amiodarone incompatibilities

Amiodarone is an effective antiarrhythmic agent and represents the drug of choice in the treatment of severe arrhythmias, especially in the setting of ventricular dysfunction. Adult; loading dose 300mg IV, infusion 900mg over 24 hours. ... n = 54), omeprazole and clopidogrel (8.8%, n = 20), and simvastatin with amiodarone (4.0%, n = 9). In the present study the physicochemical incompatibility of … Amiodarone in D5W is incompatible with the drugs shown in Table 3. Since grapefruit juice is known to inhibit CYP3A-mediated metabolism of oral amiodarone in the intestinal mucosa, resulting in increased plasma levels of amiodarone, Amiodarone was then withdrawn, and she received flecainide. PREPARE: IV Infusion: First rapid loading dose infusion: Add 150 mg (3 mL) amiodarone to 100 mL D5W to yield 1.5 mg/mL. In Australia, information on the shelf life can be found on the public summary of the Australian Register of Therapeutic Goods (ARTG). For single dose use only. Good luck with the ablation. Amiodarone is not a beta blocker. You can stop it suddenly at any time. It has a half life with various quotes ranging from 50 to 180 days. My personal experience is 14 weeks based on INR trends. Incompatibilities/Drug Interactions: Beta blockers, calcium channel blockers, and other antiarrhythmics are additive and can be proarrhythmic when given in combination with amiodarone due to similar mechanisms of action. A literature search showed that amiodarone is incompatible with heparin 19–21 and possibly with PVC, but data concerning this latter interaction are conflicting. Infuse 150 mg over 10 minutes (15 mg/min). Physical incompatibilities are the most easily detected and are evidenced by visible changes, such as particulate formation, haze, precipitation, color change, and gas evolution. IV Drug Compatibility Chart A Alteplase (Activase, rTPA) Amiodarone (Cordarone) Argatroban Atropine Calcium chloride Diltiazem (Cardizem) Dobutamine (Dobutrex) Dopamine Epinephrine (Adrenalin) Esmolol (Brevibloc) Furosemide (Lasix) Heparin Insulin (regular) Lidocaine (Xylocaine) Lorazepam (Ativan) Magnesium Sulfate Documented drug/enteral feed incompatibilities affecting drug absorption e.g. Table 3: Y-SITE INJECTION INCOMPATIBILITY Amiodarone Drug Vehicle Concentration Aminophylline D5W; NS 4 mg/mL Amoxicillin Sodium-Clavulanic Acid unknown 12.5 mg/mL Ampicillin Sodium-Sulbactam Sodium Identify hyperthyroidism by relevant clinical signs and symptoms, NS 6 mg/mL Argatroban5W 1.8 mg/mL D Bivalirudin5W 4 mg/mL D Admixture Incompatibility Amiodarone in D5WInjectionforms precipitateswith the drugs shownin Table 2.If co-administration of the following drugs is necessary, useseparate intravenous administration lines. Amiodarone has the potential for interaction with many cardiac and non-cardiac drugs. Name of the medicinal product. Therapeutic incompatibility 2. Heparin Sodium 2. 12. Table. Blue-grey discoloration of the skin (mostly lighter skin tones, may revert upon cessation but may not return to normal) Abnormal liver enzyme results. carvedilol oral brand names and other generic formulations include: amiodarone oral will increase the level or effect of carvedilol oral by altering drug metabolism. Monitor Closely Use Caution/Monitor. amiodarone oral will increase the level or effect of carvedilol oral by affecting hepatic enzyme CYP2C9/10 metabolism. • Vital signs are to be monitored as indicated in the transfer orders, not less frequently than every 15 minutes. Amiodarone may be diluted in D5W or saline and administered in polyvinyl chloride (PVC), polyolefin, or glass containers. high-grade AV block, bifascicular or trifascicular block) without a presence of pacemaker, cardiogenic shock, severe hypotension, severe respiratory failure, known or history of thyroid dysfunction, known hypersensitivity to iodine, corneal … Amiodarone HCl has the following structural formula: Amiodarone HCl is a white to slightly yellow crystalline powder, and is very slightly soluble in water. 