BCCA Chemotherapy Preparation & Stability Chart - UpDate March 2014 PDF

BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART
DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special
(Storage Prior to Use, With: Stability Precautions/Notes
Manufacturer,
Preservative Status)
Aldesleukin
22 million units 1.2 mL SWI1,2 18 million unit/mL 48 h F1 50 mL D5W1 48 h F1 - do not use in-line
(1.3 mg) (1.1 mg/mL)1,2 filter1,2
(Novartis) direct diluent against 30 – 70 mcg/mL1 - avoid bacteriostatic
(F)(PFL) side of vial during water for injection or
no preservative1 reconstitution1 Less than 30 mcg/mL: NS due to increased
dilute in D5W aggregation1
do not shake1 containing human
albumin 0.1%2
Alemtuzumab
30 mg/mL N/A filter NOT required4 discard unused SC syringe5 discard at the end of - do not shake6
(Genzyme previously portion4 the day F or RT
Bayer)3 30 mg/mL4
(F)(PFL)
do not shake 100 mL NS or D5W4 8 h F or RT4
no preservative4
**(PFL)6
100 mL NS or D5W7 8 h F or RT6
**(PFL)6
Amifostine
500 mg 9.7 mL NS only8 50 mg/mL8 24 h F, 5 h RT8 25–50 mL* NS only8 5–40 mg/mL: - discard cloudy
(MedImmune) 24 h F, 5 h RT8 solution9
(RT)
no preservative8
BC Cancer Agency Chemotherapy Preparation and Stability Chart© version 2.00 1/41
Activation Date: 2 March 2006
Revised Date: 12 March 2014
Manufacturer,
Amsacrine
75 mg/1.5 mL glass syringes 5 mg/mL10 24 h RT10 500 mL D5W10 7 d F, 48 h RT10-12
(Erfa Canada) preferred during
(RT) reconstitution; PFL10 (plastic or glass
no preservative10 max. time in plastic container)10
syringe10: 15 min
13.5 mL supplied
diluent (L-lactic
acid)1
transfer 1.5mL from

ampoule into the
diluent vial10
Arsenic
10 mg/10 mL N/A 1 mg/mL13 discard unused 100-250 mL NS, 24 h RT, 48 h F13
(Lundbeck) portion13 D5W13
(RT) (use filter needle to
no preservative13 withdraw from
ampoule)
Manufacturer,
Asparaginase14
(asparaginase E. coli) do not shake; roll to 2500 units/mL14 48 h F, RT14 syringe14 14 d F14,18
10,000 units reconstitute9,16
(Orphan 4 mL SWI17
Pharmaceutical 50 mL* NS or 14 d F,11,18
D5W11,18 2 d RT18,19
9
International) Intradermal test :
(F) • Reconstitute with
no preservative15 5 mL SWI to give
2000 units/mL
• Transfer 0.1 mL to
10 mL vial (or 12
mL syringe)
• Add 9.9 mL SWI
roll to dissolve to
give 20 units/mL
• 2 unit test dose =
0.1 mL
(Note: the rest of the
reconstituted vial
has a concentration
of 2000 units/mL)9
Manufacturer,
Erwinia asparaginase
(asparaginase Erwinia do not shake; roll to 10000-5000 15 min in original glass or 8 h in a glass or
chrysanthemi) reconstitute20 units/mL container; 8 h in a polypropylene polypropylene
10,000 units glass or syringe20 syringe20
(Orphan 1-2 mL NS20 polypropylene
Pharmaceuticals syringe20
International)
(F)
no preservative20
PEG-asparaginase
(pegasparagase) N/A 750 units/mL21 discard unused IM: maximum volume syringe: 4 h21,22 - discard cloudy
(pegylated portion21 2 mL; if greater than solution21
asparaginase E. coli) 2 mL use multiple - do not shake21
750 units/mL sites21 - do not use if stored
(Enzon) out of refrigerator for
(F) greater than 48 h21
no preservative21 IV: 100 mL NS or bag: 4 h21,22 - do not use if
D5W21 previously frozen21
Manufacturer,
Azacitidine
100 mg 4 mL SWI23 25 mg/mL23 8 h F, SC syringe23 8 h F, 45 min RT24 - discard if contains
(Celgene) 45 min RT23 large particles23
(RT) shake vigorously23 Refrigerated - re-suspend syringe
no preservative23 syringes24: contents before
• allow up to 30 min injection by
prior to vigorously rolling
administration to syringe between
reach a palms23
temperature of
approximately 20 -
25°C
• discard syringe if
time elapsed at RT
is greater than 30
min
BCG
81 mg do not shake; roll to 10.5 ± 8.7×108 2 h F, RT25 50 mL NS25 2 h F or RT after - auxiliary label:
(Sanofi Pasteur) reconstitute25 CFU/vial reconstitution25 biohazard26
(F)(PFL) (Connaught
preservative25 3 mL supplied strain)25 **(PFL)25
diluent25
record time of
reconstitution
Manufacturer,
BCG
(Tice substrain) 1 mL preservative 1 to 8×108 2 h F (PFL)27 transfer from vial to 2 h F27 - auxiliary label:
50 mg = 1 to 8 x 108 free NS for CFU/vial27 60 mL syringe, rinse biohazard26
CFU injection27 vial with another 1 mL - overfill unknown
(Hospira/Organon) NS. Add rinse to - protect from light27
(F)(PFL) use reconstitution same 60 mL syringe. - do not filter27
no preservative27 device provided qs to 50 mL with NS27
allow to stand for a

