Coutsouvelis J.,Alfred Health |
Coutsouvelis J.,Monash University |
Dong Y.-D.,Monash Institute of Pharmaceutical Sciences |
Witney K.,PeterMacCallum Cancer Care Center |
And 2 more authors.
Journal of Pharmacy Practice and Research | Year: 2015
Background: Patients undergoing allogeneic haematopoietic stem cell transplantation require cyclosporin (CsA) infusion to be administered concurrently with parenteral nutrition (PN). Aims: To evaluate the physicochemical compatibility of parenteralCsAandPNadministered via the same lumen of a central venous access device and to quantify and identify any particulate matter. Methods: Three PN formulations were tested. Standard PN solution and PN solution with glutamine manufactured by Baxter Healthcare and standardPNsolution manufactured by Fresenius Kabi.CsAconcentrate for intravenous infusion 250 mg/5 mL(Sandimmun, Novartis Pharmaceuticals) was used. PN solutions were mixed with CsA at different volume ratios to simulate different rates of co-infusion in clinical practice. A real-life simulation was also performed with CsA in glucose 5% co-infused with the PN solution via the same lumen of a central venous access device. The size of colloidal species in the resulting samples was measured using dynamic light scattering. Results: The static experiments for all dilution ratios and types of PN with CsA indicated average particle diameters of less than 500 nm. Only one sample indicated a particle larger than 5 μm. The ‘real-life’ simulation did not detect any particle with diameter greater than 5 μm. This was across all types of PN solutions and for all samples taken at a number of time points up to 24 h. Conclusion: Commercially available PNformulations can be administered concurrently with CsA via the same lumen of a central venous access device. For infusions running up to 24 h, there is minimal risk of particle formation with a diameter greater than 5 μm. © 2015 Society of Hospital Pharmacists of Australia.