BC Cancer

BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART
DRUG & STRENGTH Reconstitute To Give: Vial Product Product Stability Special
(Storage Prior to Use, With: Stability Precautions/Notes
Manufacturer, Preservative
Status)
Leucovorin
1 1,2
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8 h RT
1
(GMP) portion
(F)(PFL)
1
no preservative 0.05-10 mg/mL NS, D5W, LR,
NS, D5W, Ringer’s, Ringer’s:
1,2 1
LR, D10W, D5NS 24 h RT
(e.g., 50-250 mL*) D10W, D5-NS:

1
8 h RT
Leucovorin
3 3 3
50 mg/5 mL N/A 10 mg/mL 8h syringe 8 h RT
500 mg/50 mL
(Pfizer/Hospira)
(F)(PFL) 0.05 – 10 mg/mL NS, NS, D5W, LR,
3
no preservative D5W, LR, Ringer’s, Ringer’s:
3 3
D10W, D5NS 24 h RT
(e.g., 50-250 mL*) D10W, D5NS:

3
8 h RT
BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 1/42

Activation Date: 2 March 2006
Revised Date: 1 August 2019
Status)
Leucovorin
5 6,7
50 mg/5 mL N/A 10 mg/mL discard unused syringe 8h
5
500 mg/50 mL portion
(Teva)
(F)(PFL)
4 8
no preservative 0.4 - 4.8 mg/mL NS, 72 h F, RT
8
D5W
(e.g., 50-250 mL*)
0.06 - 0.4 mg/mL NS, NS:

4 4
D5W 24 h RT
D5W:
4
12 h RT
0.06 - 1 mg/mL Ringer’s, LR:

4
Ringer’s, Lactated 24 h RT
Ringer’s, D10W,
4
D10NS D10W:
4
12 h RT
D10NS:
4
6 h RT

Status)
Melphalan
9 9
50 mg 10mL supplied 5 mg/mL 2 h RT 0.1 – 0.45 mg/mL in complete
9 9
(GSK) diluent NS only administration within
(RT)(PFL) do NOT 60 min from time of
9
no preservative immediately after refrigerate (e.g., greater than 45 initial reconstitution at
10
adding diluent, mg and less than or RT
9
shake vigorously equal to 110 mg in
250 mL NS)*
record time of
reconstitution
Mesna
11
400 mg/4 mL N/A 100 mg/mL discard unused greater than 1 mg/mL complete
11
1000 mg/10 mL portion in D5W, D5½NS, NS, administration within
11-13 11
(Baxter) (use filter needle to LR 24 h RT
(RT) withdraw from
11
no preservative ampoule)
Mesna
11 11
1000 mg/10 mL N/A 100 mg/mL 8 days RT greater than 1 mg/mL complete
5000 mg/50 mL in D5W, D5½NS, NS, administration within
11-13 11
(Baxter) (vial may be LR 24 h RT
(RT) punctured up to 4
11 11
preservative times)
Mesna
14 14,15 14
1000 mg/10mL N/A 100 mg/mL 14 d RT,F greater than or equal 24 h RT, 48 h F
(Fresenius Kabi) to 1 mg/mL in NS or
16
(RT) D5W
14
preservative

Status)
Methotrexate
17
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
17
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
17 2
1 g/40mL portion 12 g/m as a single
18-22
(Accord) dose) : use
(RT)(PFL) 500 mg or 1 g: 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
17 17 17 17 17
no preservative 8 h RT D5W initial puncture methotrexate
- do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 17
(e.g., 1-12 g/m as a initial puncture
18-22
single dose) : 1000
mL* NS **(PFL)
Methotrexate
17 2
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info
17 2
Only preservative free portion preservative free puncture - label to include
24,25
methotrexate may be NS route in full (i.e.,
administered by the INTRATHECAL
23
intrathecal route injection) attached
50 mg/2mL to both syringe and
26
(Accord) outer ziplock bag
(RT)(PFL)
17
no preservative

Status)
Methotrexate
17 2,17 2
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
17
500 mg/20mL alcohol
(Accord) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
17 high-dose
17
preservative D5W
17 regimens (e.g., 1-
2
12 g/m as a single
17
(100 mL* NS, D5W) dose)
- do NOT use for IT
17
injection
Methotrexate
27
50 mg/2mL N/A 25 mg/mL 50mg: syringe use within 8 h RT of - for high-dose
27
500 mg/20mL discard unused initial puncture regimens (e.g., 1-
27 2
1 g/40mL portion 12 g/m as a single
18-22
2.5 g/100 mL dose) : use
(Pfizer/Hospira) 500 mg, 1 g, or 0.4–2 mg/mL NS, use within 24 h RT of preservative-free
27 27 27
(RT)(PFL) 2.5 g: D5W initial puncture methotrexate
27 27
no preservative 8 h RT - do not use for IT
(100 mL* NS, D5W) **(PFL) injection
high dose use within 24 h RT of

