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PRINTER-FRIENDLY VERSION AT PHARMACYPRACTICENEWS.

COM

Compatibility of
Commonly Used
Intravenous
Drugs
A
ll
rig

Co
ht

py
s

rig ed.
re

ht
se

LISA CAYO, PHARMD


rv

Clinical Pharmacy Coordinator


20

Garden City Hospital


11
Re

Garden City, Michigan


M
pr

cM
od
uc

ah in w
tio

on

T
n

he number of available IV
Pu
bl

medications continues to expand.


is
ho

hi

Many institutions have observed an


ng
le
or

increase in patient acuity and a rise in the


G
ro
in

number of medications administered to


up
pa

un ou
rt

each patient. This increases the likelihood


w

le

that multiple IV medications will need


ith

ss
ot

to be administered concurrently.
he
tp

rw
er

is
m

e
is

no
si
on

te
d.
is
pr
oh

These factors contribute to the escalating complex- medication is combined or added to an IV fluid. It is
ib

ity of IV drug administration and have resulted in an important to recognize that compatibility is not just
ite

ever-increasing number of possible incompatibilities. a function of the drugs themselves, but also can be
d.

The potential for serious and life-threatening adverse dependent on a variety of factors including the concen-
drug events exists when incompatible medications are tration, temperature, storage vehicle, infusion solution,
infused together. Therefore, it is important to verify drug order of mixing, and administration technique. Compat-
compatibility prior to coadministration. A clear and con- ibility differences even have been reported for different
cise compatibility chart can be a useful tool in helping to brands of the same drug.
deliver safe, high-quality IV therapy to patients. Three types of incompatibilities are commonly dis-
A chance of incompatibility exists whenever any cussed: physical, chemical, and therapeutic. Physical
Text continues on page 6

I N D E P E N D E N T LY D E V E L O P E D B Y M C M A H O N P U B L I S H I N G P H A R M AC Y P R AC T I C E N E WS • S E P T E M B E R 2 0 1 1
1
Table. Compatibility of Selected IV Drugs (continued)

Ampicillin-sulbactam

Dextrose 5% in water
Calcium gluconate

Diphenhydramine
Dexamethasone

Esomeprazole
Anidulafungin

Azithromycin

Ciprofloxacin
Caspofungin
Amiodarone

Dobutamine
Clindamycin

Fluconazole
Epinephrine
Ceftazidime
Bumetanide

Daptomycin

Doxycycline
Ceftizoxime

Eptifibatide

Furosemide
Ceftriaxone
Argatroban

Cefotaxime

Gentamicin
Famotidine
Doripenem
Ceftaroline
Aztreonam

Enalaprilat
Bivalirudin

Dopamine
Ampicillin

Diazepam
Cefepime

Diltiazem
Cefazolin
Acyclovir
Amikacin

Cefoxitin

Fentanyl
Esmolol
A

Acyclovir C N C I C C N I C C C N C I C C C C C C I C I C C I N N I I C C C I I I N C C C C N
ll

Amikacin C C N N C N I C C C C C C H C C C C C C C C C C C I C C C C C C C C C C N C C C C C
rig

Co

Amiodarone N C N I C I N N I C C C N N N N C I C C C C C N N N C N C C C C N C N C N C C C N C
ht

py

Ampicillin C N N N C N N N C N N I N N N N N N I N N S C N I I N I I I N I N N C N N N N I S I
s

Ampicillin-sulbactam I N I N C N N N C N N I N C I I N N N N I N C N A I N N I N N I N N C N N N N N N N
rig ed.
re

Anidulafungin C C C C C C C C C C C C C C C C N C C C C C N C C I C C C C C C C C C C N C C C C C
ht
se

Argatroban C N I N N C N N C N N N N N N N N N N N N N C N C N C C C C N N N N C N N N C N C N
rv

Azithromycin N I N N N C N I C N N N N N I N C I N I I I C N C N N C N N C N N N C N N I I N I I
20

Aztreonam I C N N N C N I C C C C C C C C N C C C C C C C C I C N C C N C C C C C N C C C C C
C C I C C C C C C C C I C C C C N C C C C C C C C I C C N C N C C C C C N C C C C C
11