few minutes, then
gently swirl to
suspend27
Bendamustine
25 mg 25 mg vial: 5 mg/mL28 30 minutes28 500 mL NS28 complete
100 mg add 5 mL SWI28 administration within
(Lundbeck) 0.2-0.6 mg/mL28 24 h F, 3 h RT28
(RT)(PFL) 100 mg vial:
no preservative28 add 20 mL SWI28
shake well;
dissolves completely
in 5 minutes28
Manufacturer,
Bevacizumab
100 mg/4 mL N/A 25 mg/mL29 discard unused 1.4-16.5 mg/mL30 48 h F, RT19,29,30 - do not shake29
400 mg/16 mL portion29
(Roche) 100-250 mL NS
(F)(PFL) only29,30
do not shake
no preservative29
Bleomycin
15 units 6 mL* NS31 2.5 units/mL 48 h F31 50 mL* NS31 24 h RT31 - no overfill32
(NB: dose in units only)
(Bristol)
(F)
no preservative31
Bleomycin
15 units 6 mL* NS or SWI33 2.5 units/mL33 48 h F, 24 h RT33 50 mL* NS, SWI33 24 h RT34 - no overfill35
(Hospira)
(F)(PFL)
no preservative33
Bleomycin
15 units 6 mL NS36 2.5 units/mL36 48 h F36 50 mL NS36 24 h RT36
(PPC)
(F)(PFL)
no preservative36
Manufacturer,
Bortezomib
3.5 mg 3.5 ml NS37 1 mg/mL37 2 d RT11,38 syringe37 8 h RT39 - auxiliary label:
(Ortho Biotech, formerly WARNING:
Millennium) SUBCUTANEOUS
(RT)(PFL) or INTRAVENOUS
no preservative37 use only. Fatal if
given by other
routes.26
Bortezomib
3.5 mg 3.5 mL NS37 1 mg/mL37 2d RT11,38 syringe37 8 h RT39
(Ortho Biotech formally
Millennium)
(RT)(PFL)
no preservative37
Brentuximab
50 mg 10.5 mL SWI40 5 mg/mL40 24 h F40 0.4-1.8 mg/mL in NS, 24 h F40 - solution should be
(GMD Distribution for D5W, Lactated clear to slightly
Seattle Genetics) Direct diluent Ringer’s (i.e. 100-250 Do NOT freeze40 opalescent,
(F)(PFL) against side of mL)40 colorless, and free of
no preservative40 vial during visible particulates40
reconstitution40
Do NOT shake40
Manufacturer,
Busulfan
60 mg/10 mL N/A use 5-micron nylon discard unused NS or D5W (dilute in complete
(Orphan Medical) filter provided with portion41 volume 10 times the administration within
(F) ampoule to busulfan volume to 12 h F: NS41
no preservative41 withdraw drug41 ~0.5 mg/mL)41 8 h RT: NS, D5W
6 mg/mL41
Cabazitaxel
60 mg/1.5 mL supplied diluent: 10 mg/mL42 1 h RT42 0.10 – 0.26 mg/mL complete - concentrate and
(sanofi-aventis) withdraw entire NS, D5W42 administration within diluent vials contain
(RT) contents of diluent (e.g., 250 mL*) 8 h RT, 48 h F42 overfill42
no preservative42 vial and inject into - use non-PVC (non-
the concentrate DEHP) bag and
vial42 tubing42
- use 0.22 micron in-
slowly direct diluent line filter42
against inside of vial - diluent contains
to limit foaming42 13% (w/w) ethanol in
water42
mix by repeated - discard if
inversions for 45 crystallization
sec42 occurs42
do NOT shake42
let sit for 5 min42