4.1. Intravenous. May precipitate with sodium bicarb, furosemide, and heparin. Oral amiodarone is indicated only for the treatment of severe rhythm disorders not responding to other therapies or when other treatments cannot be used. Drug incompatibility results from the simultaneous dilution and/ ... Digoxin, lorazepam, phenytoin, amiodarone, phytomenadione, and clonazepam are other drugs which show solubility problems and are formulated in injection vehicles other than aqueous vehicles. To assess the cause of the digoxin-amiodarone interaction, the systemic availability and renal excretion of digoxin were examined in 10 patients. Amiodarone HCl Injection has a pH of 4.0 . Compatibility of Selected IV Drugs (continued) Acyclovir Amikacin Amiodarone Ampicillin Ampicillin-sulbactam Anidulafungin Argatroban Azithromycin Aztreonam Bivalirudin Bumetanide Calcium gluconate Caspofungin Cefazolin Cefepime Cefotaxime Cefoxitin Ceftaroline Ceftazidime Ceftizoxime Ceftriaxone Ciprofloxacin Clindamycin Daptomycin Dexamethasone Dextrose 5% … Drug Incompatibilities: nitroprusside, sodium bicarbonate, aminophylline, ampicillin, cephalosporins, digoxin, heparin Monitor blood pressure and apical pulse prior to administration. of adenosine were sold. combinations, potential incompatibilities. Strozyk WR , Williamson R , Thompson D Am J Health Syst Pharm , 53(2):184, 01 Jan 1996 • Types of Drug Incompatibility 1. Amiodarone infusions exceeding 2 hours must be administered in glass or polyolefin bottles containing D W. Do not use evacuated glass containers for admixing, as incompatibility with a buffer in the container may cause precipitation. In other cases, care needs to be taken to ensure that if the injection Three types of incompatibilities are commonly dis-cussed: physical, chemical, and therapeutic. For single dose use only. Therapeutic indications. Due to the long half-life of amiodarone, interactions may be observed for several months after discontinuation of amiodarone. Solutions containing less than two ampoules Amiodarone in 500 ml dextrose 5% are unstable and should not be used. Hepatotoxicity Amiodarone is also associated with hepatotoxicity and treatment should be discontinued if severe liver function abnormalities or clinical signs of liver disease develop. • Since amiodarone is a substrate for CYP3A and CYP2C8, drugs/substances that inhibit these isoenzymes may decrease the metabolism and increase serum concentration of amiodarone. Prepare solution with 900 mg amiodarone in 500 mL D5W glass bottle. 1. - mixed together, e.g. I have never known this but apparently amiodarone is not compatible with saline. Incompatibility between intravenous amiodarone and heparin in an infant Amiodarone is an effective antiarrhythmic agent and represents the drug of choice in the treatment of severe arrhythmias, especially in the setting of ventricular dysfunction. Patients were studied before and after 1 week and 6 weeks of concurrent amiodarone therapy, and four were also studied after 4-8 months. Physical incompatibility 3. ... Be careful and be sure to specify the information on the section Incompatibilities in the instructions to the drug Hexarone directly from the package or from the pharmacist at the pharmacy. Incompatibility of amiodarone hydrochloride and evacuated glass bottles. Amiodarone diluted with 5% dextrose solution to a concentration of less than 0.6 mg/ml is unstable. Amiodarone may be diluted in D5W or saline and administered in polyvinyl chloride (PVC), polyolefin, or glass containers. Nonetheless few incompatibilities have been reported. INCOMPATIBILITY OF INTRAVENOUS AMIODARONE WITH A SWAN-GANZ CATHETER To find the cause of this low AM concentration and compare the results when administered through a SGC with or without heparin. Amiodarone- Side Effects. Monitor the injection site closely. Use of evacuated glass containers for admixing amiodarone HCl injection is not recommended as incompatibility with a buffer in the container may cause precipitation. Amiodarone (Incompatibilities) Beta and calcium channel blockers. Manufacture may IV (Y-site) Drug-Incompatibility Dataa Incompatible drugs AVOID Y-site administration with Zosyn® Variable Compatibility Acyclovir Amiodarone HCL Amphotericin B Caspofungin Chlorpromazine Cisplatin Daunorubicin Decarbazine Dobutamine Doxorubicin Doxycycline Droperidol Famotidine Ganciclovir Gemcitabine Haloperidol Hydroxyzine Idarubicin Mitomycin Incompatibility is present when visible or electronically-determined precipitates, particulates, haziness, turbidity, color, or gas evolution are detected. Amiodarone must not be diluted with sodium chloride 0.9%. The loss of drug concentration due to adsorption onto surfaces or absorption into polymer matrices has been documented for a number of drug entities. • Amiodarone inhibits p-glycoprotein and certain CYP450 enzymes, including CYP1A2, CYP2C9, CYP2D6, and CYP3A. IV Drug Compatibility Chart A Alteplase (Activase, rTPA) Amiodarone (Cordarone) Argatroban Atropine Calcium chloride Diltiazem (Cardizem) Dobutamine (Dobutrex) Dopamine Epinephrine (Adrenalin) Esmolol (Brevibloc) Furosemide (Lasix) Heparin Insulin (regular) Lidocaine (Xylocaine) Lorazepam (Ativan) Magnesium Sulfate However the European Pharmacopoeia High Performance Liquid Chromatography (HPLC) method was not performed because of a worldwide shortage of … Reference texts can provide information, but data are often unavailable for new drugs. If co-administration of the following drugs is necessary, use separate intravenous administration lines. Do not use evacuated glass containers for admixing, as incompatibility with a buffer in the container may cause precipitation. 6.2 Incompatibilities. Physical incompatibility 3. Intravenous to Oral Transition. These medications are not usually taken together. Amiodarone is a P-gp inhibitor. For single dose use only. Paediatric; loading dose 5mg/kg IV, infusion 15mg/kg over 24 hours. Do not use evacuated glass containers for admixing, as incompatibility with a buffer in the container may cause precipitation. Intravenous Drug Incompatibilities in the Intensive Care Unit- A Review . The initial infusion rate is not greater than 30 mg/min. This information is intended for use by health professionals. • Types of Drug Incompatibility 1. Weir et al demonstrated sorption of amiodarone to PVC infusion bags with a significant loss … Solutions containing less than two ampoules Amiodarone in 500 ml dextrose 5% are unstable and should not be used. See package insert for oral amiodarone. This inhibition Known incompatible agents Variable compatibility (Consult detailed reference) Amiodarone hydrochloride Amphotericin B conventional colloidal Amphotericin B lipid complex (Abelcet) Amphotericin B liposome (AmBisome) Amphotericin B Ciprofloxacin Dacarbazine Daunorubicin citrate liposome Diazepam Dolasetron If intravenous amiodarone is administered during pregnancy, the patient should be apprised of the potential hazard to the fetus. We aimed to identify whether variation in the clinical use of amiodarone was associated with recurrent atrial fibrillation. 1. Amiodarone increases PO digoxin serum concentrations by ~70% and IV digoxin by ~17%; measure digoxin levels before initiating amiodarone and reduce PO digoxin dose by 30-50%; decrease IV digoxin dose by 15-30% amiodarone will increase the level or effect of digoxin by basic (cationic) drug competition for renal tubular clearance. Admixture Incompatibility Amiodarone in D 5 W Injection forms precipitates with the drugs shown in Table 2. Incompatibilities Amiodarone is incompatible with many drugs. What should pharmacy technicians be advised about combining amiodarone injection with other injections? Incompatibility can involve precipitation, ionic reactions, evolution of gas and denaturation of biological molecules. Pulmonary toxicity Pneumonitis should always be suspected if new or progressive shortness of breath or cough develops in a patient taking amiodarone. HOW SUPPLIED -----Amiodarone Hydrochloride Injection, 50 mg/mL is supplied in: 3 mL (150 mg) 10 Single-dose vials per carton (NDC 60505-0722-0). . Atrial fibrillation is a common rhythm disturbance in the general medical-surgical intensive care unit. Interstitial lung disease. • Severe respiratory failure, circulatory collapse, or severe arterial hypotension; hypotension, heart failure and cardiomyopathy are also contra-indications when using amiodarone as a bolus injection • The concomitant administration of amiodarone with drugs which may prolong the QT interval (see section 4.5) Qualitative and quantitative composition. Amiodarone precipitates at certain concentrations when mixed at a Y-site with sodium bicarbonate or furosemide. Amiodarone infusions exceeding 2 hours must be administered in glass or polyolefin bottles containing D 5 W. Do not use evacuated glass containers for admixing, as incompatibility with a buffer in the container may cause precipitation. Author Comment “[W]e suspected the incompatibility between amiodarone and heparin as the explanation for the therapeutic failure.” FormalPara Key words Admixture Incompatibility. Patients whose arrhythmias have been suppressed by amiodarone may be switched to oral amiodarone. Nonetheless few incompatibilities have been reported. 