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Drug stability guidelines for a continuous infusion chemotherapy program.

H M Vyas, R J Baptista, F P Mitrano

    Hospital Pharmacy
    |June 9, 1987
    PubMed
    Summary
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    This study provides crucial chemical stability data for antineoplastic drugs used in ambulatory infusion chemotherapy. These findings address pharmacy concerns and support safe, extended drug delivery over days or months.

    Area of Science:

    • Oncology
    • Pharmaceutical Sciences
    • Clinical Pharmacy

    Background:

    • Ambulatory infusion chemotherapy utilizes advanced technology for prolonged drug delivery over days, weeks, or months.
    • The chemical stability of antineoplastic drugs is critical for the efficacy and safety of continuous infusions.
    • A lack of comprehensive extended stability data for intravenous chemotherapy solutions has raised significant pharmacy concerns.

    Purpose of the Study:

    • To compile and present extended chemical stability data for antineoplastic drugs and their admixtures.
    • To establish minimum stability limits for commonly used chemotherapy agents in ambulatory infusion settings.
    • To address pharmacy concerns regarding the safe and effective use of continuous chemotherapy infusions.

    Main Methods:

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  • Literature surveys and manufacturer correspondence were used to gather extended chemical stability data.
  • Stability was defined as maintaining at least 90% of the initial drug concentration.
  • Data were collected for single and multiple drug admixtures stored in 60-ml polyvinylchloride (PVC) reservoir bags at room temperature.

    • Main Results:

    • Minimum stability limits (in days) were determined for various single-agent chemotherapies: cytarabine (8), cyclophosphamide (6), doxorubicin (14), epidoxorubicin (14), floxuridine (8), fluorouracil (14), methotrexate (data not specified, assumed >14 based on context), mitomycin-C (14), cisplatin (14), thiotepa (7), vinblastine (8).
    • Stability data for specific admixtures included: methotrexate/fluorouracil (14), doxorubicin/vinblastine (8), doxorubicin/cyclophosphamide (7), fluorouracil/cyclophosphamide (7), and doxorubicin/vincristine (14).

    Conclusions:

    • The compiled data support defined minimum stability periods for specific antineoplastic drugs and admixtures in PVC bags.
    • This information is vital for pharmacists to ensure the integrity and safety of ambulatory infusion chemotherapy.
    • The findings facilitate the safe and effective administration of prolonged chemotherapy regimens, enhancing patient care.