Manufacturer,
CARBOplatin
50 mg/5 mL N/A 10 mg/mL43 discard unused 0.3-10 mg/mL44 24 h RT,45 48 h F43 - do NOT use
150 mg/15 mL portion43 aluminum-containing
450 mg/45 mL NS, D5W9,43 needle, syringe or
600 mg/60 mL tubing44
(Hospira) do NOT use
(RT)(PFL) aluminum-containing
no preservative43 needle or syringe44
CARBOplatin
50 mg/5 mL N/A 10 mg/mL46 discard unused 0.5-10 mg/mL47 8 h RT46 - do NOT use
150 mg/15 mL portion RT46 aluminum-containing
450 mg/45 mL NS, D5W9,46,48 needle, syringe or
(Teva/Novopharm) tubing46
(RT)(PFL) do NOT use
no preservative46 aluminum-containing
needle or syringe46
Carmustine
100 mg 3 mL diluent 3.3 mg/mL in 10% 24 h F, 8 h RT49 glass49 or polyolefin 24 h F: in glass49 or - do not use if
(Bristol Labs) (supplied)49 ethanol49 container9 polyolefin container9 product has oily
(F) droplets49
no preservative49 diluent to reach RT, 500 mL NS or D5W49 use within 4 h of
then dissolve drug reconstitution RT49
with 3 mL diluent;
add 27 mL SWI49
record time of
reconstitution
Manufacturer,
Cetuximab
100 mg/50 mL N/A 2 mg/mL50 discard unused syringe50 12 h F, 8 h RT50 - administer with a
200 mg/100 mL portion after 12 h 0.2 or 0.22 micron
(ImClone/BMS) F, 8 h RT50 low protein binding
(F) sterile evacuated 12 h F, 8 h RT50 in-line filter50
do not dilute container or bag e.g. - normal saline may
do not shake polyolefin, be used to flush the
no preservative50 polyethylene, line50
ethylene vinyl - solution may
acetate, DEHP contain white
plasticized PVC, PVC particulates which do
bag, or glass50 not affect product
quality50
CISplatin
10 mg/10 mL N/A 1 mg/mL51 48 h RT52 Less than or equal to 48 h RT52 - do NOT use
50 mg/50 mL 60 mg: 100 mL* NS aluminum-containing
100 mg/100mL needle, syringe or
(Hospira) Greater than 60 mg: tubing51
(RT)(PFL) 250 mL* NS
no preservative51
500 or 1000 mL* NS,
D5-NS, D5-1/2S, D5-
NS with mannitol, D5-
1/2S with
mannitol51,53; D5W-
1/3S with mannitol51
Manufacturer,
CISplatin
10 mg/10 mL N/A 1 mg/mL54 48 h RT54,55 Less than or equal to 24 h RT54 - do NOT use
50 mg/50 mL 60 mg: 100 mL NS* aluminum-containing
100 mg/100mL needle, syringe or
(Sandoz) Greater than 60 mg: tubing54
(RT)(PFL) 250 mL NS*
no preservative54
NS; 0.45 % Sodium
Chloride with or
without mannitol56
2 L of D5 on one-half
or one-third NS
containing 37.5 g of
mannitol54
Manufacturer,
Cladribine
10 mg/10 mL N/A 1 mg/mL57 discard unused SC syringe58 48h F, end of day - shake vigorously to
(Janssen-Ortho) portion57 RT11,57,59,60 dissolve any
(F)(PFL) precipitates from
no preservative57 refrigeration57
500 mL NS only57 24 h RT57
Do NOT use D5W57
Cassette: at least 7 days57

