Chemo Stability Chart - LtoZ PDF

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART
DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special
(Storage Prior to Use, With: Stability Precautions/Notes
Manufacturer, Preservative
Status)
Leucovorin
1 3 3
50 mg/5 mL N/A 10 mg/mL 50 mg: discard syringe 7 d F,
2 3,4
500 mg/50 mL unused portion 48 h RT
(Hospira)
(F)(PFL) 500 mg:
1 1
no preservative 8h 0.05-10 mg/mL NS, D5W, LR,
NS, D5W, Ringer’s, Ringer’s:
1,2 1
LR, D10W, D5NS 24 h RT
(e.g., 50-250 mL*) D10W, D5-NS:

1
8 h RT
BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 1/40

Activation Date: 2 March 2006
Revised Date: 18 March 2019
Status)
Leucovorin
1 6,7
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8h
1
500 mg/50 mL portion
(Teva)
(F)(PFL)
5 8
no preservative 0.4 - 4.8 mg/mL NS, 72 h F, RT
8
D5W
(e.g., 50-250 mL*)
0.06 - 0.4 mg/mL NS, NS:

5 5
D5W 24 h RT
D5W:
5
12 h RT
0.06 - 1 mg/mL Ringer’s, LR:

5
Ringer’s, Lactated 24 h RT
Ringer’s, D10W,
5
D10NS D10W:
5
12 h RT
D10NS:
5
6 h RT

Status)
Leucovorin
9 9 9
50 mg/5 mL N/A 10 mg/mL 8h syringe 8 h RT
500 mg/50 mL
(Pfizer)
(F)(PFL) 0.05 – 10 mg/mL NS, NS, D5W, LR,
9
no preservative D5W, LR, Ringer’s, Ringer’s:
9 9
D10W, D5NS 24 h RT
(e.g., 50-250 mL*) D10W, D5NS:

9
8 h RT
Mechlorethamine
10 10
10 mg do NOT use if 1 mg/mL use within 4 h of syringe complete
(Ovation/Merck) discoloured or water reconstitution administration within
7,11
(RT,PFL) droplets form in vial RT 4 h of reconstitution
10 7,10,11
no preservative before RT
10
reconstitution
10
10 mL SWI or NS
10,12
100 mL NS complete
record time of administration within
reconstitution 4 h of reconstitution
7,10,12
RT

Status)
Melphalan
13 13
50 mg 10mL supplied 5 mg/mL 2 h RT 0.1 – 0.45 mg/mL in complete
13 13
(GSK) diluent NS only administration within
(RT)(PFL) do NOT 60 min from time of
13
no preservative immediately after refrigerate (e.g., greater than 45 initial reconstitution at
11
adding diluent, mg and less than or RT
13
shake vigorously equal to 110 mg in
250 mL NS)*
record time of
reconstitution
Mesna
14
400 mg/4 mL N/A 100 mg/mL discard unused greater than 1 mg/mL complete
14
1000 mg/10 mL portion in D5W, D5½NS, NS, administration within
14-16 14
(Baxter) (use filter needle to LR 24 h RT
(RT) withdraw from
14
no preservative ampoule)
Mesna
14 14
1000 mg/10 mL N/A 100 mg/mL 8 days RT greater than 1 mg/mL complete
5000 mg/50 mL in D5W, D5½NS, NS, administration within
14-16 14
(Baxter) (vial may be LR 24 h RT
(RT) punctured up to 4
14 14
preservative times)
Mesna
17 17,18 17
1000 mg/10mL N/A 100 mg/mL 14 d RT,F greater than or equal 24 h RT, 48 h F
(Fresenius Kabi) to 1 mg/mL in NS or
19
(RT) D5W
17
preservative

Status)
Methotrexate
20
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
20
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
20 2
1 g/40mL portion 12 g/m as a single
21-25
2.5 g/100 mL dose) : use
(Pfizer/Hospira) 500 mg, 1 g, or 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
20 20 20
(RT)(PFL) 2.5 g: D5W initial puncture methotrexate
20 20
no preservative 8 h RT - do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 20
(e.g., 1-12 g/m as a initial puncture
21-25
single dose) : 1000
mL* NS **(PFL)
Methotrexate
20 29
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info :
20 18
Only preservative free portion preservative free puncture “IT”
27,28
methotrexate may be NS - label to include
administered by the route in full (i.e.,
26
intrathecal route INTRATHECAL
50 mg/2mL injection) attached
(Pfizer/Hospira) to both syringe and
29
(RT)(PFL) outer ziplock bag
20
no preservative