2 27
(e.g., 1-12 g/m as a initial puncture
18-22
single dose) : 1000
mL* NS **(PFL)

Status)
Methotrexate
27 2
IT Injection N/A 25 mg/mL discard unused qs to 6 mL with use within 4 h of initial - auxiliary info :
27 15
Only preservative free portion preservative free puncture “IT”
24,25
methotrexate may be NS - label to include
administered by the route in full (i.e.,
23
intrathecal route INTRATHECAL
50 mg/2mL injection) attached
(Pfizer/Hospira) to both syringe and
26
(RT)(PFL) outer ziplock bag
27
no preservative
Methotrexate
27 15,27 15
50 mg/2mL N/A 25 mg/mL 14 d F syringe 14 d F - contains benzyl
27
500 mg/20mL alcohol
(Pfizer/Hospira) - do NOT use for
(RT)(PFL) 0.4–2 mg/mL NS, 24 h RT
27 high-dose
27
preservative D5W
27 regimens (e.g., 1-
2
12 g/m as a single
27
(100 mL* NS, D5W) dose)
- do NOT use for IT
27
injection
Mitomycin
28 28 28 28
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Accord)
28 28 28
(RT)(PFL) shake well **(PFL) **(PFL)
28
no preservative

Status)
Mitomycin
28 28 28 28
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
28 28 28
(Accord) shake well **(PFL) **(PFL)
(RT)(PFL)
28
no preservative
29 29
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
28 30 30,31
shake well to prevent precipitation solubility
30
precipitation - do NOT
30
refrigerate
Mitomycin
28 28 28 28
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS:
28
20 mg 3 h RT, 18 h F
28 28 28
(Accord) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
28 28
no preservative 3 h RT, 6 h F
Mitomycin
32 32 32 32
20 mg 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
(Teva/Novopharm)
32 32 32
(RT)(PFL) shake well **(PFL) **(PFL)
32
no preservative

Status)
Mitomycin
32 32 32 32
intravesical 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F syringe 6 h RT, 72 h F
20 mg
32 32 32
(Teva/Novopharm) shake well **(PFL) **(PFL)
(RT)(PFL)
32
no preservative
29 29
10 mL SWI 2 mg/mL use immediately syringe use immediately after - may precipitate
after preparation preparation to prevent due to low
32 30 30,31
shake well to prevent precipitation solubility
30
precipitation - do NOT
30
refrigerate
Mitomycin
32 32 32 32
intraperitoneal 40 mL SWI 0.5 mg/mL 6 h RT, 72 h F 0.02-0.04 mg/mL NS:
32
20 mg 6 h RT, 18 h F
32 32 32
(Teva/Novopharm) shake well **(PFL) NS, sodium lactate
(RT)(PFL) sodium lactate:
32 32
no preservative 6 h RT, F
mitoXANTRONE
33 33 33
20 mg/10 mL N/A 2 mg/mL discard unused NS, D5W 24 h RT
33
(Fresenius Kabi) portion
(RT) Greater than or equal
33 33
no preservative to *50 mL

Status)
mitoXANTRONE
34 34 34
20 mg/10 mL N/A 2 mg/mL discard unused 0.2-0.6 mg/mL NS: 24 h F, RT
34
25 mg/12.5 mL portion
34 34
(Hospira) NS, D5W **(PFL)
(RT)(PFL)
34
no preservative Greater than or equal
34
to *50 mL
mitoXANTRONE
35 35
20 mg/10 mL N/A 2 mg/mL discard unused Greater than or equal 24 h RT
35 35
(Teva/Novopharm) portion to *50 mL NS, D5W
36
(RT)(PFL) **(PFL)
35
no preservative
Nivolumab
37
40 mg/4 mL N/A 10 mg/mL discard unused 1-10 mg/mL NS, complete - administer with a
37 37
100 mg/10 mL portion D5W administration within 0.2 to 1.2 micron
37 37
(BMS) 8 h RT or 24 h F in-line filter
(F)(PFL) (50-100* mL) - discard if cloudy
37
do not shake **(PFL) or has pronounced
37
no preservative mix by gentle colour change
inversion; do not (should be clear to
37 37
shake pale yellow)

