Stability of admixture containing morphine sulfate, bupivacaine hydrochloride, and clonidine hydrochloride in an implantable infusion system

Classen, Ashley; Wimbish, Gary H.; Kupiec, Thomas C.

doi:10.1016/j.jpainsymman.2004.04.011

Cited by 50 publications

(23 citation statements)

References 36 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The range of concentration was relatively high but clinically relevant to maximise any potential drug-drug or drug device material interactions [23].…”

Section: Methodsmentioning

confidence: 99%

Stability and compatibility of drug mixtures in an implantable infusion system

Bianchi¹,

Ginggen²,

Tardy³

2008

Anaesthesia

View full text Add to dashboard Cite

SummaryThis study evaluated the stability and the compatibility of mixtures of morphine sulphate, bupivacaine, and clonidine hydrochloride and of hydromorphone, bupivacaine, and clonidine hydrochloride, when used in constant flow implantable pumps under simulated clinical use conditions. The pumps were filled with drug mixtures and incubated at 37°C for a period of 90 days. Aliquots were sampled monthly from the reservoir and catheter outlet and the drug concentrations analysed using validated chromatography methods. Individual materials from the infusion system were immersed in the drug mixtures and stored at 37°C for 60 weeks and evaluated for mechanical performance for compatibility testing. Both drug mixtures were found to be stable over 90 days in the pump at 37°C. All device materials retained acceptable mechanical performance following exposure. These results demonstrate that both drug mixtures are stable when maintained at simulated body temperature in an implantable infusion system for 90 days.

show abstract

“…The range of concentration was relatively high but clinically relevant to maximise any potential drug-drug or drug device material interactions [23].…”

Section: Methodsmentioning

confidence: 99%

Stability and compatibility of drug mixtures in an implantable infusion system

Bianchi¹,

Ginggen²,

Tardy³

2008

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…Although acceptable stability of intrathecal opiates with other agents has been reported, 10 there are stability concerns with utilization of ziconotide in combination with other agents. Shields et al 11 reported on the degradation of ziconotide in the presence of two opiate solutions.…”

Section: Introductionmentioning

confidence: 99%

Successful reduction of neuropathic pain associated with spinal cord injury via of a combination of intrathecal hydromorphone and ziconotide: a case report

Saulino

2007

Spinal Cord

View full text Add to dashboard Cite

Study design: Case report. Objectives: To report a novel management strategy for neuropathic pain management after spinal cord injury. Setting: Outpatient spinal cord injury (SCI) clinic. Methods: The patient demonstrated two neuropathic pain syndromes, namely at-and belowlevel pain. These syndromes were recalcitrant to conservative measures and a decision was made to proceed with intrathecal therapies. Results: The patient's at-level pain was responsive to intrathecal hydromorphone but the below-level pain was unaffected by this intervention. Intrathecal ziconotide provided an opposite response with a positive effect observed on the below-level pain and minimal effect on the at-level pain. The combination of intrathecal ziconotide and hydromorphone provided effective relief for both components of the patient's SCI associated neuropathic pain. Conclusions: The combination of intrathecal ziconotide and hydromorphone has the potential to provide significant pain relief for patients with neuropathic pain associated with spinal cord injury.

show abstract

“…Previous in vitro stability studies of 25 mg/mL bupivacaine in water combined with morphine sulphate 50 mg/mL and clonidine 2 mg/mL in a simulated clinical study using a drug delivery device kept at 37°C showed that all the drugs remained at greater than 96% of their original concentrations after 90 days [17]. Another simulated study using 7.5 mg/mL bupivacaine in aqueous hyperbaric dextrose (82.5 mg/mL) showed a similar bupivacaine stability with greater than 96% of the original concentration remaining at 12 weeks [18].…”

Section: Discussionmentioning

confidence: 99%

Stability and Tolerability of High Concentrations of Intrathecal Bupivacaine and Opioid Mixtures in Chronic Noncancer Pain: An Open-Label Pilot Study

Goucke¹,

Dusci

Leeuwen

et al. 2010

Pain Med

View full text Add to dashboard Cite

This in vivo study demonstrates excellent stability of high concentrations of intrathecal bupivacaine and opioid mixtures. No nonreversible neurological complications were identified in patients receiving daily doses of bupivacaine up to 21.4 mg. Tolerability was variable because of motor weakness. Given that all intrathecal local anesthetics may be neurotoxic, caution must be exercised if high concentrations and daily doses are to be delivered over prolonged periods.

show abstract

Stability of admixture containing morphine sulfate, bupivacaine hydrochloride, and clonidine hydrochloride in an implantable infusion system

Cited by 50 publications

References 36 publications

Stability and compatibility of drug mixtures in an implantable infusion system

Stability and compatibility of drug mixtures in an implantable infusion system

Successful reduction of neuropathic pain associated with spinal cord injury via of a combination of intrathecal hydromorphone and ziconotide: a case report

Stability and Tolerability of High Concentrations of Intrathecal Bupivacaine and Opioid Mixtures in Chronic Noncancer Pain: An Open-Label Pilot Study

Contact Info

Product

Resources

About