Physical and chemical compatibility of intravenous ciprofloxacin with other drugs. 1993

L K Jim
Department of Clinical Pharmacy, King Saud University College of Pharmacy, Riyadh, Saudi Arabia.

OBJECTIVE To determine the physical and chemical compatibilities of ciprofloxacin lactate infusion with other commonly used intravenously administered drugs. METHODS Ciprofloxacin lactate injection in a commercially available concentration of 2 mg/mL was mixed with 15 intravenous drugs during simulated Y-site injection. Ciprofloxacin was mixed with usually employed concentrations of other drugs in a 1:1 ratio and examined physically by visual inspection and chemically by HPLC analysis. Adsorption of ciprofloxacin to intravenous administration sets with or without inline filters was also studied. METHODS The study was carried out at ambient temperature (25 degrees C) under fluorescent lighting except for vitamin B complex, which was protected from light. All samples were prepared in a laminar airflow hood. METHODS Physical incompatibility was determined by visual inspection against a black-and-white background, and chemical incompatibility was measured by a stability-indicating HPLC assay for ciprofloxacin. Concentrations determined at time zero (before mixing) were defined as 100 percent. Values estimated for each sample at subsequent time points were calculated as percentages of the initial concentration. Recovery below 90 percent of the initial concentration is defined as significant loss. RESULTS Of the 15 drugs studied, only heparin, furosemide, and teicoplanin were found to be incompatible with ciprofloxacin. Adsorption of ciprofloxacin to administration sets with and without inline filters was minimal. Metronidazole was also found to decrease to 90 percent of its initial concentration immediately upon mixing. CONCLUSIONS Ciprofloxacin ready-to-infuse solution is compatible with most of the drugs studied except heparin, furosemide, teicoplanin, and, perhaps, metronidazole. Because only the stability and potency of ciprofloxacin were studied, further testing is needed to confirm if any chemical deterioration of the other drugs occurred when combined with ciprofloxacin.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D002851 Chromatography, High Pressure Liquid Liquid chromatographic techniques which feature high inlet pressures, high sensitivity, and high speed. Chromatography, High Performance Liquid,Chromatography, High Speed Liquid,Chromatography, Liquid, High Pressure,HPLC,High Performance Liquid Chromatography,High-Performance Liquid Chromatography,UPLC,Ultra Performance Liquid Chromatography,Chromatography, High-Performance Liquid,High-Performance Liquid Chromatographies,Liquid Chromatography, High-Performance
D002939 Ciprofloxacin A broad-spectrum antimicrobial carboxyfluoroquinoline. Bay-09867,Ciprinol,Cipro,Ciprofloxacin Hydrochloride,Ciprofloxacin Hydrochloride Anhydrous,Ciprofloxacin Monohydrochloride Monohydrate,Anhydrous, Ciprofloxacin Hydrochloride,Bay 09867,Bay09867,Hydrochloride Anhydrous, Ciprofloxacin,Hydrochloride, Ciprofloxacin,Monohydrate, Ciprofloxacin Monohydrochloride,Monohydrochloride Monohydrate, Ciprofloxacin
D004344 Drug Incompatibility The quality of not being miscible with another given substance without a chemical change. One drug is not of suitable composition to be combined or mixed with another agent or substance. The incompatibility usually results in an undesirable reaction, including chemical alteration or destruction. (Dorland, 27th ed; Stedman, 25th ed) Drug Incompatibilities,Incompatibilities, Drug,Incompatibility, Drug
D004355 Drug Stability The chemical and physical integrity of a pharmaceutical product. Drug Shelf Life,Drugs Shelf Lives,Shelf Life, Drugs,Drug Stabilities,Drugs Shelf Life,Drugs Shelf Live,Life, Drugs Shelf,Shelf Life, Drug,Shelf Live, Drugs,Shelf Lives, Drugs
D004364 Pharmaceutical Preparations Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. Drug,Drugs,Pharmaceutical,Pharmaceutical Preparation,Pharmaceutical Product,Pharmaceutic Preparations,Pharmaceutical Products,Pharmaceuticals,Preparations, Pharmaceutical,Preparation, Pharmaceutical,Preparations, Pharmaceutic,Product, Pharmaceutical,Products, Pharmaceutical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000327 Adsorption The adhesion of gases, liquids, or dissolved solids onto a surface. It includes adsorptive phenomena of bacteria and viruses onto surfaces as well. ABSORPTION into the substance may follow but not necessarily. Adsorptions
D014796 Visual Perception The selecting and organizing of visual stimuli based on the individual's past experience. Visual Processing,Perception, Visual,Processing, Visual

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