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Compatibility of Parenteral Furosemide with Seventeen Secondary Drugs Used in Standard Concentrations

Author(s):  Jasti Bhaskara R, Saraf Poonam

Issue:  May/Jun 2011 - Volume 15, Number 3
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Abstract:  The compatibility of furosemide with 17 secondary drugs was studied to determine suitability for Y-site coadministration of the drug combinations. The drugs were tested at their standardized concentrations by visual observation for signs of physical incompatibilities. The secondary drugs were either tested undiluted or diluted in 5% dextrose injection or 0.9% sodium chloride injection as specified. Furosemide (10 mg/mL) was mixed with each of the secondary drugs in equal volume, and the mixture was observed for precipitation and turbidity visible to the unaided eye at 0, 4, and 24 hours after mixing. The pH was monitored over 24 hours for any significant fluctuations. The stability of furosemide was determined in combination with sodium bicarbonate over a 24-hour duration by quantifying, using spectophotometric measurements at the wavelength of 278 nm. Of the 17 secondary drugs evaluated, seven drugs showed incompatibility with furosemide resulting in the formation of gross turbid precipitates upon mixing. Dopamine hydrochloride and magnesium sulfate did not show instantaneous physical incompatibility but showed drug precipitation between 0 to 4 hours. The pH measurements did not show any significant changes in the studied drug combinations. The stability of furosemide with sodium bicarbonate at the tested standard concentrations was established since the concentrations measured up to 24 hours were within 10% of the initial value. Thus furosemide is unsuitable for Y-site coadministration with amiodarone hydrochloride, esmolol hydrochloride, labetalol hydrochloride, dobutamine hydrochloride, diltiazem hydrochloride, dopamine hydrochloride, and magnesium sulfate at their standardized concentrations. Coadministration of furosemide with sodium bicarbonate, norepinephrine bitartrate, phenylephrine hydrochloride, calcium gluconate, procainamide hydrochloride, nitroglycerin, epinephrine hydrochloride, heparin sodium, vasopressin, and insulin, at the standardized concentration, was found to be compatible.

Related Keywords: Bhaskara R. Jasti, PhD, Poonam Saraf, furosemide, parenteral preparations, intravenous administration, compatibility, drug mixtures


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