Physical compatibility of alprostadil with selected drugs commonly used in the neonatal intensive care units

The Physicochemical Compatibility of Sildenafil Injection with Parenteral Medications Used in Neonatal Intensive Care Settings

“…A potential limitation related to clinical interpretation of the present study was the drug combination contact time of 2 h, which was based on a previous report that 60 min was a plausible maximum contact time for two drug solutions in the IV tubing from the Y-site to the tip of a cannula in NICU settings [ 30 ]. By comparison, a four hour study duration is commonly used for drug compatibility studies and may be applicable to other clinical settings [ 14 , 15 , 16 , 17 , 31 , 32 , 33 , 34 , 35 ]. A further clinical consideration is that the present study and most IV compatibility research has been conducted at room temperature [ 31 , 32 , 34 , 35 , 36 ], which is comparable to the ambient temperature in the majority of clinical settings, including NICU.…”

“…By comparison, a four hour study duration is commonly used for drug compatibility studies and may be applicable to other clinical settings [ 14 , 15 , 16 , 17 , 31 , 32 , 33 , 34 , 35 ]. A further clinical consideration is that the present study and most IV compatibility research has been conducted at room temperature [ 31 , 32 , 34 , 35 , 36 ], which is comparable to the ambient temperature in the majority of clinical settings, including NICU. However, whilst the IV drugs in syringes (or other delivery devices) and a proportion of the IV tubing in NICU will most likely be at room temperature, part of the IV tubing may be inside a humidicrib at up to 37 °C and some recent IV compatibility studies have been conducted at elevated temperature to simulate the humidicrib environment [ 8 , 37 ].…”

Frequently acquired drugs in neonatal intensive care and their physical compatibility

“… 16 , 17 Fluconazole, metronidazole and paracetamol were reported to destabilise the preterm all‐in‐one parenteral nutrition. 17 De Basagoiti et al investigated the compatibility of alprostadil to neonates with several drugs in 1 + 1 mixing ratios, 18 whereas Holt et al studied the compatibility of ibuprofen lysine with several drugs at clinically relevant mixing ratios for preterm infants. 19 No other compatibility studies on intravenous drug co‐administration that specifically addressed neonates were found.…”

Physicochemical compatibility of pentoxifylline injection with high‐concentration parenteral medications

“…Turbidity and pH measurements are commonly conducted in physical compatibility studies and have been reported in physicochemical compatibility investigations. 7 , 8 , 9 , 10 , 11 However, there are resource implications for these tests, not least the requirement for large sample volumes (typically > 10 ml), which is problematic for expensive drugs. Furthermore, the intrinsic value of some physical compatibility tests is unclear and interpretation or specification limits may be inconsistent 12 ; for example, in regard to pH unit shift.…”

“…Furthermore, the intrinsic value of some physical compatibility tests is unclear and interpretation or specification limits may be inconsistent 12 ; for example, in regard to pH unit shift. 9 , 10 , 11 In regard to quantifying only the PTX concentration, we have assumed that physicochemical incompatibility would be the result of interaction between the two drugs and should be detected by the HPLC assay of the primary drug. Although there may be value in quantifying the secondary drug if chemical incompatibility is detected or suspected, a significant impediment to quantifying all of the secondary drugs would be developing and validating HPLC assays for the full range of drugs.…”