ChemoStabilityChart AtoK 14jan2014

BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative
Status) Aldesleukin 22 million units (1.3 mg) (Novartis) (F)(PFL) no preservative1 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1.2 mL SWI1,2 direct diluent against side of vial during reconstitution1 do not shake1
18 million unit/mL (1.1 mg/mL)1,2
48 h F1
50 mL D5W1 30 70 mcg/mL1 Less than 30 mcg/mL: dilute in D5W containing human albumin 0.1%2
48 h F1
- do not use in-line filter1,2 - avoid bacteriostatic water for injection or NS due to increased aggregation1
Alemtuzumab 30 mg/mL (Genzyme previously Bayer)3 (F)(PFL) do not shake no preservative4
N/A
filter NOT required4 30 mg/mL4
discard unused portion4
SC syringe5
discard at the end of the day F or RT 8 h F or RT4 **(PFL)6
- do not shake6
100 mL NS or D5W4
100 mL NS or D5W7
8 h F or RT6 **(PFL)6
Amifostine 500 mg (MedImmune) (RT) no preservative8
9.7 mL NS only8
50 mg/mL8
24 h F, 5 h RT8
2550 mL* NS only8
540 mg/mL: 24 h F, 5 h RT8
- discard cloudy solution9
BC Cancer Agency Chemotherapy Preparation and Stability Chart version 2.00 Activation Date: 2 March 2006 Revised Date: 14 January 2014
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Amsacrine 75 mg/1.5 mL (Erfa Canada) (RT) no preservative10 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
glass syringes preferred during reconstitution; max. time in plastic syringe10: 15 min 13.5 mL supplied diluent (L-lactic acid)1 transfer 1.5mL from ampoule into the diluent vial10
5 mg/mL10
24 h RT10 PFL10
500 mL D5W10 (plastic or glass container)10
7 d F, 48 h RT10-12
2/42
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Asparaginase13 (asparaginase E. coli) 10,000 units (Orphan Pharmaceutical International) (F) no preservative14 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
do not shake; roll to reconstitute9,15 4 mL SWI16 Intradermal test : Reconstitute with 5 mL SWI to give 2000 units/mL Transfer 0.1 mL to 10 mL vial (or 12 mL syringe) Add 9.9 mL SWI roll to dissolve to give 20 units/mL 2 unit test dose = 0.1 mL (Note: the rest of the reconstituted vial has a concentration of 2000 units/mL)9
9
2500 units/mL13
48 h F, RT13
syringe13 50 mL* NS or D5W11,17
14 d F13,17 14 d F,11,17 2 d RT17,18
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Erwinia asparaginase (asparaginase Erwinia chrysanthemi) 10,000 units (Orphan Pharmaceuticals International) (F) no preservative19 PEG-asparaginase (pegasparagase) (pegylated asparaginase E. coli) 750 units/mL (Enzon) (F) no preservative20 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
do not shake; roll to reconstitute19 1-2 mL NS19
10000-5000 units/mL
15 min in original container; 8 h in a glass or polypropylene syringe19
glass or polypropylene syringe19
8 h in a glass or polypropylene syringe19
N/A
750 units/mL20
IM: maximum volume 2 mL; if greater than 2 mL use multiple sites20 IV: 100 mL NS or D5W20
syringe: 4 h20,21
bag: 4 h20,21
- discard cloudy solution20 - do not shake20 - do not use if stored out of refrigerator for greater than 48 h20 - do not use if previously frozen20
4/42
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Azacitidine 100 mg (Celgene) (RT) no preservative22 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4 mL SWI22 shake vigorously22
25 mg/mL22
8 h F, 45 min RT22
SC syringe22
8 h F, 45 min RT23 Refrigerated syringes23: allow up to 30 min prior to administration to reach a temperature of approximately 20 25C discard syringe if time elapsed at RT is greater than 30 min
- discard if contains large particles22 - re-suspend syringe contents before injection by vigorously rolling syringe between palms22
BCG 81 mg (Sanofi Pasteur) (F)(PFL) preservative24
do not shake; roll to reconstitute24 3 mL supplied diluent24 record time of reconstitution
10.5 8.7108 CFU/vial (Connaught strain)24
2 h F, RT24
50 mL NS24
2 h F or RT after reconstitution24 **(PFL)24
- auxiliary label: biohazard25
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) BCG (Tice substrain) 50 mg = 1 to 8 x 108 CFU (Hospira/Organon) (F)(PFL) no preservative26 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1 mL preservative free NS for injection26 use reconstitution device provided allow to stand for a few minutes, then gently swirl to suspend26