Status)
oBINutuzumab
38 38,40
1000 mg/40 mL N/A 25 mg/mL discard unused 100 mg: 24 h F, 48 h RT -once removed
39 38
(Hoffman-La Roche) portion in 100 mL NS from the fridge,
**
(F)(PFL) diluted product is
do not shake 900 mg: stable for an
38 38
no preservative in 250 mL NS additional 48 h
38,40
RT
38
1000 mg: - do NOT shake
38
in 250 mL NS - do NOT use
dextrose containing
38
solutions
Octreotide
41 41 41 41
50 mcg/mL N/A 50 mcg/mL Use within 4 h NS 24 h RT
100 mcg/mL
41
500 mcg/mL 100 mcg/mL volume adjusted to
(Omega) ensure a continuous
41
(F)(PFL) 500 mcg/mL infusion of octreotide
41 41
no preservative at 25 mcg/hour
Octreotide
41 41 41 41
multidose vial: N/A 200 mcg/mL 15 d F NS 24 h RT
1000 mcg/5 mL
(Omega) volume adjusted to
(F)(PFL) ensure a continuous
41
preservative infusion of octreotide
41
at 25 mcg/hour

Status)
Octreotide
42 42 42
50 mcg/mL N/A 50 mcg/mL discard unused SC syringe use within 4 h
42
100 mcg/mL portion
42
500 mcg/mL 100 mcg/mL
(Teva/Novopharm)
42 42 42
(F)(PFL) 500 mcg/mL infusion: NS 24 h RT
42
no preservative
Octreotide
42 42,43 42,43
multidose vial: N/A 200 mcg/mL 14 d F SC syringe use within 14 d F
1000 mcg/5 mL
(Teva/Novopharm)
42 42
(F)(PFL) infusion: NS 24 h RT
42
preservative
Octreotide
44 10,46,47 46
(SANDOSTATIN®) N/A 200 mcg/mL discard unused 50–200 mL NS 24 h RT
45
1000 mcg/5 mL portion
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
44
preservative infusion rate of 25
46
mcg/h

Status)
Octreotide
10,47 46
(SANDOSTATIN®) N/A 50 mcg/mL discard unused 50-100 mL 24 h RT
46
50 mcg/1 mL 100 mcg/mL portion
44 46
100 mcg/1 mL 500 mcg/mL NS
500 mcg/1 mL
(Novartis) SC infusion: adjust
(F)(PFL) volume to ensure
44
no preservative infusion rate of 25
46
mcg/h
Octreotide
(SANDOSTATIN LAR®) 2 mL supplied 10 mg: 5 mg/mL discard unused deep intragluteal use within 4 h of initial - do NOT shake
46 46 7,46
10 mg diluent portion administration only reconstitution
20 mg 20 mg: 10 mg/mL
30 mg gently run 2 mL
46
(Novartis) down sides of the 30 mg: 15 mg/mL
(F)(PFL) vial; do NOT disturb
45
no preservative for 2–5 min, then
46
swirl moderately
record time of
reconstitution

Status)
oFAtumumab
48 48 48
100 mg/ 5 mL N/A 20 mg/mL discard unused 1000 mL NS 48 h RT - administer with
39
1000 mg/50 mL portion 0.2 micron in-line
48
(GlaxoSmithKline) or filter
(F)(PFL) - do NOT shake;
48
no preservative alternatively, 2000 mg mix by slow
doses may be inversion to avoid
48
supplied in formation of foam
48
2 x 500 mL NS - solution may
contain a small
withdraw volume quantity of drug
from bag equal to particles; do not
volume of drug to be administer if
48
added solution is cloudy
48
or discoloured
Olaratumab
49 49
500 mg/50 mL N/A 10 mg/mL discard unused dilute to a final complete - do NOT shake
39,49
(Lilly) portion volume of 250 mL administration within
49
(F)(PFL) NS 24 h F, plus an
49
do not shake additional 12 h RT
49
no preservative do NOT use D5W or
other dextrose
49
containing solutions
49
gently invert to mix

Status)
Oxaliplatin
50
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-0.4 mg/mL: - do NOT use
50
100 mg/20 mL portion 24 h RT aluminum-
50
200 mg/40 mL (0.2-0.7 mg/mL or containing needle,
50
(Hospira/Pfizer) 5 d F plus an syringe or tubing
50,52
(RT) do NOT use NS or additional 8 h RT
50
no preservative other chloride-
51
containing solutions 0.5–2 mg/mL:
24 h RT
do NOT use or
aluminum-containing 14 d F plus an
51 50,52
needle and syringe additional 8 h RT
Oxaliplatin
51 39,53 51
50 mg/10 mL N/A 5 mg/mL 2 d F, RT 0.2-0.7 mg/mL 0.2-2 mg/mL:
51
100 mg/20 mL 24 h RT, 48 h F
51
150 mg/30 mL 250-500 mL D5W
200 mg/40 mL
(Sandoz) do NOT use NS or
(RT)(PFL) other chloride-
51 51
no preservative containing solution
do NOT use
aluminum-containing
51
needle and syringe