Bivalirudin
Re

Bumetanide C C C N N C N N C C C C C C C C C C C C N C C C C I C C N C C C C C C C N C C C C C
M
pr

Calcium gluconate C C C N N C N N C C C C C C C C C C C I A C C I C I C C N C C C C C C C N C C N C C
cM
od

Caspofungin N C C I I C N N C I C C I I I I I I C I C I C I N I C C C C C C I C N C N C C C I C
uc

ah in w

Cefazolin C C N N N C N N C C C C I N I C N C C C N C C C C I C I I I N I C C C C N N C C C N
tio

I H N N C C N N C C C C I N N N N N N N I C C C C I I I N N N N I N C N N I N C C N
on

Cefepime
Cefotaxime C C N N I C N I C C C C I I N C N I I C N C C C C I C I N C N C C C C C N C C N C N
n

Pu

Cefoxitin C C N N I C N N C C C C I C N C N C I C N C C C C I C I I C N I C C C C N N C C C C
bl

Ceftaroline C C C N N N N C N N C C I N N N N N N N C C N C C I C C N C C N C N N N C C C C C C
is

Ceftazidime C C I N N C N I C C C C I C N I C N C C C C C C C I C I N C N I C C C C N C C N C N
ho

hi

Ceftizoxime C C C I N C N N C C C C C C N I I N C C N C C C C I C C N C N I C C C C N N C C C C
ng
le

Ceftriaxone C C C N N C N I C C C I I C N C C N C C N I C C C I C I I C N C C C C C N N C N C N
or

Ciprofloxacin I C C N I C N I C C N A C N I N N C C N N I C I C N C C C C C N N N C N N N N C I C
ro
in

Clindamycin C C C S N C N I C C C C I C C C C C C C I I C C C I C C N C N C C C C C N C C N C C
up

Daptomycin I C C C C N C C C C C C C C C C C N C C C C C C I C C C C C C C C C C C N C C C C C
pa

Dexamethasone C C N N N C N N C C C I I C C C C C C C C I C C C I C I I C C I C C C I N C C C C I
un ou
rt

D5W C C N I A C C C C C C C N C C C C C C C C C C I C N C C C C C C C C C C C C C C C C
w

le

Diazepam I I N I I I N N I I I I I I I I I I I I I N I C I N I I N I I I I I I I N I N I I I
ith

ss

Diltiazem N C C N N C C N C C C C C C I C C C C C C C C C C C I C C C C C C C C C N C C C I C
ot

Diphenhydramine N C N I N C C C N C C C C I I I I C I C I C C C I C I C C C C C C C C C N C C C I C
he
tp

Dobutamine I C C I I C C N C N N N C I N N I N N N I C N C I C N C C C C C C C C C N C C C I C
rw

Dopamine I C C I N C C N C C C C C I N C C C C C C C C C C C I C C C C C C C N C N C C C N C
er

Doripenem C C C N N C N C N N C C C N N N N C N N N C N C C C I C C C C N C N N C C C C C C C
is
m

Doxycycline C C C I I C N N C C C C C I N C I N I I C N C C I C I C C C C N C C C C N C C C I C
is

no
si

Enalaprilat C C N N N C N N C C C C I C I C C C C C C N C C C C I C C C C C C C C C N C C C C C
on

te

Epinephrine I C C N N C N N C C C C C C N C C N C C C N C C C C I C C C C N C C C C N C C C C C
d.

Eptifibatide I C N C C C C C C C C C N C C C C N C C C C C C C C I C C C N N C C C C N C C C I C
is

Esmolol I C C N N C N N C C C C C C N C C N C C C N C C I C I C C C C C C C C C N C C C I C
pr

Esomeprazole N N N N N N N N N N N N N N N N N C N N N N N N N C N N N N N C N N N N N N N N N N
oh

Famotidine C C C N N C N I C C C C C N I C N C C N N N C C C C I C C C C C C C C C C N C C N C
ib

Fentanyl C C C N N C C I C C C C C C N C C C C C C N C C C C N C C C C C C C C C C N C C C C
ite

a
Protect from light. b Testing was performed with ethylenediaminetetra-acetic acid (EDTA)-free formulation.
d.

