/ ml D5W NA 24 hrs Infusion Can be given
1mg/ ml NS ml 5 mg/ 500ml NS fresh hrs IV inf min Body
5mg/ 500ml NS Subcutaneous
weight
Serum K
5 mL
conc. in
125 mL
D5W is
Trimethoprim+
stable
Sulfamethoxazole
for 6 hr
Y-site:
SMX 5ml/125ml 5 mL
Aciclovir, CBC
80mg/ D5W conc. in Do not
atracurium, KFT
ml 0.64mg/ ml 10ml/250mlD5 1.07mg/ NA NA 100 mL NA IV inf NA 60-90 min Refrigerate
aztreonam, D5W NA NA 5ml/ 75ml D5W RFT
TMP TMP W ml D5W is Cannot be given
esmolol, Serum K
16mg/ 15ml/500mlD5 stable IVP
granisetron, Serum Na
ml W for 4 hr
labetalol…etc
5 mL
conc. in
75 mL
D5W is
stable
for 2 hr
Vancomycin 500mg/ 100ml 10mg/ ml

D5W D5W in fluid 500mg/ 50ml D5W 24 CBC
50mg/ ml 10 ml SWFI NO 5 mg/ ml NA 24hrs 24 hrs IV inf NA 2 hrs Refrigerate
Y-Site Injection NS 500mg/ 100ml restricted 500mg/ 50ml NS hrs KFT
Compatibility: NS ptient
Acyclovir sodium
Electrolyt
Vasopressin
e, vital
0.2-
20 U/ml 20U/200ml 20U/20ml D5W or Use IVP sign,
Y-site: D5W 10ml D5W 2U/ml 0.1U/ml 1U/ml NA NA NA 1u/m 15min Can be given IM
(400mcg/m D5W or NS NS fresh IV inf EKG,
Adrenaline NS in
l) drowsines
(epinephrine),
s
ciprofloxacin,
28
Rate of
Concentration Admin
fluconazole,
gentamicin,
imipenem with
cilastatin,
linezolid,
meropenem,
metronidazole
Voriconazole
Renal
Discard the vial if function
Y-Site Injection 3
D5W 10mg/2ml the vacuum of the LFT
Compatibility: 200mg 19ml SWFI 10mg/20ml Use mg/kg/hour
NS NA 0.5mg/ml 5mg/ml D5W,LR, NA NA 24hr IV inf NA vial does not pull Electrolyt
Anidulafungin powder 10 mg/mL D5W, LR, NS fresh over 1–2
LR NS the diluent into e
, Caspofungin, hours
the vial Culture,
Ceftaroline,
sensitivity
Doripenem
CBC
Zidovudine
Platelet
LFT
Y-Site Injection
MCV,
Compatibility: IV bolus, IM and
10mg D5W NA NA 2mg/ml 200mg/ 100ml SERUM
Acyclovir sodium, 4mg/ml 200mg/50ml D5W NA NA 8 hr 24hr IV inf NA 60 min rapid IV infusion
/ml D5W CREATI
Allopurinol, should be avoided
NIN
Amikacin sulfate,
KINASE,
Amphotericin
viral load,
Betc
CD4
Important note:
We consider patent drugs as generic drugs
29
Adult High Risk Medication
Parenteral
Dilution Manual
Rate of
Concentration Admin
Use sterile,
non-pyrogenic,
10mg/ 250ml
low protein-
D5W
binding
Abciximab Y- 10mg/ 250ml
0.2-0.22 um filter
NS
Should be
site stability: 7.2 mg in 250
administered aPTT
Adenosine, mL
10mg/ 250ml D5W Discard 12 IVP 10mcg/ min in a separate PT
atropine sulfate, 2mg / ml D5W 5 ml Undiluted 40mcg/ml (concentration: 40mcg/ml NA 12 hrs 1 min
10mg/ 250ml NS after use hrs IV inf for 12 hr intravenous CBC
bivalirudin, NS 28.8 mcg/mL)
line, no other Plt
fentanyl, or 9 mg in 250
medication
metoprolol, mL
should be added
midazolam (concentration:
to the infusion
36 mcg/mL) of
solution
D5W or NS
Do not shake the
vial.
1-2
sec,
but
when
using follow bolus IV
