BC CANCER CHEMOTHERAPY PREPARATION and STABILITY CHART DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative

Home , Carotuximab, Obinutuzumab, Pegaspargase, Pentostatin, Pralatrexate, Siltuximab

Leucovorin 50 mg/5 mL N/A 10 mg/mL3 8 h3 syringe 8 h RT3 500 mg/50 mL (Pfizer/Hospira) (F)(PFL) 0.05–10 mg/mL NS, D5W, LR, no preservative3 NS, D5W, LR, Ringer’s: Ringer’s, D10W, 24 h RT3 D5NS3 D10W, D5NS: 50-250 mL† 8 h RT3

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 1/49 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: 21 September 2021

50-250 mL†

0.06 - 0.4 mg/mL NS: NS, D5W4 24 h RT4

50-250 mL† D5W: 12 h RT4

0.06 - 1 mg/mL Ringer’s, LR: Ringer’s, Lactated 24 h RT4 Ringer’s, D10W, D10-NS4 D10W: 12 h RT4

D10NS: 6 h RT4

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 2/49 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: 21 September 2021

Melphalan 50 mg 10mL supplied 5 mg/mL10 2 h RT10 0.1 – 0.45 mg/mL complete (GSK) diluent10 NS only10 administration within (RT)(PFL) do NOT 60 min no preservative10 immediately after refrigerate from time of initial adding diluent, reconstitution at RT11 shake vigorously10

record time of reconstitution

Mesna 400 mg/4 mL N/A 100 mg/mL12 discard unused ≥ 1 mg/mL 24 h RT12 1000 mg/10 mL portion12 NS, D5W, (Baxter) (use filter needle to D5½-NS, LR12-14 (RT) withdraw from no preservative12 ampoule) 100 mL†

Mesna 1000 mg/10 mL N/A 100 mg/mL12 8 days RT12 ≥ 1 mg/mL 24 h RT12 5000 mg/50 mL NS, D5W, (Baxter) (vial may be D5½-NS, LR12-14 (RT) punctured up to 4 preservative12 times)12 100 mL†

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 3/49 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: 21 September 2021

Methotrexate 50 mg/2 mL N/A 25 mg/mL18 50mg: syringe use within - for high-dose 500 mg/20 mL discard unused 8 h RT regimens (e.g., 1- 1 g/40 mL portion18 of initial puncture18 12 g/m2 as a single (Accord) dose)19-23: use (RT)(PFL) 500 mg or 1 g: preservative-free no preservative18 8 h RT18 0.4–2 mg/mL use within methotrexate18 NS, D5W18 24 h RT - do not use for IT of initial puncture18 injection 50-500 mL† **(PFL)

high dose use within (e.g., 1-12 g/m2 as a 24 h RT single dose)19-23: of initial puncture18 1000 mL* NS **(PFL)

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 4/49 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: 21 September 2021

Methotrexate 50 mg/2 mL N/A 25 mg/mL18 14 d F2,18 syringe 14 d F2 - contains benzyl 500 mg/20 mL alcohol18 (Accord) - do NOT use for (RT)(PFL) 0.4–2 mg/mL 24 h RT18 high-dose 18 preservative NS, D5W18 regimens (e.g., 1- 2 12 g/m as a single 18 50-500 mL† dose) - do NOT use for IT 18 injection

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 5/49 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: 21 September 2021

high dose use within (e.g., 1-12 g/m2 as a 24 h RT single dose)19-23: of initial puncture28 1000 mL* NS **(PFL)

Methotrexate IT Injection N/A 25 mg/mL28 discard unused qs to 6 mL with use within - auxiliary info2: Only preservative free portion28 preservative free 4 h “IT” methotrexate may be NS25,26 of initial puncture16 - label to include administered by the route in full (i.e., intrathecal route24 INTRATHECAL 50 mg/2 mL injection) attached (Pfizer/Hospira) to both syringe and (RT)(PFL) outer ziplock bag27 no preservative28

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 6/49 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: 21 September 2021

Mitomycin 20 mg 40 mL SWI29 0.5 mg/mL29 72 h F, 6 h RT29 syringe 72 h F, 6 h RT29 (Accord) (RT)(PFL) shake well29 **(PFL)29 **(PFL)29 no preservative29

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 7/49 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: 21 September 2021

25 mL SWI 0.8 mg/mL33 discard unused syringe 4 days RT33 - do NOT portion2,33 refrigerate33 shake well **(PFL)2,33 **(PFL)2,33

33.3 mL SWI 0.6 mg/mL33 discard unused syringe 4 days F, RT33 portion2,33 shake well **(PFL)2,33 **(PFL)2,33

Mitomycin intraperitoneal 40 mL SWI29 0.5 mg/mL29 72 h F, 6 h RT29 0.02-0.04 mg/mL NS: 20 mg NS, sodium lactate29 18 h F, 3 h RT29 (Accord) shake well29 **(PFL)29 (RT)(PFL) sodium lactate: no preservative29 6 h F, 3 h RT29

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 8/49 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: 21 September 2021

Mitomycin intravesical 40 mL SWI34 0.5 mg/mL34 72 h F, 6 h RT34 syringe 72 h F, 6 h RT34 20 mg (Teva/Novopharm) shake well34 **(PFL)34 **(PFL)34 (RT)(PFL) no preservative34 10 mL SWI30 2 mg/mL30 use immediately syringe use immediately after - may precipitate after preparation preparation to prevent due to low shake well34 to prevent precipitation31 solubility31,32 precipitation31 - do NOT refrigerate31

25 mL SWI 0.8 mg/mL33 discard unused syringe 4 days RT33 - do NOT portion2,33 refrigerate33 shake well **(PFL)2,33 **(PFL)2,33

33.3 mL SWI 0.6 mg/mL33 discard unused syringe 4 days F, RT33 portion2,33 shake well **(PFL)2,33 **(PFL)2,33

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 9/49 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: 21 September 2021

mitoXANTRONE 20 mg/10 mL N/A 2 mg/mL35 discard unused 0.2-0.6 mg/mL 24 h RT35 (Fresenius Kabi) portion35 NS, D5W35 (RT) no preservative35 50 mL†

mitoXANTRONE 20 mg/10 mL N/A 2 mg/mL36 discard unused 0.2-0.6 mg/mL 72 h F, 24 h RT36 25 mg/12.5 mL portion36 NS, D5W36 30 mg/15 mL **(PFL)36 (Pfizer/Hospira) 50 mL† (RT)(PFL) no preservative36

Mogamulizumab 20 mg/5 mL N/A 4 mg/mL37 discard unused 0.1-3 mg/mL NS37 4 h F37 - do not shake37 (Kyowa) portion16,37 - use 0.2 micron (F)(PFL) 100 mL* in-line filter37 do not shake no preservative37 mix by gentle inversion37