1 to 8108 CFU/vial26
2 h F (PFL)26
transfer from vial to 60 mL syringe, rinse vial with another 1 mL NS. Add rinse to same 60 mL syringe. qs to 50 mL with NS26
2 h F26
- auxiliary label: biohazard25 - overfill unknown - protect from light26 - do not filter26
Bendamustine 25 mg 100 mg (Lundbeck) (RT)(PFL) no preservative27
25 mg vial: add 5 mL SWI27 100 mg vial: add 20 mL SWI27 shake well; dissolves completely in 5 minutes27
5 mg/mL27
30 minutes27
500 mL NS27 0.2-0.6 mg/mL27
complete administration within 24 h F, 3 h RT27
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Bevacizumab 100 mg/4 mL 400 mg/16 mL (Roche) (F)(PFL) do not shake no preservative28 Bleomycin 15 units (NB: dose in units only) (Bristol) (F) no preservative30 Bleomycin 15 units (NB: dose in units only) (Hospira) (F)(PFL) no preservative32 Bleomycin 15 units (NB: dose in units only) (PPC) (F)(PFL) no preservative35 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
25 mg/mL28
1.4-16.5 mg/mL29 100-250 mL NS only28,29
48 h F, RT18,28,29
- do not shake28
6 mL* NS30
2.5 units/mL
48 h F30
50 mL* NS30
24 h RT30
- no overfill31
6 mL* NS or SWI32
2.5 units/mL32
48 h F, 24 h RT32
50 mL* NS, SWI32
24 h RT33
- no overfill34
6 mL NS35
2.5 units/mL35
48 h F35
50 mL NS35
24 h RT35
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Bortezomib 3.5 mg (Ortho Biotech, formerly Millennium) (RT)(PFL) no preservative36 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
3.5 mL NS36
1 mg/mL36
2d RT11,37
syringe36
8 h RT38
- auxiliary label: WARNING: SUBCUTANEOUS or INTRAVENOUS use only. Fatal if given by other routes25 - solution should be clear to slightly opalescent, colorless, and free of visible particulates39
Brentuximab 50 mg (GMD Distribution for Seattle Genetics) (F)(PFL) no preservative39
10.5 mL SWI39 Direct diluent against side of vial during reconstitution39 Do NOT shake39
5 mg/mL39
24 h F39
0.4-1.8 mg/mL in NS, D5W, Lactated Ringers (i.e. 100-250 mL)39
24 h F39 Do NOT freeze39
Busulfan 60 mg/10 mL (Orphan Medical) (F) no preservative40
N/A
use 5-micron nylon filter provided with ampoule to withdraw drug40 6 mg/mL40
NS or D5W (dilute in volume 10 times the busulfan volume to ~0.5 mg/mL)40
complete administration within 12 h F: NS40 8 h RT: NS, D5W
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cabazitaxel 60 mg/1.5 mL (sanofi-aventis) (RT) no preservative41 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
Supplied diluent : Withdraw entire contents of the diluent vial and inject into the concentrate vial.41 Slowly direct diluent against inside of concentrate vial during reconstitution to limit foaming.41 Mix by repeated inversions for 45 sec.41 Do NOT shake.41 Let sit for 5 minutes.41
10 mg/mL41
1 h RT41
0.10 0.26 mg/mL NS, D5W41 (e.g., 250 mL*)
complete administration within 8 h RT or 48 h F41
- concentrate and diluent vials contain overfill41 - use non-PVC (nonDEHP) bag and tubing41 - use 0.22 micron inline filter41 - diluent contains 13% (w/w) ethanol in water41 - discard if crystallization occurs41
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) CARBOplatin 50 mg/5 mL 150 mg/15 mL 450 mg/45 mL 600 mg/60 mL (Hospira) (RT)(PFL) no preservative42 CARBOplatin 50 mg/5 mL 150 mg/15 mL 450 mg/45 mL (Teva/Novopharm) (RT)(PFL) no preservative45 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
10 mg/mL42
0.3-10 mg/mL43 NS, D5W9,42 do NOT use aluminum-containing needle or syringe43
24 h RT,44 48 h F42
- do NOT use aluminum-containing needle, syringe or tubing43
N/A
10 mg/mL45
discard unused portion RT45
0.5-10 mg/mL46 NS, D5W9,45,47 do NOT use aluminum-containing needle or syringe45
8 h RT45
Carmustine 100 mg (Bristol Labs) (F) no preservative48
3 mL diluent (supplied)48 diluent to reach RT, then dissolve drug with 3 mL diluent; add 27 mL SWI48 record time of reconstitution
3.3 mg/mL in 10% ethanol48
24 h F, 8 h RT48
glass48 or polyolefin container9 500 mL NS or D5W48
24 h F: in glass48 or polyolefin container9 use within 4 h of reconstitution RT48