aden injection with
osine rapid 20 ml NS
ECG
Adenosine D5W for flush
3mg/ml NA undiluted NA NA NA NA NA NA NA NA IVP NA HR
NS stress -IM not
BP
Y-site testin recommended
combatability: g the -physician
Abciximab rate required at beds
will
be
for 6
mint
1 mg/ml -ECG
Concentratio -Alteplase is -Heart
Alteplase
n (0.1 incompatible with rate
50 mg
mg/ml) Gluc solution -Blood
25mg/250ml 0.5 mg/ml -Gently swirl the pressure
Y-site 1mg/ml
50 mg/ 500 50 mg/100 ml 50 mg/50ml IVP 1-2 30 mint vial (do not shake) -Bleeding
compatability: 1 mg/ml NS SWFI 50 ml 8 hrs 8 hrs 8 hrs 8 hrs
ml 0.1mg/ml NS SWFI IV ing mint - to dissolve the assessmen
Lidocaine,
Concentratio 0.2mg/ml 3 hrs drug t
metoprolol
n (0.2 -Use polyvinyl Fibrinoge
mg/ml) chloride (PVC) n level
50 mg/ bags or glass vials Prothrom
250ml bin times
Rate of
Concentration Admin
Dilute 900mg
in 500ml
D5W
1.8mg/ml
150 mg over
the FIRST -
10 minutes
(15 mg/min).
Add 3 mL of
Amiodarone
I.V. (150 mg)
to 100 mL
D5W. Infuse
100 mL over
10 minutes.
Followed by
6mg/ ml Stable
Slow: 360 mg Premixed
for 24
over the 50mg/ 100ml
LD: hrs at
NEXT 6 D5W Premixed
1.5mg/ml 25 °C
hours (1 360mg/ 200ml 50mg/ 100ml D5W
(Premixe in D5W
mg/min). Add D5W 360mg/ 200ml Cone. > 2mg/ml
d: Don’t
Amiodarone 18 mL of D5W should be given
150mg/10 use
Amiodarone LD: through central
0ml soln.
Y-Site Injection I.V. (900 mg) 1.5mg/ml LD: line(2).
D5W) <0.6mg KFT
Compatibility: Dilute to 500 mL ( Premixed: 1.5mg/ml Protect from light
Maintena /ml in LFT
Amikacin, 150mg in 100 D5W (conc = 150mg/100ml ( Premixed: Protect from
nce inf: D5W 5- ECG
amphotericin ml D5W (1.5 1.8 mg/mL). D5W) 150mg/100ml freezing
1.8mg/ml Use (unstab IVP, 10mc 10mcg/kg/ Pulmonar
B,atracurium 50 mg/ml D5W NA mg/ Maintenance Maintenance D5W) NA NA Amiodarone
(Premixe fresh le) IV inf g/kg/ mint y function
besylate.cefuroxi ml) infusion: 540 inf: Maintenance inf: hydrochloride
d:360mg/ For min test
me…etc Loading mg over the 1.8mg/ml 1.8mg/ml infusions that will
200ml N.S. Ocular
dose REMAININ (Premixed:360 (Premixed:360mg/ exceed 2 hours
D5W) dilute changes
G 18 hours mg/200ml 200ml D5W) must be
Subseque at conc.
(0.5 mg/min). D5W) Subsequent administered in
nt of
After the first Subsequent maintenance inf: glass or polyolefin
maintena 1.8mg/
24 hours, the maintenance 1.8mg/ml bottles
nce inf: ml is
maintenance inf: (540mg/300ml
1.8mg/ml stable
infusion rate 1.8mg/ml D5W)
(540mg/3 for 24
of 0.5 mg/min (540mg/300ml
00ml hrs at
(720 mg/24 D5W)
D5W) 25°C
hours) should
be continued
utilizing a
concentration
of 1 to 6
mg/mL (7)
LD:
1.5mg/ml
(Premixed:
150mg/100ml
D5W)
Maintenance
inf:
1.8mg/ml
(Premixed:36
0mg/200ml
Rate of
Concentration Admin
D5W)
Subsequent
maintenance
inf:
1.8mg/ml
(540mg/300m
l D5W)
Protect from light