KEY

A = Physically compatible for at least 2 hours H = Physically compatible for at least 1 hour
C = Physically compatible I = Incompatible
D = Physically compatible in dextrose 5% in water N = Information on compatibility is not available or not adequate
E = Physically compatible for at least 5 minutes R = Physically compatible for 24 hours under refrigeration
G = Physically compatible in glass bottle only S = Physically compatible in 0.9% sodium chloride

I N D E P E N D E N T LY D E V E L O P E D B Y M C M A H O N P U B L I S H I N G
2
Methylprednisolone sod. Succ.
Hydrocortisone Sod. Succ.

Piperacillin-tazobactam
Penicillin G Potassium

Sodium chloride 0.9%


Sodium bicarbonate
Imipenem-cilastatin

Potassium chloride
Magnesium sulfate

Ringer’s, lactated
Prochlorperazine
Morphine sulfate
Hydromorphone

Metoclopramide

Norepinephrine
Insulin, regular

Metronidazole

Phenylephrine
Nitroprussidea

Pantoprazoleb
Palonosetron
Nitroglycerin

Voriconazole
Ondansetron
Levofloxacin

Vancomycin
Vasopressin
Meropenem
Granisetron

Tobramycin
Tigecycline
Lorazepam

Micafungin
Midazolam

Tacrolimus
Phenytoin

TMP-SMX
Labetalol

Linezolid

Propofol
Mannitol

Nafcillin
Heparin

N C C C C C I I C C C C N C N C N I N C C I N I I N C I I I C I C N C C I C C C C C C Acyclovir
ll

C I C C C N C C C C C C N C C C N C C C C C C C C C C C I C C C I C C C C C C I C C C Amikacin
rig

Co

C I N N I C C I C C N N N C N C I C C N C N C N C N C C N I C N N N I N C I C N C C C Amiodarone
ht

py

C S N N N N N C C I N N N N N C N I N I N I N I C C I N I N N I C I I C N C N I N N C Ampicillin
s

C N N C N N N C C I N N N I N C N I N N N N N I C C N N I N N I N R N C N C N I N N C Ampicillin-sulbactam
rig ed.
re

C C C C C C C C C C I C C C C C N C C C C C C C C C N C I C C C N N I C C N C C C C C Anidulafungin
ht
se

N N C C N N N N N C N N N N N N N C C N C C C C N N N C N N N N N C N C N C N N N C N Argatroban
rv

N N N N I N N N N N N N N N N N N N I N N N N C C C N N N I I N N C N C N C I N N C C Azithromycin
20

C C C C N C C C C I C C N C C I N C C N C C C C C I C C I C C I C C C C C C C N N C C Aztreonam
C C C C C C C C C C C C C C C C N C C C C C C C C N N C I C C I N N C C C C C C I C C
11

Bivalirudin
Re

C C C C C C C C C C C C N C C C C N C C C C C C C C C C I C C N C C C C C C C I C C C Bumetanide
M
pr

C C N C N C C C C C N C N I C C C C C C C C C C C C C C I C C N C C I C C C C I C C C Calcium gluconate
cM
od

C I C C C C C C C N C C C I C N N C C I C I C C C N N C I I C C N N I C C C C I C C C Caspofungin
uc

ah in w

C C C N C C N I C C N C N C C C N C C C C C C C C N C C I N C I C C C C C C N I N C C Cefazolin
tio

C C C C C H N C C C I I N C I C N I N N N N N I C I N N I C C I N N C C I C N C N C I
on

Cefepime
C C C C C C I N C C C C N I C C N C C C C C C C C I C C I N C I C C I C C C C I N C C Cefotaxime
n

Pu

C C C C C I I I C C C C N I C C N C C C C C C C C C C C I N C I C C I C C C C I N C C Cefoxitin
bl

C C C C N C I C N C N C N C C C N C C N N N C C N C N N N N C N C C C C N N C C N C C Ceftaroline
is