- do not use if product has oily droplets48
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cetuximab 100 mg/50 mL 200 mg/100 mL (ImClone/BMS) (F) do not dilute do not shake no preservative49 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
2 mg/mL49
discard unused portion after 12 h F, 8 h RT49
syringe49 sterile evacuated container or bag e.g. polyolefin, polyethylene, ethylene vinyl acetate, DEHP plasticized PVC, PVC bag, or glass49
12 h F, 8 h RT49 12 h F, 8 h RT49
- administer with a 0.2 or 0.22 micron low protein binding in-line filter49 - normal saline may be used to flush the line49 - solution may contain white particulates which do not affect product quality49 - do NOT use aluminum-containing needle, syringe or tubing50
CISplatin 10 mg/10 mL 50 mg/50 mL 100 mg/100mL (Hospira) (RT)(PFL) no preservative50
N/A
1 mg/mL50
48 h RT51
Less than or equal to 60 mg: 100 mL* NS Greater than 60 mg: 250 mL* NS 500 or 1000 mL* NS, D5-NS, D5-1/2S, D5NS with mannitol, D51/2S with mannitol50,52; D5W1/3S with mannitol50
48 h RT51
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) CISplatin 10 mg/10 mL 50 mg/50 mL 100 mg/100mL (Sandoz) (RT)(PFL) no preservative53 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL53
48 h RT53,54
Less than or equal to 60 mg: 100 mL NS* Greater than 60 mg: 250 mL NS* NS; 0.45 % Sodium Chloride with or without mannitol55 2 L of D5 on one-half or one-third NS containing 37.5 g of mannitol53
24 h RT53
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cladribine 10 mg/10 mL (Janssen-Ortho) (F)(PFL) no preservative56 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL56
SC syringe57
48h F, end of day RT11,56,58,59 24 h RT56
500 mL NS only56 Do NOT use D5W56 Cassette: qs to 100 mL with bacteriostatic NS only via SIMS DELTEC INC. MEDICATION CASSETTES56 filter drug and diluent through 0.22 micron filter as each solution is being introduced into the cassette
- shake vigorously to dissolve any precipitates from refrigeration56
at least 7 days56
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cladribine 10 mg/10 mL (PPC) (F)(PFL) no preservative60 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL60
discard unused potion60
SC syringe57
discard end of day11,59,60 24 h RT
500 mL NS only Do NOT use D5W Cassette: qs to 100 mL with bacteriostatic NS only via SIMS DELTEC INC. MEDICATION CASSETTES60 filter drug and diluent through 0.22 micron filter as each solution is being introduced into the cassette Clodronate 300 mg/10 mL (Oryx) (RT) no preservative61 N/A 30 mg/mL61 discard unused portion61 500 mL NS or D5W61
at least 7 days60
12 h RT61
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cyclophosphamide 200 mg 500 mg 1000 mg 2000 mg (Baxter) (RT)(PFL) no preservative62 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
NS63 200 mg: 10 mL 500 mg: 25 mL 1000 mg: 50 mL 2000 mg: 100 mL62
20 mg/mL62
48 h F,54,62,64 24 h RT62
Less than or equal to 1 g: 100 mL NS* Greater than 1 g: 250 mL NS* high dose in BMT: may need 500 NS* NS, D5W, D5NS62
72 h F,62,64 24 h RT62
CycloSPORINE 50 mg/1 mL 250 mg/5 mL (Novartis) (RT)(PFL) no preservative65
N/A
50 mg/mL65
NS, D5W65 dilute to concentration between 1:20 and 1:10065
dilute immediately prior to use65
- polyoxyethylated castor oil/ethanol vehicle65 - do NOT refrigerate or freeze65 - use non-PVC bag and tubing66 - do not use for IT injection
Cytarabine 100 mg/1 mL 1000 mg/10mL 2000 mg/20mL (Hospira) (RT)(PFL) no preservative67
N/A record time of puncture
100 mg/mL67
24 h RT67
100 mL* NS, Water for Injection, D5W, Lactated Ringers67
72 h F, 24 h RT from initial vial puncture67
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cytarabine 100 mg (Pfizer) (RT)(PFL) no preservative68 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
NS, D5W, SWI or BWI68 100 mg: 5 mL68
20 mg/mL68
reconstituted with NS, D5W or SWI: discard at end of day54,68 reconstituted with BWI: 48 h RT68
NS, D5W68
0.5 mg/mL: 48 h RT54,68 8-32 mg/mL: 48 h RT54,68
- for high dose use, do not use diluent containing benzyl alcohol68
Cytarabine IT injection 100 mg/1 mL 1000 mg/10mL 2000 mg/20mL (Hospira) (RT)(PFL) no preservative67
