Compatibility and stability of tramadol and dexamethasone in solution and its use in terminally ill patients

Negro, Sofı́a; Salama, Alaa H.; Sánchez, Yolanda; Azuara, María Luz; Barcia, Emilia

doi:10.1111/j.1365-2710.2007.00839.x

Cited by 19 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Eighteen of the included studies investigated compatibility at ambient temperature (18–25°C)[ 13 – 21 , 25 – 29 , 31 – 34 ], eleven also investigated compatibility at refrigerated temperature (4–8°C)[ 15 , 18 – 21 , 25 – 28 , 31 , 32 ], five investigated at body temperature (36–38°C)[ 13 , 15 , 25 , 32 , 35 ] and two studies investigated compatibility at 32°C, simulating a syringe held in a sling close to the patients’ body[ 24 , 30 ].…”

Section: Resultsmentioning

confidence: 99%

The current evidence base for the feasibility of 48-hour continuous subcutaneous infusions (CSCIs): A systematically-structured review

et al. 2018

View full text Add to dashboard Cite

BackgroundA continuous subcutaneous infusion (CSCI) is an effective method of multiple drug administration commonly encountered in end of life care when the oral route is compromised. At present, current practice is to limit syringe driver infusion time to a maximum of 24 hours as dictated by available chemical stability data. However, the ability to deliver prescribed medication by a CSCI over 48 hours may have numerous benefits in both patient care and health service resource utilisation.AimTo examine and present the current evidence base for the stability of 48-hour multiple-drug CSCIs in current clinical practice.DesignA systematically-structured review following PRISMA guidelines.Data sourcesThree electronic databases and the grey literature were searched with no time limits. Empirical studies reporting data on the chemical stability of continuous subcutaneous infusions or solutions stored in polypropylene syringes were included.ResultsTwenty-one empirical studies were included in this review reporting chemical compatibility and stability of 32 discrete combinations of twenty-four drugs tested at a variety of different drug concentrations. The majority of combinations reported were assessed as being chemically compatible. The greatest risk of clinically significant chemical degradation was observed with midazolam. Only one study reported the microbiological stability of the solution examined.ConclusionsThere is currently limited evidence for the physical, chemical and microbiological stability of solutions for continuous subcutaneous infusion over a period of 48 hours. More stability data is required before the use of 48-hour CSCIs can be evaluated for use within clinical practice.

show abstract

Section: Resultsmentioning

confidence: 99%

The current evidence base for the feasibility of 48-hour continuous subcutaneous infusions (CSCIs): A systematically-structured review

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The physical compatibility and / or stability of mixtures of several drugs in solution for use in subcutaneous infusion has been extensively studied, although in some studies only a visual inspection of the samples was performed, thus obtaining information on the physical compatibility but not on the chemical stability of the drugs in the mixture (Barcia et al, 2003;Barcia et al, 2005;Good, Schneider, Ravenscroft, 2004;Negro et al, 2006;Negro et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Determination of compatibility and stability of haloperidol and morphine mixtures used in palliative care

María

Fuensanta

Catalina

2018

Braz. J. Pharm. Sci.

View full text Add to dashboard Cite

With the aim of controlling various symptoms, possible to use mixtures of different drugs within infusion devices. This should take into account the compatibility of the mixture. Factors influence the compatibility and stability of the mixtures are: drug type, concentration, solvent, temperature and light. When evaluating the compatibility of the mixtures for infusion for subcutaneous via is important to consider infusion devices used and the conditions of light and temperature should simulate as far as possible the conditions in practice assistance. There are diverse studies that analyze the compatibility of drug mixtures, but there are still many possible combinations of drugs for which evidence is not available. The objective of this work is to study the compatibility and stability of several mixtures of haloperidol and morphine that can be used in solution for subcutaneous infusion.

show abstract

“…9 Most drugs used in palliative care can be given by subcutaneous infusion and many can be mixed, however, drug incompatibility=loss of stability can occur. 10 There are studies in which compatibility and stability of morphine is tested when combined with other drugs, [11][12][13] however, there are few compatibility studies of tramadol combined in binary drug admixtures [14][15][16] with no reports about ternary admixtures and=or their clinical performance.…”

mentioning

confidence: 98%

Compatibility and Stability of Ternary Admixtures of Tramadol, Haloperidol, and HyoscineN-Butyl Bromide: Retrospective Clinical Evaluation

Negro

Martín

Azuara

et al. 2010

Journal of Palliative Medicine

View full text Add to dashboard Cite

show abstract

Compatibility and stability of tramadol and dexamethasone in solution and its use in terminally ill patients

Abstract: Tramadol hydrochloride (100-400 mg/day) and dexamethasone sodium phosphate (4-40 mg/day) are stable for at least 5 days when combined in saline and stored at 25 degrees C. These results are only valid for the type of syringes and the specific commercial preparations tested.

Cited by 19 publications

References 11 publications

The current evidence base for the feasibility of 48-hour continuous subcutaneous infusions (CSCIs): A systematically-structured review

The current evidence base for the feasibility of 48-hour continuous subcutaneous infusions (CSCIs): A systematically-structured review

Determination of compatibility and stability of haloperidol and morphine mixtures used in palliative care

Compatibility and Stability of Ternary Admixtures of Tramadol, Haloperidol, and HyoscineN-Butyl Bromide: Retrospective Clinical Evaluation

Contact Info

Product

Resources

About