IM is not
recommended
Do not filter
Bolus infusion of
Premixed: NS immediately
Amphotericin B CBC
50mg/ preceding and
LFT
500ml 0.25mg following
Y-Site Injection 10 ml SWFI 7 2 Fever,chil
5mg/ ml D5W NA 0.1mg/ ml D5W / ml 24 hrs 24 hrs IV inf NA 4-6 hrs amphotericin B
Compatibility: Preservativ 50mg/ 200ml D5W days days ls,rigors
300 mg/ 240 ml Use may reduce drug
AmiodaroneHCL, e free only KFT
350 mg central induce
diltiazem K and
/280 ml line nephrotoxicity
HCL,doripenem,z MG levels
400 mg/ 320 ml It should be
idovudine….etc
protected from
freezing
in-line filter that
is ≥1 micron may
be used.
Protect from light

Don’t mix with
saline or drugs or
electrolyte
Invert infusion
container several
Amphotericin B times prior
Lipid complex administration LFT
Premixed:
Premixed: 2.5 and every 2hrs KFT
200mg/
Y-Site Injection 5mg/ml D5W NA NA 1mg/ml 100mg/ 2mg/ml NA 2day 6 hrs 2day IV inf NA mg/kg/hr or during infusion CBC
100ml
Compatibility: 100ml 2 hrs Do not filter K and
D5W
Anidulafungin,do D5W Flush with D5W MG levels
ripenem,telavanci before inf
n HCL It should be
protected from
freezing
in-line filter that
is ≥1 micron may
be used
Rate of
Concentration Admin
It should be
protected from
freezing
Protect from light
Amphotericin B 12 ml SWFI
Don’t mix with LFT
Liposomal Preservative
Premixed: 24 2.5 saline or drugs or KFT
4mg/ml D5W free only NA 1mg/ml 2mg/ml 100mg/50ml NA 6 hrs NA IV inf NA
50mg/50ml hrs mg/kg/hr or electrolyte CBC
Y-Site Injection Shake the vial D5W
D5W 1-2 hrs Do not filter K and
Compatibility: vigorously for
Flush with D5W MG levels
Anidulafungin,do 30 sec
before inf
ripenem
in-line filter that
is ≥1 micron may
be used.
Vital signs
-Degree of
muscle
relaxation
via
periphera
-stored under
l nerve
refrigeration and
Atracurium stimulator
protected from
50mg/5ml and
10mg/ 0.5 mg/ml Premixed: Premixed: freezing
D5W 10mg/ml 1 2.5-20 presence
ml NA Contenous 50mg/100ml 0.5 mg/ml 50mg/100ml NA NA 24 hrs 24hrs IVP -Don't mix
Y-site stability: NS undiluted mint mcg/kg/min of
Iv push infusion NS NS IV inf atracurium with
Amiodarone t spontaneo
50mg/100ml 50mg/100ml alkaline solution
HCL,Cefazolin us
D5W D5W -IM not
Na, movement
recommended
Cefuroxime ….etc -KFT
when in
ICU
-LFT
when in
ICU
-ECG
Bretylium -do not freeze
-Heart
Tosylate -IM injection in
1gm/250 ml 1gm/100ml rate
adult should not
NS NS NS immedia IVP 1 -Blood
Y-Site Injection 50 mg/ml NA Undiluted 4 mg/ml 10mg/ml NA 2 day 7 day 1-2 mg/mint Exceed 5ml per
D5W 1gm/250 1gm/100ml tely IV inf mint pressure
Compatibility: site
D5W D5W -Cardiac
No information -administer while
monitorin
patient supine
g
Rate of
Concentration Admin
Digoxine
500 mcg/2ml
5mcg/ ml 0.25mg/ 50ml Serum K
Premixed:
100mcg/ D5W NA Undiluted Or in D5W Four fold Use IVP ≥5 Protect vial from Apical
Y- 0.5mg/ 50ml D5W NA 24 hrs NA 10-20 min
ml NS 250mcg/ 50 ml 0.25gm/ 50ml dilution fresh IV inf min light Pulse
sitecompatibility: 0.5gm/ 50ml NS
ml NS daily
Bivalirudin,
ciprofloxacin,
cisatracurium,
linezolid…etc
-BP
Dobutamine
-ECG
250mg/20ml -IM not
-Heart
recommended
2-40 rate
Y-site -Correct
Premixed: mcg/kg/min -Serum K
compatibility: D5W 250mg/50ml Use hypovolemia prior
12.5 mg/ml NA NA 2mg/ml 500mg/ 5mg/ml NA NA 24hrs IV inf NA t -Urine
atracurium, NS D5W fresh dobutamine
250ml Continuous output
ciprofloxacin, 250mg/50ml administration
D5W infusion -CVP,
cisatracurium, NS -Use infusion
RAP,
dopamine…etc Pump
MAP,SV
R, PCWP
-Urine
output
-Serum
CL
-IM not
Dopamine - CVP,
recommended
200mg/5ml RAP,
- Concentrations
MAP,
2-50 greater than 3.2
Y-site: 400mg/ 3.2mg/ml SVR,
Premixed: Use 24 NA mcg/kg/min mg/mL must be
Adrenaline 40mg/ D5W NA NA 1.6mg/ml 250ml NA NA IV inf PCWP
800mg/250ml fresh hrs t given via a central
aminophylline, ml NS NS 6.4mg/ml -Blood
D5W Continuous line
atracurium, 400mg/ D5W pressure
infusion -use volumetric
aztreonam, 250ml -ECG
infusion device
ceftazidime, D5W -Heart
-Protect from
chloramphenicol rate
light
sodium…etc -
Periphera
l
perfusion
Rate of
Concentration Admin
2–3
minu
tes
into a
centr
Can be given
al
central or
vein
peripheral
if
followed by 20ml
perip BP
Epinephrine NS flush of IV
heral HR
1mg/ml, fluid
vein 1-10 Tissue
(0.1mg/ml -IVP for specialist
1mg/ml 0.1mg/ml 4mcg/ ml 1mg/ 250ml 0.08mg/ 8mg/ 100ml D5W NA NA 24 hrs 24 IV inf is mcg/kg/ necrosis
prefilled syringe) D5W NA use only if the IM
(1mg/ D5W ml 8mg/ 100ml NS hrs IVP used, mint Watch
NS route is ineffective
0.1 mg/ ml 10ml) 1mg/ 250ml NS Central line flush Continuous skin for
Y-site -Protect from
imme infusion signs of
compatability: light
diatel vasoconst
atracurium, IV and IM routes
y riction
calcium chloride, preferred
after
cisatracurium, methods of
ward
clonidine, administration in
s
dobutamine..etc pediatric
with
20
mL
NaCl
0.9%
500m
Esmolol IM not
cg/kg
100mg/10ml recommended
Premixed: /
2g/ 100ml D5W - Concentrations HR
10mg/ ml 2.5g/ 250ml mint
Y-site D5W NA 10mg/ml 20mg/ ml 2g/ 100ml NS NA NA 24 hrs 24 IV inf ≤ 200mcg/ >10 mg/mL are BP
10mg/ ml D5W Bolus
compatability: NS Continuous hrs IVP kg/ min associated with Respirato
Continuous 2.5g/ 250ml NS follo
Amikacin, infusion more severe vein ry rate
infusion wed
aminophylline irritation and
by
…etc phlebitis
infusi
on
Fentanyl
20mc
20mcg/
Y-Site Injection g/ml Resp.
ml in
Compatibility: 20 mcg/ml in NS function
NS 30d
Abciximab, Epidural 30d Cardio
100mcg/ NA NA Undiluted Use < 3-5 50mcg-
Acyclovir 2 mcg/ ml 1000mcg/50ml 50mcg/ml NA < 20 IV P Can be give IM function
ml 50mcg/ml 50mcg/ml fresh 20mcg/ min 100mcg/h
sodiumAlprostadi PCA mcg/ IV inf BP
mlin r
l, Anidulafungin 10 mcg/ml mlin Sign of
NS
…etc NS addiction
24hr
24hr
Rate of
Concentration Admin
Heparine -Diluted solutions BP