1. When given into a peripheral vein, injection site reactions are common and includ e severe pain, phlebitis and necrosis. Table. Amiodarone can cause serious adverse reactions affecting the eyes, heart, lung, liver, thyroid gland, skin and peripheral nervous system (see section 4.8). Amiodarone Hydrochloride infusions. Admixture Incompatibility . high-grade AV block, bifascicular or trifascicular block) without a presence of pacemaker, cardiogenic shock, severe hypotension, severe respiratory failure, known or history of thyroid dysfunction, known hypersensitivity to iodine, corneal … Amiodarone 200 mg Tablets. ... amiodarone hydrochloride or adrenaline acid tartrate). carbamazepine, ciprofloxacin, hydralazine, phenytoin, theophylline, warfarin.3,6 Stop the feed for 1h before and 1–2h after administering the drug (phenytoin 2h before and after);3 dilute the drug as much as possible, and flush with 30–60ml water. Does AMIODARONE HCL Interact with other Medications? • Y-injection incompatibility; the following will precipitate with Amiodarone Hydrochloride: 1. A drug incompatibility occurs when two or more injectable drugs are mixed and the stability or structure of the drugs is altered by physical or chemical reactions. 2 reported substantial loss of insulin to infusion solution containers and administration sets. Store at 20° to 25°C (68° to 77°F) Protect from light. Amiodarone diluted with 5% dextrose solution to a concentration of less than 0.6 mg/ml is unstable. The resulting solution is often no longer optimal or safe for the patient. Drug Incompatibility • Definition of Drug Incompatibility: Drug Incompatibility refers to interactions between two or more substances which lead to changes in chemical, physical, therapeutic properties of the pharmaceutical dosage form. Because these reactions may be delayed, patients on long-term treatment should be carefully supervised. We report the incompatibility between amiodarone and heparin administrated in the same vein in a case of a one month old baby with atrial flutter. Medscape - Indication-specific dosing for (milrinone), frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and … Amiodarone has been reported to reduce the clearance of lidocaine (lignocaine) in two case reports, although a small prospective study of combined therapy on lidocaine (lignocaine) pharmacokinetics found no change in clearance or other pharmacokinetic factors. Amiodarone diluted with 5% dextrose solution to a concentration of less than 0.6 mg/ml is unstable. Amiodarone is incompatible with saline and should be administered solely in 5% dextrose solution. Amiodarone- Incompatibility. Amiodarone adsorbs to polyvinyl chloride (PVC) tubing, but all of the clinical experience has been Loading dose given as a slow IV push over 1-2 minutes in the critical patient. Manufacture may sometimes recommend administering the drug drugs and inappropriate IV solutions as diluent. Amiodarone Hydrochloride Injection is a solution containing amiodarone hydrochloride, an iodinated benzofuran-derivative antiarrhythmic agent. Amiodarone hydrochloride, an antiarrhythmic and vasodilatory drug, was characterized from a thermodynamic point of view. The loss of drug concentration due to adsorption onto surfaces or absorption into polymer matrices has been documented for a number of drug entities. It is important to recognize that compatibility is not just a function of the drugs themselves, but also is dependent upon a variety of factors, including concen- • Since amiodarone is a substrate for CYP3A and CYP2C8, drugs/substances that inhibit these isoenzymes may decrease the metabolism and increase serum concentration of amiodarone. In clinical trials, treatment-emergent, drug-related hypotension was reported as an adverse effect in 288 (16%) of 1836 patients treated with intravenous amiodarone. Amiodarone is most soluble and most stable at acidic pH. Amiodarone given during the preoperative period has been reported to react with anesthetic agents and cause pulmonary dysfunction, hypotension, hepatic dysfunction, and low heart flow. Amiodarone has the potential for interaction with many cardiac and non-cardiac drugs. (Class IIb Level of Evidence C) 10 Amoxicillin/ Clavulanate No data available. Its formulation contains amiodarone HCl, polysorbate 80, benzyl alcohol, and water for injection. Reference ID: 4853130 This was a retrospective audit of 177 critically ill … Prepare solution with 150 mg amiodarone in 100-mL D5W bag. IV INCOMPATIBILITIES Amphotericin B complex (Abelcet, AmBi- some, Amphotec), cefepime (Maxipime), doxorubicin (Doxil), phenytoin (Dilantin). When changing to oral amiodarone