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 10/49 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: 21 September 2021

oBINutuzumab 1000 mg/40 mL N/A 25 mg/mL39 discard unused NS 24 h F, 48 h RT39,41 -once removed (Roche) portion40 from the fridge, (F)(PFL)** 100 mg: diluted product is do not shake 100 mL39 stable for an no preservative39 additional 48 h 900 mg: RT39,41 250 mL39 - do NOT shake39 - do NOT use 1000 mg: dextrose containing 250 mL39 solutions39

Octreotide 50 mcg/1 mL N/A 50 mcg/mL42 use within NS42 24 h RT42 100 mcg/1 mL 4 h42 500 mcg/1 mL volume adjusted to (Omega) 100 mcg/mL42 ensure a continuous (F)(PFL) infusion of octreotide no preservative42 at 25 mcg/h42 500 mcg/mL42

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 11/49 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: 21 September 2021

Octreotide 50 mcg/1 mL N/A 50 mcg/mL43 discard unused SC syringe43 use within 100 mcg/1 mL portion43 4 h43 500 mcg/1 mL (Teva/Novopharm) 100 mcg/mL43 infusion: NS43 24 h RT43 (F)(PFL) no preservative43 500 mcg/mL43

Octreotide multidose vial: N/A 200 mcg/mL43 14 d F43,44 SC syringe use within 1000 mcg/5 mL 14 d F43,44 (Teva/Novopharm) (F)(PFL) preservative43 infusion: NS43 24 h RT43

Octreotide (SANDOSTATIN®) N/A 200 mcg/mL45 discard unused 50–200 mL NS11,47,48 24 h RT47 1000 mcg/5 mL portion46 (Novartis) SC infusion: (F)(PFL) adjust volume to preservative45 ensure infusion rate of 25 mcg/h47

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 12/49 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: 21 September 2021

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special (Storage Prior to Use, With: Stability (for IV bag size selection, Precautions/Notes Manufacturer, Preservative see Notes†) Status) Octreotide (SANDOSTATIN®) N/A 50 mcg/mL45 discard unused 50-100 mL NS11,47,48 24 h RT47 50 mcg/1 mL portion47 100 mcg/1 mL SC infusion: 500 mcg/1 mL 100 mcg/mL45 adjust volume to (Novartis) ensure infusion rate of (F)(PFL) 25 mcg/h47 no preservative45 500 mcg/mL45 Octreotide (SANDOSTATIN LAR®) 2 mL supplied 10 mg: discard unused deep intragluteal use within - do NOT shake 10 mg diluent 5 mg/mL47 portion47 administration only47 4 h 20 mg of initial 30 mg gently run 2 mL reconstitution7,47 (Novartis) down sides of the 20 mg: (F)(PFL) vial; do NOT disturb 10 mg/mL47 no preservative46 for 2–5 min, then swirl moderately47 30 mg: record time of 15 mg/mL47 reconstitution

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 13/49 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: 21 September 2021

Oxaliplatin 50 mg/10 mL N/A 5 mg/mL50 2 d F, RT40,52 0.2-0.7 mg/mL50 0.2-2 mg/mL: - do NOT use 100 mg/20 mL 48 h F, 24 h RT50 aluminum- 150 mg/30 mL 100-500 mL† containing needle 200 mg/40 mL and syringe50 (Sandoz) do NOT use NS or (RT)(PFL) other chloride- no preservative50 containing solution50

do NOT use aluminum-containing needle and syringe50

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 14/49 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: 21 September 2021

do NOT use aluminum-containing needle and syringe53

PACLitaxel 30 mg/5 mL N/A 6 mg/mL54 30 mg: 0.3-1.2 mg/mL complete - use non-DEHP 100 mg/16.7 mL 48 h RT40,54 NS, D5W, D5NS, administration within bag and tubing 300 mg/50 mL D5LR54 27 h RT54 - administer with (Accord) 100 mg: 0.2 micron in-line (RT)(PFL) 48 h RT40,54 50-500 mL† filter54 no preservative54 - avoid excessive 300 mg: shaking54 24 h RT54

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 15/49 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: 21 September 2021

0.012-0.12 mg/mL 16 h RT58 NS60

devices with spikes (e.g., chemo dispensing pins) may be used with vials61

PACLitaxel 30 mg/5 mL N/A 6 mg/mL63 48 h RT40,63,64 0.3-1.2 mg/mL complete - use non-DEHP 100 mg/16.7 mL NS, D5W, D5-NS, administration within bag and tubing 150 mg/25 mL D5-LR63 27 h RT63 - administer with 300 mg/50 mL 0.2 micron in-line (Hospira) 50-500 mL† filter63 (RT)(PFL) preservative62

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 16/49 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: 21 September 2021

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special (Storage Prior to Use, With: Stability (for IV bag size selection, Precautions/Notes Manufacturer, Preservative see Notes†) Status) PACLitaxel, nanoparticle, albumin- 20 mL NS65 5 mg/mL65 use immediately in empty sterile PVC, 48 h F - each vial contains bound (NAB) (RT) non-PVC, or non- plus an additional 900 mg human 100 mg - slowly direct or DEHP infusion bag65 8 h RT66 albumin65 (Celgene) diluent against side 8 h F65 - to prevent (RT)(PFL) of vial (i.e., greater foaming, do NOT no preservative65 than or equal to 1 **(PFL)65 inject NS directly min) during onto the powder65 reconstitution65 - some settling may occur; use mild - let stand for agitation to greater than or resuspend65 equal to 5 min to wet - administer with 15 powder65 micron filter ONLY (NOTE:filters with a - gently swirl or pore size less than invert for greater 15 microns may than or equal to 2 cause filter min65 blockage)67,68

Pamidronate 30 mg/10 mL N/A 3 mg/mL69 discard unused ≤ 0.36 mg/mL69 24 h RT69 - do NOT mix with 60 mg/10 mL portion69 NS, D5W69 calcium containing 90 mg/10 mL solutions69 (Fresenius Kabi) 6 mg/mL69 50-500 mL† (RT) no preservative69 9 mg/mL69

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 17/49 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: 21 September 2021

Pamidronate 30 mg/10 mL N/A71 3 mg/mL71 discard unused 0.06–0.36 mg/mL 24 h F - do NOT mix with 60 mg/10 mL portion71 NS, D5W71 plus an additional calcium containing 90 mg/10 mL 24 h RT solution (e.g., (Omega) 6 mg/mL71 250 mL† (total 48 h)71 Ringer’s)71 (RT) no preservative71 **(PFL)71 9 mg/mL71

