The compatibility and stability of midazolam and dexamethasone in infusion solutions

Good, PD, Schneider, JJ and Ravenscroft, PJ (2004) The compatibility and stability of midazolam and dexamethasone in infusion solutions. Journal of Pain and Symptom Management, 27 5: 471-475. doi:10.1016/j.jpainsymman.2004.02.002


Author Good, PD
Schneider, JJ
Ravenscroft, PJ
Title The compatibility and stability of midazolam and dexamethasone in infusion solutions
Journal name Journal of Pain and Symptom Management   Check publisher's open access policy
ISSN 0885-3924
Publication date 2004-01-01
Sub-type Article (original research)
DOI 10.1016/j.jpainsymman.2004.02.002
Volume 27
Issue 5
Start page 471
End page 475
Total pages 5
Language eng
Subject 2703 Anesthesiology and Pain Medicine
2728 Clinical Neurology
2808 Neurology
2900 Nursing
Abstract The delivery of subcutaneous medication by continuous infusion is common in palliative medicine. Many centers combine multiple medications, but the analytical confirmation of the compatibility and stability of these combinations has rarely been performed. This study examined the compatibility and stability of midazolam and dexamethasone using high performance liquid chromatography. Nine different solutions were prepared in polypropylene syringes by combining these two drugs with 0.9% sodium chloride. When these two drugs were combined in a syringe, there was significant loss of midazolam over 48 hours, with only 60-80% of the initial concentration remaining in syringes stored at 35-39°C. This study demonstrates that cloudiness of a solution is not the only predictor of drug loss and that drug loss may occur even in solutions that remain clear at time of preparation. The clinical implications of these results are that dexamethasone and midazolam should not be combined in syringe driver solutions.
Keyword dexamethasone
drug compatibility
drug stability
midazolam
palliative care
Parenteral infusions
subcutaneous injection
syringes
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
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Citation counts: TR Web of Science Citation Count  Cited 9 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 12 times in Scopus Article | Citations
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