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Updated: Jun 28, 2025
A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
Compatibility studies of selected multichamber bag parenteral nutrition with fluconazole
Katarzyna Dettlaff1, Gabriela Anglart1, Agnieszka Gruszczyńska1
1Department of Pharmaceutical Chemistry, Poznan University of Medical Sciences, Poznań, Poland.
Objective:
Fluconazole (FLZ) is a drug widely used in the treatment of fungal infections including the treatment of immunocompromised patients, HIV-infected patients, and cancer patients. Critically ill patients often require the administration of drugs with parenteral nutrition (PN). The safety of this combination should be defined before the drug and PN are administered in one infusion line. This study aimed to determine the compatibility of FLZ with six selected multichamber bag parenteral nutrition.
Methods:
FLZ solution for infusion was combined with PNs in appropriate proportions, considering most clinical situations resulting from different possible administration rates of the preparations. Samples were visually assessed, and pH, osmolality, turbidity, particle size (dynamic light scattering and light obscuration methods), and zeta potential were measured. These measurements were made immediately after combining the solutions and after 4 h of storage at 23 ± 1°C.
Results:
FLZ combined with PNs did not cause changes observed visually. The turbidity of the samples was <0.4 NTU. The average particle size of the lipid emulsion was below 300 nm, and the PFAT5 parameter was ≤0.02%. The absolute value of the zeta potential of the PN + FLZ samples was higher for 5 out of 6 PN than the corresponding value for PN immediately after activation. Changes in pH and osmolality during 4 h of sample observations were within acceptable limits.
Conclusion:
Compatibility of the FLZ with six multichamber bag PN was confirmed. Hence, those preparations can be administered to patients in one infusion line using the Y-site.
Insights
Fluconazole (FLZ) is compatible with six parenteral nutrition (PN) formulations, confirming safety for co-administration in critically ill patients. This ensures safe Y-site administration of FLZ and PN in one infusion line.
Area of Science:
- Pharmaceutical Sciences
- Clinical Pharmacy
- Critical Care Medicine
Background:
- Fluconazole (FLZ) is essential for treating fungal infections, especially in immunocompromised, HIV-infected, and cancer patients.
- Critically ill patients often require co-administration of medications with parenteral nutrition (PN).
- Ensuring the safety of combining FLZ with PN in a single infusion line is crucial for patient care.
Purpose of the Study:
- To evaluate the physicochemical compatibility of Fluconazole (FLZ) with six different multichamber bag parenteral nutrition (PN) formulations.
- To determine if FLZ can be safely administered simultaneously with PN via a Y-site connection.
Main Methods:
- FLZ solutions were combined with six PN formulations in clinically relevant proportions.
- Visual assessment, pH, osmolality, turbidity, particle size (DLS and light obscuration), and zeta potential were measured.
- Analyses were conducted immediately after mixing and after 4 hours of storage at room temperature.
Main Results:
- No visual changes were observed upon combining FLZ with PN.
- Turbidity remained below 0.4 NTU, and lipid emulsion particle size was under 300 nm (PFAT5 ≤0.02%).
- pH and osmolality changes were within acceptable limits, and zeta potential indicated stable mixtures.
Conclusions:
- Fluconazole (FLZ) is compatible with the tested six multichamber bag parenteral nutrition (PN) formulations.
- This compatibility supports the co-administration of FLZ and PN through a single infusion line (Y-site).
- The findings provide evidence for the safe use of this drug-PN combination in clinical settings.
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