C C C C C C C C C C C C N C C C N I C C C I C N C N C C I N C I N C C C C C C I N C C Ceftazidime
ho

hi

C C C C C C C C C C C C N C C C N C C C C C C C C C C C I N C I C C C C C C C I N C C Ceftizoxime
ng
le

C C C C I C I C N C I C N C C C N C C C C C C N C C C C I N C I C I C C C C I I N C C Ceftriaxone
or

C I I C N N N N C C I N N I C C N C N N N N C C C I N N I I C N I C I C C C C N N C C Ciprofloxacin
ro
in

C C C C C C N C C C C C N C C C N N C C C C C C C N C C I C C I C C C C C C N I C C C Clindamycin
up

C C C C I C C C C C C C C C C I N C C C I C C C C I N C I C C C N C C C C C C C I C C Daptomycin
pa

C C C N C C I C C C I C C C C C N I C C C C C C C I C C I C C I C C C C C C I I N C C Dexamethasone
un ou
rt

C N C C N C C C C N C N I N C N C C C C G C C C C C C C I C C N C C C C N C C N C N C D5W
w

le

I I I N I I I I I N I I I I I I N I N N I I I N I I I I I C I I I I I N I I I I I I I Diazepam
ith

ss

C N N C C N C C C C C C C N C C I C C N C C C C C I C C I I C C N N N C C C C C C C C Diltiazem
ot

C N N C C I C C C C C C C I C C N C C N C I C C C I C C I C C C C C I C C C C I C C C Diphenhydramine
he
tp

C N I C N N C C C C N C C C C C I N C C C N C C C I I C I I C C C C I C C C C I C C C Dobutamine
rw

C C C C C N C C C C C C C C C C C C C C C C C C C N C C I C C C C C N C C C C I C C C Dopamine
er

C C C C N C C C C C C C N C C C C C C N N N C C N C N C N N C N I N C C C C C N C N C Doripenem
is
m

C I I C C C C C C C C C N I C C N C C I C C C C I C I C I I C C C N I C C N C I C C C Doxycycline
is

no
si

C C C C C C C C C C C C C C C C N C C C C C C C C N C C I C C C C N C C C C C N C C C Enalaprilat
on

te

C C C C C N C C C C C C N C C C I C C C C C C C C C C C I C C C C C I C C C C I C C C Epinephrine
d.

C C C C C N C C C C C C C C C C C C C N C N C C C N N C I C C C N N C C N C C C C N N Eptifibatide
is

C N N C C C C C C C C C N N C C C C C N C C C C C I C C N C C C C C C C C C C N C C C Esmolol
pr

N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N C N C I N N N N N N Esomeprazole
oh

C C C C C N C C C C C C N C C C N C C C C C C C C I C C N I C C C C C C C C C I C C C Famotidine
ib

C C C C C C C C C C C C N C C C N C C C C C C C C I C C I C C C C N C C C C C I C C C Fentanyl
ite

Table continues on page 4


d.

I N D E P E N D E N T LY D E V E L O P E D B Y M C M A H O N P U B L I S H I N G
3
Table. Compatibility of Selected IV Drugs (continued)

Ampicillin-sulbactam

Dextrose 5% in water
Calcium gluconate

Diphenhydramine
Dexamethasone

Esomeprazole
Anidulafungin

Azithromycin

Ciprofloxacin
Caspofungin
Amiodarone

Dobutamine
Clindamycin

Fluconazole
Epinephrine
Ceftazidime
Bumetanide

Daptomycin

Doxycycline
Ceftizoxime

Eptifibatide

Furosemide
Ceftriaxone
Argatroban

Cefotaxime

Gentamicin
Famotidine
Doripenem
Ceftaroline
Aztreonam

Enalaprilat
Bivalirudin

Dopamine
Ampicillin

Diazepam
Cefepime

Diltiazem
Cefazolin
Acyclovir
Amikacin

Cefoxitin

Fentanyl
Esmolol
A

Fluconazole C C C I N C N N C C C N C C C N C C N C N C N C C C I C C C C C C C C C C N C C N C
ll