Pamidronate 30 mg/10 mL N/A 3 mg/mL72 discard unused 0.06-0.36 mg/mL 24 h F - do NOT mix with 60 mg/10 mL portion72 NS, D5W72 plus an additional calcium containing 90 mg/10 mL 24 h RT solution (e.g., (Pfizer) 6 mg/mL72 250 mL† (total 48 h)72 Ringer’s)72 (RT) no preservative72 **(PFL)72 9 mg/mL72

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 18/49 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: 21 September 2021

PANitumumab 100 mg/5 mL N/A 20 mg/mL74 discard unused 1-10mg/mL NS74 24 h F, 6 h RT74-77 - administer with 400 mg/20 mL portion74 0.2 micron in-line (Amgen) 100 mL† filter74 (F)(PFL) - solution may do not shake contain particulates no preservative74 which do not affect product quality74 - do not administer if discoloured74

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 19/49 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: 21 September 2021

IV: bag: 100 mL use within NS, D5W78 4 h of vial puncture40,78

Pembrolizumab 100 mg/4 mL N/A 25 mg/mL79 discard unused 1-10 mg/mL complete - administer with (Merck) portion2,79 NS, D5W79 administration within 0.2 micron in-line (F)(PFL) 96 h F, 6 h RT79 filter79 do not shake 50 mL* - allow vials and no preservatives79 diluted solutions to mix by gentle come to RT prior to inversion79 use79 - vials contain 0.25 mL overfill79

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 20/49 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: 21 September 2021

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special (Storage Prior to Use, With: Stability (for IV bag size selection, Precautions/Notes Manufacturer, Preservative see Notes†) Status) Pembrolizumab 50 mg 2.3 mL SWI80 25 mg/mL80 24 h F, 6 h RT80 1-10 mg/mL complete - administer with (Merck) NS, D5W80 administration within 0.2 micron in-line (F) direct diluent against 24 h F, 6 h RT80 filter81 no preservative80 side of vial during 50 mL† - allow reconstitution to reconstituted vials avoid foaming80 mix by gentle and diluted inversion80 solutions to come allow up to 5 to RT prior to use80 minutes for bubbles - vials can be at RT to clear80 for up to 24 h prior to use80 do NOT shake80 - vials contain 20% overfill80

Pemetrexed 100 mg 100 mg: 25 mg/mL82 24 h F, RT82 100 mL NS82 24 h F, RT82 - do NOT mix with 500 mg 4.2 mL NS82 calcium containing (Accord) solution (e.g., (RT) Ringer’s)82 no preservative82 500 mg: 20 mL NS82

Pemetrexed 100 mg 100 mg: 25 mg/mL83 24 h F, RT83 100 mL NS83 24 h F, RT83 - do NOT mix with 500 mg 4.2 mL NS83 calcium containing (Eli Lilly) solution (e.g., (RT) Ringer’s)84 no preservative83 500 mg: 20 mL preservative- free NS83

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 21/49 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: 21 September 2021

1000 mg: 40 mL NS85

Pentostatin 10 mg 5 mL SWI86 2 mg/mL86 8 h RT86 0.18-0.33 mg/mL86 8 h RT86 (Hospira/Pfizer) (F) 25-50 mL no preservative86 NS, D5W86

PERTuzumab 420 mg/14 mL N/A 30 mg/mL87 discard unused 250 mL 24 h F, RT87 - do NOT use (Roche) portion40,87 NS only87 dextrose containing (F)(PFL) do NOT shake87 solutions87 no preservative87 mix by gentle inversion to avoid foaming87

Plerixafor 24 mg/1.2 mL N/A 20 mg/mL88 discard unused SC syringe88 48 hours RT44,89 (sanofi-aventis) portion88 (RT) no preservative88

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 22/49 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: 21 September 2021

gently invert bag to in ½NS90: mix90 18 h F, 4 h RT

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 23/49 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: 21 September 2021

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 24/49 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: 21 September 2021

Ramucirumab 100 mg/10 mL N/A 10 mg/mL94 discard unused 0.4–4 mg/mL NS94,95 24 h F, 4 h RT94 - administer with 500 mg/50 mL portion94 0.2 micron in-line (Eli Lilly) 250-500 mL† filter94 (F)(PFL) - do NOT use (do not shake) gently invert to mix94 dextrose containing no preservative94 solutions94 do NOT shake94

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 25/49 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: 21 September 2021

riTUXimab subcutaneous N/A 120 mg/mL97 discard unused SC syringe97 48 h F - contains (RITUXAN® SC) portion97 plus 8 h RT97 hyaluronidase97 1400 mg/11.7 mL - formulations are 1600 mg/13.4 mL NOT (Roche) interchangeable97 (F)(PFL) no preservative97

riTUXimab (RIXIMYO®) N/A 10 mg/mL98 discard unused 1-4 mg/mL NS: 100 mg/10 mL portion98 NS, D5W98 14 d F 500 mg/50 mL plus an additional (Sandoz) 250-500 mL† 24 h RT2,98 (F)(PFL) (do NOT shake) gently invert to mix D5W: no preservative98 24 h F plus an additional 12 h RT98

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 26/49 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: 21 September 2021

riTUXimab (TRUXIMA®) N/A 10 mg/mL100 discard unused 1-4 mg/mL 24 h F 100 mg/10 mL portion100 NS, D5W100 plus an additional 500 mg/50 mL 8 h RT100 (Celltrion/Teva) 250-500 mL† (F)(PFL) no preservative100 gently invert to mix

romiDEPsin 10 mg 2.2 mL of supplied 5 mg/mL101 8 h RT101 500 mL NS101 24 h RT101 - reconstituted (Celgene Inc.) diluent101,102 solution will be (RT)101 slightly viscous103 no preservative40 swirl gently to mix101 - vials contain overfill to allow for full drug recovery (drug vial contains 11 mg romidepsin; diluent vial contains 2.4 mL diluent)101

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 27/49 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: 21 September 2021

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special (Storage Prior to Use, With: Stability (for IV bag size selection, Precautions/Notes Manufacturer, Preservative see Notes†) Status) Sacituzumab govitecan 20 mL NS104 10 mg/mL104 discard unused 1.1 - 3.4 mg/mL NS104 4 h F - do NOT shake 180 mg portion104 plus an additional - protect infusion (Immunomedics) allow vials to come 250-500 mL* 4 h RT including bag from light (F)(PFL) to room temperature use immediately infusion time104 during no preservative104 before after dilute to final volume administration104 reconstitution104 reconstitution to by withdrawing volume **(PFL) - patients with body prepare infusion from bag equal to weight >170 kg: slowly add solution solution104 volume of drug to be divide total dose to vial and gently added equally between swirl to dissolve 2x500 mL bags powder; slowly inject solution and administer allow to dissolve (up into infusion bag to sequentially104 to 15 min)104 minimize foaming; do NOT shake104