100 mg/mL67
24 h RT67
diluents containing preservatives should NOT be used for intrathecal administration67 qs to 6 mL with preservative free NS69
use within 4 h of initial vial puncture9,11
- auxiliary label70: IT - label to include route in full (i.e., INTRATHECAL injection) attached to both syringe and outer ziplock bag70
Cytarabine IT injection 100 mg (Pfizer) (RT)(PFL) no preservative68
preservative-free NS68 100 mg: 5 mL68
20 mg/mL68
discard at end of day54,68
diluents containing preservatives should NOT be used for intrathecal administration68 qs to 6 mL with preservative free NS69
use within 4 h of initial vial puncture9,11
- auxiliary label70: IT - label to include route in full (i.e., INTRATHECAL injection) attached to both syringe and outer ziplock bag70
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Cytarabine SC injection: 100 mg (Pfizer) (RT)(PFL) no preservative71 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
100 mg: 5 mL BWI71
20 mg/mL71
48 h RT71,72
syringe
14 d F, 48 h RT72
- for high dose use, do not use diluent containing benzyl alcohol73 - do not use for IT injection
Dacarbazine 100 mg 200 mg (Abraxis) (F)(PFL) no preservative74
100 mg: 9.9 mL SWI74 200 mg: 19.7 mL SWI74
10 mg/mL74
72 h F, 8 h RT74
250-1000 mL* NS or D5W
24 h F, 8 h RT74 **(PFL)9,74 see Special Precautions/Notes Column
- protect container from light during storage and administration75 - overfill unknown
Dacarbazine 200 mg 600 mg (Hospira) (F)(PFL) no preservative76
200 mg: 19.7 mL SWI76 600 mg: 59.1 mL SWI76
10 mg/mL76
48 h F, 8 h RT76 (PFL)77
0.193.0 mg/mL11,76 250-1000 mL* NS or D5W
24 h F76 **(PFL)75 see Special Precautions/Notes Column
- protect container from light during storage and administration75 - no overfill34,77
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Dactinomycin 0.5 mg (Lundbeck) (RT)(PFL) no preservative78 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1.1 mL SWI (preservative-free)78 Do NOT use SWI with preservative (may form precipitate)78
0.5 mg/mL (500 mcg/mL)78
discard at end of day54
syringe78
use within 4 h of initial vial puncture54
- drug loss reported with some cellulose ester membrane inline filters78
10 mcg/mL or greater78 D5NS78
Dactinomycin 0.5 mg (Ovation)79 (RT)(PFL) no preservative80
1.1 mL SWI (preservative-free)80 Do NOT use SWI with preservative (may form precipitate)80 4 mL SWI83
0.5 mg/mL80 (500 mcg/mL)
24 h F, RT81
syringe80,82
24 h F, RT54
- do not filter80,82
DAUNOrubicin 20 mg (Erfa Canada Inc.)83 (RT)(PFL)84 no preservative85
5 mg/mL83,86
48 h F, 24 h RT85
100-250 mL in isotonic solution e.g., NS83 no data for D5W85
24 h RT, 48 h F83
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DAUNOrubicin 20 mg (Teva/Novopharm) (RT)(PFL) no preservative87 Degarelix 80 mg 120 mg (Ferring) (RT) do not shake no preservative88 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
4 mL SWI87
5 mg/mL87
24 h RT, 48 h F87 (PFL)87
100-250 mL NS or D5W9
48 h F, 24 h RT87 **(PFL)87
80 mg: 4.2 mL SWI (supplied diluent)88 120 mg: 3 mL SWI (supplied diluent)88 do NOT use bacteriostatic water for injection88 swirl gently; keep vial vertical at all times88 reconstitution may take up to 15 min88
20 mg/mL88
2 h RT88
SC syringe88
2 h RT89
40 mg/mL88
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Denosumab (XGEVA) 120 mg/1.7 mL (Amgen) (F)(PFL) do not shake no preservative90 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
71 mg/mL90
discard unused portion54,90
SC syringe90
use within 4 h of initial puncture54
- not interchangeable with PROLIA90 - do not use if solution is cloudy; trace amounts of translucent to white proteinaceous particles are acceptable90 - avoid vigorous shaking90 - bring to room temperature 15-30 minutes prior to administration90
Dexrazoxane 250 mg 500 mg (Pfizer) (RT) no preservative91
supplied diluent91: 250 mg: 25 mL 500 mg: 50 mL
10 mg/mL91
6 h F91
empty viaflex bag91
6 h RT92
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Dexrazoxane (same formulation, no diluent provided) 250 mg 500 mg (Pfizer) (RT) no preservative93 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