Furosemide C C N S N C C I C C C C I C C C C C C C C I C C C C I I I I N C I C C I I N N C N N
rig

Co

Gentamicin N C C I N C N I C C C C C N N N C C N C N C C C I C I C C C C C C C C C C N C C C N
ht

py

Granisetron N C C C C C N N C C C C C C C C C C C C C C C C C C I C C C C C C C C C C N C C C C C
s

Heparin C I I S N C N N C C C C I C C C C C C C C I C C C N I N N N C C I C C C N N C C C C I
rig ed.
re

Hydrocortisone C C N N N C C N C C C N C C C C C C C C C I C C C C I N N I C C I C C C N N C C C C N
ht
se

Hydromorphone C C N N C C C N C C C C C N C C C C C C C C C C N C N C C C C C C C C C C N C C C C C
rv

Imipenem-cilastatin C C I N N C N I N C C N C C C C C N C C I N C I C N I C C N C N C C C C C N C C N C C
20

Insulin, regular C N C N N C N N C C C C C C H C I C C C C N C C C C I N I N N C C C N N C N N C C C N
I C C N N C N N C C C C C N N I I I C C I N N C I C I C C C C C C C C C C N C C C N C
11

Labetalol
Re

Levofloxacin I C I C C C N N C C C C C I C N I C C C C N C C C C I C C C C C C C C C C N C C C I C
M
pr

Linezolid C C C C C C N N C C C C C C C C C N C C N C C C C C I C C C C C C C C C C N C C C C C
cM
od

Lorazepam C C C I I C C N I C C C N C C C C C C C C C C C C N N C C C C C C C C C C N C C C C C
uc

ah in w

Magnesium sulfate C C N N N I N N C C C N C N I C C N C C I I C C I C I C C N C C C C C C C N C C C N C
tio

C C N N N C N N C C C C C C I C C C C C C N C C C N I C C C C C C C C C C N C C C C C
on

Mannitol
Meropenem N N N N N C N N N C N N C N N N N N N N N N N C C I I C C C C N N C N C N N N N C C C
n

Pu

Methylprednisolone C C C N I C N N C C C I I C C I I C C C C I C C C N I N I C C C I C C C N N C C C C C
bl

Metoclopramide N C N N N C N N C C C C C C I C C C C C C C C C C C I C C C C C C C C C C N C C C N C
is

Metronidazole C C C C C C N N I C C C N C C C C C C C C C C I C N I C C C C C C C C C C N C C C C C
ho

hi

Micafungin N N I N N N N N N N C C N N N N N N N N N N N N N C N I N I C C N N I C C N N N N C N
ng
le

Midazolam I C C I I C C N C C N C C C I C C C I C C C N C I C I C C N C C C C C C C N C C C I C
or

Morphine sulfate N C C N N C C I C C C C C C N C C C C C C N C C C C N C C C C C C C C C C N C C C N C
ro
in

Nafcillin C C N I N C N N N C C C I C N C C N C C C N C C C C N N N C C N I C C N N N C C C C N
up

Nitroglycerin C C C N N C C N C C C C C C N C C N C C C N C I C G I C C C C N C C C C C N C C C N C
pa

Nitroprussidea I C N I N C C N C C C C I C N C C N I C C N C C C C I C I N C N C C C N C N C C C C C
un ou
rt

Norepinephrine N C C N N C C N C C C C C C N C C C C C C C C C C C I C C C C C C C C C C N C C C N C
w

le

Ondansetron I C N I I C C C C C C C C C I C C C N C N C C C C C N C C C C C C C C C C N C C C I C
ith

ss

Palonosetron I C C C C C N C C C C C C C C C C N C C C C C C C C I C C C C N I C C C C N C C C C C
ot

Pantoprazoleb N C N C C C N C I N C C N N I I C C N C C I N I I C I I I I N C C N C N I N I I I N C
he
tp

