Chemo Stability Chart - LtoZ

BC CANCER 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)
Leucovorin
1 1,2
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8 h RT
1
(GMP) portion
(F)(PFL)
1
no preservative 0.05-10 mg/mL NS, D5W, LR,
NS, D5W, Ringer’s, Ringer’s:
1
LR, D10W, 24 h RT
1,2
D5-NS
D10W, D5-NS:
1
(e.g., 50-250 mL*) 8 h RT
Leucovorin
3 3 3
50 mg/5 mL N/A 10 mg/mL 8h syringe 8 h RT
500 mg/50 mL
(Pfizer/Hospira)
(F)(PFL) 0.05–10 mg/mL NS, NS, D5W, LR,
3
no preservative D5W, LR, Ringer’s, Ringer’s:
3 3
D10W, D5NS 24 h RT
(e.g., 50-250 mL*) D10W, D5NS:

3
8 h RT
BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 1/43
This document may not be reproduced in any form without the express written permission of BC Cancer Provincial Pharmacy.
Activation Date: 2 March 2006
Revised Date: 1 March 2020
Status)
Leucovorin
5 6,7
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8h
5
500 mg/50 mL portion
(Teva)
(F)(PFL)
4 8
no preservative 0.4 - 4.8 mg/mL NS, 72 h F, RT
8
D5W
(e.g., 50-250 mL*)
0.06 - 0.4 mg/mL NS, NS:

4 4
D5W 24 h RT
D5W:
4
12 h RT
0.06 - 1 mg/mL Ringer’s, LR:

4
Ringer’s, Lactated 24 h RT
Ringer’s, D10W,
4
D10-NS D10W:
4
12 h RT
D10NS:
4
6 h RT
Status)
Melphalan
9 9
50 mg 10mL supplied 5 mg/mL 2 h RT 0.1 – 0.45 mg/mL in complete
9 9
(GSK) diluent NS only administration within
(RT)(PFL) do NOT 60 min from time of
9
no preservative immediately after refrigerate (e.g., greater than 45 initial reconstitution at
10
adding diluent, mg and less than or RT
9
shake vigorously equal to 110 mg in
250 mL NS)*
record time of
reconstitution
Mesna
11 11
400 mg/4 mL N/A 100 mg/mL discard unused greater than 1 mg/mL 24 h RT
11
1000 mg/10 mL portion in D5W, D5½-NS,
11-13
(Baxter) (use filter needle to NS, LR
(RT) withdraw from
11
no preservative ampoule)
Mesna
11 11 11
1000 mg/10 mL N/A 100 mg/mL 8 days RT greater than 1 mg/mL 24 h RT
5000 mg/50 mL in D5W, D5½-NS,
11-13
(Baxter) (vial may be NS, LR
(RT) punctured up to 4
11 11
preservative times)
Mesna
14 14,15 14
1000 mg/10mL N/A 100 mg/mL 14 d F, RT greater than or equal 24 h RT, 48 h F
(Fresenius Kabi) to 1 mg/mL in NS,
16
(RT) D5W
14
preservative
Status)
Methotrexate
17
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
17
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
17 2
1 g/40mL portion 12 g/m as a single
18-22
(Accord) dose) : use
(RT)(PFL) 500 mg or 1 g: 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
17 17 17 17 17
no preservative 8 h RT D5W initial puncture methotrexate
- do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 17
(e.g., 1-12 g/m as a initial puncture
18-22
single dose) : 1000
mL* NS **(PFL)
Methotrexate
17 2
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info
17 2
Only preservative free portion preservative free puncture - label to include
24,25
methotrexate may be NS route in full (i.e.,
administered by the INTRATHECAL
23
intrathecal route injection) attached
50 mg/2mL to both syringe and
26
(Accord) outer ziplock bag
(RT)(PFL)
17
no preservative
Status)
Methotrexate
17 2,17 2
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
17
500 mg/20mL alcohol
(Accord) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
17 high-dose
17
preservative D5W
17 regimens (e.g., 1-
2
12 g/m as a single
17
(100 mL* NS, D5W) dose)
- do NOT use for IT
17
injection
Methotrexate
27
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
27
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
27 2
1 g/40mL portion 12 g/m as a single
18-22
2.5 g/100 mL dose) : use
(Pfizer/Hospira) 500 mg, 1 g, or 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
27 27 27
(RT)(PFL) 2.5 g: D5W initial puncture methotrexate
27 27
no preservative 8 h RT - do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 27
(e.g., 1-12 g/m as a initial puncture
18-22
single dose) : 1000
mL* NS **(PFL)
Status)
Methotrexate
27 2
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info :
27 15
Only preservative free portion preservative free puncture “IT”
24,25
methotrexate may be NS - label to include
administered by the route in full (i.e.,
23
intrathecal route INTRATHECAL
50 mg/2mL injection) attached
(Pfizer/Hospira) to both syringe and
26
(RT)(PFL) outer ziplock bag
27
no preservative
Methotrexate
27 15,27 15
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
27
500 mg/20mL alcohol
(Pfizer/Hospira) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
27 high-dose
27
preservative D5W
27 regimens (e.g., 1-
2
12 g/m as a single
27
(100 mL* NS, D5W) dose)
- do NOT use for IT
27
injection
Mitomycin
28 28 28 28
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Accord)
28 28 28
(RT)(PFL) shake well **(PFL) **(PFL)
28
no preservative
Status)
Mitomycin
28 28 28 28
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
28 28 28
(Accord) shake well **(PFL) **(PFL)
(RT)(PFL)
28
no preservative
29 29
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
28 30 30,31
shake well to prevent precipitation solubility
30
precipitation - do NOT
30
refrigerate
32 32
25 mL SWI 0.8 mg/mL discard unused syringe 4 days RT - do NOT
2,32 32
portion refrigerate
2,32
shake well **(PFL)
2,32
**(PFL)
32 32
33.3 mL SWI 0.6 mg/mL discard unused syringe 4 days F, RT
2,32
portion
2,32
shake well **(PFL)
2,32
**(PFL)
Mitomycin
28 28 28 28
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS:
28
20 mg 3 h RT, 18 h F
28 28 28
(Accord) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
28 28
no preservative 3 h RT, 6 h F
Status)
Mitomycin
33 33 33 33
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Teva/Novopharm)
33 33 33
(RT)(PFL) shake well **(PFL) **(PFL)
33
no preservative
Mitomycin
33 33 33 33
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
33 33 33
(Teva/Novopharm) shake well **(PFL) **(PFL)
(RT)(PFL)
33
no preservative
29 29
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
33 30 30,31
shake well to prevent precipitation solubility
30
precipitation - do NOT
30
refrigerate
32 32
25 mL SWI 0.8 mg/mL discard unused syringe 4 days RT - do NOT
2,32 32
portion refrigerate
2,32
shake well **(PFL)
2,32
**(PFL)
32 32
33.3 mL SWI 0.6 mg/mL discard unused syringe 4 days F, RT
2,32
portion
2,32
shake well **(PFL)
2,32
**(PFL)
Status)
Mitomycin
33 33 33 33
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS:
33
20 mg 6 h RT, 18 h F
33 33 33