Status)
Methotrexate
20 18,20 18
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
20
500 mg/20mL alcohol
(Pfizer/Hospira) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
20 high-dose
20
preservative D5W
20 regimens (e.g., 1-
2
12 g/m as a single
20
(100 mL* NS, D5W) dose)
- do NOT use for IT
20
injection
Mitomycin
30 30 30 30
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Accord)
30 30 30
(RT)(PFL) shake well **(PFL) **(PFL)
30
no preservative
Mitomycin
30 30 30 30
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
30 30 30
(Accord) shake well **(PFL) **(PFL)
(RT)(PFL)
30
no preservative
31 31
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
30 32 32,33
shake well to prevent precipitation solubility
32
precipitation - do NOT
32
refrigerate

Status)
Mitomycin
30 30 30 30
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS:
30
20 mg 3 h RT, 18 h F
30 30 30
(Accord) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
30 30
no preservative 3 h RT, 6 h F
Mitomycin
34 34 34 34
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Teva/Novopharm)
34 34 34
(RT)(PFL) shake well **(PFL) **(PFL)
34
no preservative
Mitomycin
34 34 34 34
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
34 34 34
(Teva/Novopharm) shake well **(PFL) **(PFL)
(RT)(PFL)
34
no preservative
31 31
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
34 32 32,33
shake well to prevent precipitation solubility
32
precipitation - do NOT
32
refrigerate
Mitomycin
34 34 34 34
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS:
34
20 mg 6 h RT, 18 h F
34 34 34
(Teva/Novopharm) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
34 34
no preservative 6 h RT, F

Status)
mitoXANTRONE
35 35 35
20 mg/10 mL N/A 2 mg/mL discard unused NS, D5W 24 h RT
35
(Fresenius Kabi) portion
(RT) Greater than or equal
35 35
no preservative to *50 mL
mitoXANTRONE
36 36 36
20 mg/10 mL N/A 2 mg/mL discard unused 0.2-0.6 mg/mL NS: 24 h F, RT
36
25 mg/12.5 mL portion
36 36
(Hospira) NS, D5W **(PFL)
(RT)(PFL)
36
no preservative Greater than or equal
36
to *50 mL
mitoXANTRONE
37 37
20 mg/10 mL N/A 2 mg/mL discard unused Greater than or equal 24 h RT
37 37
(Teva/Novopharm) portion to *50 mL NS, D5W
38
(RT)(PFL) **(PFL)
37
no preservative
Nivolumab
39
40 mg/4 mL N/A 10 mg/mL discard unused 1-10 mg/mL NS, complete - administer with a
39 39
100 mg/10 mL portion D5W administration within 0.2 to 1.2 micron
39 39
(BMS) 8 h RT or 24 h F in-line filter
(F)(PFL) (50-100* mL) - discard if cloudy
39
do not shake **(PFL) or has pronounced
39
no preservative mix by gentle colour change
inversion; do not (should be clear to
39 39
shake pale yellow)

Status)
oBINutuzumab
40 40,41
1000 mg/40 mL N/A 25 mg/mL discard unused 100 mg: 24 h F, 48 h RT -once removed
2 40
(Hoffman-La Roche) portion in 100 mL NS from the fridge,
**
(F)(PFL) diluted product is
do not shake 900 mg: stable for an
40 40
no preservative in 250 mL NS additional 48 h
40,41
RT
40
1000 mg: - do NOT shake
40
in 250 mL NS - do NOT use
dextrose containing
40
solutions
Octreotide
42 42 42 42
50 mcg/mL N/A 50 mcg/mL Use within 4 h NS 24 h RT
100 mcg/mL
42
500 mcg/mL 100 mcg/mL volume adjusted to
(Omega) ensure a continuous
42
(F)(PFL) 500 mcg/mL infusion of octreotide
42 42
no preservative at 25 mcg/hour
Octreotide
42 42 42 42
multidose vial: N/A 200 mcg/mL 15 d F NS 24 h RT
1000 mcg/5 mL
(Omega) volume adjusted to
(F)(PFL) ensure a continuous
42
preservative infusion of octreotide
42
at 25 mcg/hour

