Physical compatibility of telavancin hydrochloride with select i.v. drugs during simulated Y-site administration

The physical compatibility of telavancin with select i.v. drugs during simulated Y-site administration was evaluated.

Telavancin for injection was reconstituted according to manufacturer's recommendations and diluted with 0.9% sodium chloride injection, 5% dextrose injection, or lactated Ringer's injection to a concentration of 7.5 mg/mL. A Y site was simulated in culture tubes by mixing 5 mL of telavancin solution with 5 mL of a tested drug solution and then switching the order of drug mixing. All mixtures were prepared in duplicate and stored at room temperature. Solutions were inspected for visual, turbidity, and pH changes immediately after preparation and 15, 60, and 120 minutes after preparation.

Of the 52 drugs tested, telavancin was physically compatible with 39 drugs in all test solutions. Telavancin was incompatible with amphotericin B deoxycholate, liposomal amphotericin B, digoxin, esomeprazole sodium, furosemide, levofloxacin, and micafungin sodium in all diluents. Colistimethate sodium, cyclosporine, heparin sodium, imipenem-cilastatin sodium, methylprednisolone sodium succinate, and propofol were incompatible with telavancin in specific diluents. Incompatibilities included precipitation, positive Tyndall beam test, and increases in turbidity. There were no substantial changes in pH over the 120-minute study period.

Telavancin 7.5 mg/mL in 0.9% sodium chloride injection, 5% dextrose injection, and lactated Ringer's injection was found to be physically compatible for 120 minutes at room temperature with 39 of the 52 drugs tested during simulated Y-site administration. Seven drugs were incompatible in all diluents, and 6 were incompatible in at least one diluent.