qs to 100 mL with
bacteriostatic NS
only via SIMS
DELTEC INC.
MEDICATION
CASSETTES®57 filter
drug and diluent
through 0.22 micron
filter as each solution
is being introduced
into the cassette
Manufacturer,
Cladribine
10 mg/10 mL N/A 1 mg/mL61 discard unused SC syringe58 discard end of
(PPC) potion61 day11,60,61
(F)(PFL)
no preservative61
500 mL NS only 24 h RT
Do NOT use D5W
Cassette: at least 7 days61

qs to 100 mL with
bacteriostatic NS
only via SIMS
DELTEC INC.
MEDICATION
CASSETTES®61 filter
drug and diluent
through 0.22 micron
filter as each solution
is being introduced
into the cassette
Clodronate
300 mg/10 mL N/A 30 mg/mL62 discard unused 500 mL NS or D5W62 12 h RT62
(Oryx) portion62
(RT)
no preservative62
Manufacturer,
Cyclophosphamide
200 mg NS64 20 mg/mL63 48 h F,55,63,65 Less than or equal to 72 h F,63,65
500 mg 24 h RT63 1 g: 100 mL NS* 24 h RT63
1000 mg 200 mg: 10 mL
2000 mg 500 mg: 25 mL Greater than 1 g: 250
(Baxter) 1000 mg: 50 mL mL NS*
(RT)(PFL) 2000 mg: 100 mL63
no preservative63 high dose in BMT:
may need 500 NS*
NS, D5W, D5NS63
CycloSPORINE
50 mg/1 mL N/A 50 mg/mL66 discard unused NS, D5W66 dilute immediately - polyoxyethylated
250 mg/5 mL portion66 prior to use66 castor oil/ethanol
(Novartis) dilute to concentration vehicle66
(RT)(PFL) between 1:20 and - do NOT refrigerate
no preservative66 1:10066 or freeze66
- use non-PVC bag
and tubing67
Cytarabine
100 mg/1 mL N/A 100 mg/mL68 24 h RT68 100 mL* NS, Water 72 h F, 24 h RT from - do not use for IT
1000 mg/10mL for Injection, D5W, initial vial puncture68 injection
2000 mg/20mL record time of Lactated Ringer’s68
(Hospira) puncture
(RT)(PFL)
no preservative68
Manufacturer,
Cytarabine
100 mg NS, D5W, SWI or 20 mg/mL69 reconstituted with NS, D5W69 0.5 mg/mL: 48 h - for high dose use,
(Pfizer) BWI69 NS, D5W or SWI: RT55,69 do not use diluent
(RT)(PFL) discard at end of containing benzyl
no preservative69 100 mg: 5 mL69 day55,69 8-32 mg/mL: 48 h alcohol69
reconstituted with RT55,69
BWI: 48 h RT69
Cytarabine
IT injection N/A 100 mg/mL68 24 h RT68 diluents containing use within 4 h of - auxiliary label71:
100 mg/1 mL preservatives should initial vial puncture9,11 “IT”
1000 mg/10mL record time of NOT be used for - label to include
2000 mg/20mL puncture intrathecal route in full (i.e.,
(Hospira) administration68 INTRATHECAL
(RT)(PFL) injection) attached to
no preservative68 qs to 6 mL with both syringe and
preservative free NS70 outer ziplock bag71
Cytarabine
IT injection preservative-free 20 mg/mL69 discard at end of diluents containing use within 4 h of - auxiliary label71:
100 mg NS69 day55,69 preservatives should initial vial puncture9,11 “IT”
(Pfizer) NOT be used for - label to include
(RT)(PFL) 100 mg: 5 mL69 intrathecal route in full (i.e.,
no preservative69 administration69 INTRATHECAL
injection) attached to
qs to 6 mL with both syringe and
preservative free NS70 outer ziplock bag71
Manufacturer,
Cytarabine
SC injection: 100 mg: 5 mL BWI72 20 mg/mL72 48 h RT72,73 syringe 14 d F, 48 h RT73 - for high dose use,
100 mg do not use diluent
(Pfizer) containing benzyl
(RT)(PFL) alcohol74
no preservative72 - do not use for IT
injection
Dacarbazine
100 mg 100 mg: 9.9 mL 10 mg/mL75 72 h F, 8 h RT75 250-1000 mL* NS or 24 h F, 8 h RT75 - protect container
200 mg SWI75 D5W from light during
(Abraxis) 200 mg: 19.7 mL **(PFL)9,75 storage and
(F)(PFL) SWI75 administration76
no preservative75 see Special - overfill unknown
Precautions/Notes
Column
Dacarbazine
200 mg 200 mg: 19.7 mL 10 mg/mL77 48 h F, 8 h RT77 0.19–3.0 mg/mL11,77 24 h F77 - protect container
600 mg SWI77 from light during
(Hospira) 600 mg: 59.1 mL (PFL)78 250-1000 mL* NS or **(PFL)76 storage and
(F)(PFL) SWI77 D5W see Special administration76
no preservative77 Precautions/Notes - no overfill35,78
Column
Manufacturer,
Dactinomycin
0.5 mg 1.1 mL SWI 0.5 mg/mL discard at end of syringe79 use within 4 h of - drug loss reported
(Lundbeck) (preservative-free)79 (500 mcg/mL)79 day55 initial vial puncture55 with some cellulose
(RT)(PFL) ester membrane in-
no preservative79 Do NOT use SWI line filters79
with preservative
(may form 10 mcg/mL or
precipitate)79 greater79
D5NS79
Dactinomycin
0.5 mg 1.1 mL SWI 0.5 mg/mL81 24 h F, RT82 syringe81,83 24 h F, RT55 - do not filter81,83
(Ovation)80 (preservative-free)81 (500 mcg/mL)
(RT)(PFL)
no preservative81 Do NOT use SWI
with preservative
(may form
precipitate)81
DAUNOrubicin
20 mg 4 mL SWI84 5 mg/mL84,87 48 h F, 24 h RT86 100-250 mL in 24 h RT, 48 h F84
(Erfa Canada Inc.)84 isotonic solution e.g.,
(RT)(PFL)85 NS84
no preservative86
no data for D5W86
Manufacturer,
DAUNOrubicin
20 mg 4 mL SWI88 5 mg/mL88 24 h RT, 48 h F88 100-250 mL 48 h F, 24 h RT88
(Teva/Novopharm) NS or D5W9
(RT)(PFL) (PFL)88 **(PFL)88
no preservative88
Degarelix
80 mg 80 mg: 4.2 mL SWI 20 mg/mL89 2 h RT89 SC syringe89 2 h RT90
120 mg (supplied diluent)89
(Ferring)
(RT)
do not shake 120 mg: 3 mL SWI 40 mg/mL89
no preservative89 (supplied diluent)89
do NOT use
bacteriostatic water
for injection89
swirl gently; keep