Status)
Octreotide
43 43 43
50 mcg/mL N/A 50 mcg/mL discard unused SC syringe use within 4 h
43
100 mcg/mL portion
43
500 mcg/mL 100 mcg/mL
(Teva/Novopharm)
43 43 43
(F)(PFL) 500 mcg/mL infusion: NS 24 h RT
43
no preservative
Octreotide
43 43,44 43,44
multidose vial: N/A 200 mcg/mL 14 d F SC syringe use within 14 d F
1000 mcg/5 mL
(Teva/Novopharm)
43 43
(F)(PFL) infusion: NS 24 h RT
43
preservative
Octreotide
45 11,47,48 47
(SANDOSTATIN®) N/A 200 mcg/mL discard unused 50–200 mL NS 24 h RT
46
1000 mcg/5 mL portion
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
45
preservative infusion rate of 25
47
mcg/h

Status)
Octreotide
11,48 47
(SANDOSTATIN®) N/A 50 mcg/mL discard unused 50-100 mL 24 h RT
47
50 mcg/1 mL 100 mcg/mL portion
45 47
100 mcg/1 mL 500 mcg/mL NS
500 mcg/1 mL
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
45
no preservative infusion rate of 25
47
mcg/h
Octreotide
(SANDOSTATIN LAR®) 2 mL supplied 10 mg: 5 mg/mL discard unused deep intragluteal use within 4 h of initial - do NOT shake
47 47 7,47
10 mg diluent portion administration only reconstitution
20 mg 20 mg: 10 mg/mL
30 mg gently run 2 mL
47
(Novartis) down sides of the 30 mg: 15 mg/mL
(F)(PFL) vial; do NOT disturb
46
no preservative for 2–5 min, then
47
swirl moderately
record time of
reconstitution

Status)
oFAtumumab
49 49 49
100 mg/ 5 mL N/A 20 mg/mL discard unused 1000 mL NS 48 h RT - administer with
2
1000 mg/50 mL portion 0.2 micron in-line
49
(GlaxoSmithKline) or filter
(F)(PFL) - do NOT shake;
49
no preservative alternatively, 2000 mg mix by slow
doses may be inversion to avoid
49
supplied in formation of foam
49
2 x 500 mL NS - solution may
contain a small
withdraw volume quantity of drug
from bag equal to particles; do not
volume of drug to be administer if
49
added solution is cloudy
49
or discoloured
Olaratumab
50 50
500 mg/50 mL N/A 10 mg/mL discard unused dilute to a final complete - do NOT shake
2,50
(Lilly) portion volume of 250 mL administration within
50
(F)(PFL) NS 24 h F, plus an
50
do not shake additional 12 h RT
50
no preservative do NOT use D5W or
other dextrose
50
containing solutions
50
gently invert to mix

Status)
Oxaliplatin
51
50 mg 50 mg: 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
51 51 51 51
100 mg 10 mL SWI, D5W portion (0.2-0.7 mg/mL) 24 h F aluminum-
(Actavis) containing needle,
51
(RT)(PFL) 100 mg: do NOT use NS or syringe or tubing
51 51
no preservative 20 mL SWI, D5W other chloride-
51
containing solutions
do NOT use
aluminum-containing
51
needle and syringe
Oxaliplatin
52
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-0.4 mg/mL: - do NOT use
52 52
100 mg/20 mL portion (0.2-0.7 mg/mL) 24 h RT aluminum-
200 mg/40 mL or containing needle,
52
(Hospira/Pfizer) do NOT use NS or 5 d F plus an syringe or tubing
52,54
(RT) other chloride- additional 8 h RT
52 53
no preservative containing solutions
0.5–2 mg/mL:
do NOT use 24 h RT
aluminum-containing or
53
needle and syringe 14 d F plus an
52,54
additional 8 h RT