Status)
Oxaliplatin
54
50 mg/10 mL N/A 5 mg/mL discard unused 250-500 mL D5W 0.2-2 mg/mL: - do NOT use
54 54
100 mg/20 mL portion 24 h RT, 48 h F aluminum-
54
200 mg/40 mL (0.2-0.7 mg/mL) containing needle,
54
(Teva) syringe or tubing
(RT)(PFL) do NOT use NS or
54
no preservative other chloride-
54
containing solution
do NOT use
aluminum-containing
54
needle and syringe
PACLitaxel
55
30 mg/5 mL N/A 6 mg/ mL 30 mg: 0.3-1.2 mg/mL in NS, complete - use non-DEHP
39,55 55
100 mg/16.7 mL 48 h RT D5W, D5NS, D5LR administration within bag and tubing with
55
300 mg/50 mL 27 h RT 0.22 micron in-line
55
(Accord) 100 mg: (e.g., 100-1000 mL)* filter
39,55
(RT)(PFL) 48 h RT - avoid excessive
55 55
no preservative shaking
300 mg:
55
24 h RT

Status)
PACLitaxel
57 39,58
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
57
100 mg/16.7 mL D5W administration within bag and tubing with
57,59
57
(Biolyse) (e.g., 100-1000 mL)* filter
56
(RT)
57
no preservative
60 60
0.1 mg/mL in NS 44 h F, RT
59
0.012-0.12 mg/mL in 16 h RT
61
NS
devices with spikes

(e.g., chemo
dispensing pins) may
62
be used with vials
PACLitaxel
64 39,64,65
30 mg/5 mL N/A 6 mg/mL 48 h RT 0.3-1.2 mg/mL in NS, complete - use non-DEHP
64
100 mg/16.7 mL D5W, D5NS, D5LR administration within bag and tubing with
64
64
300 mg/50 mL (e.g., 100-1000 mL)* filter
(Hospira)
(RT)(PFL)
63
preservative

Status)
PACLitaxel,
66 66
nanoparticle, albumin- 20 mL NS 5 mg/mL use immediately in empty sterile PVC, 48 h F plus an - each vial contains
67
bound (nab) (RT) or non-PVC, or non- additional 8 h RT 900 mg human
66 66 66
100 mg - slowly direct 8hF DEHP infusion bag albumin
(Celgene) diluent against side - to prevent
66
(RT)(PFL) of vial (i.e., greater **(PFL) foaming, do NOT
66
no preservative than or equal to 1 inject NS directly
66
min) during onto the powder
66
reconstitution - some settling may
occur; use mild
- let stand for agitation to
66
greater than or resuspend
equal to 5 min to wet - administer using
66
powder a 15 micron filter
ONLY
- gently swirl or (NOTE:filters with a
invert for greater pore size less than
than or equal to 2 15 microns may
66
min cause filter
68,69
blockage)
Pamidronate
70 70
30 mg/10 mL N/A 3 mg/mL discard unused Less than or equal to 24 h RT - do NOT mix with
70 70
60 mg/10 mL portion 0.36 mg/mL NS, calcium containing
70 70
90 mg/10 mL D5W solutions
70
(Fresenius Kabi) 6 mg/mL
(RT)
70
no preservative
70
9 mg/mL

Status)
Pamidronate
71
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
71 71 71
60 mg/10 mL portion NS, D5W RT (total 48 h) calcium containing
90 mg/10 mL solution (e.g.,
71 71 71
(Hospira) 6 mg/mL **(PFL) Ringer’s)
(RT)
71
no preservative
71
9 mg/mL
Pamidronate
72 72
30 mg/10 mL N/A 3 mg/mL discard unused 0.06–0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
72 72 72
72 72 72
(Omega) 6 mg/mL **(PFL) Ringer’s)
(RT)
72
no preservative
72
9 mg/mL
Pamidronate
73
30 mg/10 mL N/A 3 mg/mL discard unused 0.06-0.36 mg/mL in 24 h F followed by 24 h - do NOT mix with
73 73 73
73 73 73
(Pfizer) 6 mg/mL **(PFL) Ringer’s)
(RT)
73
no preservative
73
9 mg/mL

Status)
Pamidronate
74 74 74
30 mg/10 mL N/A 3 mg/mL discard unused NS; D5W 24 h RT - do NOT mix with
43,74
60mg/10 mL portion calcium containing
74 74
(Sandoz Canada) 6 mg/mL Ringer’s)
RT
74
no preservative
74
9 mg/mL
PANitumumab
75 75,76
100 mg/5 mL N/A 20 mg/mL discard unused Less than or equal to 24 h F, 6 h RT - administer with
75
400 mg/20 mL portion 1000 mg: 0.2 or 0.22 micron
75 75
(Amgen) 100 mL NS in-line filter
(F)(PFL) - solution may
do not shake Greater than 1000mg: contain particulates
75 75
no preservative 150 mL NS which do not affect
75
product quality
75,76
1-10mg/mL - do not administer
75
if discoloured