must always be aPTT
Premixed:
Y-site 5000 IU/ Titrate inverted at least 6 PT
25000U/ 250ml 50000U/ 250ml
compatibility: ml D5W 200 IU/ 30 24 according times during INR
NA NA 100 IU/ ml D5W D5W NA 24 hrs IV inf NA
Furosemide, 25000 IU/ NS ml Days hrs to aPTT or mixing to ensure Platelet
25000U/ 250ml 50000U/ 250ml NS
linezolid, ml PT distribution of count
NS
metoclopramide drug. Signs of
bleeeding
Regular insulin
can be given IV or
Human Soluble SubQ
Insuline Regular -Up to 4.2
units/kg/h were
Y-site required
compatibility: Co- occasionally in
administration of hyperglycemic
Titrate
drugs is not 30 24 IV inf very LBW Blood
NS NA NA 0.1- 1U/ ml 100U/ 100ml 1U/ ml NA 24 hrs depend on
recommended 100U/ ml 100U/ 100ml NS Days hrs SC NA neonates (<1000 Glucose
NS Blood
because of the g) during first 2 level
Glucose
risk of weeks of life
inadvertently -In DKA, some
affecting insulin endocrinologists
infusion rate do not use more
than 3 units/h in
children
-Protect vial from

light
-the 100 mg/ ml
BP
concentration
10mg/ 500mg/ 500ml HR
Ketamine SWFI 500mg/ 250ml should not be
ml Dilute to D5W Discard IVP ≥1 0.1-0.5mg/ Respirato
10mg/ml D5W NA 1mg/ ml 2mg/ ml D5W NA NA NA administered I.V.
50mg/ ml 1mg/ ml 500mg/ 500ml after use IV inf min min ry
NS 500mg/ 250ml NS unless properly
100mg/ml NS depressio
diluted with an
n
equal volume of
SWFI ,NS,or
D5W
-Patients must be
Labetalol
kept in a supine BP
5mg/ml Y-
position during -Pulse
site
100mg/ 100ml administration -LFT
compatibility:
NS 100mg/ 50ml NS 10 because a Respirato
Adrenaline, Use Use IVP Continuous
5mg/ ml D5W NA Undiluted 1mg/ ml Premixed 2mg/ ml Premixed NA 24hrs mg/ substantial fall in ry
amikacin, fresh fresh IV inf Infusion
NS 100mg/ 100ml 100mg/ 50ml D5W mint blood pressure function
aminophylline,
D5W may occur upon -Infusion
ampicillin,
standing site every
calcium …etc
-Protect from 30 mint
light
Rate of
Concentration Admin
-Use infusion
Pump
Lidocaine
25-50 - Products
1% Vial
mg/ containing
2%vial 1% vial
min adrenaline
1% prefilled and
i.e. (epinephrine) or
syringe syringe
give preservatives -ECG
2% prefilled 10mg/m
1% must not be given Respirato
syringe l
inject by IV injection or ry
Premixed bag 2%viale 1g/ 500ml
ion at infusion function
2gm/500ml D5W and D5W
10mg/ ml Use 24 2.5-5 -8 mg/mL in D5W -Blood
20% viale Syringe D5W NA 1-4mg/ ml 1g/ 500ml NS 8mg/ ml 2g/ 250ml D5W NA 24 hrs IVP
20mg/ ml fresh hrs mL/ Infusion has been used in pressure
20mg/m NS Premixed 2g/ 250ml NS IV inf
mint; fluid-restricted -Vital
Y-site l 2gm/500ml
give patients signs
compatability: Premixed D5W
2% -Too rapid -State of
Alteplase, bag
inject injection can conscious
bivalirudin, 4mg/ml
ion at cause seizure ness
cisatracurium, 20% vial
1.25 - -10% and 20%
ciprofloxacin, 200mg/
2.5 concentrated
dobutamine, ml
mL/ solutions must not
dopamine….etc
mint be administered
without proper
dilution
May administer
IM
Magnesium 20% or 50% conc
Sulfate may be used for
50% adult and dilution
Serum
1gm(8mEq)/2ml 0.6 to
Mg
10%(0.8mEq/ml) mmol ≤ 20% solution is
0.8 -KFT
2gm20ml 1g/ 50ml D5W /minu recommended for
mmol/mL -BP
1g/ 50ml NS Premixed te children
D5W NA (i.e. a Use Use 24 ≤150mg/ Respirato
Y-site 500mg/ ml 10-20mg/ ml 1g / 100 ml 40mg/ ml 2g/ 50ml D5W NA IVP given -IVP must diluted
NS maximum fresh fresh hrs mint ry rate
compatibility: 4meq/ ml D5W 2g/ 50ml NS IV inf over first and not be
concentratio -Patellar
Aciclovir, 1g/100ml NS 5–15 giving faster than
n of 20%) reflex
amikacin, minu 150mg/mint
-Urinary
ampicillin, tes -Maximal rate of
output
aztreonam, infusion 2g/hrs to
benzylpenicillin, avoid hypotension
cefotaxime…etc Neonates: 25–50
mg magnesium
sulfate/kg 8–12
hours for two or
Rate of
Concentration Admin
three doses
-1gm= 4 mmol =8
meq
-ECG
Metoprolol
-Heart
tartrate
rate
5mg/5ml
-Protect from -BP
5mg/50ml 20mg/50ml 1–2 light Respirato
Y-site
1mg/ml D5W NA Undiluted 0.1mg/ml D5W 0.4mg/ml D5W Use mg -Doses greater ry
compatibility: NA NA NA IVP 30 mint
NS 5mg/50ml 20mg/50ml fresh per than 20mg function
Abciximab, IV inf
NS NS minu unlikely to be or oxygen
alteplase,
te beneficial saturation
bivalirudin
in at risk
individual
s
initial
infusion
rate of
-It is no longer
admixture
marketed in the
is 4 mL/min
UK as toxicity is
over the
common even at
first hour
therapeutic blood
followed by
concentrations
infusion of
-Protect from
A loading dose is given by intravenous injection at a rate of 1 mL the next 250
light
(25 mg) per minute. This is followed by intravenous infusion of a mL at 2
Mexiletine -Give by IV
500-mg/500 mL (1mg/mL) dilution in a suitable infusion solution. mL/min
250mg/10ml infusion via a
The initial infusion rate of the first 250 mL of the admixture is 4 over the -ECG
volumetric
25mg/ NS NA NA mL/min over the first hour followed by infusion of the next 250 NA NA 8 hrs NA IV inf NA next two -Blood
Y-site infusion device
ml D5W mL at 2 mL/min over the next two hours. Maintenance is hours. pressure
compatibility: - slow IV injection
performed using a 250-mg/500 mL (0.5mg/mL) dilution Maintenanc
No information at a maximum
administered at a rate of e is
rate of
1 mL/min performed
25 mg/minute (1
using a 250-
mL/minute) May
mg/500 mL
be diluted with
(0.5-
NaCl 0.9% or
mg/mL)
Gluc 5% to
dilution
facilitate slow
administere
administration
d at a rate
of
1 mL/min
-Can be
administer IM
Midazolam but it's painful use
2-5
Y-site only if no other Respirato
mint
compatibility: 50mg/ 100ml route is available ry and
Premixed at 0.5-5
Adrenaline, 1mg/ ml D5W D5W IVP -Administer as cardiovas
NA Undiluted 0.5mg/ ml 1mg/ ml 50mg/ 50ml D5W Discard NA 24 hrs NA conc mcg/kg/
amikacin, 5mg/ ml NS 50mg/ 100ml IV inf per conscious cular
50mg/ 50ml NS after use of 1-5 min
atracurium, NS sedation Protocol status
mg/m
cisatracurium, -dose should be -BP
l
.etc calculated on
ideal body weight
in obese patients
Rate of
Concentration Admin
-For infusion use