Status)
Oxaliplatin
55 55
50 mg/10 mL N/A 5 mg/mL discard unused 250–500 mL D5W 0.2-1.3 mg/mL: - do NOT use
55 55,56 4,56,57
100 mg/20 mL portion (0.2-2 mg/mL) 48 h RT, 14 d F aluminum-
200 mg/40 mL containing needle,
55
(sanofi-aventis) do NOT use NS or 1.3-2 mg/mL: syringe or tubing
55
(RT)(PFL) other chloride- 24 h RT, 48 h F
55 55
no preservative containing solutions
do NOT use
aluminum-containing
55
needle and syringe
Oxaliplatin
53 2,58 53
50 mg/10 mL N/A 5 mg/mL 2 d F, RT 250-500 mL D5W 0.2-2 mg/mL:
53 53
100 mg/20 mL (0.2-0.7 mg/mL) 24 h RT, 48 h F
150 mg/30 mL
200 mg/40 mL
(Sandoz) do NOT use NS or
(RT)(PFL) other chloride-
53 53
no preservative containing solution
do NOT use
aluminum-containing
53
needle and syringe

Status)
Oxaliplatin
59
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
59 59 59
100 mg/20 mL portion (0.2-0.7 mg/mL) 24 h RT, 48 h F aluminum-
200 mg/40 mL containing needle,
59
(Teva) do NOT use NS or syringe or tubing
(RT)(PFL) other chloride-
59 59
no preservative containing solution
do NOT use
aluminum-containing
59
needle and syringe
PACLitaxel
60
30 mg/5 mL N/A 6 mg/ mL 30 mg: 0.3-1.2 mg/mL in NS, complete - use non-DEHP
2,60 60
100 mg/16.7 mL 48 h RT D5W, D5NS, D5LR administration within bag and tubing with
60
300 mg/50 mL 27 h RT 0.22 micron in-line
60
(Accord) 100 mg: (e.g., 100-1000 mL)* filter
2,60
(RT)(PFL) 48 h RT - avoid excessive
60 60
no preservative shaking
300 mg:
60
24 h RT

Status)
PACLitaxel
62 2,63
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
62
100 mg/16.7 mL D5W administration within bag and tubing with
62,64
62
(Biolyse) (e.g., 100-1000 mL)* filter
61
(RT)
62
no preservative
65 65
0.1 mg/mL in NS 44 h F, RT
64
0.012-0.12 mg/mL in 16 h RT
66
NS
devices with spikes

(e.g., chemo
dispensing pins) may
67
be used with vials
PACLitaxel
69 2,69,70
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
69
100 mg/16.7 mL D5W, D5NS, D5LR administration within bag and tubing with
69
69
300 mg/50 mL (e.g., 100-1000 mL)* filter
(Hospira)
(RT)(PFL)
68
preservative

Status)
PACLitaxel,
71 71
nanoparticle, albumin- 20 mL NS 5 mg/mL use immediately in empty sterile PVC, 48 h F plus an - each vial contains
72
bound (nab) (RT) or non-PVC, or non- additional 8 h RT 900 mg human
71 71 71
100 mg - slowly direct 8hF DEHP infusion bag albumin
(Celgene) diluent against side - to prevent
71
(RT)(PFL) of vial (i.e., greater **(PFL) foaming, do NOT
71
no preservative than or equal to 1 inject NS directly
71
min) during onto the powder
71
reconstitution - some settling may
occur; use mild
- let stand for agitation to
71
greater than or resuspend
equal to 5 min to wet - administer using
71
powder a 15 micron filter
ONLY
- gently swirl or (NOTE:filters with a
invert for greater pore size less than
than or equal to 2 15 microns may
71
min cause filter
73,74
blockage)
Pamidronate
75 75
30 mg/10 mL N/A 3 mg/mL discard unused Less than or equal to 24 h RT - do NOT mix with
75 75
60 mg/10 mL portion 0.36 mg/mL NS, calcium containing
75 75
90 mg/10 mL D5W solutions
75
(Fresenius Kabi) 6 mg/mL
(RT)
75
no preservative
75
9 mg/mL

Status)
Pamidronate
76
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
76 76 76
60 mg/10 mL portion NS, D5W RT (total 48 h) calcium containing
90 mg/10 mL solution (e.g.,
76 76 76
(Hospira) 6 mg/mL **(PFL) Ringer’s)
(RT)
76
no preservative
76
9 mg/mL
Pamidronate
77 77
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
77 77 77
77 77 77
(Omega) 6 mg/mL **(PFL) Ringer’s)
(RT)
77
no preservative
77
9 mg/mL
Pamidronate
78
30 mg/10 mL N/A 3 mg/mL discard unused 0.06-0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
78 78 78
78 78 78
(Pfizer) 6 mg/mL **(PFL) Ringer’s)
(RT)
78
no preservative
78
9 mg/mL