Penicillin G C C C I N N N N C N C C N C N C C N C C C N C N C C I C C I C N I C C N C N C C C C C
rw

Phenylephrine I C C N N C C N C C C C C C N C C N C C C N C C C C I C C C C C C C C C C N C C C I C
er

Phenytoin I I N I I I N N I I I I I I I I I N I I I I I I I I I I I I I N I I I I N N N I N I I
is
m

Piperacillan-tazobactam I C I N N C N I C C C C I N C N N N N N N I C C C C C I C I C N I C C C C N I C C C N
is

no
si

Potassium chloride C C C N N C N I C C C C C C C C C C C C C C C C C C I C C C C C C C C C C N C C C C C
on

te

Prochlorperazine I C N I I C N N I I N N C I I I I N I I I N I C I N I C C C C N C C C C C N C C C I C
d.

Propofol C I N C N N N N C N C C N C N C C C N C C I C N C C I N C C C I C C C N C N C C C C I
is

Ringer’s, lactated N C N I R N C C C N C C N C N C C C C C I C C C C C I N C C C N N N C N C C C N C C C
pr

Sodium bicarbonate C C I I N I N N C C C I I C C I I C C C C I C C C C I N I I N C I C I C C N C C C C C
oh

Sodium chloride 0.9% C C N C C C C C C C C C C C C C C C C C C C C C C C N C C C C C C C C C C C C C C C C


ib

Tacrolimus I C C N N C N N C C C C C C I C C N C C C C C C C N I C C C C C C C C N C I C C C N C
ite

Tigecycline C C I C C N C C C C C C C C C C C N C C C C C C C C I C C C C C N C C C C N C C C C C
d.

Tobramycin C C C N N C N I C C C C C N N C C C C C I C N C I C I C C C C C C C C C C N C C C C C
TMP-SMX C I N I I C N N N C I I I I C I I C I I I N I C I N I C I I I N I N I C N N I I I I I
Vancomycin C C C N N C N N N I C C C N N N N N N N N N C I N C I C C C C C C C C C C N C C C I C
Vasopressin C C C N N C C C C C C C C C C C C C C C C C C C C N I C C C C N C C C N C N C C C N C
Voriconazole C C C C C C N C C C C C C C I C C C C C C C C C C C I C C C C C C C C N C N C C C C C
a
Protect from light. b Testing was performed with ethylenediaminetetra-acetic acid (EDTA)-free formulation.

I N D E P E N D E N T LY D E V E L O P E D B Y M C M A H O N P U B L I S H I N G
4
Methylprednisolone sod. Succ.
Hydrocortisone Sod. Succ.

Piperacillin-tazobactam
Penicillin G Potassium

Sodium chloride 0.9%


Sodium bicarbonate
Imipenem-cilastatin

Potassium chloride
Magnesium sulfate

Ringer’s, lactated
Prochlorperazine
Morphine sulfate
Hydromorphone

Metoclopramide

Norepinephrine
Insulin, regular

Metronidazole

Phenylephrine
Nitroprussidea

Pantoprazoleb
Palonosetron
Nitroglycerin

Voriconazole
Ondansetron
Levofloxacin

Vancomycin
Vasopressin
Meropenem
Granisetron

Tobramycin
Tigecycline
Lorazepam

Micafungin
Midazolam

Tacrolimus
Phenytoin

TMP-SMX
Labetalol

Linezolid

Propofol
Mannitol

Nafcillin
Heparin

C C C C N C C C C C C C C C C C N C C C C C C C C I C C N C C C C C C C C C C I C C C Fluconazole
ll

C C C C C C N I C C N C C C N C C I N C N C N I C N C I I C C I C C C C N C C I I N C Furosemide
rig

Co

C I N C C N C C C C C C C C C C N C C N C C C C C C C C I N C C I C C C C C C I C C C Gentamicin
ht

py

C C C C C C C C C C C C C C C N C C C C C C N N C N C I C C C C N C C C C C C C C C Granisetron
s

C N N C C N I C C C C C N C C C C N C C C C C C C C C I C C N C N C C C C I E I C C Heparin
rig ed.
re