SWI93 250 mg: 25 mL 500 mg: 50 mL
10 mg/mL93
30 min RT, 4 h F93
MUST BE FURTHER DILUTED With Lactated Ringers Injection to 1.3 3.0 mg/mL93
1 h RT, 4 h F93
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DOCEtaxel 20 mg/2 mL 80 mg/8 mL 160 mg/16 mL (Hospira) (F, RT)(PFL) preservative94 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
10 mg/mL94
20mg/2 mL vial: discard unused portion25,94
0.3-0.74 mg/mL94 (250 mL NS or D5W)94
complete administration within 4 h F,94 48 h RT25,95
- use non-PVC (nonDEHP) bag and IV administration set94 - do not use chemo dispensing pins96
80 mg/8 mL or 160 mg/16 mL vial (maximum number of punctures: up to 3 doses can be removed when a venting needle is also inserted, i.e., 6 punctures total)97 14 d F25,94 **(PFL)25,94
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DOCEtaxel 20 mg/0.5 mL 80 mg/2 mL (sanofi-aventis) (F, RT)(PFL) no preservative98 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
supplied diluent : - if vials were refrigerated, allow to warm for 5 min at 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 sec98 DO NOT SHAKE98 Let sit for 5 minutes98
10 mg/mL98
48 h F, RT25,98,99
0.3-0.74 mg/mL98 (250 mL NS or D5W)98
complete administration within 4 h F,98 48 h RT25,99
- use non-PVC (nonDEHP) bag and IV administration set98
DOXOrubicin 10 mg 50 mg 150 mg (Hospira) (RT)(PFL) no preservative100
NS, SWI, D5W100 (NS reconstitution takes longer) 10 mg: 5 mL 50 mg: 25 mL 150 mg: 75 mL
2 mg/mL100
48 h F, 24 h RT11,100
syringe100
48 h F, 24 h RT11,101
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DOXOrubicin 10 mg/5 mL 20 mg/10 mL 50 mg/25 mL 200 mg/100 mL (Teva/Novopharm) (F)(PFL) no preservative102 DOXOrubicin 10 mg/5 mL 50 mg/25 mL 200 mg/100 mL (Pfizer) (F) no preservative103 DOXOrubicin Pegylated Liposomal 20 mg/10 mL (Janssen) (F) no preservative104 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
2 mg/mL102
8 h102
syringe102 100 mL* NS
48 h F, 24 h RT102 from initial vial puncture
N/A
2 mg/mL103
syringe103 100 mL* NS
48 h F, 24 h RT103
N/A
2 mg/mL104
Less than 90 mg: 250 mL D5W only104 Greater than or equal to 90 mg: 500mL D5W only104
24 h F104
- do not filter104
24/42
BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) DOXOrubicin Pegylated Liposomal 20 mg/10 mL 50 mg/25 mL (Schering) (F) no preservative105 Epirubicin 10 mg/5 mL 20 mg/10 mL 50 mg/25 mL 150 mg/75 mL 200 mg/100 mL (Novopharm) (F)(PFL) no preservative106 Epirubicin 10 mg/5 mL 50 mg/25 mL 200 mg/100 mL (PPC) (F)(PFL) no preservative107 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
2 mg/mL105
Less than 90 mg: 250 mL D5W only105 Greater than or equal to 90 mg: 500mL D5W only
24 h F105
- do not filter105
N/A
2 mg/mL106
8 h F, RT106
syringe106
48 h F, 24 h RT from initial vial puncture106
2 mg/mL107
8 h107
syringe107
48 h F, 24 h RT from initial vial puncture107 2 d F, RT: NS or D5W25,107
100 mL* NS or D5W
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Epirubicin 10 mg/5 mL 50 mg/25 mL 200 mg/100 mL (Pfizer) (F)(PFL) no preservative108 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
2 mg/mL108
8 h108
syringe108
48 h F, 24 h RT from initial vial puncture108 2 d F, RT: NS or D5W51
100 mL* NS or D5W9
Eribulin 1 mg/2 mL (Eisai Limited) (RT)(PFL)109 no preservative25
N/A
0.5 mg/mL109
discard at end of day25,109
IV syringe109 0.005-0.2 mg/mL NS only109 100 mL* NS109
24 h F, 6 h RT109 48 h F, 24 h RT109
- do not administer through dextrose containing lines109 - vials contain dehydrated alcohol USP (5% v/v)109 - use non-PVC bag and tubing only
Etoposide 100 mg/5 mL 500 mg/25 mL 1000 mg/50 mL (BMS) (RT) preservative110
N/A
20 mg/mL110
14 d RT9,11,111-113
0.2 0.4 mg/mL110 500 mL* NS or D5W110
0.2 mg/mL: 48 h RT11,110 0.4 mg/mL: 24 h RT110
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Etoposide 100 mg/5 mL 200 mg/10 mL 500 mg/25 mL 1000 mg/50 mL (Teva/Novopharm) (RT)(PFL) no preservative114 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL114
NS Stability is concentration dependent
0.2-0.3 mg/mL: 7 d F,115 2 d RT115,116 0.4-0.5 mg/mL: 1 d F,115 1d RT115 0.6-9.0mg/mL: generally unstable 9.5 mg/mL: 2 d F,115 1d RT115 10-12 mg/mL: 7 d F,115 2 d RT115,116