Status)
pegaspargase
77 77
(pegylated N/A 750 units/mL discard unused IM: syringe: - do NOT shake
77
asparaginase E. coli) portion max volume: use within 4 h of vial
39,77
3750 units/5 mL 2 mL in children and puncture
(Shire) adolescents;
(F)(PFL) 3 mL in adults
do not shake
77
no preservative if volume greater than
above, use multiple
77
sites
IV: bag:
77
100 mL NS, D5W use within 4 h of vial
39,77
puncture
Pembrolizumab
78
100 mg/4 mL N/A 25 mg/mL discard unused 1-10 mg/mL complete - use a 0.2 to 5
39,78 78
(Merck) portion NS, D5W administration within micron in-line
78 78
(F)(PFL) 6 h RT, 24 h F filter
do not shake mix by gentle - allow vials and
78 78
no preservatives inversion diluted solutions to
come to RT prior to
78
use
- vials contain 0.25
78
mL overfill

Status)
Pembrolizumab
78 78 78
50 mg 2.3 mL SWI 25 mg/mL 6 h RT, 24 h F 1-10 mg/mL NS, complete - use 0.2 to 5
78
(Merck) D5W administration within 6 micron in-line
78 79
(F) direct diluent against h RT, 24 h F filter
78
no preservative side of vial during mix by gentle - allow
78
reconstitution to inversion reconstituted vials
78
avoid foaming and diluted
solutions to come
78
allow up to 5 to RT prior to use
minutes for bubbles - vials can be at RT
78
to clear for up to 24 h prior
78
to use
78
do NOT shake - vials contain 20%
78
overfill
Pemetrexed
80 80 80
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
80 80
500 mg 4.2 mL NS NS calcium containing
(Accord) solution (e.g.,
80
(RT) 500 mg: Ringer’s)
80 80
no preservative 20 mL NS
Pemetrexed
81 81 81
100 mg 100 mg: 25 mg/mL 24 h F, RT 100 mL 24 h F, RT - do NOT mix with
81 81
500 mg 4.2 mL NS NS calcium containing
(Eli Lilly) solution (e.g.,
82
(RT) 500 mg: Ringer’s)
81
no preservative 20 mL preservative-
81
free NS

Status)
PERTuzumab
83 83 83
420 mg/14 mL N/A 30 mg/mL discard unused 250 mL NS only 24 h F, RT - do NOT use
39,83
(Roche) portion dextrose containing
83 83
(F)(PFL) do NOT shake mix by gentle solutions
83
no preservative inversion to avoid
83
foaming
Plerixafor
84 84 43,85
24 mg/1.2 mL N/A 20 mg/mL discard unused SC syringe 48 hours RT
84
(sanofi-aventis) portion
(RT)
84
no preservative
Porfimer
86 86
15 mg 15 mg: 2.5 mg/mL 24 h F syringe use within 4 h of initial - avoid contact with
86 7,87
75 mg 6.6 mL D5W reconstitution skin and eyes;
86
(Axcan) **(PFL) protect exposed
86 86
(RT)(PFL) 75 mg: **(PFL) area from light
86 86
no preservative 31.8 mL D5W
record time of
reconstitution
Raltitrexed
88 88 88
2 mg 4 mL SWI 0.5 mg/mL 24 h F, RT 50-250 mL NS, complete
88
(Pfizer) D5W administration within
88
(F,RT)(PFL) 24 h F, RT
88
(no preservative)

Status)
Ramucirumab
89 89 89
100 mg/10 mL N/A 10 mg/mL discard unused 250 mL* NS 4 h RT, 24 h F - use 0.22 micron
89 89
500 mg/50 mL portion filter
90
(Eli Lilly) (0.4 – 4 mg/mL) - do NOT use
(F)(PFL) dextrose containing
89 89
(do not shake) gently invert to mix solutions
89
no preservative
89
do NOT shake
riTUXimab
91 92,93
100 mg/10 mL N/A 10 mg/mL discard unused 1-4 mg/mL NS, 24 h F, 12 h RT - once removed
91 91
500 mg/50 mL portion D5W from the fridge,
(Roche) compounded
(F)(PFL) (e.g., 250-500 mL)* product is stable
91 92,93
no preservative for 12h RT
riTUXimab
94 94 94
subcutaneous N/A 120 mg/mL discard unused SC syringe 48 h F plus 8 h RT - contains
94 94
1400 mg/11.7 mL portion hyaluronidase
1600 mg/13.4 mL - formulations are
(Roche) NOT
94
(F)(PFL) interchangeable
94
no preservative