(Teva/Novopharm) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
33 33
no preservative 6 h RT, F
mitoXANTRONE
34 34 34
20 mg/10 mL N/A 2 mg/mL discard unused NS, D5W 24 h RT
34
(Fresenius Kabi) portion
(RT) Greater than or equal
34 34
no preservative to *50 mL
mitoXANTRONE
35 35
20 mg/10 mL N/A 2 mg/mL discard unused 0.2-0.6 mg/mL NS, 72 h F, 24 h RT
35 35
25 mg/12.5 mL portion D5W
35
30 mg/15 mL **(PFL)
(Pfizer/Hospira) Greater than or equal
35
(RT)(PFL) to *50 mL
35
no preservative
Status)
Nivolumab
36
40 mg/4 mL N/A 10 mg/mL discard unused 1-10 mg/mL NS, complete - administer with a
36 36
100 mg/10 mL portion D5W administration within 0.2 to 1.2 micron
36 36
(BMS) 8 h RT or 24 h F in-line filter
(F)(PFL) (50-100* mL) - discard if cloudy
36
do not shake **(PFL) or has pronounced
36
no preservative mix by gentle colour change
inversion; do not (should be clear to
36 36
shake pale yellow)
oBINutuzumab
37 37,39
1000 mg/40 mL N/A 25 mg/mL discard unused 100 mg: 24 h F, 48 h RT -once removed
38 37
(Hoffman-La Roche) portion in 100 mL NS from the fridge,
**
(F)(PFL) diluted product is
do not shake 900 mg: stable for an
37 37
no preservative in 250 mL NS additional 48 h
37,39
RT
37
1000 mg: - do NOT shake
37
in 250 mL NS - do NOT use
dextrose containing
37
solutions
Status)
Octreotide
40 40 40 40
50 mcg/mL N/A 50 mcg/mL Use within 4 h NS 24 h RT
100 mcg/mL
40
500 mcg/mL 100 mcg/mL volume adjusted to
(Omega) ensure a continuous
40
(F)(PFL) 500 mcg/mL infusion of octreotide
40 40
no preservative at 25 mcg/hour
Octreotide
40 40 40 40
multidose vial: N/A 200 mcg/mL 15 d F NS 24 h RT
1000 mcg/5 mL
(Omega) volume adjusted to
(F)(PFL) ensure a continuous
40
preservative infusion of octreotide
40
at 25 mcg/hour
Octreotide
41 41 41
50 mcg/mL N/A 50 mcg/mL discard unused SC syringe use within 4 h
41
100 mcg/mL portion
41
500 mcg/mL 100 mcg/mL
(Teva/Novopharm)
41 41 41
(F)(PFL) 500 mcg/mL infusion: NS 24 h RT
41
no preservative
Status)
Octreotide
41 41,42 41,42
multidose vial: N/A 200 mcg/mL 14 d F SC syringe use within 14 d F
1000 mcg/5 mL
(Teva/Novopharm)
41 41
(F)(PFL) infusion: NS 24 h RT
41
preservative
Octreotide
43 10,45,46 45
(SANDOSTATIN®) N/A 200 mcg/mL discard unused 50–200 mL NS 24 h RT
44
1000 mcg/5 mL portion
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
43
preservative infusion rate of 25
45
mcg/h
Octreotide
10,46 45
(SANDOSTATIN®) N/A 50 mcg/mL discard unused 50-100 mL 24 h RT
45
50 mcg/1 mL 100 mcg/mL portion
43 45
100 mcg/1 mL 500 mcg/mL NS
500 mcg/1 mL
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
43
no preservative infusion rate of 25
45
mcg/h
Status)
Octreotide
(SANDOSTATIN LAR®) 2 mL supplied 10 mg: 5 mg/mL discard unused deep intragluteal use within 4 h of initial - do NOT shake
45 45 7,45
10 mg diluent portion administration only reconstitution
20 mg 20 mg: 10 mg/mL
30 mg gently run 2 mL
45
(Novartis) down sides of the 30 mg: 15 mg/mL
(F)(PFL) vial; do NOT disturb
44
no preservative for 2–5 min, then
45
swirl moderately
record time of
reconstitution
Olaratumab
47 47
500 mg/50 mL N/A 10 mg/mL discard unused dilute to a final complete - do NOT shake
38,47
(Lilly) portion volume of 250 mL administration within
47
(F)(PFL) NS 24 h F, plus an
47
do not shake additional 12 h RT
47
no preservative do NOT use D5W or
other dextrose
47
containing solutions
47
gently invert to mix
Status)
Oxaliplatin
48
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-0.4 mg/mL: - do NOT use
48
100 mg/20 mL portion 24 h RT aluminum-
48
200 mg/40 mL (0.2-0.7 mg/mL or containing needle,
48
(Hospira/Pfizer) 5 d F plus an syringe or tubing
48,50
(RT) do NOT use NS or additional 8 h RT
48
no preservative other chloride-
49
containing solutions 0.5–2 mg/mL:
24 h RT
do NOT use or
aluminum-containing 14 d F plus an
49 48,50
needle and syringe additional 8 h RT
Oxaliplatin
49 38,51 49
50 mg/10 mL N/A 5 mg/mL 2 d F, RT 0.2-0.7 mg/mL 0.2-2 mg/mL:
49
100 mg/20 mL 24 h RT, 48 h F
49
150 mg/30 mL 250-500 mL D5W
200 mg/40 mL
(Sandoz) do NOT use NS or
(RT)(PFL) other chloride-
49 49
no preservative containing solution
do NOT use
aluminum-containing
49
needle and syringe
Status)
Oxaliplatin
52
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
52 52
100 mg/20 mL portion 24 h RT, 48 h F aluminum-
52
200 mg/40 mL (0.2-0.7 mg/mL) containing needle,
52
(Teva) syringe or tubing
(RT)(PFL) do NOT use NS or
52
no preservative other chloride-
52
containing solution
do NOT use
aluminum-containing
52
needle and syringe
PACLitaxel
53
30 mg/5 mL N/A 6 mg/ mL 30 mg: 0.3-1.2 mg/mL in NS, complete - use non-DEHP
38,53 53
100 mg/16.7 mL 48 h RT D5W, D5NS, D5LR administration within bag and tubing with
53
300 mg/50 mL 27 h RT 0.22 micron in-line
53
(Accord) 100 mg: (e.g., 100-1000 mL)* filter
38,53
(RT)(PFL) 48 h RT - avoid excessive
53 53
no preservative shaking
300 mg:
53
24 h RT
Status)
PACLitaxel
55 38,56
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
55
100 mg/16.7 mL D5W administration within bag and tubing with
55,57
300 mg/50 mL 27 h RT 0.22 micron in-line
55
(Biolyse) (e.g., 100-1000 mL)* filter
54
(RT)
55
no preservative
58 58
0.1 mg/mL in NS 44 h F, RT
57
0.012-0.12 mg/mL in 16 h RT
59
NS
devices with spikes