Siltuximab 100 mg 100 mg: 20 mg/mL105 2 h RT105 250 mL D5W105 complete - administer with 400 mg 5.2 mL SWI105 administration within 0.2 micron in-line (Janssen) dilute to final volume 6 h RT105 filter105 (F)(PFL) 400 mg: by withdrawing volume no preservative105 20 mL SWI105 from bag equal to volume of drug to be allow vial to come to added105 room temperature prior to use (~30 min)105

gently swirl, do NOT shake105

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 28/49 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: 21 September 2021

Streptozocin 1g 9.5mL NS, SWI, 100 mg/mL106 48 h F,106 24 h RT syringe106 48 h F, 24 h RT106 (Pfizer) D5W106 (F)(PFL) no preservative106 50-500 mL* 48 h F, 24 h RT106 NS, D5W, SWI106

Temsirolimus 30 mg/1.2 mL 1.8 mL diluent 10 mg/mL107 24 h RT107 250 mL NS107 complete - use non-DEHP (Pfizer/Wyeth) (supplied)107 administration within bag and tubing (F)(PFL)107 **(PFL)107 6 h107 - administer with no preservative108 0.2 micron in-line mix by gentle filter107 inversion to avoid foaming107

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 29/49 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: 21 September 2021

Thiotepa 15 mg 15 mg: 10 mg/mL111 8 h F111 0.5-1 mg/mL NS111 24 h F, 4 h RT111 - do not use if 100 mg 1.5 mL SWI111 precipitates are (Adienne/Methapharm) reconstituted solution present111 (F) 100 mg: is hypotonic and must - reconstituted no preservative111 10 mL SWI111 be further diluted with solution may be NS prior to use111 used if to remove haze, opalescent111 filter through 0.22 ≤ 500 mg: - administer with micron filter after 500 mL111 0.2 micron in-line reconstitution112 filter111 > 500 mg: record time of 1000 mL111 reconstitution

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 30/49 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: 21 September 2021

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special (Storage Prior to Use, With: Stability (for IV bag size selection, Precautions/Notes Manufacturer, Preservative see Notes†) Status) Thiotepa IT injection diluents containing 10 mg/mL111 8 h F111 qs to 6 mL with use within - auxiliary info27: 15 mg preservatives should preservative free NS26 4 h “IT” 100mg NOT be used for of initial reconstitution2 - label to include (Adienne/Methapharm) intrathecal route in full (i.e., (F) administration113 INTRATHECAL no preservative111 injection) attached 15 mg: to both syringe and 1.5 mL SWI111 outer ziplock bag27 - do not use if 100 mg: precipitates are 10 mL SWI111 present111 - reconstituted to remove haze, solution may be filter through 0.22 used if micron filter after opalescent111 reconstitution112

record time of reconstitution

Thyrotropin alfa 1.1 mg 1.2 mL SWI114 0.9 mg/mL114 24 h F114 syringe114 24 h F114 (Genzyme) (F)(PFL) swirl contents114 no preservative114 do NOT shake

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 31/49 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: 21 September 2021

allow to come to RT prior to administration117

mix by gentle inversion; do not shake117

Tocilizumab 80 mg/4 mL N/A 20 mg/mL118 discard unused 100 mL NS118 complete - to prevent 200 mg/10 mL portion118 administration within foaming: slowly 400 mg/20 mL dilute to final volume 24 h F, RT118 add drug to (Roche) by withdrawing volume infusion bag and (F)(PFL) from bag equal to bring to room gently invert bag to no preservative118 volume of drug to be temperature prior to mix118 added118 administration118

gently invert to mix118

Topotecan 4 mg/4 mL N/A 1 mg/mL119 discard unused 0.025-0.5 mg/mL 14 d F, 48 h RT2,119 (Accord) portion2,119 NS, D5W119 (RT)(PFL) no preservative119 25-50 mL†

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 32/49 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: 21 September 2021

Topotecan 4 mg/4 mL N/A 1 mg/mL121 discard unused 0.02-0.5 mg/mL 24 h F, RT121 (Pfizer/Hospira) portion2,121 NS, D5W121 (F)(PFL) no preservative121 25-50 mL†

Topotecan 4 mg/4 mL N/A 1 mg/mL122 discard unused 0.02-0.5 mg/mL 24 h F122 (Sandoz) portion122 NS, D5W122 (F)(PFL) **(PFL)122 no preservative122 25-50 mL†

Trastuzumab (HERCEPTIN®) 20 mL supplied 21 mg/mL123 14 d F40 250 mL 24 h F, RT123 - do NOT shake123 440 mg BWI123 NS only123 (Roche) (F) swirl vial gently; do NOT use no preservative123 allow to stand dextrose containing undisturbed for 5 solutions123 min123

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 33/49 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: 21 September 2021

Trastuzumab (HERZUMA®) 150 mg vial: 21 mg/mL125 discard unused 250 mL 24 h F, RT125 - do NOT shake125 150 mg 7.2 mL SWI125 portion125 NS only125 - supplied BWI 440 mg contains benzyl (Celltrion/Teva) do NOT use alcohol125 (F) 440 mg vial: 14 d F2,125 dextrose containing no preservative125 20 mL supplied solutions125 BWI125

swirl vial gently; allow to stand undisturbed for 5 min125

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 34/49 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: 21 September 2021

swirl vial gently; allow to stand undisturbed for 5 min126

Trastuzumab (TRAZIMERA®) 150 mg vial: 21 mg/mL127 discard unused 250 mL 24 h F, RT127 - do NOT shake127 150 mg 7.2 mL SWI127 portion127 NS only127 - supplied BWI 440 mg contains benzyl (Pfizer) do NOT use alcohol127 (F) dextrose containing no preservative127 440 mg vial: 14 d F2,127 solutions127 20 mL supplied BWI127

swirl vial gently; allow to stand undisturbed for 5 min127

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 35/49 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: 21 September 2021

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special (Storage Prior to Use, With: Stability (for IV bag size selection, Precautions/Notes Manufacturer, Preservative see Notes†) Status) Trastuzumab Emtansine 100 mg vial: 20 mg/mL128 24 h F128 250 mL 24 h F128 - do not use if (KADCYLA®) 5 mL SWI128 NS or ½NS only128 reconstituted 100 mg do NOT freeze128 do NOT freeze128 solution contains 160 mg 160 mg vial: do NOT shake128 visible particulates (Roche) 8 mL SWI128 or is cloudy or (F)(PFL) discolored128 no preservative128 swirl gently until - dextrose 5% completely dissolved solutions cause aggregation of the do NOT shake128 protein; do not dilute with dextrose containing solutions128 - administer with 0.2 micron in-line filter or 0.22 micron polyethersulfane (PES) filter for infusions prepared in NS; filter is optional for solutions in 0.45% NS128

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 36/49 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: 21 September 2021