- use non-PVC bag and tubing only
D5W114 Fludarabine 50 mg (Berlex) (F) no preservative118 2 mL SWI118 25 mg/mL118 48 h F or RT11,51 dilute to maximum of 1 mg/mL118,119 50-100 mL* NS or D5W118
4 h RT114,117 48 h F, RT11,51
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Fludarabine 50 mg (Teva/Novopharm) (F) no preservative120 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
25 mg/mL120
dilute to maximum of 1 mg/mL120 50-100 mL* NS or D5W
48 h F, 24 h RT120
Fluorouracil 5000 mg/100 mL (Hospira) (RT)(PFL) no preservative121
N/A
50 mg/mL121
8 h RT121,122
syringe11
48 h RT11,18,122
2-10 mg/mL in D5W121,122 50-1000 mL* D5W CIVI: ambulatory pump122
24 h RT121,122
complete within 8 d9,11,123
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Fluorouracil 500 mg/10 mL 5000 mg/100 mL (Sandoz) (RT)(PFL) no preservative124 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
50 mg/mL124
4 h RT25
syringe
4 h RT25
D5W124
24 h RT124
CIVI: ambulatory pump122
complete within 8 d9,11,123
Gemcitabine 200 mg 1000 mg 2000 mg (Accord Healthcare) (RT) no preservative125
200 mg: 5 mL NS 1000 mg: 25 mL NS 2000 mg: 50 mL NS125
38 mg/mL125
24 h RT125
0.1 - 10 mg/mL NS125
48 h RT112,126
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Gemcitabine 200 mg 1000 mg (Eli-Lilly) (RT) no preservative127 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
200 mg: 5 mL NS 1000 mg: 25 mL NS127
38 mg/mL127
48 h RT127,128
syringe127
48 h RT11,127,128
0.110 mg/mL NS127,128 Gemcitabine 200 mg 1000 mg 2000 mg (Hospira) (F) no preservative129 Gemcitabine 200 mg 1000 mg 2000 mg (Hospira) (RT)130 no preservative131 N/A 38 mg/mL129 discard unused portion at the end of the day129 0.1 38 mg/mL NS, D5W129
48 h F, RT11,127,128
24 h RT129
200 mg: 5 mL NS 1000 mg: 25 mL NS 2000 mg: 50 mL NS130
38 mg/mL130
48 RT54,130,132
syringe130
24 h RT130,132
0.1 - 26 mg/mL NS130,132
48 h RT54,132
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Gemcitabine 200 mg 1000 mg (Teva/Novopharm) (RT) no preservative133 Gemcitabine 200 mg 1000 mg (Sandoz Standard) (RT) no preservative134 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
200 mg: 5mL NS 1000 mg: 25 mL NS133
38 mg/mL133
24 h RT133
0.1 - 38 mg/mL NS133
24 RT133
200 mg: 5 mL NS 1000 mg: 25 mL NS134
38 mg/mL134
48 h RT134,135
syringe134
48 h RT134-136
0.1 - 38 mg/mL NS or D5W134,137 IDArubicin 5 mg 10mg (Pfizer) (RT)(PFL) no preservative139 5 mg: 5 mL SWI139 10 mg: 10 mL SWI139 vial contents under negative pressure139 do NOT use BWI to reconstitute139 1 mg/mL139 48 h F, 24 h RT139 **(PFL)139 syringe139
48 h RT11,138
48 h F, 24 h RT139
- avoid alkaline solutions139
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) IDArubicin PFS 5 mg/5 mL 10 mg/10 mL 20 mg/20 mL (Pfizer) (F)(PFL) no preservative139 IDArubicin 5 mg/5 mL 10 mg/10 mL 20 mg/20 mL (PPC) (F)(PFL) no preservative140 Ifosfamide 1000 mg 3000 mg (Baxter) (RT)9 no preservative141 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
1 mg/mL139
24 h RT, 48 h F **(PFL)139
syringe139
4 h from initial puncture25
N/A
1 mg/mL140
discard unused solution140
syringe140
4 h from initial puncture25
1000 mg: 20 mL SWI141 3000 mg: 60 mL SWI shake well
50 mg/mL141
48 h F11,141
0.620 mg/mL141 5001000 mL* NS, D5W, D5-NS, D5-1/2NS, Lactated Ringers9,141
72 h F141 24 h F, RT when mixed with mesna9 D5W or Lactated Ringers when mixed
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Ifosfamide 1000 mg 3000 mg (PPC) (RT) no preservative142 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1000 mg: 20 mL SWI 3000 mg: 60 mL SWI142 shake well
50 mg/mL142
72 h F, 24 h RT142
0.6-20 mg/mL142 500-1000 mL* NS D5W; Lactated Ringers142
72 h F 24 h RT142 24 h F, RT when mixed with mesna9 D5W or Lactated Ringers when mixed 24 h RT143 - *may also use empty IV bag and qs to final volume of 250 mL with NS, D5W143
Iniparib 100 mg/10 mL (sanofi-aventis) (F) no preservative143
N/A
10 mg/mL143
250 mL NS, D5W dilute to 250 mL final volume by withdrawing volume from bag equal to volume of drug to be added*143
