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Abstract:  Chemotherapy-induced nausea and vomiting is problematic for many patients undergoing chemotherapy. Multiple-drug treatments have been developed to mitigate chemotherapy induced nausea and vomiting. A patient-controlled infusion of diphenhydramine hydrochloride, lorazepam, and dexamethasone sodium phosphate has been studied in patients who are refractory to first-line therapy. Unfortunately, the physical and chemical compatibility of this three-drug combination is not available in the published literature. Chemical compatibility was evaluated using high-performance liquid chromatography with ultraviolet detection. Visual observation was employed to detect change in color, clarity, or gas evolution. Turbidity and pH measurements were performed in conjunction with visual observation at hours 0, 24, and 48. Results showed that diphenhydramine hydrochloride 4 mg/mL, lorazepam 0.16 mg/mL, and dexamethasone sodium phosphate 0.27 mg/mL in 0.9% sodium chloride stored in polypropylene syringes were compatible, and components retained greater than 95% of their original concentration over 48 hours when stored at room temperature.

Related Keywords: Collin R. Anderson, PharmD, PhD, BCPS, Zachery Halford, PharmD, BCOP, Mark MacKay, BS Pharm, diphenhydramine hydrochloride, lorazepam, dexamethasone sodium phosphate, chemotherapy-induced nausea and vomiting, CINV, cancer, drug combination, physical compatibility, chemical compatibility, emesis, antiemesis, antiemetic therapy, BAD pump, patient-controlled infusion, compounded sterile preparations, stability, isotonic normal saline solution

Related Categories: CANCER AND AIDS, EXCIPIENTS, PEER-REVIEWED, STABILITIES, COMPATIBILITIES, ADVERSE DRUG EVENTS, STORAGE

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