vial vertical at all
times89
reconstitution may
take up to 15 min89
Manufacturer,
Denosumab
(XGEVA) N/A 71 mg/mL91 discard unused SC syringe91 use within 4 h of - not interchangeable
120 mg/1.7 mL portion55,91 initial puncture55 with PROLIA91
(Amgen) - do not use if
(F)(PFL) solution is cloudy;
do not shake trace amounts of
no preservative91 translucent to white
proteinaceous
particles are
acceptable91
- avoid vigorous
shaking91
- bring to room
temperature 15-30
minutes prior to
administration91
Dexrazoxane
250 mg supplied diluent92: 10 mg/mL92 6 h F92 empty viaflex bag92 6 h RT93
500 mg 250 mg: 25 mL
(Pfizer) 500 mg: 50 mL
(RT)
no preservative92
Manufacturer,
Dexrazoxane (same
formulation, no SWI94 10 mg/mL94 30 min RT, 4 h MUST BE FURTHER 1 h RT, 4 h F94
diluent provided) F94 DILUTED With
250 mg 250 mg: 25 mL Lactated Ringers
500 mg 500 mg: 50 mL Injection to 1.3 – 3.0
(Pfizer) mg/mL94
(RT)
no preservative94
Manufacturer,
DOCEtaxel
20 mg/2 mL N/A 10 mg/mL95 20mg/2 mL vial: 0.3-0.74 mg/mL95 complete - use non-PVC (non-
80 mg/8 mL discard unused administration within DEHP) bag and IV
160 mg/16 mL portion26,95 (250 mL NS or 4 h F,95 48 h RT26,96 administration set95
(Hospira) D5W)95 - do not use chemo
(F, RT)(PFL) dispensing pins97
preservative95
80 mg/8 mL or
160 mg/16 mL
vial (maximum
number of
punctures: up to 3
doses can be
removed when a
venting needle is
also inserted, i.e.,
6 punctures
total)98
14 d F26,95
**(PFL)26,95
Manufacturer,
DOCEtaxel
20 mg/0.5 mL supplied diluent : 10 mg/mL99 48 h F, RT26,99,100 0.3-0.74 mg/mL99 complete - use non-PVC (non-
80 mg/2 mL - if vials were administration within DEHP) bag and IV
(sanofi-aventis) refrigerated, allow to (250 mL NS or 4 h F,99 administration set99
(F, RT)(PFL) warm for 5 min at D5W)99 48 h RT26,100
no preservative99 RT. Withdraw entire
contents of the
diluent and inject the
entire contents of
the syringe into the
corresponding
concentrate vial. Mix
by repeated
inversions for 45
sec99
DO NOT SHAKE99
Let sit for 5

