Compatibility of Docetaxel with Selected Drugs during Simulated Y-Site Administration

The compatibility of docetaxel with 81 secondary additives during simlated Y-site injection was evaluated by visual observation with the unaided eye and a Tyndall beam as well as with electronic turbidity measurement. Five milliliters of docetaxel 0.9 mg/mL in 5% dextrose injection was combined with 5 mL of solutions of 81 secondary additives including suportive-care drugs and anti-infectives in 5% dextrose injection or, if necessary to avoid incompatibilities with the diluent, 0.9% sodium chloride injection. Visual examinations were performed in fluorescent light with the unaided eye and a Tyndall beam (high-intensity monodirectional light beam) to enhance visualization of small particles and low-level turbidity. The turbidity of each sample was quantitated as well. Evaluation of the samples was performed initially and at one and four hours after preparation. Most of the drugs tested were physically compatible with docetaxel at 0.9 mg/mL. However, three drugs exhibited incompatibilites with docetaxel within the four-hour observation period, Amphotericin B resulted in the formation of a substantially more intense haze measuring about 11.5 nephelometric turbidity units (NTU) after four hours; the haze was visible in normal room light. The nalbuphine hydrochloride mixtures resulted in a small increase of about 0.8 NTU in sub-visual haze. The methylprednisolone sodium succinate combination resulted in a small loss of the expected natural haze of about 0.5 to 0.6 NTU. Docetaxel was physically compatible with 78 supportive care and anti-infective drugs during simulated simultaneous Y-site administration. However, amphotericin B, nalbuphine hydrochloride, and mehtylprednisolone sodium succinate resulted in physical incompatibilites. Simultaneous Y-site administration of these three drugs with docetaxel should be avoided.