Hplc–dad Method for Studying the Stability of Solutions Containing Morphine, Dexamethasone, Haloperidol, Midazolam, Famotidine, Metoclopramide, and Dimenhydrinate

Abstract

The objectives of this study were to evaluate both the compatibility and the stability of morphine when mixed with different drugs and to provide recommendations for appropriate conservation conditions. Five drug mixtures used for palliative care were stored in polypropylene syringes at different temperatures (25 • C, 4 • C) up to 96 h. These mixtures were: 1) ORDER REPRINTS 266NASSR ET AL.Haloperidol, Famotidine, Metoclopramide, Dimenhydrinate. Drug mixtures were prepared in NaCl 0.9%, in order to obtain a 100 mL final solution containing the maximum daily dose of each component. For the separation and quantification of active ingredients, a fast, precise, accurate, and sensitive method was developed. Drugs were separated using HPLC-DAD (High performance liquid chromatography-diode array detector) with a Zorbax Eclipse XDB C 18 ) column under elution gradient. Just after preparing the mixture of drugs and then after 4,8,12,24, 48, 72, 96 h, the physical appearance of each solution was observed, and drug concentrations were controlled. Stability was assumed if the loss after 96 h was less than 10% of the initial concentration. Mixture number (2) was incompatible when drugs were mixed. Mixing haloperidol and dexamethasone gave rise to the formation of a white precipitate. Mixture (3) was stable and compatible at 25 • C, but incompatible at 4 • C due to crystallization of haloperidol. All the other drug mixtures were stable and compatible both at 4 • C and 25 • C for 96 h.

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

“…A total of 24 drugs were included in the 21 studies, involving 32 different combinations. The most drugs included in a single combination were six[ 26 ] and the least included in a single combination were two[ 13 , 15 – 21 , 23 , 24 , 28 , 29 , 32 – 34 ]. The drugs included most frequently in syringe driver combinations reported were haloperidol ( n = 13), morphine sulphate, midazolam and dexamethasone ( n = 7 each).…”

“…Nassr et al[ 26 ] attempted to investigate the compatibility and stability of a tertiary combination of morphine sulphate 10mg/mL, dexamethasone 0.4mg/mL and haloperidol 0.5mg/mL. However, it was noted that upon mixing of haloperidol and dexamethasone a white, fluffy precipitate was formed regardless of the order the drugs were mixed in.…”

“…Nassr et al[ 26 ] investigated the compatibility and stability of a quintenary combination of morphine sulphate 10mg/mL, octreotide 0.01mg/mL, haloperidol 0.5mg/mL, midazolam 1mg/mL and famotidine 0.4mg/mL. Physical incompatibility was observed after 24 hours in the syringes stored at 4 °C where a precipitate was noted to form on the surface of the polypropylene syringe.…”

Off-label drug use in palliative care – a narrative review

“…Najczęściej rekomendowane połączenia dwóch leków rozcieńczonych w 0,9% chlorku sodu (na podst. [79]; piśmiennictwo dotyczące dopuszczalności łączenia poszczególnych leków w odpowiednich polach) morfina [87,88] midazolam zgodność leków potwierdzona badaniami lub praktyką kliniczną zgodność w stężeniach haloperidolu < 1 mg/ml i morfiny < 10 mg/ml jednoczesne stosowanie tych leków nie jest rekomendowane…”

Optimization and validation of a dissolution test for famotidine tablets using flow injection analysis

“…However, when it comes to dissolution testing, flow injection analysis is an advantageous analytical technique in terms of rapidity, cost effectiveness and solvent-free wastes. Although several HPLC methods have been reported for the analysis of famotidine formulations [5][6][7][8][9][10][11][12][13][14][15][16][17], only two flow injection (FIA) assays were found in literature [18,19]. They are based on the reaction of famotidine with either 2,4-dichloro-6-nitrophenol (λ max = 450 nm) [18] or cupric acetate (λ max = 630 nm) [19].…”