Implementation

PO: May be administered after milk or meals to minimize gastric irritation; give with plenty of fluid. May be crushed and given with fluid or mixed with food for patients who have difficulty swallowing

IV Adminstration:

• Intermittent Infusion:
Diluent: Reconstitute each 500 mg vial with 25 ml of sterile water for injection. Solution should be clear and almost colorless with only slight opalescence. Dilute to desired concentration with 0.9% NaCl or D5W. Administer within 10 hr of reconstitution; do not refrigerate. Do not administer solutions that are discolored or contain particulate matter.
Concentration: Not >6 mg/ml

• Rate:
Infusion should be initiated 24–48 hr before start of chemotherapy known to cause tumor cell lysis. Rate of infusion depends on volume of infusate (100–300 mg doses may be infused over 30 minutes). May be administered as a single infusion or equally divided infusions at 6-, 8-, or 12-hr intervals

• Y-Site Compatibility:

» acyclovir

» aminophylline

» aztreonam

» bleomycin

» bumetanide

» buprenorphine

» butorphanol

» calcium gluconate

» carboplatin

» cefazolin

» cefotetan

» ceftazidime

» ceftizoxime

» ceftriaxone

» cefuroxime

» cisplatin

» cyclophosphamide

» dactinomycin

» dexamethasone sodium phosphate

» doxorubicin liposome

» enalaprilat

» etoposide

» famotidine

» filgrastim

» fluconazole

» fludarabine

» fluorouracil

» furosemide

» ganciclovir

» granisetron

» heparin

» hydrocortisone

» hydromorphone

» ifosfamide

» lorazepam

» mannitol

» mesna

» methotrexate

» metronidazole

» mitoxandrone

» morphine

» piperacillin

» potassium chloride

» ranitidine

» teniposide

» thiotepa

» ticarcillin/clavulanate

» trimethoprim/sulfamethoxazole

» vancomycin

» vinblastine

» vincristine

» zidovudine

• Y-Site Incompatibility:

» amikacin

» amphotericin B

» carmustine

» cefotaxime

» chlorpromazine

» cimetidine

» clindamycin

» cytarabine

» dacarbazine

» daunorubicin

» diphenhydramine

» doxorubicin

» doxycycline

» droperidol

» floxuridine

» gentamicin

» haloperidol

» idarubicin

» imipenem/cilastatin

» mechlorethamine

» meperidine

» methylprednisolone sodium succinate

» metoclopramide

» minocycline

» nalbuphine

» ondansetron

» prochlorperazine

» promethazine

» sodium bicarbonate

» streptozocin

» tobramycin

» vinorelbine

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