minutes99
DOXOrubicin
10 mg NS, SWI, D5W101 2 mg/mL101 48 h F, 24 h syringe101 48 h F, 24 h RT11,102
50 mg (NS reconstitution RT11,101
150 mg takes longer)
(Hospira) 10 mg: 5 mL
(RT)(PFL) 50 mg: 25 mL
no preservative101 150 mg: 75 mL
Manufacturer,
DOXOrubicin
10 mg/5 mL N/A 2 mg/mL103 8 h103 syringe103 48 h F, 24 h RT103
20 mg/10 mL from initial vial
50 mg/25 mL record time of 100 mL* NS puncture
200 mg/100 mL puncture
(Teva/Novopharm)
(F)(PFL)
no preservative103
DOXOrubicin
10 mg/5 mL N/A 2 mg/mL104 discard unused syringe104 48 h F, 24 h RT104
50 mg/25 mL portion55,104
200 mg/100 mL 100 mL* NS
(Pfizer)
(F)
no preservative104
DOXOrubicin
Pegylated Liposomal N/A 2 mg/mL105 discard unused Less than 90 mg: 250 24 h F105 - do not filter105
20 mg/10 mL portion105 mL D5W only105
(Janssen)
(F) Greater than or equal
no preservative105 to 90 mg: 500mL
D5W only105
Manufacturer,
DOXOrubicin
Pegylated Liposomal N/A 2 mg/mL106 discard unused Less than 90 mg: 250 24 h F106 - do not filter106
20 mg/10 mL portion106 mL D5W only106
50 mg/25 mL
(Schering) Greater than or equal
(F) to 90 mg: 500mL
no preservative106 D5W only
Epirubicin
10 mg/5 mL N/A 2 mg/mL107 8 h F, RT107 syringe107 48 h F, 24 h RT
50 mg/25 mL puncture107
150 mg/75 mL
200 mg/100 mL
(Novopharm)
(F)(PFL)
no preservative107
Epirubicin
10 mg/5 mL N/A 2 mg/mL108 8 h108 syringe108 48 h F, 24 h RT
200 mg/100 mL record time of puncture108
(PPC) puncture
(F)(PFL)
no preservative108 100 mL* NS or D5W 2 d F, RT:
NS or D5W26,108
Manufacturer,
Epirubicin
10 mg/5 mL N/A 2 mg/mL109 8 h109 syringe109 48 h F, 24 h RT from
50 mg/25 mL initial vial puncture109
200 mg/100 mL record time of
(Pfizer) puncture
(F)(PFL) 100 mL* NS or D5W9 2 d F, RT: NS or
no preservative109 D5W52
Eribulin
1 mg/2 mL N/A 0.5 mg/mL110 discard at end of IV syringe110 24 h F, 6 h RT110 - do not administer
(Eisai Limited) day26,110 through dextrose
(RT)(PFL)110 containing lines110
no preservative26 0.005-0.2 mg/mL NS 48 h F, 24 h RT110 - vials contain
only110 dehydrated alcohol
USP (5% v/v)110
100 mL* NS110
Etoposide
100 mg/5 mL N/A 20 mg/mL111 14 d RT9,11,112-114 0.2– 0.4 mg/mL111 0.2 mg/mL: - use non-PVC bag
500 mg/25 mL 48 h RT11,111 and tubing only
1000 mg/50 mL 500 mL* NS or
(BMS) D5W111 0.4 mg/mL:
(RT) 24 h RT111
preservative111
Manufacturer,
Etoposide
100 mg/5 mL N/A 20 mg/mL115 discard unused NS 0.2-0.3 mg/mL: - use non-PVC bag
200 mg/10 mL portion115 7 d F,116 2 d RT116,117 and tubing only
500 mg/25 mL Stability is
1000 mg/50 mL concentration 0.4-0.5 mg/mL:
(Teva/Novopharm) dependent 1 d F,116 1d RT116
(RT)(PFL)
no preservative115 0.6-9.0mg/mL:
generally unstable
9.5 mg/mL:
2 d F,116 1d RT116
10-12 mg/mL:
7 d F,116 2 d RT116,117
D5W115 4 h RT115,118
Fludarabine
50 mg 2 mL SWI119 25 mg/mL119 48 h F or RT11,52 dilute to maximum of 48 h F, RT11,52
(Berlex) 1 mg/mL119,120
(F)
no preservative119 50-100 mL* NS or
D5W119
Manufacturer,
Fludarabine
50 mg N/A 25 mg/mL121 discard unused dilute to maximum of 48 h F, 24 h RT121
(Teva/Novopharm) portion121 1 mg/mL121
(F)
no preservative121 50-100 mL* NS or
D5W
Fluorouracil
5000 mg/100 mL N/A 50 mg/mL122 8 h RT122,123 syringe11 48 h RT11,19,123
(Hospira)
(RT)(PFL)
no preservative122
2-10 mg/mL in 24 h RT122,123

D5W122,123
50-1000 mL* D5W
CIVI: ambulatory complete within

pump123 8 d9,11,124
Manufacturer,
Fluorouracil
500 mg/10 mL N/A 50 mg/mL125 4 h RT26 syringe 4 h RT26
5000 mg/100 mL
(Sandoz)
(RT)(PFL)
no preservative125
D5W125 24 h RT125
CIVI: ambulatory complete within