Interferon Alfa -2b 18 million units/3 mL (Schering) (F)(or up to 7 days at RT before use)144 preservative145
N/A
6 million units/mL144
48 h F11,144
syringe144 Greater than or equal to 0.3 million IU/mL144 50 mL NS144
2 d F11,146 24 h F, RT146
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Interferon Alfa -2b 10 million units/1 mL 25 million units/2.5 mL (Schering) (F)(or up to 7 days at RT before use)144 preservative145 Interferon Alfa -2b 10 million units (Schering) (F)144 no preservative (unless reconstituted with BWI)145 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
48 h F11,144
syringe144 0.3 million IU/mL144 50 mL NS144
2 d F11,146 24 h F, RT146
1 mL supplied diluent (SWI)144 do not shake; roll to reconstitute144
24 h F144
syringe144
24 h F, RT146
Greater than 0.1 million IU/mL146 100 mL NS147
48 h RT9,11
1 mL BWI144 do not shake; roll to reconstitute144
48 h F, RT11,144
syringe147 100 mL NS147
14 d F, 48 h RT11,147 48 h RT9,11
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Interferon Alfa -2b 18 million units (Schering) (F)144 no preservative (unless reconstituted with BWI)145 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
1 mL supplied diluent144 do not shake; roll to reconstitute144
24 h F144
syringe144
24 h F, RT146
> 0.1 million IU/mL148 100 mL NS147
48 h RT9,11
1 mL BWI144 do not shake; roll to reconstitute144
48 h F, RT11
syringe144 100 mL NS147
14 d F11,147 48 h RT9,11
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Ipilimumab 50 mg/10 mL 200 mg/40 mL (BMS Canada) (F)(PFL) no preservative149 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
5 mg/mL149
24 h F,RT149
1 4 mg/mL in NS, D5W 100 mL149 OR undiluted in empty viaflex bag or glass bottle (allow vials to stand at RT for ~5 min prior to withdrawal of contents)149
24 h F,RT149
- do NOT shake149 - administer with 0.2 or 0.22 low protein binding in-line filter149 - vials may contain translucent-to-white amorphous particles149 - discard if cloudy or has pronounced colour change (should be clear to pale yellow)149 - flush line with NS or D5W after infusion149 - do NOT refrigerate if in NS153
Irinotecan 40 mg/2 mL 100 mg/5 mL 500 mg/25 mL (Hospira) (RT)(PFL) no preservative150
N/A
20 mg/mL150
2 days RT11,151,152
0.12 2.8 mg/mL150 500 mL9 D5W (preferred), NS150
24 h RT: D5W, NS150 48 h F: D5W **(PFL)150
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Irinotecan 40 mg/2 mL 100 mg/5 mL (Pfizer) (RT)(PFL) no preservative153 Irinotecan 40 mg/2 mL 100 mg/5 mL 500 mg/25 mL (Sandoz) (RT)(PFL) no preservative154 Ixabepilone 15 mg (contains 16 mg) 45 mg (contains 47 mg) (BMS) (F)(PFL) no preservative155 Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes
N/A
20 mg/mL153
0.12 2.8 mg/mL153 500 mL9 D5W (preferred), NS153
24 h RT: D5W, NS153 48 h F: D5W **(PFL)153
- do NOT refrigerate if in NS153
N/A
20 mg/mL154
0.12-2.8 mg/mL154 D5W (recommended), NS154
24 h RT: D5W, NS154 48 h F: D5W154 **(PFL)154
15 mg: 8 mL supplied diluent155 45 mg: 23.5 mL supplied diluent155
2 mg/mL155
1 h RT155
0.2 0.6 mg/mL in Lactated Ringers Injection USP (use non-PVC infusion container)155
6 h RT155
- use 0.2-1.2 micron in-line filter155 - use non-PVC (i.e., DEHP-free) administration set155
* Suggested volume based on usual dose range and any concentration range of stability data ** Protect from light means minimizing exposure to direct sunlight over a storage period. More specific information on protection from light (eg, protecting container and tubing during administration) will be indicated in the Under the Special Precautions/Notes column.
Centres are not to change the content locally but should forward suggestions to the Cancer Drug Manual staff.
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Explanatory Notes
Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the classification 18,156 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.
Abbreviations
PFL = protect from light RT = room temperature F = refrigerate SWI = sterile water for injection NS = normal saline D5W = dextrose 5% in water BWI = bacteriostatic water for injection
References
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative

