A comparative analysis of the loss of amiodarone from small and large volume PVC and non-PVC infusion systems

The time-course of the adsorption of amiodarone hydrochloride onto flexible polyvinyl chloride (PVC) infusion bags and administration sets has been studied under ambient conditions similar to the intensive and coronary care units at the Repatriation General Hospital--Daw Park. When admixtures containing 900-1000 mg amiodarone hydrochloride in 500 ml PVC infusion bags containing glucose 5% were assayed, a minimal (2.7%) loss of amiodarone was detected at 24 hours compared with glass infusion bottles. There was no loss apparent when 100 ml PVC infusion bags were used compared with 100 ml glass bottles. When PVC administration sets were attached to 500 ml glass infusion bottles, maximal adsorption losses of up to 4.9% were observed in the effluent within one hour of the commencement of the simulated infusion. In Australia, the current recommendations by the distributor of amiodarone, Reckitt & Colman Pharmaceuticals, advise that the administration of amiodarone should be via glass infusion bottles or rigid PVC plastic containers without plasticisers together with non-PVC administration lines. These results do not support this recommendation.