Implementation

• Do not confuse Cytovene (ganciclovir) with Cytosar (cytarabine)

» Prepare solution in a biologic cabinet. Wear gloves, gown, and mask while handling medication. Discard IV equipment in specially designated containers

» Do not administer subcut or IM; severe tissue irritation may result

• PO: Administer capsules with food. Swallow capsules whole; do not open, crush, or chew

• IV: Observe infusion site for phlebitis. Rotate infusion site to prevent phlebitis

» Maintain adequate hydration throughout therapy

• Intermittent Infusion:
Reconstitute 500 mg with 10 mL of sterile water for injection for a concentration of 50 mg/mL. Do not reconstitute with bacteriostatic water with parabens; precipitation will occur. Shake well to dissolve completely. Discard vial if particulate matter or discoloration occurs. Reconstituted solution is stable for 12 hr at room temperature; do not refrigerate
Diluent: Dilute in 100 mL of D5W, 0.9% NaCl, Ringer's or LR. Once diluted for infusion, solution should be used within 24 hr. Refrigerate but do not freeze
Concentration: 10 mg/mL

• Rate:
Administer slowly, via infusion pump, over 1 hr using an in-line filter. Rapid administration may increase toxicity

• Y-Site Compatibility:

» alfentanyl

» allopurinol

» amphotericin B cholesteryl

» anidulafungin

» atropine

» bivalirudin

» calcium gluconate

» carboplatin

» caspofungin

» cisplatin

» cyanocobalamin

» cyclophosphamide

» cyclosporine

» dactinomycin

» daptomycin

» dexamethasone

» dexmedetomidine

» digoxin

» docetaxel

» doxacurium

» doxorubicin liposome

» enalaprilat

» epoetin alfa

» eptifibatide

» ertapenem

» etoposide

» etoposide phosphate

» fentanyl

» filgrastim

» fluconazole

» fluorouracil

» folic acid

» furosemide

» glycopyrrolate

» granisetron

» heparin

» hetastarch

» hydromorphone

» ifosfamide

» indomethacin

» insulin

» labetalol

» linezolid

» lorazepam

» mannitol

» mechlorethamine

» melphalan

» methotrexate

» metoprolol

» milrinone

» mitoxantrone

» nafcillin

» naloxone

» nesiritide

» nitroglycerin

» nitroprusside

» octreotide

» oxytocin

» paclitaxel

» pancuronium

» pantoprazole

» pemetrexed

» pentobarbital

» phenobarbital

» phytonadione

» potassium chloride

» propofol

» propranolol

» protamine

» ranitidine

» remifentanil

» rituximab

» rocuronium

» sodium acetate

» sufentanil

» teniposide

» thiotepa

» tigecycline

» tirofiban

» trastuzumab

» trimetaphan

» vasopressin

» vincristine

» voriconazole

• Y-Site Incompatibility:

» aldesleukin

» amifostine

» amikacin

» aminophylline

» amphotericin B colloidal

» ampicillin

» ampicillin/sulbactam

» amsacrine

» ascorbic acid

» atracurium

» azathioprine

» aztreonam

» bumetanide

» butorphanol

» cefazolin

» cefepime

» cefonocid

» cefoperazone

» cefotaxime

» cefotetan

» cefoxitin

» ceftazidime

» ceftizoxime

» ceftriaxone

» cefuroxime

» chloramphenicol

» chlorpromazine

» cimetidine

» clindamycin

» cytarabine

» dantrolene

» diazepam

» diazoxide

» diltiazem

» diphenhydramine

» dobutamine

» dopamine

» doxorubicin

» doxycycline

» ephedrine

» epinephrine

» epirubicin

» erythromycin

» esmolol

» famotidine

» fenoldopam

» fludarabine

» foscarnet

» gemcitabine

» gentamicin

» haloperidol

» hydralazine

» hydrocortisone

» hydroxyzine

» idarubicin

» imipenem/cilastatin

» inamrinone

» isorpoterenol

» isoproterenol

» ketorolac

» levofloxacin

» lidocaine

» meperidine

» metaraminol

» methoxamine

» methyldoapte

» methylprednisolone

» metoclopramide

» metronidazole

» midazolam

» morphine

» multivitamins

» nalbuphine

» norepinephrine

» ondansetron

» palonosetron

» penicillin G

» pentazocine

» phentolamine

» phenylephrine

» phenytoin

» piperacillin/tazobactam

» procainamide

» prochlorperazine

» promethazine

» pyridoxime

» quinupristin/dalfopristin

» sargramostim

» sodium bicarbonate

» streptokinase

» succinylcholine

» tacrolimus

» theophylline

» thiamine

» ticarcillin/clavulanate

» tobramycin

» tolazoline

» trimethoprim/sulfamethoxazone

» vancomycin

» verapamil

» vinorelbine

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