18 million unit/mL (1.1 mg/mL)1,2

Alemtuzumab 30 mg/mL (Genzyme previously Bayer)3 (F)(PFL) do not shake no preservative4

filter NOT required4 30 mg/mL4

discard unused portion4

discard at the end of the day F or RT 8 h F or RT4 **(PFL)6

Amifostine 500 mg (MedImmune) (RT) no preservative8

2550 mL* NS only8

540 mg/mL: 24 h F, 5 h RT8

- discard cloudy solution9

500 mL D5W10 (plastic or glass container)10

syringe13 50 mL* NS or D5W11,17

14 d F13,17 14 d F,11,17 2 d RT17,18

do not shake; roll to reconstitute19 1-2 mL NS19

15 min in original container; 8 h in a glass or polypropylene syringe19

glass or polypropylene syringe19

8 h in a glass or polypropylene syringe19

discard unused portion20

4 mL SWI22 shake vigorously22

BCG 81 mg (Sanofi Pasteur) (F)(PFL) preservative24

do not shake; roll to reconstitute24 3 mL supplied diluent24 record time of reconstitution

10.5 8.7108 CFU/vial (Connaught strain)24

2 h F or RT after reconstitution24 **(PFL)24

- auxiliary label: biohazard25

Bendamustine 25 mg 100 mg (Lundbeck) (RT)(PFL) no preservative27

500 mL NS27 0.2-0.6 mg/mL27

complete administration within 24 h F, 3 h RT27

discard unused portion28

1.4-16.5 mg/mL29 100-250 mL NS only28,29

50 mL* NS, SWI32

Brentuximab 50 mg (GMD Distribution for Seattle Genetics) (F)(PFL) no preservative39

0.4-1.8 mg/mL in NS, D5W, Lactated Ringers (i.e. 100-250 mL)39

24 h F39 Do NOT freeze39

Busulfan 60 mg/10 mL (Orphan Medical) (F) no preservative40

discard unused portion40

NS or D5W (dilute in volume 10 times the busulfan volume to ~0.5 mg/mL)40

complete administration within 12 h F: NS40 8 h RT: NS, D5W

0.10 0.26 mg/mL NS, D5W41 (e.g., 250 mL*)

complete administration within 8 h RT or 48 h F41

discard unused portion42

0.3-10 mg/mL43 NS, D5W9,42 do NOT use aluminum-containing needle or syringe43

- do NOT use aluminum-containing needle, syringe or tubing43

discard unused portion RT45

0.5-10 mg/mL46 NS, D5W9,45,47 do NOT use aluminum-containing needle or syringe45

- do NOT use aluminum-containing needle, syringe or tubing45

Carmustine 100 mg (Bristol Labs) (F) no preservative48

3.3 mg/mL in 10% ethanol48

glass48 or polyolefin container9 500 mL NS or D5W48

24 h F: in glass48 or polyolefin container9 use within 4 h of reconstitution RT48

- do not use if product has oily droplets48

discard unused portion after 12 h F, 8 h RT49

CISplatin 10 mg/10 mL 50 mg/50 mL 100 mg/100mL (Hospira) (RT)(PFL) no preservative50

- do NOT use aluminum-containing needle, syringe or tubing53

discard unused portion56

48h F, end of day RT11,56,58,59 24 h RT56

- shake vigorously to dissolve any precipitates from refrigeration56

discard unused potion60

discard end of day11,59,60 24 h RT

CycloSPORINE 50 mg/1 mL 250 mg/5 mL (Novartis) (RT)(PFL) no preservative65

discard unused portion65

NS, D5W65 dilute to concentration between 1:20 and 1:10065

dilute immediately prior to use65

N/A record time of puncture