therapy, clinical monitoring is recommended, particularly for elderly patients. Interestingly, incompatibility occurred when vasopressin and furosemide were both at the lower concentration (0.4 units/mL and 4 mg/mL, respectively) regardless of the vehicle . Active learning template: M e d i c a t i o n Medication: Amiodarone … Admixture Incompatibility Amiodarone in D 5 W Injection forms precipitates with the drugs shown in Table 2. Rare: Jaundice, Hepatomegaly, Hepatitis, Pseudo-alcoholic cirrhosis. PURPOSE Fig.1–exampleofaSwan-Ganz Thermodilution Catheter … It is well known that amiodarone adsorbs to polyvinyl chloride (PVC) tubing and the clinical trial dose administration schedule was designed to account for this adsorption. Suggest no dose adjustment required. Sodium Bicarbonate • Amiodarone Hydrochloride The information provided in Incompatibilities of Bio-Amiodarone is based on data of another medicine with exactly the same composition as the Bio-Amiodarone. View Notes - Amiodarone .pdf from NURSING 360 at Hawkeye Community College. Amiodarone is incompatible with saline and should be administered solely in 5% dextrose solution. Incompatibilities were either not assessed or not identified as part of the registration of this medicine. Amiodarone and/or its metabolite, desethylamiodarone, inhibit CYP1A1, CYP1A2, CYP3A4, CYP2C9, CYP2D6 and P-glycoprotein and may increase exposure of their substrates. Mean (+/- SD) pea … Prism's initial submission supported vial and syringe presentations. Amiodarone is indicated only for the treatment of severe cardiac rhythm disorders not responding to other therapies or when other treatments cannot be used. PREPARE: IV Infusion: First rapid loading dose infusion: Add 150 mg (3 mL) amiodarone to 100 mL D5W to yield 1.5 mg/mL. For a full list of excipients, see section 6.1. He states that it is okay to draw it up with NS and give it fast IV push during a cardiac arrest, but that if you mix it in a bag of NS and infuse it, the drug will precipitate. Amiodarone has the potential for interaction with many cardiac and non-cardiac drugs. IV COMPATIBILITIES Amiodarone (Cordarone), atropine, bu- metanide (Bumex), bupivacaine (Mar- caine, Sensorcaine), dexmedetomidine. Amiodarone precipitates at certain concentrations when mixed at a Y-site with sodium bicarbonate or furosemide. In some cases, the manufacturer recommends administration of the undiluted drug. After consuming a high-fat meal, the AUC of amiodarone increased 2.3 times the fasting and the C max increased 3.8 times the fasting value. 3. In 2008, Prism received approval for Amiodarone (Nexterone) in a vial presentation. FDA has received reports that the adenosine and amiodarone pre-filled glass syringes can become clogged and malfunction during the process of connecting them to pin-activated needleless IV access systems. Amiodarone infusions exceeding 2 hours must be administered in glass or polyolefin bottles containing D 5 W. Do not use evacuated glass containers for admixing, as incompatibility with a buffer in the container may cause precipitation. D5W = Dextrose 5% in Sterile Water, NS = Normal Saline Amiodarone 30mg/ml Injection is a clear, slightly yellow solution, practically free from particulates. Oral amiodarone is known to be insufficient for preventing postoperative arrhythmia, but sometimes the preoperative loading dose can prove sufficient. Amiodarone (Adult dosage: VF/Pulseless VT) 300 mg IV over 30 - 60, repeat 3 - 5 min with 150 mg. Amiodarone (Adult dosage: Wide complex tachycardia, a fib, a flutter, SVT w/ cardioversion) Incompatibilities/Drug Interactions: Beta blockers, calcium channel blockers, and other antiarrhythmics are additive and can be proarrhythmic when given in combination with amiodarone due to similar mechanisms of action. Severe Interactions . . Second infusion during first 24 h (slow loading dose and maintenance infusion): Add 900 mg (18 mL) amiodarone to 500 mL D5W to yield 1.8 mg/mL. A chance of incompatibility exists whenever one or more medications are combined or added to an IV fluid. Loading dose given over a minimum of 20 minutes in the non-critical patient. To make sure this medicine is safe for you, tell your doctor if you have ever had:asthma or another lung disorder;liver disease;a thyroid disorder;vision problems;high or low blood pressure;an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); orif you have a pacemaker or defibrillator implanted in your chest. Amiodarone HCl injection infusions exceeding 