Compatibility and Stability Study of Butorphanol, Nicardipine, Urapidil, and Tirofiban During Multidrug Simultaneous...

This study aimed to assess the physicochemical stability and compatibility of butorphanol tartrate, nicardipine hydrochloride, urapidil, and tirofiban hydrochloride to support safe infusion practices in the ICU.

Compatibility systems involving four-, three-, and two-drug combinations were prepared in 0.9% sodium chloride injection under simulated clinical conditions at room temperature in the absence of light. Evaluations included appearance, pH, and insoluble particle counts at 0, 2, 4, 8, 12, and 24 hours. Quantitative analysis of drug concentrations was performed using high performance liquid chromatography (HPLC).

All tested combinations retained physical stability within 24 hours, showing no measurable variation in appearance, pH, or particle. Nicardipine concentrations declined significantly, reaching 74.35% of baseline in the nicardipine-urapidil-tirofiban mixture at 24 hours, and decreasing to 76.29% at 12 hours and 71.46% at 24 hours in the nicardipine-tirofiban combination. The concentrations of active ingredients in the remaining mixtures remained stable, consistently exceeding 90% of initial values.

Butorphanol demonstrated compatibility with the other agents under the tested conditions. In clinical application, infusion of nicardipine combined with tirofiban should be restricted to less than 8 hours, and nicardipine combined with urapidil and tirofiban should not exceed 12 hours. Other mixtures can be administered for up to 24 hours with flexibility in infusion duration.