(e.g., chemo
dispensing pins) may
60
be used with vials
PACLitaxel
62 38,62,63
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
100 mg/16.7 mL D5W, D5-NS, administration within bag and tubing with
62 62
150 mg/25 mL D5-LR 27 h RT 0.22 micron in-line
62
300 mg/50 mL filter
(Hospira) (e.g., 100-1000 mL)*
(RT)(PFL)
61
preservative
Status)
PACLitaxel,
64 64
nanoparticle, albumin- 20 mL NS 5 mg/mL use immediately in empty sterile PVC, 48 h F plus an - each vial contains
65
bound (nab) (RT) or non-PVC, or non- additional 8 h RT 900 mg human
64 64 64
100 mg - slowly direct 8hF DEHP infusion bag albumin
(Celgene) diluent against side - to prevent
64
(RT)(PFL) of vial (i.e., greater **(PFL) foaming, do NOT
64
no preservative than or equal to 1 inject NS directly
64
min) during onto the powder
64
reconstitution - some settling may
occur; use mild
- let stand for agitation to
64
greater than or resuspend
equal to 5 min to wet - administer using
64
powder a 15 micron filter
ONLY
- gently swirl or (NOTE:filters with a
invert for greater pore size less than
than or equal to 2 15 microns may
64
min cause filter
66,67
blockage)
Pamidronate
68 68
30 mg/10 mL N/A 3 mg/mL discard unused Less than or equal to 24 h RT - do NOT mix with
68 68
60 mg/10 mL portion 0.36 mg/mL NS, calcium containing
68 68
90 mg/10 mL D5W solutions
68
(Fresenius Kabi) 6 mg/mL
(RT)
68
no preservative
68
9 mg/mL
Status)
Pamidronate
69
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
69 69 69
60 mg/10 mL portion NS, D5W RT (total 48 h) calcium containing
90 mg/10 mL solution (e.g.,
69 69 69
(Hospira) 6 mg/mL **(PFL) Ringer’s)
(RT)
69
no preservative
69
9 mg/mL
Pamidronate
70 70
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
70 70 70
70 70 70
(Omega) 6 mg/mL **(PFL) Ringer’s)
(RT)
70
no preservative
70
9 mg/mL
Pamidronate
71
30 mg/10 mL N/A 3 mg/mL discard unused 0.06-0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
71 71 71
71 71 71
(Pfizer) 6 mg/mL **(PFL) Ringer’s)
(RT)
71
no preservative
71
9 mg/mL
Status)
Pamidronate
72 72 72
30 mg/10 mL N/A 3 mg/mL discard unused NS; D5W 24 h RT - do NOT mix with
42,72
60mg/10 mL portion calcium containing
72 72
(Sandoz Canada) 6 mg/mL Ringer’s)
RT
72
no preservative
72
9 mg/mL
PANitumumab
73 73,74
100 mg/5 mL N/A 20 mg/mL discard unused Less than or equal to 24 h F, 6 h RT - administer with
73
400 mg/20 mL portion 1000 mg: 0.2 or 0.22 micron
73 73
(Amgen) 100 mL NS in-line filter
(F)(PFL) - solution may
do not shake Greater than 1000mg: contain particulates
73 73
no preservative 150 mL NS which do not affect
73
product quality
73,74
1-10mg/mL - do not administer
73
if discoloured
Status)
pegaspargase
75 75
(pegylated N/A 750 units/mL discard unused IM: syringe: - do NOT shake
75
asparaginase E. coli) portion max volume: use within 4 h of vial
38,75
3750 units/5 mL 2 mL in children and puncture
(Shire) adolescents;
(F)(PFL) 3 mL in adults
do not shake
75
no preservative if volume greater than
above, use multiple
75
sites
IV: bag:
75
100 mL NS, D5W use within 4 h of vial
38,75
puncture
Pembrolizumab
76
100 mg/4 mL N/A 25 mg/mL discard unused 1-10 mg/mL complete - use a 0.2 to 5
2,76 76
(Merck) portion NS, D5W administration within micron in-line
76 76
(F)(PFL) 96 h F, 6 h RT filter
do not shake mix by gentle - allow vials and
76 76
no preservatives inversion diluted solutions to
come to RT prior to
76
use
- vials contain 0.25
76
mL overfill
Status)
Pembrolizumab
77 77 77
50 mg 2.3 mL SWI 25 mg/mL 6 h RT, 24 h F 1-10 mg/mL NS, complete - use 0.2 to 5
77
(Merck) D5W administration within micron in-line
77 78
(F) direct diluent against 24 h F, 6 h RT filter