C N C C C I C C C N C N N C C N N C N C C C C C N C C I C C N C C C C C C N I N C C Hydrocortisone
ht
se

C N C C C C C C C C C C C C C C C C C C C C C C N C C I C C N C C I C C C C C C C N Hydromorphone
rv

C C C C C C C C I C I N C C C N N C C C N C C I C C C I N N I C I I R C C C I C C C Imipenem-cilastatin
20

C C C C C I N C C C C C C C C I N N N C C N N C N C I I I C I C G C N C C N I C N C Insulin, regular
C N I C C I C C C C C N C C C I C C N C C C C C I N C I I C C C C N C C C C N C C C
11

Labetalol
Re

C I C C C N C C N N C N C C C N C C N I I N C C I N C I I C I I N C C C C C C C C C Levofloxacin
M
pr

C C C C C C C C C C C C C C C N C C C C C C C C I N C I C C C N C C C C C C N C C C Linezolid
cM
od

C C C C I C C N C C C C C C C C C C C C C C I C I N C I C C N C N C N C C C C C C C Lorazepam
uc

ah in w

C C N C C C C C C C C C I C C C C C C C C C C C N C C I C C C C C C C C C C N C C C Magnesium sulfate
tio

C C C C I C C C C C C I C C C N C C C C C C C C N C C I C C C C N C N C C C I C C C
on

Mannitol
C C N C N C N N C C C I N C C N N C N N N C N C N N N N N N N N I I R C C N N C C C Meropenem
n

Pu

C N N C C C C C C C I C N C C N N C N C C C N N I C C I C N C I N C C C N C I C C C Methylprednisolone
bl

C C C C C C C C C C C C C C C N C C C C C C C C N C C I C C C I C C C C C C I C C C Metoclopramide
is

C C C C C C C C C C C C C C C N C C C C C C C C I N C I C C C N N C N C C C C C C C Metronidazole
ho

hi

N C N C N I I N N C C N N N N N I I N C C C I N N N C I N C N N C N C C N N N N C N Micafungin
ng
le

C C N C N N C C C C C C N N C C I C N C C C C C I C C I I C I N N I C C C C I C C C Midazolam
or

C N C C C N C C C C C C C C C C I C C C C C C C N C C I C C C N C N C C C C N C C C Morphine sulfate
ro
in

C C N C C N N N C C C C N N C C N N C C C C C I C C C I N C C C C C C C C N I N C C Nafcillin
up

C C C C C C C I C C C C N C C C C C C C C C C C N C C I C C C C G C G C C C I C C C Nitroglycerin
pa

C C C C N C C I C C C C N C C C C C C C C C C C N C C I C C I C C C C C C C I C C I Nitroprussidea
un ou
rt

C C C C C N C N C C C C C C C C C C C C C C C C N C C I C C C C C I C C C C I C C C Norepinephrine
w

le

N C C C C N C C C I C C N N C C I C C C C C C N I C C I C C C C C I C C C C I C C C Ondansetron
ith

ss

N C C C I C C C C C C C C N C C N C C I C C C N I N C I C C C C N C C C C C C C C C Palonosetron
ot

C C N N C N I I I I N N N I N I N I N C N N N I I N C I N C I N C N C N C N N N C I Pantoprazoleb
he
tp

N C C C C C N N N N C C N C C N N C C C C C C C N N C I N C C N C N N C N C I N C N Penicillin G
rw

C C C C C I C C C C C C N C C C C C C C C C C C C C C I C C C N C C C C C C I C C C Phenylephrine
er

I I I I I I I I I I I I N I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Phenytoin
is
m

C C C C N I I I C C C C N C C C N I C N C C C C C N N C I C I N C C C C C I C N C C Piperacillin-tazobactam
is

no
si

C C C C N C C C C C C C N N C C C C C C C C C C C C C C I C C C C C C C C C I C C C Potassium chloride
on

te

C N N N I I C I C N C C N C C C N I C C C I C C C I C C I I C C C N N C C C I C C N Prochlorperazine
d.