Morphine
2 infusion pump or -Blood
mg/m PCA pump pressure
Y-site
inute -Administer as Respirato
compatibility:
1 mg/ ml (1 per conscious ry Rate
Adrenaline, Infusion
50mg/ 50ml NS mg/m sedation Protocol -O2
amikacin, 7
10mg/ ml D5W 5ml Undiluted Epidural Premixed 5mg/ ml 250mg/ 50ml D5W Discard NA 7 days IVP inute -SC injection not Saturatio
aminophylline, days Epidural
15mg/ ml NS infusion : 50mg/ 50ml 250mg/ 50ml NS after use IV inf in suitable for n
ampicillin, infusion:
0.05 mg / ml D5W opioi oedematous -CNS
atenolol, 5 mg/ hr
d patients depressio
atracurium,
naive - Can be given n
aztreonam,
patie Epidural using -Heart
benzylpenicillin..e
nts) preservative free rate
tc
solution
BP
Protect from light HR
Do not use if Urine
solution become output
pink or dark Vital signs
8mg/ 100ml 0.16mg/ 16mg/ 100ml D5W Use 2-4 Do not use it every 15
Norepinephrine 1mg/ ml D5W NA NA 0.08mg/ ml NA 24 hrs NA IV inf NA
D5W ml Central Line fresh mcg/min undiluted min
Use infusion Check
Pump infusion
IM is not site for
recommended extravasat
ions
NS 10U/ 1000ml Use Use No Special
Oxytocin 10U/ ml NA NA 0.01U/ ml 0.06U/ ml 30U/ 500ml NS NA NA IV inf NA infusion HR
LR NS fresh fresh Conditions
BP
Bolus injection is
HR
25mg/ 250ml recommended
Respirato
1mg/ ml D5W D5W 50mg/ 50ml D5W Discard 48 IVP 1mcg/kg/mi over continuous
Pancuronium NA Undiluted 0.1mg/ ml 1mg/ ml NA 48 hrs 1 min ry
2mg/ ml NS 25mg/ 250ml 50mg/ 50ml NS after use hrs IV inf n infusion
function
NS Sedative must be
Train of
used
four
Avoid rapid IV BP
SWFI infusion. Serum
0-100mg/ Discard IVP Max 60mg/
Phenobarbital 65mg/ ml D5W 5-10ml Undiluted 65mg/ ml >100mg/ 100ml NA NA NA NA Do not give by level
50ml after use IV inf min
NS subcutaneous Respirato
route. ry Rate
Protect from light