Status)
Pamidronate
79 79 79
30 mg/10 mL N/A 3 mg/mL discard unused NS; D5W 24 h RT - do NOT mix with
44,79
60mg/10 mL portion calcium containing
79 79
(Sandoz Canada) 6 mg/mL Ringer’s)
RT
79
no preservative
79
9 mg/mL
PANitumumab
80 80,81
100 mg/5 mL N/A 20 mg/mL discard unused Less than or equal to 24 h F, 6 h RT - administer with
80
400 mg/20 mL portion 1000 mg: 0.2 or 0.22 micron
80 80
(Amgen) 100 mL NS in-line filter
(F)(PFL) - solution may
do not shake Greater than 1000mg: contain particulates
80 80
no preservative 150 mL NS which do not affect
80
product quality
80,81
1-10mg/mL - do not administer
80
if discoloured

Status)
pegaspargase
82 82
(pegylated N/A 750 units/mL discard unused IM: syringe: - do NOT shake
82
asparaginase E. coli) portion max volume: use within 4 h of vial
2,82
3750 units/5 mL 2 mL in children and puncture
(Shire) adolescents;
(F)(PFL) 3 mL in adults
do not shake
82
no preservative if volume greater than
above, use multiple
82
sites
IV: bag:
82
100 mL NS, D5W use within 4 h of vial
2,82
puncture
Pembrolizumab
83
100 mg/4 mL N/A 25 mg/mL discard unused 1-10 mg/mL complete - use a 0.2 to 5
2,83 83
(Merck) portion NS, D5W administration within micron in-line
83 83
(F)(PFL) 6 h RT, 24 h F filter
do not shake mix by gentle - allow vials and
83 83
no preservatives inversion diluted solutions to
come to RT prior to
83
use
- vials contain 0.25
83
mL overfill

Status)
Pembrolizumab
83 83 83
50 mg 2.3 mL SWI 25 mg/mL 6 h RT, 24 h F 1-10 mg/mL NS, complete - use 0.2 to 5
83
(Merck) D5W administration within 6 micron in-line
83 84
(F) direct diluent against h RT, 24 h F filter
83
no preservative side of vial during mix by gentle - allow
83
reconstitution to inversion reconstituted vials
83
avoid foaming and diluted
solutions to come
83
allow up to 5 to RT prior to use
minutes for bubbles - vials can be at RT
83
to clear for up to 24 h prior
83
to use
83
do NOT shake - vials contain 20%
83
overfill
Pemetrexed
85 85 85
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
500 mg 4.2 mL preservative- preservative-free calcium containing
85 85
(Eli Lilly) free NS NS solution (e.g.,
86
(RT) Ringer’s)
85
no preservative 500 mg:
20 mL preservative-
85
free NS
PERTuzumab
87 87 87
420 mg/14 mL N/A 30 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT use
2,87
(Roche) portion dextrose containing
87 87
(F)(PFL) do NOT shake mix by gentle solutions
87
no preservative inversion to avoid
87
foaming

Status)
Plerixafor
88 88 44,89
24 mg/1.2 mL N/A 20 mg/mL discard unused SC syringe 48 hours RT
88
(sanofi-aventis) portion
(RT)
88
no preservative
Porfimer
90 90
15 mg 15 mg: 2.5 mg/mL 24 h F syringe use within 4 h of initial - avoid contact with
90 7,91
75 mg 6.6 mL D5W reconstitution skin and eyes;
90
(Axcan) **(PFL) protect exposed
90 90
(RT)(PFL) 75 mg: **(PFL) area from light
90 90
no preservative 31.8 mL D5W
record time of
reconstitution
Raltitrexed
92 92 92
2 mg 4 mL SWI 0.5 mg/mL 24 h F, RT 50-250 mL NS, complete
92
(Pfizer) D5W administration within
92
(F,RT)(PFL) 24 h F, RT
92
(no preservative)
Ramucirumab
93 93 93
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL* NS 4 h RT, 24 h F - use 0.22 micron
93 93
500 mg/50 mL portion filter
94
(Eli Lilly) (0.4 – 4 mg/mL) - do NOT use
(F)(PFL) dextrose containing
93 93
(do not shake) gently invert to mix solutions
93
no preservative
93
do NOT shake