Treosulfan 1 g pre-heat diluent to 50 mg/mL131,132 48 h RT2,131,133 undiluted134 48 h RT2,131,133 - compatible with 5 g 25-30°C (max) polytetrafluoroethyl (medac) or ene filters135 (RT) shake vial carefully - may sometimes no preservative131,132 to loosen powder dilute with NS or D5W require vigorous before adding the in empty infusion bag shaking to warmed diluent for final concentration reconstitute131,132 = 20 mg/mL133 - do NOT 1 g vial: refrigerate as may 20 mL SWI or ½NS cause gently shake while precipitation131,132 adding diluent131,132

5 g vial: 100 mL SWI or ½NS gently shake while adding diluent131,132

(takes ~2 min to reconstititute)

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 37/49 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: 21 September 2021

vinBLAStine 10 mg/10 mL N/A 1 mg/mL140 discard unused 25-50 mL use within - auxiliary info: (Teva) portion2,140 NS, D5W137 4 h of initial vial WARNING: FOR (F)(PFL) puncture2,140 INTRAVENOUS no preservative140 USE ONLY – FATAL IF GIVEN BY OTHER ROUTES138,139

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 38/49 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: 21 September 2021

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 39/49 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: 21 September 2021

Vinorelbine 10 mg/1 mL N/A 10 mg/mL145 discard unused 0.5-2.0 mg/mL 24 h F, RT145 - auxiliary info: 50 mg/5mL portion145 NS, D5W, ½NS, WARNING: FOR (Fresenius Kabi) D5-½NS, Ringer’s, INTRAVENOUS (F)(PFL) Ringer’s Lactate145 USE ONLY – no preservative145 FATAL IF GIVEN 50 mL† BY OTHER ROUTES139,142

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 40/49 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: 21 September 2021

Vinorelbine 10 mg/1 mL N/A 10 mg/mL147 discard unused 0.5–2.0 mg/mL 24 h F, RT147 - auxiliary info: 50 mg/5 mL portion147 NS, D5W, ½NS, WARNING: FOR (Pfizer/Hospira) D5-½NS, Ringer’s, INTRAVENOUS (F)(PFL) Ringer’s Lactate147 USE ONLY – no preservative147 FATAL IF GIVEN 50 mL† BY OTHER ROUTES139,142

Vinorelbine 10 mg/1 mL N/A 10 mg/mL148 discard unused 0.5–2.0 mg/mL 24 h F, RT148 - auxiliary info: 50 mg/5 mL portion148 NS, D5W, ½NS, WARNING: FOR (Teva) D5-½NS, Ringer’s, INTRAVENOUS (F)(PFL) Ringer’s Lactate148 USE ONLY – no preservative148 FATAL IF GIVEN 50 mL† BY OTHER ROUTES139,142

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 41/49 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: 21 September 2021

Zoledronic acid 4 mg/5 mL N/A 0.8 mg/mL150 discard unused 100 mL complete infusion - do NOT mix with (Marcan) portion150 NS, D5W150 within calcium containing (RT) 24 h of preparation150 solutions (e.g., no preservative150 Lactated refrigerate diluted Ringer’s)150 product if not used immediately after preparation; bring to RT prior to administration150

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 42/49 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: 21 September 2021

Zoledronic acid (ZOMETA) N/A 0.8 mg/mL152 discard unused 100 mL complete infusion - do NOT mix with 4 mg/ 5 mL portion40 NS, D5W152 within calcium containing (Novartis) 24 h of preparation152 solutions152 (RT) no preservative152 refrigerate diluted product if not used immediately after preparation; bring to RT prior to administration152

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 43/49 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: 21 September 2021

* Suggested volume based on usual dose range and any concentration range of stability data † see BC Cancer IV Bag Selection table: standardized bag sizes are provided for select Benefit Drugs with concentration-dependent stability or large drug volume ** 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 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 be 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 classification outlined in USP 797.154,155 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. Nomenclature for In-line filters has been standardized in the chart to 0.2 micron filter size. For more information, refer to CDM drug monograph.

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 44/49 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: 21 September 2021

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

References:

1. Generic Medical Partners Inc. Leucovorin calcium injection product monograph. Toronto, Ontario; 6 March 2020. 2. BC Cancer. Provincial Pharmacy Directive Number II-20: Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer; 5 December 2018. 3. Pfizer Canada Inc. Leucovorin calcium injection product monograph. Kirkland, Quebec; 21 June 2018. 4. Teva Canada Limited. Leucovorin calcium injection® product monograph. Toronto, Ontario; 5 May 2014. 5. Hospira Healthcare Corporation. LEUCOVORIN CALCIUM INJECTION® product monograph. Saint-Laurent, Quebec; 7 June 2007. 6. Novopharm Limited (Teva). LEUCOVORIN CALCIUM® Injection product information package. Toronto, Ontario; undated. 7. BC Cancer Agency. Pharmacy Policy Number II-20: Guiding Principles for Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer Agency; 6 January 2006. 8. Jenny Yeung. Medical Information Specialist, Teva Canada. Personal communication. 12 April 2017. 9. Pharma Mar. Lurbinectedin Compassionate Use: Preparation Guide for Infusion - edition 1. Madrid, Spain; April 2019. 10. GlaxoSmithKline Inc. Alkeran Package Insert. Mississauga, Ontario; Montreal, Quebec; 2004. 11. Trissel LA. Handbook on Injectable Drugs. 13th ed. Bethesda, MD: American Society of Health-System Pharmacists, Inc.; 2005. 12. Baxter Corporation. UROMITEXAN® product monograph. Mississauga, Ontario; 6 August 2013. 13. Mona Ghobros BPharm MSc. Medical Information, Baxter Corporation. Personal communication. 29 November 2018. 14. Trissel's® 2 Clinical Pharmaceutics Database (database on the Internet). Mesna. Lexi-Comp Inc.; created by Lawrence A. Trissel, Available at: http://online.lexi.com. Accessed 29 November 2018. 15. Fresenius Kabi Canada Ltd. Mesna for injection product monograph. Richmond Hill, Ontario; 21 December 2017. 16. BC Cancer. Pharmacy Policy Number II-20: Guiding Principles for Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer; 19 September 2007. 17. Fresenius Kabi Canada Ltd. Mesna for injection product monograph. Richmond Hill, Ontario; 30 March 2015. 18. Accord Healthcare Inc. Methotrexate injection product monograph. Kirkland, Quebec; 6 April 2018. 19. BC Cancer Agency Miscellaneous Origins Tumour Group. (MOHDMTX) BCCA Protocol Summary for Treatment of Meningeal Disease (Miscellaneous Tumour Origins) using High Dose Methotrexate with Leucovorin Rescue. Vancouver, British Columbia: BC Cancer Agency; 1 Jan 2013. 20. BC Cancer Agency Sarcoma Tumour Group. (SAHDMTX) BCCA Protocol Summary for Treatment of Osteosarcoma Using High Dose Methotrexate with Leucovorin Rescue. Vancouver, British Columbia: BC Cancer Agency; 1 Nov 2012. 21. BC Cancer Agency Lymphoma Tumour Group. (LYHDMRP) BCCA Protocol Summary for Treatment of Primary Intracerebral Lymphoma with High Dose Methotrexate and riTUXimab. Vancouver, British Columbia: BC Cancer Agency; 1 Jun 2014.