Dilute Iml of 40mg/ 500ml Do not use if
D5W
Phenylephrine the 10mg/ ml D5W 0.08mg/ 40mg/ 500ml D5W IVP 1-2 40-80 solution is brown BP
10mg/ ml NS NA 0.08mg/ ml NA NA 48 hrs NA
solution in 40mg/ 500ml ml 40mg/ 500ml NS IV inf min mcg/min or has any HR
SWFI
9ml SWFI NS precipitate
Do not refrigerate
>100mg and
≤ 500 mg in
Do not CBC
50 ml 50
100mg/ 50ml IVP Refrigerate ECG
Phenytoin 50mg/ ml NS NA NA >500mg 10 mg/ ml 100mg/ 50ml NS NA NA 4 hrs NA mg/ 30 - 60 min
NS IV inf Watch for LFT
≤1gm in 100 min
precipitation BP
ml
>1gm ≤ 2.5
Rate of
Concentration Admin
gm in 250ml
10meq/ 100ml
D5W
10meq/ 100ml
NS
20meq/ 250ml Never give as IV ECG
D5W 0.08meq/
Potassium D5W 0.4meq/ push or IM may Serum K,
2meq/ ml NS NA NA ml 40meq/ 100ml NS NA NA 24 hrs NA IV inf NA 10meq/ hr
Chloride 20meq/ 250ml ml cause instant Cl
SWFI 0.1meq/ ml
NS death KFT
40meq/ 500ml
D5W
40meq/ 500ml
NS
4.4meq/ ml 15mmol/ 15mmol/ 100ml
ECG
Potassium k D5W 250ml D5W 0.15mmol D5W 4-6 hrs
NA NA 0.06mmol/ ml NA NA 24 hrs NA IV inf NA NA Serum K
Phosphat 3mmol NS 15mmol/ / ml 15mmol/ 100ml 2 hrs
KFT
e PO4 250ml NS1 NS2
D5W BP
1g/ 250ml Use 24 IVP 50mg Do not
Procainamide 100mg/ ml NA Undiluted 4mg/ ml 8mg/ ml 2g/ 250ml D5W 24 hrs NA infusion CBC
D5W fresh hrs IV inf / min Refrigerate
NS ECG
25mg/ 250ml
D5W D5W 0.25mg/ 25mg/ 100ml D5W Use Use
Promethazine 25mg/ ml NA NA 0.5-0.1mg/ ml NA NA IV inf NA 30 min Can be given IM LFT
NS 25mg/ 250ml ml 25mg/ 100ml NS fresh fresh
NS
Do not
Not less than Refrigerate BP
10mg/ ml 2mg/ ml 500mg/ 50ml IVP 1-2 0.3mg/ Shake well before Respirato
Propofol D5W NA 10mg/ ml 10mg/ ml 500mg/ 50ml D5W 12 hrs NA 12 hrs NA
20mg/ ml Standard D5W IV inf min kg/ hr use ry
10mg/ ml Replace IV tubing function
q6-12h
1mg/ 50ml
D5W 0.06mg/ 15mg/ 250ml D5W Use IVP 1 mg/ IM not BP
Propranolol 1 mg/ ml NA Undiluted 0.02mg/ ml D5W NA 24 hrs NA 30 min
NS ml 15mg/ 50ml NS fresh IV inf min recommended ECG
1mg/ 50ml NS
For
For MI: MI:
10U/ 10ml 4 hrs
SWFI For
For Catheter- For Catheter-
For aPTT
directed For Catheter- Cathete Fro directed
18.1mg Include For MI 10U/ 10ml SWFI MI: IVP No Special PT
Retaplase 10ml thrombolytic directed 1U/ ml NA NA r- MI thrombo-
(10.4U) SWFI 10U/ 10ml 4 hrs IV inf Conditions ECG
therapy thrombolytic directe 2 min lytic
CBC
10U/ 500ml therapy: d therapy
5-10U/ 100- thromb 0.25-1 U/hr
500ml NS olytic
therapy
:
Rate of
Concentration Admin
24 hrs
50000U/ 250000U/ 50ml

BP
ml NS
5000U/ ml LFT
150000U/ 750000U/ 30000U/ 1.5million U/ 50ml 24
Streptokinase NS 5 ml NS NA 7500U/ ml NA NA 24 hrs IV inf NA 30-60 min Do not freeze KFT
ml 100ml NS ml NS hrs
15000U/ ml aPTT
300000U/ 1.5Million U/
PT
ml 100ml NS
IM deep injection
preferably into
20mg/ ml
high deltoid ECG
50mg/ ml
500mg/ 250ml muscle Potassium
100mg/ ml SWFI 500mg/ 250ml 24 hrs
Succinylcholine D5W 24 IVP 10-30 0.5-10 For IM total dose level
D5W 5-10ml Undiluted 1-2mg/ ml 2mg/ ml D5W for NA NA
Suxamehtonium 500mg/ 250ml hrs IV inf sec mg/min not exceed 150mg Respirato
NS 500mg/ 250ml NS powder
NS Test dose 0.1mg/ ry
kg to determine function
sensitivity and
recovery time
500mg/ 250ml ECG
SWFI
D5W 5g/ 100ml D5W Discard 7 IVP 20-30 Infusion Avoid RR
Thiopental 50mg/ ml D5W 10ml 25mg/ ml 2 mg/ ml 50mg/ ml NA 3 days
500mg/ 250ml 5g/ 100ml NS after use days IV inf sec Extravasatio Neurologi
NS
NS n cal status
Vecuronium
Bromide
Y-Site Injection Bact. Cannot be given
0.7- Bl. Gas,
Compatibility: 10ml of WFI IV P IM
1mg/ml D5W 1mg/ml 0.1- 0.2mg/ml 1mg/10ml 1mg/ml 1mg/5ml D5W or Bact.WF NA 24hr 30sec 1.7mcg/kg/ BP,RR,
Alprostadil, bact.WFI 5d IV inf Or intermittent
NS D5W or NS NS I 5d min HR
Aminophylline, Or SWFI SWF inf.
Cefazolin sodium, I
…etc 24hr
Verapamil
Y-Site Injection 160mg/ 100ml