77
no preservative side of vial during mix by gentle - allow
77
reconstitution to inversion reconstituted vials
77
avoid foaming and diluted
solutions to come
77
allow up to 5 to RT prior to use
minutes for bubbles - vials can be at RT
77
to clear for up to 24 h prior
77
to use
77
do NOT shake - vials contain 20%
77
overfill
Pemetrexed
79 79 79
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
79 79
500 mg 4.2 mL NS NS calcium containing
(Accord) solution (e.g.,
79
(RT) 500 mg: Ringer’s)
79 79
no preservative 20 mL NS
Pemetrexed
80 80 80
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
80 80
500 mg 4.2 mL NS NS calcium containing
(Eli Lilly) solution (e.g.,
81
(RT) 500 mg: Ringer’s)
80
no preservative 20 mL preservative-
80
free NS
Status)
PERTuzumab
82 82 82
420 mg/14 mL N/A 30 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT use
38,82
(Roche) portion dextrose containing
82 82
(F)(PFL) do NOT shake mix by gentle solutions
82
no preservative inversion to avoid
82
foaming
Plerixafor
83 83 42,84
24 mg/1.2 mL N/A 20 mg/mL discard unused SC syringe 48 hours RT
83
(sanofi-aventis) portion
(RT)
83
no preservative
Polatuzumab vedotin
85 85 85 85 85
140 mg 7.2 mL SWI 20 mg/mL 48 h F, 8 h RT 0.72-2.7 mg/mL NS, in NS : - do NOT shake
85
(Genentech) D5W, ½NS 24 h F, 4h RT - use 0.2-0.22
85
(F)(PFL) direct diluent against (PFL) micron in-line
85 85
do not shake side of vial during (dilute to a minimum in D5W : filter
85 85 85
no preservative reconstitution volume of 50 mL) 36 h F, 4 h RT
85
gently invert bag to in ½NS :
85
mix 18 h F, 4 h RT
Pralatrexate
86 86 87 86
20 mg/1 mL N/A 20 mg/mL discard unused syringe 24 h F, RT - do NOT dilute
2
40 mg/2 mL portion
87
(Servier) **(PFL)
(F)(PFL)
86
no preservative
Status)
Raltitrexed
88 88 88
2 mg 4 mL SWI 0.5 mg/mL 24 h F, RT 50-250 mL NS, complete
88
(Pfizer) D5W administration within
88
(F,RT)(PFL) 24 h F, RT
88
(no preservative)
Ramucirumab
89 89 89
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL* NS 4 h RT, 24 h F - use 0.22 micron
89 89
500 mg/50 mL portion filter
90
(Eli Lilly) (0.4 – 4 mg/mL) - do NOT use
(F)(PFL) dextrose containing
89 89
(do not shake) gently invert to mix solutions
89
no preservative
89
do NOT shake
riTUXimab
91
100 mg/10 mL N/A 10 mg/mL discard unused 1-4 mg/mL NS, NS: - once removed
2,91 91 91
500 mg/50 mL portion D5W 14 d F, 24 h RT from the fridge,
(Roche) product
(F)(PFL) (e.g., 250-500 mL)* D5W: compounded in NS
91 91
no preservative 24 h F, 12 h RT is stable for 24h
91
RT
- once removed
from the fridge,
product
compounded in
D5W is stable for
91
12h RT
Status)
riTUXimab
92 92 92
subcutaneous N/A 120 mg/mL discard unused SC syringe 48 h F plus 8 h RT - contains
92 92
1400 mg/11.7 mL portion hyaluronidase
1600 mg/13.4 mL - formulations are
(Roche) NOT
92
(F)(PFL) interchangeable
92
no preservative
romiDEPsin
93 93 93 93
10 mg 2.2 mL of supplied 5 mg/mL 8 h RT 500 mL NS 24 h RT - reconstituted
93,94
(Celgene Inc.) diluent solution will be
93 95
(RT) slightly viscous
38 93
no preservative swirl gently to mix - vials contain
overfill to allow for
full drug recovery
(drug vial contains
11 mg romidepsin;
diluent vial
contains 2.4 mL
93
diluent)
Status)
Siltuximab
96 96 96
100 mg 100 mg: 20 mg/mL 2 h RT 250 mL D5W complete - use 0.2 micron in-
96 96
400 mg 5.2 mL SWI administration within line filter
96
(Janssen) dilute to 250 mL final 6 h RT
(F)(PFL) 400 mg: volume by
96 96
no preservative 20 mL SWI withdrawing volume
from bag equal to
allow vial to come to volume of drug to be
96
room temperature added
prior to use (~30
96
minutes)
gently swirl, do NOT

