Physical Compatibility of Alprostadil with Commonly Used IV Solutions and Medications in the Neonatal Intensive Care Unit

Abstract

To determine the physical compatibility of alprostadil with intravenous (IV) solutions, a parenteral nutrition (PN) solution, and other intravenous medications commonly used in the neonatal intensive care unit (NICU). To simulate y-site administration, each IV solution and the PN solution were slowly mixed 1:1 with alprostadil 15 μg/mL at 25°C. The mixtures were gently shaken and visually examined at 1, 15, 30, 45, and 60 minutes for physical incompatibility (gross precipitation, color change, haze, separation or gas production). In addition, each test tube was touched to assess for gross temperature change. The above mixtures were made a second time and each mixture was slowly mixed 1:1 with each of the test medications at 25°C. The ampicillin-parenteral nutrition and the chlorothiazide-parenteral nutrition solution mixtures were not tested with alprostadil. The mixtures were examined for physical incompatibility as described above. Alprostadil was visually compatible with D5W 0.45% NaCl, D5W 0.45% NaCl with 20 mEq KCl/L, D10W 0.45% NaCl, D10W 0.45% NaCl with 20mEq KCl/L, and a PN solution. Alprostadil was visually compatible with ampicillin, cefazolin, cefotaxime, chlorothiazide, dobutamine, dopamine, fentanyl, furosemide, gentamicin, methylprednisolone, tobramycin, vancomycin and vecuronium when mixed in D5W 0.45% NaCl, D5W 0.45% NaCl with 20mEq KCl/L, D10W 0.45% NaCl, and D10W 0.45% NaCl with 20mEq KCl/L. Alprostadil was visually compatible with cefazolin, cefotaxime, dobutamine, dopamine, fentanyl, furosemide, gentamicin, methylprednisolone, tobramycin, vancomycin and vecuronium when mixed in a PN solution. In addition, no gross temperature change was detected in any mixture. Based on the results, alprostadil is physically compatible with the tested IV solutions and a PN solution, as well as commonly prescribed IV medications used in the NICU when mixed with the tested IV solutions and a PN solution.