160mg/ 100ml Serum K,
Compatibility: D5W D5W IVP Compatible with
2.5mg/ ml NA Undiluted 1mg/ ml 1mg/ ml D5W NA NA 24 hrs NA 2 min 5mg/ hr Na, Ca,
Argatroban, NS 160mg/ 100ml IV inf KCl
160mg/ 100ml NS Mg
Bivalirudin, NS
Ciprofloxacin,
Clarithromycin
Important note:
Chemotherapy
parentral
Dilution Manual
ROUTE STABILITY
INFUSION LIGHT
MEDICATION SOLUTION OF VOLUME CONCENTRATION TUBING AFTER Comment
RATE PROTECTION
ADMINISTRATION INFUSTION
Arsenic 100-250
NS, D5W IV 1mG / 1mL 1-2 HR RT : 24HR
Trioxide mL
50-250mL
Rec: NS 2000 unit /mL (IV)
(IV)
Asparaginase Inf : NS IV, IM 10000 unit/mL (IM) 30-60 MIN 8HR
Max 2mL
D5W
(SQ)
50-
RT: 1HR
100mL(IV) 10mG/mL (IV)
Azacitidine NS IV, SQ 10-40 MIN RF:8HR(SQ
Max 2mL 25mG/mL(SQ)
)
(SQ)
RT: 3HR
Bendamustine NS, D5W IV 500mL 0.2-0.6 mG/mL 30-60 MIN
RF :24HR
Bevacizumab NS IV, INTRAVITREAL 100mL 25 mG/mL 8HR YES
Bleomycin NS IV, IM, SQ, IP 50-100mL 10 MIN RT: 24HR
3-5
1mG/mL (IV)
Bortezomib NS IVP, SQ SECONDS 8HR YES
2.5mG/mL (SQ)
(IV)
non-PVC
RT: 8HR
Cabazitaxel NS, D5W IV 250-500mL 0.1-0.26 mL/mG 1 HR INFUSIO IMF BAG
RF: 24HR
N
100mL
15 MIN – RT: 8HR
Carobpatin NS, D5W IV OR 0.5 mG/ mL
24HRS RF: 24HR
250 mL
Loading:
Straight RT:8HR DO NOT SHAKE
Cetuximab IV 2mG/mL 2HR
Drug RF:12HR OR DILUTE
Main.: 1HR
Final sodium
30 MIN-
Cisplatin NS, D5W IV 250 mL 0.05-2 mG/mL RT: 24HR YES concoction
24HR
≥0.2%
ROUTE STABILITY
INFUSION LIGHT
RATE PROTECTION
CAUTION: Different
30MIN- Rates and
Cladribine NS IV 500 mL 1mG/mL 24HR YES concentration for 7-
24HR
Day Cl
1-24HR
Cyclophosphadime NS, D5W IV 250 mL 20 mG/mL 24HR
250-1000 20 mG/mL 24HR
Cytarabine NS, D5W IV, IT, may be SQ 1-3HR or Cl
mL 100 mG/mL IT : 4HR
250-1000 IRRITANT
Dacarbazine NS, D5W IV 10 mG/mL 30-60 MIN RT: 24HR YES
mL Discard if Pink
Dactinomycin NS, D5W Slow IVP ≥ 10 mcG/mL IVP 4HR YES
Push: 1- Vesicant
5MIN IVPB in
Daunorubicin NS, D5W IV 100 mL 5mG/mL 24HR YES
IVBP : 15- Central
30 MIN Line
250-500 Non- IMF Bags
Docetaxel NS, D5W IV 0.3-0.74 Mg/mL 1HR 4HR YES
mL DEHP IRRITANT
<90mG in
Doxorubicin 250mL
D5W IV 2mG/mL 1HR RF: 24HRS Vesicant
(Liposomal) >90mG in
500mL
Push: 3-5
MIN
50-1000
Doxorubicin NS, D5W IV 2mG/mL IVPB :15- 24HR YES Vesicant
mL
60 MIN or
Cl
Push: 3-10
MIN
Epirubicin NS, D5W IV 50-250mL IVP: 2mG/mL IVPB: 15- 24HR YES Vesicant
60 MIN or
Cl
IMF Bag:
Etoposide NS, D5W IV 0.2-0.4 mG/mL 30-60 MIN Non-PVC 24HR YES
IRRITANT
ROUTE STABILITY
INFUSION LIGHT
RATE PROTECTION
100mL- 15-30 MIN