Status)
romiDEPsin
95 95 95 95
10 mg 2.2 mL of supplied 5 mg/mL 8 h RT 500 mL NS 24 h RT - reconstituted
95,96
(Celgene Inc.) diluent solution will be
95 97
(RT) slightly viscous
39 95
no preservative swirl gently to mix - vials contain
overfill to allow for
full drug recovery
(drug vial contains
11 mg romidepsin;
diluent vial
contains 2.4 mL
95
diluent)
Siltuximab
98 98 98
100 mg 100 mg: 20 mg/mL 2 h RT 250 mL D5W complete - use 0.2 micron in-
98 98
400 mg 5.2 mL SWI administration within line filter
98
(Janssen) dilute to 250 mL final 6 h RT
(F)(PFL) 400 mg: volume by
98 98
no preservative 20 mL SWI withdrawing volume
from bag equal to
allow vial to come to volume of drug to be
98
room temperature added
prior to use (~30
98
minutes)
gently swirl, do NOT

98
shake

Status)
Streptozocin
99 99 99 99
1g 9.5mL NS, SWI, 100 mg/mL 48 h F, 24 h RT syringe 48 h F, 24 h RT
99
(Pfizer) D5W
(F)(PFL)
99 99
no preservative 50-500 mL* NS, 48 h F, 24 h RT
99
D5W, SWI
Temsirolimus
100,101 100,101 100,101
30 mg/1.2 mL 1.8 mL supplied 10 mg/mL 24 h RT 250 mL NS complete - use non-DEHP
100,101
(Wyeth) diluent administration within 6 bag and tubing with
100,101 100 100,101 100,101
(F)(PFL) **(PFL) h in-line filter
102
no preservative
Teniposide
103
50 mg/5 mL N/A 10 mg/mL discard unused 50 – 500 mL NS or 0.1-0.4 mg/mL: 24 h - do not refrigerate
103
(BMS) portion D5W for a final RT - use non-DEHP
103
(RT) concentration of 0.1-1 bag and tubing
103 103
preservative mg/mL 1 mg/mL: complete - do not use if
103,104
administration within 4 precipitates
h of preparation - contains DMA***
103,104
RT - excessive
agitation may
cause
103
precipitation

Status)
Thiotepa
105 105 105
15 mg 15 mg: 10 mg/mL 8hF reconstituted solution 4 h RT, 24 h F - do not use if
105
100 mg 1.5 mL SWI is hypotonic and must precipitates are
105
(Adienne/Methapharm) be further diluted with present
105
(F) 100 mg: NS prior to use - reconstituted
105 105
no preservative 10 mL SWI solution may be
doses ≤ 500 mg: used if
105
to remove haze, 500 mL NS or with an opalescent
filter through 0.22 appropriate volume to - administer with
micron filter after achieve 0.5-1 mg/mL 0.2 micron inline
106 105 105
reconstitution concentration filter
record time of doses > 500 mg:

105
reconstitution 1000 mL NS

Status)
Thiotepa
105 105 26
IT injection diluents containing 10 mg/mL 8hF qs to 6 mL with use within 4 h of initial - auxiliary info :
25 2
15 mg preservatives should preservative free NS reconstitution “IT”
100mg NOT be used for - label to include
(Adienne/Methapharm) intrathecal route in full (i.e.,
107
(F) administration INTRATHECAL
105
no preservative injection) attached
15 mg: to both syringe and
105 26
1.5 mL SWI outer ziplock bag
- do not use if
100 mg: precipitates are
105 105
10 mL SWI present
- reconstituted
to remove haze, solution may be
filter through 0.22 used if
105
micron filter after opalescent
106
reconstitution
record time of
reconstitution
Thyrotropin alfa
108 108 108 108 108
1.1 mg 1.2 mL SWI 0.9 mg/mL 24 h F syringe 24 h F
(Genzyme)
108
(F)(PFL) swirl contents
108
no preservative
do NOT shake

Status)
Tocilizumab
109 109
80 mg/4 mL N/A 20 mg/mL discard unused 100 mL NS complete - to prevent
109
200 mg/10 mL portion administration within foaming: slowly
109
400 mg/20 mL dilute to final volume 24 h F, RT add drug to
(Roche) by withdrawing infusion bag and
(F)(PFL) volume from bag bring to room gently invert bag to
109 109
no preservative equal to volume of temperature prior to mix
109 109
drug to be added administration
109
gently invert to mix
Topotecan
110 2,110
4 mg/4 mL N/A 1 mg/mL discard unused 0.025-0.5 mg/mL 14 d F, 48 h RT
2,110
(Accord) portion
(RT)(PFL) 50-100 mL NS,
110 110
no preservative D5W
Topotecan
111 111 111
1 mg 1 mg: 1 mg/mL 24 h F,RT 0.02-0.5 mg/mL 24 F, RT
111
4 mg 1.1 mL SWI
(Actavis) 50-100 mL NS,
111
(RT)(PFL) 4 mg: D5W
111 111
no preservative 4 mL SWI
Topotecan
112 112
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F, RT
2,112
(Pfizer/Hospira) portion
(F)(PFL) 50-100 mL NS,
112 112
no preservative D5W