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 45/49 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: 21 September 2021

22. BC Cancer Agency Lymphoma Tumour Group. (LYHDMTXP) BCCA Protocol Summary for Treatment of Primary Intracerebral Lymphoma with High Dose Methotrexate. Vancouver, British Columbia: BC Cancer Agency; 1 Jun 2014. 23. BC Cancer Agency Lymphoma Tumour Group. (LYHDMTXR) BCCA Protocol Summary for Treatment of Leptomeningeal Lymphoma or Recurrent Intracerebral Lymphoma with High Dose Methotrexate. Vancouver, British Columbia: BC Cancer Agency; 1 Jun 2014. 24. Mayne Pharma Canada. Methotrexate Product Monograph. Montreal, Quebec; December 2003. 25. BC Cancer Lymphoma Tumour Group. (LYIT) BC Cancer Protocol Summary for Treatment of Lymphoma using Intrathecal Methotrexate and Cytarabine. Vancouver, British Columbia: BC Cancer; 1 June 2014. 26. BC Cancer Miscellaneous Origin Tumour Group. (MOIT) BC Cancer Protocol Summary for Solid Tumours using Intrathecal Methotrexate and/or Thiotepa and/or Cytarabine. Vancouver, British Columbia: BC Cancer; 1 October 2018. 27. BC Cancer. Systemic Therapy Policy and Procedure III-50: Administration of High Alert Medications by the Intrathecal Route via Lumbar Puncture or Ommaya Reservoir. Vancouver, British Columbia; 1 May 2019. 28. Pfizer Canada Inc. Methotrexate injection product monograph. Kirkland, Quebec; 13 October 2017. 29. Accord Healthcare Inc. Mitomycin product monograph. Kirkland, Quebec; 7 June 2017. 30. Au JLS, Badalament RA, Wientjes MG, et al. Methods to improve efficacy of intravesical mitomycin C: results of a randomized phase III trial. J Natl Cancer Inst April 18, 2001;93(8):597-604. 31. Jessie LS Au PharmD PhD. Professor, Ohio State University. Personal communication. 14 May 2007. 32. Myers AL, Zhang Y, Kawedia JD, et al. Solubilization and stability of mitomycin C solutions prepared for intravesical administration. Drugs R D 2017;17:297-304. 33. Beijnen JH, Van Gijn R, Underberg WJM. Chemical stability of the antitumor drug mitomycin C in solutions for intravesical instillation. Journal of Parenteral Science and Technology 1990;44(6):332-335. 34. Teva Canada Limited. Mitomycin for injection® product monograph. Toronto, Ontario; 30 June 2017. 35. Fresenius Kabi Canada Ltd. Mitoxantrone injection® product monograph. Richmond Hill, Ontario; 28 September 2016. 36. Pfizer Canada Inc. Mitoxantrone injection product monograph. Kirkland, Quebec; 17 October 2018. 37. Kyowa Kirin Inc. POTELIGEO® full prescribing information. Bedminister, New Jersey, USA; August 2018. 38. Bristol-Myers Squibb Canada. OPDIVO® product monograph. Montreal, Quebec; 16 July 2018. 39. Hoffmann-La Roche Ltd. GAZYVA® product monograph. Mississauga, Ontario; 21 December 2015. 40. BC Cancer Agency. Pharmacy Policy Number II-20: Guiding Principles for Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer Agency; 19 September 2007. 41. Anna Sivojelezova MSc. Drug Information Associate, Hoffmann-La Roche Ltd. Personal communication. 24 April 2015. 42. Omega Laboratories Ltd. Octreotide Acetate Injection product monograph. Montreal, Quebec; 23 July 2010. 43. Novopharm Limited. Octreotide Injection Product Monograph. Scarborough, Ontario; 15 March 2007. 44. BC Cancer Agency. Pharmacy Policy Number II-20: Guiding Principles for Chemotherapy Preparation Chart. Vancouver, British Columbia: BC Cancer Agency; 19 September 2007. 45. Novartis Pharmaceuticals Canada Inc. SANDOSTATIN® Product Monograph. Dorval, Quebec; 9 January 2001. 46. Repchinsky C, editor. Sandostatin LAR monograph, Compendium of Pharmaceuticals and Specialties. Ottawa, Ontario: Canadian Pharmacists Association; 2005. p. 1912-1916. 47. Repchinsky C editor. Compendium of Pharmaceuticals and Specialties. 12th ed. Ottawa, Ontario: Canadian Pharmacists Association; 2004. 48. Vancouver Hospital and Health Sciences Centre Pharmacy Department. Octreotide. Parenteral drug therapy manual. Vancouver, BC; February 2002. 49. Pfizer Canada Inc. Oxaliplatin injection product monograph. Kirkland, Quebec; 31 May 2017. 50. Sandoz Canada Inc. Oxaliplatin injection product monograph. Boucherville, Quebec; 12 August 2015. 51. Medical Information Pfizer Canada Inc. Personal communication. 6 June 2017. 52. Katryn Vosburg. Drug Information & Pharmacovigilance Specialist, Sandoz Canada Inc. Personal communication. 26 February 2016. 53. Teva Canada Limited. Teva-Oxaliplatin injection® product monograph. Toronto, Ontario; 11 September 2015. 54. Accord Healthcare Inc. Paclitaxel injection product monograph. Markham, Ontario; 13 August 2012. 55. Claude Mercure. Production Manager Biolyse Pharma Corporation. Personal communication. 21 December 2009. 56. Biolyse. PACLITAXEL FOR INJECTION® product monograph. St. Catherines, Ontario; 2 December 2005. 57. Claude Mercure. Manager, Biolyse Pharma Corporation. Personal communication. 24 June 2014.