96
shake
Streptozocin
97 97 97 97
1g 9.5mL NS, SWI, 100 mg/mL 48 h F, 24 h RT syringe 48 h F, 24 h RT
97
(Pfizer) D5W
(F)(PFL)
97 97
no preservative 50-500 mL* NS, 48 h F, 24 h RT
97
D5W, SWI
Temsirolimus
98,99 98,99 98,99
30 mg/1.2 mL 1.8 mL supplied 10 mg/mL 24 h RT 250 mL NS complete - use non-DEHP
98,99
(Wyeth) diluent administration within 6 bag and tubing with
98,99 98 98,99 98,99
(F)(PFL) **(PFL) h in-line filter
100
no preservative
Status)
Teniposide
101
50 mg/5 mL N/A 10 mg/mL discard unused 50 – 500 mL NS, 0.1-0.4 mg/mL: 24 h - do not refrigerate
101
(BMS) portion D5W for a final RT - use non-DEHP
101
(RT) concentration of 0.1-1 bag and tubing
101 101
preservative mg/mL 1 mg/mL: complete - do not use if
101,102
administration within 4 precipitates
h of preparation - contains DMA***
101,102
RT - excessive
agitation may
cause
101
precipitation
Thiotepa
103 103 103
15 mg 15 mg: 10 mg/mL 8hF reconstituted solution 4 h RT, 24 h F - do not use if
103
100 mg 1.5 mL SWI is hypotonic and must precipitates are
103
(Adienne/Methapharm) be further diluted with present
103
(F) 100 mg: NS prior to use - reconstituted
103 103
no preservative 10 mL SWI solution may be
doses ≤ 500 mg: used if
103
to remove haze, 500 mL NS or with an opalescent
filter through 0.22 appropriate volume to - administer with
micron filter after achieve 0.5-1 mg/mL 0.2 micron inline
104 103 103
reconstitution concentration filter
record time of doses > 500 mg:

103
reconstitution 1000 mL NS
Status)
Thiotepa
103 103 26
IT injection diluents containing 10 mg/mL 8hF qs to 6 mL with use within 4 h of initial - auxiliary info :
25 2
15 mg preservatives should preservative free NS reconstitution “IT”
100mg NOT be used for - label to include
(Adienne/Methapharm) intrathecal route in full (i.e.,
105
(F) administration INTRATHECAL
103
no preservative injection) attached
15 mg: to both syringe and
103 26
1.5 mL SWI outer ziplock bag
- do not use if
100 mg: precipitates are
103 103
10 mL SWI present
- reconstituted
to remove haze, solution may be
filter through 0.22 used if
103
micron filter after opalescent
104
reconstitution
record time of
reconstitution
Thyrotropin alfa
106 106 106 106 106
1.1 mg 1.2 mL SWI 0.9 mg/mL 24 h F syringe 24 h F
(Genzyme)
106
(F)(PFL) swirl contents
106
no preservative
do NOT shake
Status)
Tocilizumab
107 107
80 mg/4 mL N/A 20 mg/mL discard unused 100 mL NS complete - to prevent
107
200 mg/10 mL portion administration within foaming: slowly
107
400 mg/20 mL dilute to final volume 24 h F, RT add drug to
(Roche) by withdrawing infusion bag and
(F)(PFL) volume from bag bring to room gently invert bag to
107 107
no preservative equal to volume of temperature prior to mix
107 107
drug to be added administration
107
gently invert to mix
Topotecan
108 2,108
4 mg/4 mL N/A 1 mg/mL discard unused 0.025-0.5 mg/mL 14 d F, 48 h RT
2,108
(Accord) portion
(RT)(PFL) 50-100 mL NS,
108 108
no preservative D5W
Topotecan
109 109 109
1 mg 1 mg: 1 mg/mL 24 h F,RT 0.02-0.5 mg/mL 24 F, RT
109
4 mg 1.1 mL SWI
(Actavis) 50-100 mL NS,
109
(RT)(PFL) 4 mg: D5W
109 109
no preservative 4 mL SWI
Topotecan
110 110
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F, RT
2,110
(Pfizer/Hospira) portion
(F)(PFL) 50-100 mL NS,
110 110
no preservative D5W
Status)
Topotecan
111 111
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F
111
(Sandoz) portion
111
(F)(PFL) 50-100 mL NS, **(PFL)
111 111
no preservative D5W
Trastuzumab
112 38 112 112 112
(HERCEPTIN®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
112
440 mg BWI
(Roche) do NOT use dextrose
112
(F) swirl vial gently; containing solutions
112
no preservative allow to stand
undisturbed for 5
112
min
Trastuzumab
113 2,113 113 113 113
(HERZUMA®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
113
440 mg BWI - supplied BWI
(Celltrion/Teva) Do NOT use dextrose contains benzyl
113 113
(F) swirl vial gently; containing solutions alcohol
113
no preservative allow to stand
undisturbed for 5
113
min
Status)
Trastuzumab
114 114 114 114
(OGIVRI®) 150 mg vial: 21 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT shake
114 114
150 mg 7.2 mL SWI portion - supplied BWI
440 mg Do NOT use dextrose contains benzyl
114 114
(BGP) containing solutions alcohol
(F)
114 2,114
no preservative 440 mg vial: 14 d F
20 mL supplied
114
BWI
swirl vial gently;