Status)
Topotecan
113 113
4 mg/4 mL N/A 1 mg/mL discard unused 0.02-0.5 mg/mL 24 h F
113
(Sandoz) portion
113
(F)(PFL) 50-100 mL NS, **(PFL)
113 113
no preservative D5W
Trastuzumab
114 39 114 114 114
(HERCEPTIN®) 20 mL supplied 21 mg/mL 14 d F 250 mL NS only 24 h F, RT - do NOT shake
114
440 mg BWI
(Roche) do NOT use dextrose
114
(F) swirl vial gently; containing solutions
114
preservative allow to stand
undisturbed for 5
114
min

Status)
Trastuzumab
115 115 115
Emtansine 100 mg vial: 20 mg/mL 24 h F 250 mL NS or 0.45% 24 h F - do not use if
115
(KADCYLA®) 5 mL SWI sodium chloride only reconstituted
115 115 115
100 mg do NOT freeze do NOT freeze solution contains
160 mg 160 mg vial: visible particulates
115 115
(Roche) 8 mL SWI do NOT shake or is cloudy or
115
(F)(PFL) discolored
115
no preservative swirl gently until - dextrose 5%
completely dissolved solutions cause
aggregation of the
115
do NOT shake protein; do not
dilute with dextrose
containing
115
solutions
- use a 0.2 micron
in-line filter or 0.22
micron
polyethersulfane
(PES) filter to
administer
infusions prepared
in NS; filter is
optional for
solutions in 0.45%
115
NS

Status)
TRC105 (Carotuximab)
116 117
100 mg/4 mL N/A 25 mg/mL discard unused 0.6 – 10 mg/mL NS complete infusion - use a 0.2 micron
39
200 mg/8 mL portion within 8 h RT, 24 h in-line filter for
116,117 116
400 mg/16 mL invert gently to mix F administration
(Tracon)
(F)(PFL)
116
no preservative
Treosulfan
118 7,118 119 7,118
1g pre-heat SWI to 50 mg/mL 48 h RT undiluted 48 h RT - compatible with
5g 30°C (not higher) polytetrafluoroethyl
118
(medac) shake vial carefully dilute with NS or D5W ene filters
(RT) before adding the in empty infusion bag - may require
118
no preservative warmed SWI for final concentration vigorous shaking to
118 118
1 g vial: 20 mL SWI, = 20 mg/mL reconstitute
while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
118
2 min
5 g vial: 100 mL
SWI, while slightly
shaking vial and
syringe; continue
shaking the
reconstituted
solution for another
118
2 min

Status)
vinBLAStine
120 121 122,123
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, D5W 24 h F, RT - auxiliary info:
120
(Hospira) portion WARNING: FOR
(F)(PFL) INTRAVENOUS
120
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
124,125
ROUTES
vinBLAStine
126
10 mg/10 mL N/A 1 mg/mL discard unused 25-50 mL NS, use within 4 h of initial - auxiliary info:
126 121,127 39
(Teva) portion D5W puncture WARNING: FOR
(F)(PFL) INTRAVENOUS
126
no preservative USE ONLY –
FATAL IF GIVEN
BY OTHER
124,125
ROUTES

Status)
vinCRIStine
128 128 128 128
2 mg/2 mL N/A 1 mg/mL 8 h F, RT 50 mL* NS, D5W 24 h F, 6 h RT - auxiliary info:
5 mg/5 mL WARNING: FOR
128
(Hospira) **(PFL) INTRAVENOUS
(F)(PFL) USE ONLY –
128
no preservative FATAL IF GIVEN
BY OTHER
124,125
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)

Status)
vinCRIStine
129 129 129
1 mg/1 mL N/A 1 mg/mL 8 h F, RT 0.01-0.1 mg/mL NS, 24 h F, RT - auxiliary info:
129
2 mg/2 mL D5W WARNING: FOR
5 mg/5 mL INTRAVENOUS
(Teva) 25-50 mL NS, D5W
130
USE ONLY –
(F)(PFL) FATAL IF GIVEN
129
no preservative BY OTHER
124,125
ROUTES
- for ULYEPOCHR
protocol, see entry
for EPOCHR
(3-in-1 solution
containing
etoposide,
DOXOrubicin,
vinCRIStine)
Vinorelbine
131 131 131
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary info:
131
50 mg/5mL portion WARNING: FOR
(Fresenius Kabi) NS, D5W, ½NS, INTRAVENOUS
(F)(PFL) D5½NS, Ringer’s, USE ONLY –
131 131
no preservative Ringer’s Lactate FATAL IF GIVEN
BY OTHER
124,132
ROUTES