Status)
riTUXimab
95 96,97
100 mg/10 mL N/A 10 mg/mL discard unused 1-4 mg/mL NS, 24 h F, 12 h RT - once removed
95 95
500 mg/50 mL portion D5W from the fridge,
(Roche) compounded
(F)(PFL) (e.g., 250-500 mL)* product is stable
95 96,97
no preservative for 12h RT
riTUXimab
98 98 98
subcutaneous N/A 120 mg/mL discard unused SC syringe 48 h F plus 8 h RT - contains
98 98
1400 mg/11.7 mL portion hyaluronidase
1600 mg/13.4 mL - formulations are
(Roche) NOT
98
(F)(PFL) interchangeable
98
no preservative
romiDEPsin
99 99 99 99
10 mg 2.2 mL of supplied 5 mg/mL 8 h RT 500 mL NS 24 h RT - reconstituted
99,100
(Celgene Inc.) diluent solution will be
99 101
(RT) slightly viscous
2 99
no preservative swirl gently to mix - vials contain
overfill to allow for
full drug recovery
(drug vial contains
11 mg romidepsin;
diluent vial
contains 2.4 mL
99
diluent)

Status)
Siltuximab
102 102 102
100 mg 100 mg: 20 mg/mL 2 h RT 250 mL D5W complete - use 0.2 micron in-
102 102
400 mg 5.2 mL SWI administration within line filter
102
(Janssen) dilute to 250 mL final 6 h RT
(F)(PFL) 400 mg: volume by
102 102
no preservative 20 mL SWI withdrawing volume
from bag equal to
allow vial to come to volume of drug to be
102
room temperature added
prior to use (~30
102
minutes)
gently swirl, do NOT

102
shake
Streptozocin
103 103 103 103
1g 9.5mL NS, SWI, 100 mg/mL 48 h F, 24 h RT syringe 48 h F, 24 h RT
103
(Pfizer) D5W
(F)(PFL)
103 103
no preservative 50-500 mL* NS, 48 h F, 24 h RT
103
D5W, SWI
Temsirolimus
104,105 104,105 104,105
30 mg/1.2 mL 1.8 mL supplied 10 mg/mL 24 h RT 250 mL NS complete - use non-DEHP
104,105
(Wyeth) diluent administration within 6 bag and tubing with
104,105 104 104,105 104,105
(F)(PFL) **(PFL) h in-line filter
106
no preservative

Status)
Teniposide
107
50 mg/5 mL N/A 10 mg/mL discard unused 50 – 500 mL NS or 0.1-0.4 mg/mL: 24 h - do not refrigerate
107
(BMS) portion D5W for a final RT - use non-DEHP
107
(RT) concentration of 0.1-1 bag and tubing
107 107
preservative mg/mL 1 mg/mL: complete - do not use if
107,108
administration within 4 precipitates
h of preparation - contains DMA***
107,108
RT - excessive
agitation may
cause
107
precipitation
Thiotepa
109 109 109
15 mg 15 mg: 10 mg/mL 8hF reconstituted solution 4 h RT, 24 h F - do not use if
109
100 mg 1.5 mL SWI is hypotonic and must precipitates are
109
(Adienne) be further diluted with present
109
(F) 100 mg: NS prior to use - reconstituted
109 109
no preservative 10 mL SWI solution may be
doses ≤ 500 mg: used if
109
to remove haze, 500 mL NS or with an opalescent
filter through 0.22 appropriate volume to - administer with
micron filter after achieve 0.5-1 mg/mL 0.2 micron inline
110 109 109
reconstitution concentration filter
record time of doses > 500 mg:

109
reconstitution 1000 mL NS

Status)
Thiotepa
109 109 2,29
IT injection diluents containing 10 mg/mL 8hF qs to 6 mL with use within 4 h of initial - auxiliary info :
2
15 mg preservatives should preservative free reconstitution “IT”
112
100mg NOT be used for NS - label to include
(Adienne) intrathecal route in full (i.e.,
111
(F) administration INTRATHECAL
109
no preservative injection) attached
15 mg: to both syringe and
109 2
1.5 mL SWI outer ziplock bag
- do not use if
100 mg: precipitates are
109 109
10 mL SWI present
- reconstituted
to remove haze, solution may be
filter through 0.22 used if
109
micron filter after opalescent
110
reconstitution
record time of
reconstitution
Thyrotropin alfa
113 113 113 113 113
1.1 mg 1.2 mL SWI 0.9 mg/mL 24 h F syringe 24 h F
(Genzyme)
113
(F)(PFL) swirl contents
113
no preservative
do NOT shake

Status)
Tocilizumab
114 114
80 mg/4 mL N/A 20 mg/mL discard unused 100 mL NS complete - to prevent
114
200 mg/10 mL portion administration within foaming: slowly
114
400 mg/20 mL dilute to final volume 24 h F, RT add drug to
(Roche) by withdrawing infusion bag and
(F)(PFL) volume from bag bring to room gently invert bag to
114 114
no preservative equal to volume of temperature prior to mix
114 114
drug to be added administration
114
gently invert to mix
Topotecan
115 115 115
4 mg N/A 1 mg/mL discard unused 0.02–0.5 mg/mL 24 h F, RT
116
(Hospira) portion
(F)(PFL) 50-100 mL NS,
115 116
no preservative D5W
Topotecan
117 117 117 117 117
4 mg 4 mL SWI 1 mg/mL 24 h F, RT 0.02 – 0.5 mg/mL 24 h F, RT
(Mylan)
(RT)(PFL) 50-100 mL NS,
117 117
no preservative D5W
Topotecan
118 118
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F
118
(Sandoz) portion
118
(F)(PFL) 50-100 mL NS, **(PFL)
118 118
no preservative D5W

Status)
Trastuzumab
119 2 119 119 119
(HERCEPTIN®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
119
440 mg BWI
(Roche) do NOT use dextrose
119
(F) swirl vial gently; containing solutions
119
preservative allow to stand
undisturbed for 5
119
min

Status)
Trastuzumab
120 120 120
Emtansine 100 mg vial: 20 mg/mL 24 h F 250 mL NS or 0.45% 24 h F - do not use if
120
(KADCYLA®) 5 mL SWI sodium chloride only reconstituted
120 120 120
100 mg do NOT freeze do NOT freeze solution contains
160 mg 160 mg vial: visible particulates
120 120
(Roche) 8 mL SWI do NOT shake or is cloudy or
120
(F)(PFL) discolored
120
no preservative swirl gently until - dextrose 5%
completely dissolved solutions cause
aggregation of the
120
do NOT shake protein; do not
dilute with dextrose
containing
120
solutions
- use a 0.2 micron
in-line filter or 0.22
micron
polyethersulfane
(PES) filter to
administer
infusions prepared
in NS; filter is
optional for
solutions in 0.45%
120
NS

Status)
TRC105 (Carotuximab)
121 122
100 mg/4 mL N/A 25 mg/mL discard unused 0.6 – 10 mg/mL NS complete infusion - use a 0.2 micron
2
200 mg/8 mL portion within 8 h RT, 24 h in-line filter for
121,122 121
400 mg/16 mL invert gently to mix F administration
(Tracon)
(F)(PFL)
121
no preservative
Treosulfan
123 7,123 124 7,123
1g pre-heat SWI to 50 mg/mL 48 h RT undiluted 48 h RT - compatible with
5g 30°C (not higher) polytetrafluoroethyl
123
(medac) shake vial carefully dilute with NS or D5W ene filters
(RT) before adding the in empty infusion bag - may require
123
no preservative warmed SWI for final concentration vigorous shaking to
123 123
1 g vial: 20 mL SWI, = 20 mg/mL reconstitute
while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
123
2 min
5 g vial: 100 mL
SWI, while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
123
2 min

Status)
vinBLAStine
125 126 127,128
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W 24 h F, RT - auxiliary info:
125
(Hospira) portion WARNING: FOR
(F)(PFL) INTRAVENOUS
125
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
129,130
ROUTES
vinBLAStine
131
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, use within 4 h of initial - auxiliary info:
131 126,132 2
(Teva) portion D5W puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
131
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
129,130
ROUTES

