Does an interaction exist between ketamine hydrochloride and Becton Dickinson syringes?

Abstract

IntroductionAn international alert from Becton Dickinson (BD) has noted the possibility of interaction between several molecules and some syringes. The Centralized IntraVenous Additives Service of the institution was using 3 mL BD syringes to store ketamine HCl. This study evaluated the interaction between ketamine and these syringes.MethodA batch of BD syringes produced in Europe and left in quarantine from the day of the international alert has been tested at 22, 29, 36, 43 and 50 days of storage at room temperature. At each time, the pH of the solutions was measured. The solutions were inspected visually and by microscope, and spectrophotometric measurements were performed. The concentrations were measured by a validated ultra-high-performance liquid chromatography-diode array detector.ResultsNeither physical change nor pH modification was observed during the study. According to a lower limit of the 95% unilateral CI on the mean >90% of the theoretical concentration, the solutions remain stable for at least 50 days.ConclusionIn our study conditions, ketamine can be stored for at least 50 days without risk of sorption with syringes.

Quality control and stability of ketamine, remifentanil, and sufentanil syringes in a pediatric operating theater

“…Stress degradation studies operating in different conditions from those used in this study have yielded four degradation products and one degradation product in alkaline condition for sufentanil and ketamine, respectively. Closset et al found no degradation products for ketamine . For these two drugs, our results revealed more degradation products, offering a wider opportunity to check for drug instability.…”

“…A previous study noted that a 1-mg/mL solution could be stored out of light and at ambient temperature for over 1 year. 13 Stress degradation studies operating in different conditions from those used in this study have yielded four degradation products 14 and one degradation product in 16 For these two drugs, our results revealed more degradation products, offering a wider opportunity to check for drug instability. This could be accounted for by the difference in elution conditions (eg, gradient elution mode and the geometry of our column) which contributed to improving analytical efficiency.…”

Physicochemical Stability of Ketamine After Reconstitution for Injection: A Scoping Review

“…This is an indication that interaction between the package material and molecules of ketamine is unlikely, though interaction between ketamine and the packaging material might result in some degradation that may be hastened in higher temperature conditions. 2,3 Significant interaction between plastic syringes and molecules of drugs has been reported. 2 In tropical areas such as Africa, temperatures often exceed 30 °C, which is frequently experienced during mass casualty events and medical outreach activities.…”

“…2,3 Significant interaction between plastic syringes and molecules of drugs has been reported. 2 In tropical areas such as Africa, temperatures often exceed 30 °C, which is frequently experienced during mass casualty events and medical outreach activities. Drugs prepared in syringes may contain concentrations outside the designated range of acceptability.…”

Should Ketamine Not Be Banned? A Scoping Review

“…Closset et al was able to show that ketamine is stable in a Becton Dickinson® (BD) syringe for up to 50 days. 10 Foy et al was able to determine that ketamine was stable at 33°C for at least 7 days in the patient-controlled analgesia systems between preparation and administration. 11 Huvelle et al reported that ketamine diluted in 3 mL propylene syringes may be chemically stable for up to 180 days at room temperature at 25°C, while Daouphars et al demonstrated that ketamine is stable in a polyvinyl chloride bag for 7 days at 23ºC, though ketamine was mixed with oxycodone in the latter.…”