Stability and compatibility of ondansetron with haloperidol in parenteral admixtures

Estan-Cerezo, Gabriel; Chirivella, C Matoses; Soriano-Irigaray, Leticia; Murcia-López, Ana Cristina; Lucena, Francisco José Rodríguez; Ruíz, A Navarro

doi:10.1136/ejhpharm-2016-001200

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…The main possibility of incompatibility identified was between two antiemetics, dimenhydrinate and ondansetron, found in 65.19% of prescriptions. This high prevalence occurs because antiemetics are commonly prescribed for patients undergoing chemotherapy, as described in other studies 19,20 , since nausea and vomiting are frequent and debilitating adverse effects directly causing a meaningful impact in patients' quality of life 20 . Antiemetics are advisable from the first treatment cycle and are also used as prophylaxis for anticipatory vomiting in other stages of treatment 21 .…”

Section: Discussionmentioning

confidence: 99%

Potential Medication Incompatibilities In Pediatric Oncology Prescriptions

Santos

Rocha

Lopes

et al. 2023

CBR

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Introduction:Pediatric oncology patients have a limited number of venous access routes and need a large number of drugs during hospitalization. This study evaluates potential medication incompatibilities (MI) in pediatric oncology prescriptions and identifies possible factors associated with the risk of their occurrence. Methods:This cross-sectional study evaluated prescriptions from a tertiary universitary hospital from December 2014 to December 2015. The association between variables and the risk of potential incompatibilities between drugs was determined by Student's t-test and Pearson's chi-square, considering p < 0.05 significant. The odds ratio was calculated considering a 95% confidence interval for each drug.Results: 385 prescriptions were evaluated. The mean age of 124 patients was 9.22 years old (SD = ± 5.10), and 50.65% were male. The most frequent diagnosis and reason for hospitalization were leukemia (27.30%) and chemotherapy (36.10%). The totally implantable catheter was the most commonly used venous access (61.30%). In 87.5% of prescriptions, there was the possibility of MI, and 2108 incompatibilities were found, considering 300 different combinations between two drugs. Age, diagnosis, reason for hospitalization, and type of venous access were risk factors for potential incompatibilities (p < 0.05). The following drugs present higher risk of potential incompatibilities: leucovorin, sodium bicarbonate, cefepime, diphenhydramine, dimenhydrinate, hydrocortisone, and ondansetron, with a significant odds ratio. Conclusion:The possibility of MI in prescriptions for pediatric oncology patients is frequent. Thus, the identification of risk factors may contribute to patient safety and to the rational use of drugs.

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Section: Discussionmentioning

confidence: 99%

Potential Medication Incompatibilities In Pediatric Oncology Prescriptions

Santos

Rocha

Lopes

et al. 2023

CBR

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“…The use of different drugs under combination allows the administrations of smaller volumes, reducing the number of pumps and preventing stress on the veins. However, to know if an admixture with two or more drugs can be prepared, the physicochemical stability has to be studied (Estan-Cerezo et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Midazolam and haloperidol for palliative sedation: physicochemical stability and compatibility of parenteral admixtures

Estan-Cerezo

Lucena

Chirivella

et al. 2019

Braz. J. Pharm. Sci.

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This study was done to determine the time while the binary admixtures with midazolam and haloperidol drugs are administered by perfusion to the patients in the clinical routine. Samples with different concentrations of both drugs were prepared following the usual clinical practice. Solvents used were 0.9 % sodium chloride solution and 5% dextrose, and viaflo plastic bags were used as the containers of the admixtures. Samples were not protected from light and were stored at 20 ºC or at 4 ºC. Compatibility and physicochemical stability were studied by visual inspection, turbidity measurement, pH determination and ultraviolet detection high performance liquid chromatography (UV-HPLC) was used to determine midazolam and haloperidol concentrations. The assay was validated following the FDA and EMA guidelines. Darunavir was used as internal standard (IS). For the studied admixtures, turbidity measurements and pH determinations showed little changes in function of the time. Haloperidol and midazolam concentrations determined by HPLC are within the acceptable range of drug concentrations, which are considered stable for four days in case of admixtures stored at 20 ºC and for seven days for refrigerated admixtures. Taking into account the microbiological risk matrix, the compatibility and the chemical and microbiological stability of the midazolam and haloperidol in the co-administered admixtures in viaflo plastic bags with 0.9 % sodium chloride solution and 5% dextrose can be set as 48 hours when samples are stored at 20 ºC and one week if they are refrigerated.

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“…Several bioanalytical methods have been reported in the literature for the quantification of OND, for example, spectrophotometric [20] and more popular liquid chromatography with UV [21][22][23][24] or MS [25][26][27][28][29] detection. Raza et al [20] estimated drug concentration in bulk material using the spectrophotometry method.…”

Section: Introductionmentioning

confidence: 99%

Application of the HPLC Method in Parenteral Nutrition Assessment: Stability Studies of Ondansetron

et al. 2021

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Ondansetron (OND) is a serotonin type 3 receptor antagonist that exhibits antiemetic activity. From the clinical point of view, vomiting and nausea prevention is an important task. Anticancer treatment and recovery impact the patient’s overall state by affecting appetite, well-being, and physical activity, and consequently, nutrition quality. Depending on the patient’s indication and condition, parenteral nutrition is administered to meet full nutritional requirements. In addition, antiemetic drugs can be added to the parenteral nutrition (PN) admixture to treat chemo- or radio-therapy-induced nausea and vomiting. However, adding any medication to the PN admixture can result in the instability of the composition in the overall admixture. This study aimed to develop the HPLC method of determination of OND in Lipoflex special, one of the most popular, ready-to-use PN admixtures. The proposed HPLC method and the sample preparation procedure were suitable for analyzing OND in PN admixture stored under various conditions, such as exposure to sunlight and temperature. It was found that the decomposition of OND during the seven-day storage did not exceed 5% and did not depend on external factors. Based on the conducted research, it is recommended to add OND to Lipoflex special, and it is possible to store such an admixture for seven days.

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Stability and compatibility of ondansetron with haloperidol in parenteral admixtures

Cited by 3 publications

References 17 publications

Potential Medication Incompatibilities In Pediatric Oncology Prescriptions

Potential Medication Incompatibilities In Pediatric Oncology Prescriptions

Midazolam and haloperidol for palliative sedation: physicochemical stability and compatibility of parenteral admixtures

Application of the HPLC Method in Parenteral Nutrition Assessment: Stability Studies of Ondansetron

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