Compatibility of intravenous busulfan with BBraun giving sets, fludarabine and Posiflush

Abstract

Background Intravenous busulfan (BU) is known to be incompatible with certain plastics and is recommended for infusion through specific filters. The Queensland Children's Hospital has experienced precipitation on two occasions where BU was administered following a fludarabine (FLU) infusion via a BBraun giving set containing a filter, and after flushing a line with Posiflush (PF). Aim This study determined the chemical and visual compatibility of BU with FLU, PF and BBraun giving sets, with or without a filter. Methods Infusion solutions of 0.5 mg/mL BU were prepared and a control infusion of BU was passed through Giving set B (no filter). The control was compared to three test infusions passed through Giving set A (filter included). Samples were taken at 0, 1, 2 and 3 h to determine BU concentrations via HPLC. Infusions were visualised for precipitation. Admixtures of 0.25 mg/mL BU and 0.85 mg/mL FLU or 0.25 mg/mL BU and PF in a syringe were prepared, visualised at 1 h and tested by HPLC to determine BU concentration. Results There were no differences in BU concentrations at 1, 2 or 3 h after infusion through Giving set A versus Giving set B. No precipitation occurred. Admixture samples of BU with FLU or BU with PF also showed no precipitation. BU concentrations were also maintained in the samples. Discussion BBraun giving sets with, or without a filter, are compatible with BU and have no affect on BU concentration and do not cause precipitation. BU is compatible with both FLU and PF as an admixture.