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 46/49 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: 21 September 2021

58. Zeng Z, Lazakovitch E. Study IR 120: Physical and Chemical Stability Study of Paclitaxel for Injection in 0.9 % Sodium Chloride in concentration range 0.012-0.12 mg/mL. Biolyse Pharma March 2010. 59. Mercure C. Stability of 0.1 mg/mL of paclitaxel for injection in sodium chloride (0.9%) solution. St Catharines, Ontario: Biolyse Pharma; 2 February 2007. 60. Xu Q, Trissel LA, Martinez JF. Stability of paclitaxel in 5% dextrose injection or 0.9% sodium chloride injection at 4, 22, or 32 degrees C. Am J Hosp Pharm Dec 15, 1994;51(24):3058-60. 61. Lisa Tavano. Biolyse Pharma Corporation. Personal communication. 14 May 2012. 62. Robyn MacKenzie. Area Manager, Hospira Healthcare Corporation. Personal communication. 4 April 2012. 63. Hospira Healthcare Corporation. PACLITAXEL FOR INJECTION® product monograph. Saint-Laurent, Quebec; 1 September 2009. 64. Rose Toussaint. Hospira Canada Healthcare Corporation. Personal communication. 4 April 2012. 65. Celgene Inc. ABRAXANE® product monograph. Mississauga, Ontario; 24 July 2014. 66. Aisling Cahill. Drug Safety and Medical Information Specialist. Celgene Inc. Personal communication. 23 April 2015. 67. Celgene Europe Limited. ABRAXANE® product monograph. Uxbridge, UK; 11 January 2013. 68. Celgene Inc. ABRAXANE® product monograph. Mississauga, Ontario; 18 January 2016. 69. Pharmaceutical Partners of Canada. Pamidronate Disodium For Injection product monograph. Richmond Hill, Ontario; 18 January 2010. 70. Mayne Pharma (Canada) Inc. Pamidronate Package Insert. Montreal, Quebec; 2002. 71. Omega Laboratories Ltd. Pamidronate Disodium product monograph. Montreal, Quebec; 06 June 2005. 72. Pfizer Canada ULC. Pamidronate disodium for injection product monograph. Kirkland, Quebec; 11 December 2018. 73. Sandoz Canada Inc. Pamidronate injection product monograph. Boucherville, Quebec; 28 February 2006. 74. Amgen Canada. VECTIBIX® product monograph. Mississauga, Ontario; 31 March 2017. 75. Amgen Inc. VECTIBIX® full prescribing information. Thousand Oaks, California USA; June 2017. 76. Amgen Canada. VECTIBIX® product monograph. Mississauga, Ontario; 5 March 2009. 77. Diane Lord. Medical Information Department, Amgen Canada Inc. Personal communication. 19 June 2009. 78. Shire Pharma Canada ULC. ONCASPAR® product monograph. Toronto, Ontario; 20 April 2018. 79. Merck Canada Inc. KEYTRUDA® product monograph. Kirkland, Quebec; 6 December 2019. 80. Merck Canada Inc. KEYTRUDA® product monograph. Kirkland, Quebec; 21 February 2018. 81. Merck Canada Inc. KEYTRUDA® product monograph. Kirkland, Quebec; 5 February 2016. 82. Accord Healthcare Inc. Pemetrexed disodium for injection product monograph. Kirkland, Quebec; 12 March 2015. 83. Eli Lilly Canada. Pemetrexed product information. Toronto, Ontario; 2008. 84. Eli Lilly Canada Inc. ALIMTA® Product Monograph. Toronto, Ontario; 21 May 2004. 85. Taro Pharmaceuticals Inc. Pemetrexed disodium for injection product monograph. Brampton, Ontario; 30 August 2018. 86. Hospira Inc. NIPENT® full prescribing information. Lake Forest, Illinois USA; Oct 2019. 87. Hoffmann-La Roche Limited. PERJETA® product monograph. Mississauga, Ontario; 12 April 2013. 88. sanofi-aventis Canada Inc. MOZOBIL® product monograph. Laval, Quebec; 8 October 2014. 89. Maureen Coughlin BSc Pharm. Solutions in Health Inc. (acting as an authorized agent of sanofi-aventis and ). Personal communication. 24 May 2017. 90. Genentech Inc. POLIVY® full prescribing information. South San Francisco, CA, USA; June 2019. 91. Servier Canada Inc. FOLOTYN® product monograph. Laval, Quebec; 19 October 2018. 92. Marjolaine Migeon PharmD. Servier Canada Medical Information. Personal communication. 24 September 2019. 93. Pfizer Canada Inc. TOMUDEX® product monograph. Kirkland, Quebec; 8 August 2017. 94. Eli Lilly Canada Inc. CYRAMZA® product monograph. Toronto, Ontario; 16 July 2015. 95. Marilyn Bain BScN. Senior Medical Information Associate, Eli Lilly Canada Inc. Personal communication. 16 January 2017. 96. Hoffmann-La Roche Ltd. RITUXAN® product monograph. Mississauga, Ontario; 10 October 2019. 97. Hoffmann-La Roche Ltd. RITUXAN® SC product monograph. Mississauga, Ontario; 21 March 2018. 98. Sandoz Canada Inc. RIXIMYO® product monograph. Boucherville, Quebec; 28 April 2020. 99. Pfizer Canada ULC. RUXIENCE® product monograph. Kirkland, Quebec; 4 May 2020. 100. Teva Canada Limited for Celltrion Healthcare Co Ltd. TRUXIMA® product monograph. Toronto, Ontario; 22 July 2019. 101. Celgene Inc. ISTODAX® product monograph. Mississauga, Ontario; 13 December 2016.

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 47/49 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: 21 September 2021