pump123 8 d9,11,124
Gemcitabine
200 mg 200 mg: 5 mL NS 38 mg/mL126 24 h RT126 0.1 - 10 mg/mL NS126 48 h RT113,127
1000 mg 1000 mg: 25 mL NS
2000 mg 2000 mg: 50 mL
(Accord Healthcare) NS126
(RT)
no preservative126
Manufacturer,
Gemcitabine
200 mg 200 mg: 5 mL NS 38 mg/mL128 48 h RT128,129 syringe128 48 h RT11,128,129
1000 mg 1000 mg: 25 mL
(Eli-Lilly) NS128
(RT)
no preservative128
0.1–10 mg/mL 48 h F, RT11,128,129
NS128,129
Gemcitabine
200 mg N/A 38 mg/mL130 discard unused 0.1– 38 mg/mL NS, 24 h RT130
1000 mg portion at the end D5W130
2000 mg of the day130
(Hospira)
(F)
no preservative130
Gemcitabine
200 mg 200 mg: 5 mL NS 38 mg/mL131 48 RT55,131,133 syringe131 24 h RT131,133
1000 mg 1000 mg: 25 mL NS
2000 mg 2000 mg: 50 mL
(Hospira) NS131
(RT)131
no preservative132
0.1 - 26 mg/mL 48 h RT55,133
NS131,133
Manufacturer,
Gemcitabine
200 mg 200 mg: 5mL NS 38 mg/mL134 24 h RT134 0.1 - 38 mg/mL NS134 24 RT134
1000 mg 1000 mg: 25 mL
(Teva/Novopharm) NS134
(RT)
no preservative134
Gemcitabine
200 mg 200 mg: 5 mL NS 38 mg/mL135 48 h RT135,136 syringe135 48 h RT135-137
1000 mg 1000 mg: 25 mL
(Sandoz Standard) NS135
(RT)
no preservative135
0.1 - 38 mg/mL NS or 48 h RT11,139

D5W135,138
IDArubicin
5 mg 5 mg: 5 mL SWI140 1 mg/mL140 48 h F, syringe140 48 h F, 24 h RT140 - avoid alkaline
10mg 10 mg: 10 mL 24 h RT140 solutions140
(Pfizer) SWI140
(RT)(PFL) **(PFL)140
no preservative140 vial contents under
negative pressure140
do NOT use BWI to

reconstitute140
Manufacturer,
IDArubicin PFS
5 mg/5 mL N/A 1 mg/mL140 24 h RT, syringe140 4 h from initial - avoid alkaline
10 mg/10 mL 48 h F puncture26 solutions140
20 mg/20 mL
(Pfizer) **(PFL)140
(F)(PFL)
no preservative140
IDArubicin
5 mg/5 mL N/A 1 mg/mL141 discard unused syringe141 4 h from initial - avoid alkaline
10 mg/10 mL solution141 puncture26 solutions141
20 mg/20 mL
(PPC)
(F)(PFL)
no preservative141
Ifosfamide
1000 mg 1000 mg: 20 mL 50 mg/mL142 48 h F11,142 0.6–20 mg/mL142 72 h F142
3000 mg SWI142
(Baxter) 3000 mg: 60 mL 500–1000 mL* NS, 24 h F, RT when
(RT)9 SWI D5W, D5-NS, mixed with mesna9
no preservative142 D5-1/2NS, Lactated
shake well Ringer’s9,142 D5W or Lactated
Ringer’s when mixed
Manufacturer,
Ifosfamide
1000 mg 1000 mg: 20 mL 50 mg/mL143 72 h F, 0.6-20 mg/mL143 72 h F
3000 mg SWI 24 h RT143 24 h RT143
(PPC) 3000 mg: 60 mL
(RT) SWI143 500-1000 mL* NS 24 h F, RT when
no preservative143 D5W; Lactated mixed with mesna9
shake well Ringer’s143
D5W or Lactated
Ringer’s when mixed
Iniparib
100 mg/10 mL N/A 10 mg/mL144 discard unused 250 mL NS, D5W 24 h RT144 - *may also use
(sanofi-aventis) portion144 empty IV bag and qs
(F) dilute to 250 mL final to final volume of
no preservative144 volume by 250 mL with NS,
withdrawing volume D5W144
from bag equal to
volume of drug to be
added*144
Interferon Alfa -2b

18 million units/3 mL N/A 6 million 48 h F11,145 syringe145 2 d F11,147
(Schering) units/mL145
(F)(or up to 7 days at
RT before use)145 Greater than or equal 24 h F, RT147
preservative146 to 0.3 million IU/mL145
50 mL NS145
Manufacturer,
Interferon Alfa -2b
10 million units/1 mL N/A 10 million 48 h F11,145 syringe145 2 d F11,147
25 million units/2.5 mL units/mL145
(Schering)
(F)(or up to 7 days at ≥ 0.3 million IU/mL145 24 h F, RT147
RT before use)145
preservative146 50 mL NS145
Interferon Alfa -2b