Status)
vinCRIStine
133 133 133 133
2 mg/2 mL N/A 1 mg/mL 8 h F, RT 50 mL* NS, D5W 24 h F, 6 h RT - auxiliary info:
5 mg/5 mL WARNING: FOR
133
(Hospira) **(PFL) INTRAVENOUS
(F)(PFL) USE ONLY –
133
no preservative FATAL IF GIVEN
BY OTHER
129,130
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)

Status)
vinCRIStine
134 134 134
1 mg/1 mL N/A 1 mg/mL 8 h F, RT 0.01-0.1 mg/mL NS, 24 h F, RT - auxiliary info:
134
2 mg/2 mL D5W WARNING: FOR
5 mg/5 mL INTRAVENOUS
(Teva) 25-50 mL NS, D5W
135
USE ONLY –
(F)(PFL) FATAL IF GIVEN
134
no preservative BY OTHER
129,130
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Vinorelbine
136 136 136
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary info:
136
50 mg/5mL portion WARNING: FOR
(Fresenius Kabi) NS, D5W, ½NS, INTRAVENOUS
(F)(PFL) D5½NS, Ringer’s, USE ONLY –
136 136
no preservative Ringer’s Lactate FATAL IF GIVEN
BY OTHER
129,130
ROUTES

Status)
Vinorelbine
137 137 137
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
137
50 mg/5 mL portion WARNING: FOR
(Hospira) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5½NS, USE ONLY –
137
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
137
Lactate BY OTHER
129,130
ROUTES
Vinorelbine
138 138 138
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
138
50 mg/5 mL portion WARNING: FOR
(Teva) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5½NS, USE ONLY –
138
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
138
Lactate BY OTHER
129,130
ROUTES
Zoledronic acid
139 139
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
139
(Dr Reddy’s) portion within 24 h of calcium containing
139 139
(RT) preparation solutions
139
no preservative
Refrigerate diluted
product if not used
immediately after
preparation; bring to
RT prior to
139
administration

Status)
Zoledronic acid
140 140
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
140
(MDA) portion within 24 h of calcium containing
140 140
(RT) preparation solutions
140
no preservative
Refrigerate diluted
product if not used
immediately after
RT prior to
140
administration
Zoledronic acid
141 141
(ZOMETA) N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
2
4 mg/ 5 mL portion within 24 h of calcium containing
141 141
(Novartis) preparation solutions
(RT)
141
no preservative Refrigerate diluted
product if not used
immediately after
RT prior to
141
administration

Status)
Zoledronic acid
142 142
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 ml NS, D5W complete infusion - do NOT mix with
142
(Sandoz) portion within 24 h of calcium- or other
142
(RT) preparation divalent cation-
142
no preservative containing infusion
Refrigerate diluted solutions (e.g.,
product if not used Lactated
142
immediately after Ringer’s)
RT prior to
142
administration
* 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.
*** Contains DMA (N,N dimethylacetamide). Product may be incompatible with closed system transfer devices such as ChemoLock.
Centres are not to change the content locally but should forward suggestions to the Cancer Drug Manual staff.
Explanatory Notes
Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the classification
143,144
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.
“Complete administration within __” is stated if the manufacturer specifies that the infusion must be completed in a specific time frame following preparation,
usually including entire time required for preparation (from first puncture), storage, and administration of infusion.

Abbreviations
BWI = bacteriostatic water for injection
CIVI: ambulatory pump = Continuous Intravenous Infusion (e.g., elastomeric infusor)
D5W = dextrose 5% in water
DMA = N,N dimethylacetamide
F = refrigerate
Non-DEHP = not containing Di(2-ethylhexyl) phthalate (DEHP)
NS = normal saline
PFL = protect from light
RT = room temperature
SWI = sterile water for injection
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BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART

(e.g., 50-250 mL*) D10W, D5-NS:

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 1/40

(e.g., 50-250 mL*)

0.06 - 0.4 mg/mL NS, NS:

0.06 - 1 mg/mL Ringer’s, LR:

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 2/40

(e.g., 50-250 mL*) D10W, D5NS:

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 3/40

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high dose use within 24 h RT of

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devices with spikes

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gently swirl, do NOT

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record time of doses > 500 mg:

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