C C C C C C C I N C C C N I I N N N N C C C C C C N N N I N C C C C N N N I N N N N Propofol
is

N N C C I G C N C N C N I N C N C N C C G C C C N C C C I C C C C N N N C C N C N N Ringer’s, lactated
pr

C C C I I C N C C C C C I C C C N I N C C C I I C N N C I C C N C N C C C C I N C C Sodium bicarbonate
oh

C C C C R N C C C N C N R C C N C C C C G C C C C C N C I C C N N N C N N C N C N C Sodium chloride 0.9%


ib

C C C C C C C C C C C C C C C C C C C C C C C C C N C C I C C C N N C N C C N C C C Tacrolimus
ite

C C C C C C C C C C C C C N C C N C C C C C C C C C N C I C C C N C C N C C C C C N Tigecycline
d.

C I N C C N C C C C C C N C C C N C C N C C C C C N C C I I C C I C C C C C I C C C Tobramycin
C E I C I I N C N C N I N I I C N I N I I I I I C N I I I C I I N N I N N C I I N C TMP-SMX
C I N C C C C C C C C C C C C C N C C N C C C C C N N C I N C C N C N C C C C I C C Vancomycin
C C C C C N C C C C C C C C C C C C C C C C C C C C C C I C C C N N C N C C C N C C Vasopressin
C C C N C C C C C C C C C C C C N C C C C I C C C I N C I C C N N N C C C N C C C C Voriconazole

I N D E P E N D E N T LY D E V E L O P E D B Y M C M A H O N P U B L I S H I N G
5
Text continued from page 1 help clinicians minimize their occurrence. Continuing
incompatibilities are the most easily detected and are research adding to the existing body of knowledge on
evidenced by visible changes, such as particulate for- IV compatibilities is vital.
mation, haze, precipitation, color change, and gas evo-
lution. Chemical incompatibilities are those that result Suggested Reading
in decomposition of a drug. Loss of potency of greater
than 10% over the defined testing period is considered Bertsche T, Mayer Y, Stahl R, Hoppe-Tichy T, Encke J, Haefeli WE.
Prevention of intravenous drug incompatibilities in an intensive care
chemical incompatibility. Most chemical incompat- unit. Am J Health Syst Pharm. 2008;65(19):1834-1840.
ibilities can be detected only with a suitable analytic
method. Therapeutic incompatibilities in which a drug Canann D, Tyler LS, Barker B, Condie C. Visual compatibility of IV
medications routinely used in bone marrow transplant recipients.
combination results in undesirable antagonistic or syn- Am J Health Syst Pharm. 2009;66(8):727-729.
A

ergistic pharmacologic activity are beyond the scope of


ll

most compatibility references. Condie CK, Tyler LS, Barker B, Canann DM. Visual compatibility of
rig

Co

caspofungin acetate with commonly used drugs during simulated


The purpose of this chart is to provide data in an
ht

Y-site delivery. Am J Health Syst Pharm. 2008;65(5):454-457.


py

organized, concise format from which compatibility


s

rig ed.

information can be accessed quickly and conveniently. Data on file. Wyeth Pharmaceuticals.
re

Although there are differing types of incompatibilities,


ht
se

DRUGDEX® System (Internet database). Greenwood Village, CO:


the type of incompatibility or compatibility is not spec-
rv

Thomson Reuters (Healthcare) Inc.


ified in this chart. A designation of “compatible” indi-
20

cates that the combination evaluated appears to be Nemec K, Kopelent-Frank H, Greif R. Standardization of infusion solu-
11

tions to reduce the risk of incompatibility. Am J Health Syst Pharm.


Re

compatible based on the tests performed, whether 2008;65(17):1648-1654.


M
pr

these tests measured physical, chemical, or both types


cM
od

of compatibility. All conditions that may affect com- Trissel LA, ed. Handbook on Injectable Drugs. 16th ed. Bethesda, MD:
American Society of Health-System Pharmacists; 2011.
patibility cannot be included in such a format and it
uc

ah in w

is not possible to predict all incompatibilities that may


tio

on

arise, but it is hoped that the information provided may Dr. Cayo reports no relevant conflicts of interest.
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