Status)
Vinorelbine
131 133 133
10 mg/1 mL N/A 10 mg/mL discard unused 0.5-2.0 mg/mL 24 h F, RT - auxiliary info:
2
50 mg/5 mL portion WARNING: FOR
(GMP) 50 mL* NS, D5W, INTRAVENOUS
(F)(PFL) ½NS, D5½NS, USE ONLY –
133
no preservative Ringer’s, Ringer’s FATAL IF GIVEN
133
Lactate BY OTHER
124,132
ROUTES
Vinorelbine
134 134 134
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
134
(Pfizer/Hospira) 50 mL* NS, D5W, INTRAVENOUS
134
134
Lactate BY OTHER
124,132
ROUTES
Vinorelbine
135 135 135
10 mg/1 mL N/A 10 mg/mL discard unused 0.5–2.0 mg/mL 24 h F, RT - auxiliary info:
135
(Teva) 50 mL* NS, D5W, INTRAVENOUS
135
135
Lactate BY OTHER
124,132
ROUTES

Status)
Zoledronic acid
136 136
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
136
(Dr Reddy’s) portion within 24 h of calcium containing
136 136
(RT) preparation solutions
136
no preservative
Refrigerate diluted
product if not used
immediately after
preparation; bring to
RT prior to
136
administration
Zoledronic acid
137 137
137
(Marcan) portion within 24 h of calcium containing
137
(RT) preparation solutions (e.g.,
137
no preservative Lactated
137
Refrigerate diluted Ringer’s)
product if not used
immediately after
RT prior to
137
administration

Status)
Zoledronic acid
138 138
138
(MDA) portion within 24 h of calcium containing
138 138
(RT) preparation solutions
138
no preservative
Refrigerate diluted
product if not used
immediately after
RT prior to
138
administration
Zoledronic acid
139 139
(ZOMETA) N/A 0.8 mg/mL discard unused 100 mL NS, D5W complete infusion - do NOT mix with
39
4 mg/ 5 mL portion within 24 h of calcium containing
139 139
(Novartis) preparation solutions
(RT)
139
no preservative Refrigerate diluted
product if not used
immediately after
RT prior to
139
administration

Status)
Zoledronic acid
140 140
4 mg/5 mL N/A 0.8 mg/mL discard unused 100 ml NS, D5W complete infusion - do NOT mix with
140
(Sandoz) portion within 24 h of calcium- or other
140
(RT) preparation divalent cation-
140
no preservative containing infusion
Refrigerate diluted solutions (e.g.,
product if not used Lactated
140
immediately after Ringer’s)
RT prior to
140
administration
* Suggested volume based on usual dose range and any concentration range of stability data
** Protect from light means minimizing exposure to direct sunlight over a storage period. More specific information on protection from light (eg, protecting container and tubing during
administration) will be indicated in the Under the Special Precautions/Notes column.
*** Contains DMA (N,N dimethylacetamide). Product may be incompatible with closed system transfer devices such as ChemoLock.
Centres are not to change the content locally but should forward suggestions to the Cancer Drug Manual staff.
Explanatory Notes
Stability data assumes products prepared using standard aseptic technique in biological safety cabinet at low risk for contamination according to the classification
141,142
outlined in USP 797.
Vial stability: Stability of solution after first puncture or reconstituted solution.
Storage temperature: If information states same stability with refrigerator and room temperature storage, then fridge stability is bolded as preferred (ie, to minimize
growth of micro-organisms).
Discard unused portion: Unused portion from single use vials should be discarded at the end of the day.
“overfill known” is stated if the manufacturer states overfill that is present is within acceptable limits.
“Complete administration within __” is stated if the manufacturer specifies that the infusion must be completed in a specific time frame following preparation,
usually including entire time required for preparation (from first puncture), storage, and administration of infusion.

Abbreviations
BWI = bacteriostatic water for injection
CIVI: ambulatory pump = Continuous Intravenous Infusion (e.g., elastomeric infusor)
D5W = dextrose 5% in water
DMA = N,N dimethylacetamide
F = refrigerate
Non-DEHP = not containing Di(2-ethylhexyl) phthalate (DEHP)
NS = normal saline
PFL = protect from light
RT = room temperature
SWI = sterile water for injection
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BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY CHART

(e.g., 50-250 mL*) D10W, D5-NS:

(e.g., 50-250 mL*) D10W, D5NS:

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 1/42

(e.g., 50-250 mL*)

0.06 - 0.4 mg/mL NS, NS:

0.06 - 1 mg/mL Ringer’s, LR:

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 2/42

BC Cancer Chemotherapy Preparation and Stability Chart© version 2.00 3/42

high dose use within 24 h RT of

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high dose use within 24 h RT of

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devices with spikes

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gently swirl, do NOT

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record time of doses > 500 mg:

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