102. Celgene Inc. INFO Rx ISTODAX® (romidepsin) for Injection. Mississauga, Ontario; 10 July 2017. 103. Aisling Cahill. Drug Safety and Medical Information Specialist. Celgene Inc. Personal communication. 17 July 2015. 104. Immunomedics Inc. TRODELVY® full prescribing information. Morris Plains, New Jersey, USA; Apr 2020. 105. Janssen Inc. SYLVANT® product monograph. Toronto, Ontario; 6 January 2016. 106. Pharmacia Canada Inc. Zanosar Package Insert. Mississauga, Ontario; March 2003. 107. Pfizer Canada Inc (for Wyeth Canada). TORISEL® product monograph. Kirkland, Quebec; 21 December 2016. 108. Anna Sivojelezova M.Sc. Medical Information Associate, Wyeth. Personal communication. 6 January 2010. 109. Bristol-Myers Squibb Canada. VUMON® product monograph. St. Laurent, Quebec; 26 October 2004. 110. Trissel's®2 IV Compatibility (database on the Internet). Teniposide. Thomson Reuters MICROMEDEX® 2.0, updated periodically. Available at: http://www.micromedex.com. Accessed 27 April 2011. 111. Adienne SA. TEPADINA® product monograph. Lugano, Switzerland; 28 March 2017. 112. AHFS Drug Information® (database on the Internet). Thiotepa. Lexi-Comp Inc., 27 February 2018. Available at: http://online.lexi.com. Accessed 21 August 2018. 113. Hematology/Oncology Pharmacy Association. HOPA News Clinical Pearls: Intrathecal Chemotherapy: Focus on Drugs, Dosing, and Preparation. 13(4) ed. Chicago, Illinois, USA: Hematology/Oncology Pharmacy Association; 2016. 114. Genzyme Canada. Thyrogen Product Monograph. Mississauga, Ontario; 2004. 115. Lillian Phan. Senior Manager, Medical Affairs US, EU & New Markets. Personal communication. BeiGene Ltd.; 15 January 2021. 116. BeiGene Ltd. Clinical Study Pharmacy Manual Protocol BGB-A317-207: An phase 2, open-label study of BGB-A317 in patients with relapsed or refractory mature T- and NK-cell neoplasms. (Version 5.0). San Mateo, California, USA; 8 November 2019. 117. BeiGene Ltd. Tislelizumab (BGB-A317) Product Information for Investigator Sponsored Research (ISR) Investigators (Version 0.0). San Mateo, California, USA; 19 May 2020. 118. Hoffmann-La Roche Limited. ACTEMRA® product monograph. Mississauga, Ontario; 27 October 2017. 119. Accord Healthcare Inc. Topotecan hydrochloride for injection product monograph. Kirkland, Quebec; 9 May 2019. 120. Actavis Pharma Company. Topotecan for injection product monograph. Mississauga, Ontario; 3 January 2018. 121. Pfizer Canada Inc. Topotecan hydrochloride for injection product monograph. Kirkland, Quebec; 5 January 2018. 122. Sandoz Canada Inc. Topotecan injection product monograph. Boucherville, Quebec; 5 September 2014. 123. Hoffman-La Roche Limited. HERCEPTIN® product monograph. Mississauga, Ontario; 16 November 2012. 124. Celltrion Healthcare Co Ltd (distributed by Teva Canada Limited). HERZUMA® product monograph. Toronto, Ontario; 3 September 2019. 125. Celltrion Healthcare Co Ltd (distributed by Teva Canada Limited). HERZUMA® product monograph. Toronto, Ontario; 20 October 2020. 126. BGP Pharmacy ULC. OGIVRI® product monograph. Etobicoke, Ontario; 3 May 2019. 127. Pfizer Canada ULC. TRAZIMERA® product monograph. Kirkland, Quebec; 15 August 2019. 128. Hoffmann-La Roche Limited. KADCYLA® product monograph. Mississauga, Ontario; 11 September 2013. 129. Tracon Pharmaceuticals Inc. TRC105 (carotuximab) investigational brochure. San Diego, California; 14 February 2017 (version 10.0). 130. Tracon Pharmaceuticals Inc. Clincial Protocol: A Phase 2A Study of TRC105 (with Option to Add Bevacizumab) in Patients with Refractory Gestastional Trophoblastic Neoplasia (GTN). San Diego, California; 20 September 2016 Amendment #3. 131. medac GmbH. TRECONDI® product monograph (summary of product characteristics). Wedel, Germany; undated. 132. medac UK. TREOSULFAN injection® product monograph (summary of product characteristics). Wedel, Germany; 26 Jan 2017. 133. medac UK. TREOSULFAN injection® Details about Handling and Stability. Hamburg, Germany; August 2008. 134. Henrik Fenger. Management Associate, International Division medac. Personal communication. 03 March 2010. 135. medac UK. TREOSULFAN injection® product monograph. Hamburg, Germany; 24 June 2008. 136. Pfizer Canada ULC. Vinblastine sulfate injection product monograph. Kirkland, Quebec; 18 April 2019. 137. Lexi-Drugs® (database on the Internet). VinBLAStine. Lexi-Comp Inc., 16 January 2020. Available at: http://online.lexi.com. Accessed 30 January 2020. 138. World Health Organization. Information Exchange System - Vincristine (and other vinca alkaloids) should only be given intravenously via a minibag. Alert No. 115 ed. Geneva, Switzerland: World Health Organization; 18 July 2007. 139. BC Cancer Provincial Systemic Therapy Program. Policy V-40: Dispensing and Labelling of Vinca Alkaloid Preparations. Vancouver, British Columbia: BC Cancer; 1 April 2015. 140. Teva Canada Limited. Vinblastine sulfate injection product monograph. Toronto, Ontario; 22 October 2019. 141. Mayne Pharma (Canada) Inc. Vincristine Package Insert. Montreal, QC; Undated. 142. World Health Organization. Information Exchange System: Alert No. 115 (QSM/MC/IEA.115). Geneva, Switzerland: World Health Organization; 18 July 2007.

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 48/49 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: 21 September 2021

143. BCCA Provincial Systemic Therapy Program. Labeling of vinca alkaloid syringes. Policy # V-40. Vancouver, British Columbia: BC Cancer Agency; 27 May 1999. 144. Teva Canada Limited. Vincristine sulfate injection® product monograph. Scarborough, Ontario; 27 March 2014. 145. Pharmaceutical Partners of Canada. Vinorelbine Injection product monograph. Richmond Hill, Ontario; 15 January 2008. 146. Generic Medical Partners Inc. Vinorelbine Injection product monograph. Toronto, Ontario; 3 September 2014. 147. Pfizer Canada Inc. Vinorelbine Tartrate for Injection product monograph. Kirkland, Quebec; 21 July 2017. 148. Teva Canada Limited. Vinorelbine tartrate for Injection product monograph. Toronto, Ontario; 20 March 2014. 149. Innomar Strategies Inc. (for Dr. Reddy's Laboratories Limited). Zoledronic acid for injection concentrate® product monograph. Oakville, Ontario; 11 March 2015. 150. Marcan Pharmaceuticals Inc. Zoledronic acid concentrate for injection product monograph. Ottawa, Ontario; 5 February 2018. 151. MDA Inc. Zoledronic acid for injection product monograph. Mississauga, Ontario; 11 August 2015. 152. Novartis Pharmaceuticals Canada Inc. ZOMETA® product monograph. Dorval, Quebec; 26 July 2013. 153. Sandoz Canada Inc. Zoledronic Acid - Z® product monograph. Boucherville, Quebec; 02 December 2016. 154. The United States Pharmacopeia (USP). General Chapter 797: Pharmaceutical compounding - sterile preparations. USP 27-NF 22. Rockville, Maryland: The United States Pharmacopeial Convention, Inc.; 2004. 155. Kastango ES. The ASHP discussion guide for compounding sterile preparations. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; 2004. p. 5. 156. Keocyt. Streptozocin Summary of Product Characteristics. Montrouge, France; February 2016. 157. Keocyt. ZANOSAR® Package Leaflet. Montrouge, France; 24 February 2016. 158. Keocyt. ZANOSAR® Summary of Product Characteristics. Montrouge, France; 31 October 2017. 159. Marie-Laure Vedel. Sales Order Handling & Hospitals Relationships Manager, Keocyt-Riemser Pharma. Personal communication. 16 September 2021.

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00. All rights reserved. 49/49 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: 21 September 2021