2 hours must be administered in glass or polyolefin bottles containing D 5 W. Use of evacuated glass containers for admixing amiodarone HCl injection is not recommended as incompatibility with a … Amiodarone HCl is (2-butyl-3-benzofuranyl)[4-[2-(diethylamino)ethoxy]-3,5-diiodophenyl]methanone hydrochloride. Learn incompatibility with free interactive flashcards. Drug interactions Nursing responsibilities Continuous cardiorespiratory monitoring. Do not administer with TPN solution or Intralipid. Reshma Ramesan¹, Dhanya Dharman² . Background Amiodarone has been widely dispensed as capsules prepared in the pharmacy department for paediatric patients. Each tablet contains 200 mg of amiodarone hydrochloride. Between January 2009 through August 2010, 3.6 million single items (vials, syringes, bottles, etc.) A study of Captisol-enabled ® Amiodarone demonstrated no changes in blood pressure. Therapeutic incompatibility 2. Compatibility of Selected IV Drugs (Acyclovir through Dextrose 5% in water) Acyclovir Amikacin Amiodarone Ampicillin Ampicillin-sulbactam Anidulafungin Argatroban Atracurium Azithromycin Aztreonam Bivalirudin Bumetanide Calcium gluconate Caspofungin Cefazolin Cefepime Cefotaxime Cefoxitin Ceftaroline Ceftazidime Ceftizoxime Ceftriaxone Ciprofloxacin … W Injection forms precipitates with the drugs shown in Table 2. Amiodarone HCL Amphotericin B Caspofungin Chlorpromazine Cisplatin Daunorubicin Decarbazine Dobutamine Doxorubicin Doxycycline Droperidol Famotidine ... Promethazine Streptozocin Tobramycinb Cisatracuriumc Vancomycind aTable lists known Y-site incompatibilities with pip/tazo, for all other agents, refer to Micromedex for compatibility … Use of evacuated glass containers for admixing amiodarone HCl injection is not recommended as incompatibility with a buffer in the container may cause precipitation. PgP Substrates. Amiodarone is an effective antiarrhythmic agent and represents the drug of choice in the treatment of severe arrhythmias, especially in the setting of ventricular dysfunction. Hypotension is the most common adverse reaction seen with intravenous amiodarone. Table 2: Y-SITE INJECTION INCOMPATIBILITY Drug Vehicle Amiodarone Concentration Aminophylline D5W; NS 4 mg/mL Amoxicillin Sodium-Clavulanic Acid If co-administration of the following drugs is necessary, use separate intravenous administration lines. PURPOSE Fig.1–exampleofaSwan-Ganz Thermodilution Catheter … When changing to oral amiodarone therapy, clinical monitoring is recommended, particularly for elderly patients. It is well known that amiodarone adsorbs to polyvinyl chloride (PVC) tubing and the clinical trial dose administration schedule was designed to account for this adsorption. The risk of phlebitis increases with the dose and duration of the infusion.4 Amiodarone is adsorbed onto PVC and leaches plasticiser from PVC.1,2 For Amiodarone is a popular drug in this setting but evidence to inform clinical practice remains scarce. Cardiac monitor should be used on patients receiving amiodarone therapy. Admixture Incompatibility. A 10% or greater loss of intact drug within 24 hours is also considered evidence of incompatibility. Amiodarone: Belongs to class III antiarrhythmics., Sinus bradycardia, sino-atrial heart block, severe conduction disturbances (e.g. 1 In 1968, Weisenfeld et al. Food may enhance rate and extent of absorption. Dose. ... phenytoin, amiodarone and phytomenadione. Pulmonary toxicity Pneumonitis should always be suspected if new or progressive shortness of breath or cough develops in a patient taking amiodarone. Choose from 421 different sets of incompatibility flashcards on Quizlet. 2. amiodarone Cordarone® polysorbate (tween) paracetamol Perfalgan® mannitol, phosphate, NaOH esomeprazole Nexium® NaOH, EDTA phenytoin Phenhydan® glycofurol-75, EDTA clonazepam Rivotril® propyleneglycol, acetic acid Co-solvent and/or adjusting pH can increase the solubility of drugs in solution Drug incompatibility 12 At least 35 additional published articles and research studies have addressed this sorptive loss of … If coadministration of the following drugs is necessary, use separate intravenous administration lines. 6.3 Shelf Life. Ex: amiodarone, nitroglycerine, tacrolimus HUG: Flexs Bioren and syringues BD in PP Standard iv-lines in PVC Connecting lines for syrines in PE adsorption to in … • Y-injection incompatibility; the following will precipitate with Amiodarone Hydrochloride: 1.

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