Fludarabine NS, D5W IV Max : 10-25 mG/mL 24HR
125mL Or Cl
Total Volume
50-1000 IVP, IV
Fluorouracil NS, D5W IV 50mG/mL 48HR YES for 24hr
mL INFUSION
Infusions
Reconstitu
IM not
Ganciclovir D5W,NS IV tion ≤ 10mg/ml 60 mint 5 days
recommended
volume
10ml SWFI
Gemcitabine NS IV 50-500mL Min. 0.1 mG/mL 30MIN RT: 24HR
Push: 3-5
MIN
Idarubicin NS,D5W IV 100 mL IVPB: 10- 24HR YES Vesicant
15
MIN
30MIN-
Ifosfamide NS, D5W IV 50-1000mL 0.6-20mG/mL RF: 24HRS
24HRS
More Stable in
Irinotecan D5W IV,SQ 250-500mL 0.12-2.8mG/mL 90 MINS 24HRS YES
D5W
15min-2HR
MAX
100-
Leucovorin NS,D5W IVP,IM,IV Infusion RATE: 24HRS YES
1000mL
160mg/mi
n
15min-
Mesna N5, D5W IV 50-1000mL 20mG/mL RT: 24HRS
24HR
ROUTE STABILITY
INFUSION LIGHT
RATE PROTECTION
Slow Push,
short
Bollus
Fusion RT: 24HRS
Methotrexate NS,D5W IV,IM,SQ,IT 50-1000mL 1-4mG/mL YES
Or 24 to 4HR (IT)
42-hour
continuous
infusion
Vesicant:
IV, Slow IVP : Stable for 7
Mitomycin NS 20-40mG/mL RT:12HRS YES
INTRAVESICULAR 15-30MINS Days in a
Syringe
Mitoxantrone NS,D5W IV 50mL 2mG/mL 5-30MINS 24HRS IRRITANT
RT:6HRS
Oxaliplatin D5W IV 250-500mL 0.7mG/mL 2-6HRS VESICANT
RF:24HRS
1HR FOR
WEEKLY/
250- 3HRS FOR NON PVC IMF BAG:
PaclitaxilRT NS,D5W IV,IP 0.3-1.2mG/mL RT: 24HRS
1000mL Q3 WEEKS TUBIN VESICANT
FOR CL
≤1gM/100 ≤1gM :
mL 1HR RT: 6HR
Panitumumab NS IV ≤10mG/mL DO NOT SHAKE
≥1gM/150 ≥1Gm:90M RF:24HR
mL IN
Pegaspargase NS,D5W IV,IM 100mL (IV) 750 IU/mL IV: 1-2HRS RF:24HRS
RT/FR:
Pemetrexed NS IV 100mL 25mG/mL 10MINS
24HRS
Per RT:12HRS
Rituximab NS,D5W IV 1-4mG/mL DO NOT SHAKE
Protocol RF: 24HRS
ROUTE STABILITY
INFUSION LIGHT
RATE PROTECTION
Loading:
90mins
Trastuzumab NS IV 250mL 21mG/mL RF: 24HRS
Maint:
30mins
Push: 2-
3MINS
Vinblastine NS,D5W IV 50mL 1mG/mL 24HRS VESICANT
IVPB: 2-
15MINS
PUSH: 1-
2MINS
Vinocristine NS,D5W IV 25-50mL 0.02mG/mL 24HRS VESICANT
IVPB: 10-
15 MINS
1.5-3mG/mL in
PUSH: 6-
syringe
10MINS
Vinorelbine NS,D5W IV 10-50mL OR 24HRS VESICANT
IVPB: 30
0.5-2mG/mL in IV
MINS
bags
Reconstitu
At least 15
Zoledronic Acid D5W,NS IV tion 4mg/100ml 24 HRS
mint
volume 5
ml
(BOLDED LETTERS = PRIMARY SOLUTION)
Important note:
References
(1) Injectable Drugs Guide, 12-Apr-2014
(2) Saudi National Formulary (SNF) 4thEdition 2009-2010
(3) Pediatric Injectable Drugs 12-Apr-2014
(4) Ministry of Health Formulary
(5) Handbook Injectable Drugs 12-Apr-2014
(6) http://www.Globalrph.com
(7) McGraw-Hill’s IV drug Handbook 2012.
Abbreviations
aPTT: activated Partial Thromboplastin Time
BP: Blood Pressure
CBC: Complete Blood Count
D5W: Dextrose 5% in Water
ECG: Electrocardiogram
HR: Heart Rate
IM: Intramuscular
INR: International Normalization Ratio
IVBP: Intravenous Piggyback (polyvinyl Chloride=PVC)
IVP: Intravenous Push
KFT: Kidney Function Test
LFT: Liver Function Test
NA: Not Applicable/ Not available9
NS: Normal Saline
PT: ProthrombinTime
Ref: Refrigerate
RR: Respiratory Rate
RT: Room Temperature
SWFI: Sterile Water For Injection
FBC: Full blood count
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Deputy Minister of Health for Curative Service

Assistant Deputy Minister for Supportive Medical Services

Director of General Administration of Pharmaceutical care at Ministry of Health

DR YOUSEF AHAMED ALOMI

DR Somaiya Mohammed Aljudaibi DR Hajer Yousef Almudaiheem

DR Norah Abdulaziz Aljohany DR Samia Zaben Atallah Almurshadi

DR Wajed Awad AL-Shammari DR AMANI ABDULLAH BAHDEALAH

Aminophylline 500mg/ 500ml Loading

any one site

-Do not freeze

-IV bolus may

-Do not mix with

And allow 2-3

Y-Site Injection 2.5ml SWFI 24hr 24hr

Dexamethasone -protect from

-The patient must

-The IV inf either

Iron Dextran -IV push not Body

NS diluting 1 1mg/ 500ml NS 2mg/ 500ml NS Subcutaneous amic

Check for minute

Lorazepam 2 Intravenous Respirato

adrenaline, over avoid inadvertent glycol

Micafungin Reconstitute 50mg/100ml -Protect from -U&Es

calcium inner wall of disperse the containing a

Vancomycin 500mg/ 100ml 10mg/ ml

Protect from light

Protect from light

Heparine -Diluted solutions BP

-Protect vial from

-For infusion use

Protect from light

50000U/ 250000U/ 50ml

Y-Site Injection 160mg/ 100ml

Bevacizumab NS IV, INTRAVITREAL 100mL 25 mG/mL 8HR YES

Bleomycin NS IV, IM, SQ, IP 50-100mL 10 MIN RT: 24HR

Dactinomycin NS, D5W Slow IVP ≥ 10 mcG/mL IVP 4HR YES

100mL- 15-30 MIN

Gemcitabine NS IV 50-500mL Min. 0.1 mG/mL 30MIN RT: 24HR

Mitoxantrone NS,D5W IV 50mL 2mG/mL 5-30MINS 24HRS IRRITANT

(BOLDED LETTERS = PRIMARY SOLUTION)

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