allow to stand
undisturbed for 5
114
min
Trastuzumab
115 115 115 115
(TRAZIMERA®) 150 mg vial: 21 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT shake
115 115
150 mg 7.2 mL SWI portion - supplied BWI
440 mg Do NOT use dextrose contains benzyl
115 115
(Pfizer) containing solutions alcohol
(F)
115 2,115
no preservative 440 mg vial: 14 d F
20 mL supplied
115
BWI
swirl vial gently;

allow to stand
undisturbed for 5
115
min
Status)
Trastuzumab
116 116 116
Emtansine 100 mg vial: 20 mg/mL 24 h F 250 mL NS or ½NS 24 h F - do not use if
116 116
(KADCYLA®) 5 mL SWI only reconstituted
116 116
100 mg do NOT freeze do NOT freeze solution contains
116
160 mg 160 mg vial: do NOT shake visible particulates
116
(Roche) 8 mL SWI or is cloudy or
116
(F)(PFL) discolored
116
no preservative swirl gently until - dextrose 5%
completely dissolved solutions cause
aggregation of the
116
do NOT shake protein; do not
dilute with dextrose
containing
116
solutions
- use a 0.2 micron
in-line filter or 0.22
micron
polyethersulfane
(PES) filter to
administer
infusions prepared
in NS; filter is
optional for
solutions in 0.45%
116
NS
Status)
TRC105 (Carotuximab)
117 118
100 mg/4 mL N/A 25 mg/mL discard unused 0.6 – 10 mg/mL NS complete infusion - use a 0.2 micron
38
200 mg/8 mL portion within 8 h RT, 24 h in-line filter for
117,118 117
400 mg/16 mL invert gently to mix F administration
(Tracon)
(F)(PFL)
117
no preservative
Treosulfan
119,120 2,119,121 122 2,119,121
1g pre-heat diluent to 50 mg/mL 48 h RT undiluted 48 h RT - compatible with
5g 25-30°C (max) polytetrafluoroethyl
123
(medac) or ene filters
(RT) shake vial carefully - may sometimes
119,120
no preservative to loosen powder dilute with NS or D5W require vigorous
before adding the in empty infusion bag shaking to
119,120
warmed diluent for final concentration reconstitute
121
= 20 mg/mL - do NOT
1 g vial: refrigerate as may
20 mL SWI or ½NS cause
119,120
gently shake while precipitation
119,120
adding diluent
5 g vial:
100 mL SWI or ½NS
gently shake while
119,120
adding diluent
(takes ~2 min to
reconstititute)
Status)
vinBLAStine
124 125
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W within 4 h of initial vial - auxiliary info:
2,124 2,124
(Pfizer) portion puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
124
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
126,127
ROUTES
vinBLAStine
128 125
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W use within 4 h of initial - auxiliary info:
2,128 2,128
(Teva) portion vial puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
128
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
126,127
ROUTES
Status)
vinCRIStine
129 129 129 129
2 mg/2 mL N/A 1 mg/mL 8 h F, RT 50 mL* NS, D5W 24 h F, 6 h RT - auxiliary info:
5 mg/5 mL WARNING: FOR
129
(Hospira) **(PFL) INTRAVENOUS
(F)(PFL) USE ONLY –
129
no preservative FATAL IF GIVEN
BY OTHER
130,131
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Status)
vinCRIStine
132 132 132
1 mg/1 mL N/A 1 mg/mL 8 h F, RT 0.01-0.1 mg/mL NS, 24 h F, RT - auxiliary info:
132
2 mg/2 mL D5W WARNING: FOR
5 mg/5 mL INTRAVENOUS
(Teva) 25-50 mL NS, D5W
133
USE ONLY –
(F)(PFL) FATAL IF GIVEN
132
no preservative BY OTHER
130,131
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Vinorelbine
134 134 134
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary info:
134
50 mg/5mL portion WARNING: FOR
(Fresenius Kabi) NS, D5W, ½NS, INTRAVENOUS
(F)(PFL) D5-½NS, Ringer’s, USE ONLY –
134 134
no preservative Ringer’s Lactate FATAL IF GIVEN
BY OTHER
127,130
ROUTES
Status)
Vinorelbine
135 135 135
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary info:
2
50 mg/5 mL portion WARNING: FOR
(GMP) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5-½NS, USE ONLY –
135
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
135
Lactate BY OTHER
127,130
ROUTES
Vinorelbine
136 136 136
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
136
(Pfizer/Hospira) 50 mL* NS, D5W, INTRAVENOUS
136
136
Lactate BY OTHER
127,130
ROUTES
Vinorelbine
137 137 137
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
137
(Teva) 50 mL* NS, D5W, INTRAVENOUS
137
137
Lactate BY OTHER
127,130
ROUTES
Status)
Zoledronic acid
138 138
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
138
(Dr Reddy’s) portion within 24 h of calcium containing
138 138
(RT) preparation solutions
138
no preservative
Refrigerate diluted
product if not used
immediately after
preparation; bring to
RT prior to
138
administration
Zoledronic acid
139 139
139
(Marcan) portion within 24 h of calcium containing
139
(RT) preparation solutions (e.g.,
139
no preservative Lactated
139
Refrigerate diluted Ringer’s)
product if not used
immediately after
RT prior to
139
administration
Status)
Zoledronic acid
140 140
140
(MDA) portion within 24 h of calcium containing
140 140
(RT) preparation solutions
140
no preservative
Refrigerate diluted
product if not used
immediately after
RT prior to
140
administration
Zoledronic acid
141 141
(ZOMETA) N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
38
4 mg/ 5 mL portion within 24 h of calcium containing
141 141
(Novartis) preparation solutions
(RT)
141
no preservative Refrigerate diluted
product if not used
immediately after
RT prior to
141
administration
Status)
Zoledronic acid
142 142
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 ml NS, D5W complete infusion - do NOT mix with
142
(Sandoz) portion within 24 h of calcium- or other
142
(RT) preparation divalent cation-
142
no preservative containing infusion
Refrigerate diluted solutions (e.g.,
product if not used Lactated
142
immediately after Ringer’s)
RT prior to
142
administration
* 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.
*** Contains DMA (N,N dimethylacetamide). Product may be incompatible with closed system transfer devices such as ChemoLock.
Centres are not to change content locally. All suggestions for change are to forwarded to the Cancer Drug Manual editor.
Explanatory Notes:
 Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the
143,144
classification outlined in USP 797.
 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.
 “Complete administration within __” is stated if the manufacturer specifies that the infusion must be completed in a specific time frame following preparation,
usually including entire time required for preparation (from first puncture), storage, and administration of infusion.
Abbreviations:
BWI = bacteriostatic water for injection

CIVI: ambulatory pump = Continuous Intravenous Infusion (e.g., elastomeric infusor)
D5W = dextrose 5% in water
DMA = N,N dimethylacetamide
F = refrigerate
Non-DEHP = not containing Di(2-ethylhexyl) phthalate (DEHP)
NS = normal saline
PFL = protect from light
RT = room temperature
SWI = sterile water for injection
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BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART

(e.g., 50-250 mL*) D10W, D5NS:

(e.g., 50-250 mL*)

0.06 - 0.4 mg/mL NS, NS:

0.06 - 1 mg/mL Ringer’s, LR:

high dose use within 24 h RT of

high dose use within 24 h RT of

devices with spikes

gently swirl, do NOT

record time of doses > 500 mg:

swirl vial gently;

swirl vial gently;

BWI = bacteriostatic water for injection

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