702 FLOXURIDINE ASHP INJECTABLE DRUG INFORMATION Floxuridine AHFS 10:00 Products Escherichia coli, Pseudomonas aeruginosa, and Candida albicans. The arbitrary application of an extended expiration date to flox- Floxuridine is supplied in 5-mL vials containing 500 mg of uridine solutions is, therefore, highly questionable.827 drug.3070 Each vial should be reconstituted with 5 mL of sterile water for injection to yield a solution with a concentration of Syringes approximately 100 mg/mL.3070 Floxuridine (Roche) 50 mg/mL and 1 mg/mL in sodium chloride pH 0.9% was packaged as 3 mL in 10-mL polypropylene infusion A 2% aqueous solution has a pH of 4 to 5.5.3070 pump syringes (Pharmacia Deltec). Little or no loss occurred during 21 days of storage at 30°C.1967 Administration Implantable Pumps Floxuridine is administered only by continuous regional intra- Floxuridine 10 mg/mL was filled into an implantable infu- arterial infusion using an infusion pump after dilution in dextrose sion pump (Fresenius VIP 30) and associated capillary tubing 5% or sodium chloride 0.9% to a volume appropriate for the and stored at 37°C. No floxuridine loss and no contamination 3070 device to be used. from components of pump materials occurred during 6 weeks of storage. However, an unidentified substance appeared in 7 Stability weeks, and 22% loss of floxuridine occurred by 8 weeks.1903 Intact vials of floxuridine should be stored at 20 to 25°C.3070 The Floxuridine (Roche) at concentrations ranging from about reconstituted solution in vials should be stored under refrigera- 2.5 to 12 mg/mL with heparin sodium 200 units/mL in bacte- tion at 2 to 8°C for no longer than 2 weeks.3070 riostatic sodium chloride 0.9% was evaluated for stability in an The pH of optimum stability is 4 to 7. Extreme acidity or implantable infusion pump (Infusaid model 400). In this in vivo alkalinity may result in hydrolysis.1379 assessment, the floxuridine concentrations were determined At a concentration of 5 mg/mL in sodium chloride 0.9%, prior to implantation in patients and again at the time of pump floxuridine supported the growth of several microorgan- refills. No appreciable floxuridine loss occurred during 8 courses 767 isms commonly implicated in nosocomial infections, including of therapy, from 4 to 12 days in duration, in 5 patients. Compatibility Information Solution Compatibility Floxuridine Test Soln Name Mfr Mfr Conc/L or % Remarks Ref C/I Dextrose 5% 5 to 10 g Under 10% loss in 14 days at room temperature 1379 C Dextrose 5% APP Manufacturer-recommended solution 3070 C Sodium chloride 0.9% 5 to 10 g Under 10% loss in 14 days at room temperature 1379 C Sodium chloride 0.9% APP Manufacturer-recommended solution 3070 C Additive Compatibility Floxuridine Test Drug Mfr Conc/L or % Mfr Conc/L or % Test Solution Remarks Ref C/I Carboplatin 1 g 10 g W Under 10% drug loss in 7 days at 23°C 1954 C Cisplatin BR 500 mg RC 10 g NS 13% floxuridine loss in 7 days at room 1386 C temperature in dark Cisplatin with 200 mg 700 mg NS All drugs stable for 7 days at room 1379 C etoposide 300 mg temperature DOI: 10.37573/9781585286850.169 ASHP INJECTABLE DRUG INFORMATION FLOXURIDINE 703 Additive Compatibility (Cont.) Test Drug Mfr Conc/L or % Mfr Conc/L or % Test Solution Remarks Ref C/I Cisplatin with 200 mg 700 mg NS All drugs stable for 7 days at room 1379 C leucovorin calcium 140 mg temperature Etoposide 200 mg 10 g NS Both drugs stable for 15 days at room 1379 C temperature Etoposide with 300 mg 700 mg NS All drugs stable for 7 days at room 1379 C cisplatin 200 mg temperature Fluorouracil 10 g 10 g NS Both drugs stable for 15 days at room 1390 C temperature Leucovorin calcium QU 30 mg QU 1 g NS Physically compatible. Stable for 48 hr 1317 C at 4 and 20°C. No floxuridine and 10% leucovorin loss in 48 hr at 40°C Leucovorin calcium QU 240 mg QU 2 g NS Physically compatible. Stable for 48 hr 1317 C at 4 and 20°C. No floxuridine and 7% leucovorin loss in 48 hr at 40°C Leucovorin calcium QU 960 mg QU 4 g NS Physically compatible. Stable for 48 hr 1317 C at 4, 20, and 40°C Leucovorin calcium 200 mg 10 g NS Both drugs stable for 15 days at room 1387 C temperature protected from light Leucovorin calcium with 140 mg 700 mg NS All drugs stable for 7 days at room 1379 C cisplatin 200 mg temperature Y-Site Injection Compatibility (1:1 Mixture) Floxuridine Test Drug Mfr Conc Mfr Conc Remarks Ref C/I Allopurinol sodium BW 3 mg/mLb RC 3 mg/mLb Tiny particles form in 1 to 4 hr 1686 I Amifostine USB 10 mg/mLa RC 3 mg/mLa Physically compatible for 4 hr at 23°C 1845 C Aztreonam SQ 40 mg/mLa RC 3 mg/mLa Physically compatible for 4 hr at 23°C 1758 C Etoposide phosphate BR 5 mg/mLa RC 3 mg/mLa Physically compatible for 4 hr at 23°C 2218 C Filgrastim AMG 30 mcg/mLa RC 3 mg/mLa Physically compatible for 4 hr at 22°C 1687 C Fludarabine phosphate BX 1 mg/mLa RC 3 mg/mLa Visually compatible for 4 hr at 22°C 1439 C Gemcitabine HCl LI 10 mg/mLb RC 3 mg/mLb Physically compatible for 4 hr at 23°C 2226 C Granisetron HCl SKB 0.05 mg/mLa RC 3 mg/mLa Physically compatible for 4 hr at 23°C 2000 C Melphalan HCl BW 0.1 mg/mLb RC 3 mg/mLb Physically compatible for 3 hr at 22°C 1557 C Ondansetron HCl GL 1 mg/mLb RC 3 mg/mLa Visually compatible for 4 hr at 22°C 1365 C Paclitaxel NCI 1.2 mg/mLa RC 3 mg/mLa Physically compatible for 4 hr at 22°C 1556 C Piperacillin sodium– LEd 40 mg/mLa e RC 3 mg/mLa Physically compatible for 4 hr at 22°C 1688 C tazobactam sodium Sargramostim IMM 10 mcg/mLb RC 3 mg/mLb Visually compatible for 4 hr at 22°C 1436 C Teniposide BR 0.1 mg/mLa RC 3 mg/mLa Physically compatible for 4 hr at 23°C 1725 C.