10 million units 1 mL supplied 10 million 24 h F145 syringe145 24 h F, RT147
(Schering) diluent (SWI)145 units/mL145
(F)145
no preservative (unless do not shake; roll to
reconstituted with reconstitute145 Greater than 48 h RT9,11
BWI)146 0.1 million IU/mL147
100 mL NS148
1 mL BWI145 48 h F, RT11,145 syringe148 14 d F, 48 h RT11,148
do not shake; roll to

reconstitute145 100 mL NS148 48 h RT9,11
Manufacturer,
Interferon Alfa -2b
18 million units 1 mL supplied 18 million 24 h F145 syringe145 24 h F, RT147
(Schering) diluent145 units/mL145
(F)145
no preservative (unless do not shake; roll to > 0.1 million IU/mL149 48 h RT9,11
reconstituted with reconstitute145
BWI)146 100 mL NS148
1 mL BWI145 48 h F, RT11 syringe145 14 d F11,148
do not shake; roll to

reconstitute145 100 mL NS148 48 h RT9,11
Ipilimumab
50 mg/10 mL N/A 5 mg/mL150 24 h F,RT150 1 – 4 mg/mL in 24 h F,RT150 - do NOT shake150
200 mg/40 mL NS, D5W 100 mL150 - administer with 0.2
(BMS Canada) or 0.22 low protein
(F)(PFL) OR binding in-line filter150
no preservative150 undiluted in empty - vials may contain
viaflex bag or glass translucent-to-white
bottle amorphous
particles150
(allow vials to stand at - discard if cloudy or
RT for ~5 min prior to has pronounced
withdrawal of colour change
contents)150 (should be clear to
pale yellow)150
- flush line with NS or
D5W after infusion150
Manufacturer,
Irinotecan
40 mg/2 mL N/A 20 mg/mL151 2 days RT11,152,153 0.12– 2.8 mg/mL151 24 h RT: D5W, NS151 - do NOT refrigerate
100 mg/5 mL if in NS154
500 mg/25 mL 500 mL9 D5W 48 h F: D5W
(Hospira) (preferred), NS151 **(PFL)151
(RT)(PFL)
no preservative151
Irinotecan
40 mg/2 mL N/A 20 mg/mL154 discard unused 0.12– 2.8 mg/mL154 24 h RT: D5W, NS154 - do NOT refrigerate
100 mg/5 mL portion154 if in NS154
(Pfizer) 500 mL9 D5W 48 h F: D5W
(RT)(PFL) (preferred), NS154 **(PFL)154
no preservative154
Irinotecan
40 mg/2 mL N/A 20 mg/mL155 discard unused 0.12-2.8 mg/mL155 24 h RT: D5W, NS155
100 mg/5 mL portion155,55
500 mg/25 mL D5W (recommended), 48 h F: D5W155
(Sandoz) NS155
(RT)(PFL) **(PFL)155
no preservative155
Manufacturer,
Ixabepilone
15 mg 15 mg: 8 mL 2 mg/mL156 1 h RT156 0.2 – 0.6 mg/mL in 6 h RT156 - use 0.2-1.2 micron
(contains 16 mg) supplied diluent156 Lactated Ringer’s in-line filter156
45 mg Injection USP (use - use non-PVC (i.e.,
(contains 47 mg) 45 mg: 23.5 mL non-PVC infusion DEHP-free)
(BMS) supplied diluent156 container)156 administration set156
(F)(PFL)
no preservative156
* Suggested volume based on usual dose range and any concentration range of stability data
** Protect from light means minimizing exposure to direct sunlight over a storage period. More specific information on protection from light (eg, protecting container and tubing during
administration) will be indicated in the Under the Special Precautions/Notes column.
Centres are not to change the content locally but should forward suggestions to the Cancer Drug Manual staff.
Explanatory Notes
Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the classification
outlined in USP 79719,157
Vial stability: Stability of solution after first puncture or reconstituted solution
Storage temperature: If information states same stability with refrigerator and room temperature storage, then fridge stability is bolded as preferred (ie, to minimize
growth of micro-organisms).
Discard unused portion: Unused portion from single use vials should be discarded at the end of the day.
“overfill known” is stated if the manufacturer states overfill that is present is within acceptable limits.
Abbreviations
PFL = protect from light
RT = room temperature
F = refrigerate
SWI = sterile water for injection
NS = normal saline
D5W = dextrose 5% in water
BWI = bacteriostatic water for injection
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BC CANCER AGENCY CHEMOTHERAPY PREPARATION AND STABILITY CHART

100 mL NS or D5W7 8 h F or RT6

transfer 1.5mL from

allow to stand for a

let sit for 5 min42

Do NOT use D5W57

Cassette: at least 7 days57

Do NOT use D5W

Cassette: at least 7 days61

NS, D5W, D5NS63

swirl gently; keep

Let sit for 5

2-10 mg/mL in 24 h RT122,123

50-1000 mL* D5W

CIVI: ambulatory complete within

CIVI: ambulatory complete within

0.1 - 38 mg/mL NS or 48 h RT11,139

do NOT use BWI to

Interferon Alfa -2b

Interferon Alfa -2b

1 mL BWI145 48 h F, RT11,145 syringe148 14 d F, 48 h RT11,148

do not shake; roll to

1 mL BWI145 48 h F, RT11 syringe145 14 d F11,148

do not shake; roll to

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