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06/21/2012 08:29AM
Plate # 0-Composite
pg 85 # 85
AMMONIUM CHLORIDE
AHFS 40:04
Products Ammonium chloride additive solution is available in 20mL vials containing 5.35 g of ammonium chloride, which provides
100 mEq (5 mEq/mL) of NH4+ and Cl ions. The solution also contains 2 mg/mL of disodium edetate as a stabilizer and hydrochloric
acid to adjust the pH. The additive solution is intended to be used
only after further dilution in a larger volume of sodium chloride 0.9%
injection. (1)
One gram of ammonium chloride contains 18.7 mEq each of ammonium and chloride ions. (4)
Compatibility Information
Solution Compatibility
Ammonium chloride
Solution
Mfr
Mfr
Conc/L
Remarks
Ref
C/I
AB
AB
AB
AB
Dextrosesaline combinations
AB
AB
Dextrose 2.5%
AB
AB
Dextrose 5%
AB
AB
Dextrose 10%
AB
AB
Ionosol products
AB
AB
Ringers injection
AB
AB
AB
AB
AB
AB
AB
AB
Sodium lactate M
AB
AB
Ref
C/I
16
Additive Compatibility
Ammonium chloride
Drug
Dimenhydrinate
Mfr
SE
Conc/L
500 mg
Mfr
AB
Conc/L
20 g
Test
Soln
D5W
Remarks
Physically compatible
15
Name /bks_51512_trissel/51512_a_0001
06/21/2012 08:29AM
Plate # 0-Composite
pg 86 # 86
86/AMMONIUM CHLORIDE
Warfarin sodium
Mfr
DU
DU
DU
Conc
0.1 mg/mLa
0.1 mg/mLb
2 mg/mLc
Mfr
AB
AB
AB
Conc
5 mEq/mL
5 mEq/mL
5 mEq/mL
Remarks
Ref
C/I
2011
2011
2011
I
C
I
AMOXICILLIN SODIUM
AHFS 8:12.16.08
Products Amoxicillin sodium is available in vials containing the
equivalent of amoxicillin 250 mg, 500 mg, and 1 g. (38; 115)
For intramuscular injection, reconstitute the vials with the following volumes of sterile water for injection (38; 115):
Vial Size
250 mg
250 mg
500 mg
500 mg
1g
1g
Volume of Diluent
Final Volume
1.5 mL
2.0 mL
2.0 mL
2.5 mL
2.5 mL
4.0 mL
1.7 mL
2.2 mL
2.4 mL
2.9 mL
3.3 mL
4.8 mL
Alternatively, the 1-g vial may be reconstituted with lidocaine hydrochloride 1% or procaine hydrochloride 0.5%. However, a greater
volume of local anesthetic is required to dissolve amoxicillin 1 g than
sterile water for injection. Dividing a 1-g dose into two 500-mg portions given at different sites has been suggested. (38; 115)
For intravenous injection, reconstitute the vials with the following
volumes of sterile water for injection (38):
Vial Size
250 mg
500 mg
1g
Volume of Diluent
Final Volume
5 mL
10 mL
20 mL
5.2 mL
10.4 mL
20.8 mL
Administration Amoxicillin sodium may be administered by intramuscular injection, direct intravenous injection over three to four minutes, or intermittent intravenous infusion over 30 to 60 minutes. (38;
115)
Stability Store amoxicillin sodium vials in a cool, dry place protected from light. (38; 115) After reconstitution with sterile water for
injection, a transient pink color or slight opalescence may appear.
Reconstituted solutions are normally a pale straw color. The reconstituted solution should be administered or diluted immediately in a
suitable infusion solution. (38; 115)
Concentration Effects Amoxicillin sodium 50 mg/mL is substantially
less stable in all infusion solutions than at lower concentrations of 10
or 20 mg/mL. (1469)
Freezing Solutions Amoxicillin sodium 10 mg/mL in sterile water for
injection was unstable when stored frozen at between 0 and 20 C
but was stable for 13 days when stored below 30 C. Amoxicillin
sodium 10 mg/mL in sterile water for injection was stable for only
two days at 0 C in the unfrozen state. (1470)
Amoxicillin sodium 10 mg/mL in sodium chloride 0.9% was stable
for 10.5 days at 0 C (unfrozen) and for 14 hours when frozen at
19 C; in dextrose 5%, the comparative times were 12.5 and 8.4
hours, respectively. (1471)
The processes of freezing and thawing increase the degradation rate
of amoxicillin sodium 10 mg/mL in sodium chloride 0.9% in PVC
bags (Travenol). Freezing and thawing (natural or microwave) could
account for a 5 to 10% loss of amoxicillin; the losses will be affected
by the time to reach the equilibrium frozen temperature. (1472)
Sorption Acetazolamide sodium was shown not to exhibit sorption
to PVC bags and tubing, polyethylene tubing, Silastic tubing, polypropylene syringes, and trilayer bags of polyethylene, polyamide, and
polypropylene. (536; 606; 1918)
Filtration Amoxicillin sodium 1.98 mg/mL in sodium chloride 0.9%
did not exhibit signicant drug loss due to sorption to a 0.22-m
cellulose ester membrane lter (Ivex-HP, Millipore). (1034)
Name /bks_51512_trissel/51512_a_0001
06/21/2012 08:29AM
Plate # 0-Composite
pg 87 # 87
AMOXICILLIN SODIUM / 87
Compatibility Information
Solution Compatibility
Amoxicillin sodium
Solution
Mfr
Mfr
Conc/L
Dextrose 5%
1g
10, 20,
50 g
Sodium chloride 0.9%
Remarks
Ref
C/I
768
1469
1g
10, 20,
50 g
10 g
768
1469
C
I
1472
10, 20,
50 g
1469
Sodium lactate 16 M
10, 20,
50 g
1469
TR
Additive Compatibility
Amoxicillin sodium
Drug
Mfr
Conc/L
Mfr
Test
Soln
Conc/L
Remarks
Ref
C/I
Ciprooxacin
2g
10 g
Precipitates immediately
1473
Dextran 40
10%
10, 20,
50 g
10, 20,
50 g
D5W
1469
1469
2800
10%
NS
Imipenemcilastatin sodium
GSK
4g
MSD
8g
Midazolam HCl
RC
50 and
250 mg
400 mg
BE
10 g
NS
Transient precipitate
355
BE
10 g
NS
355
D5W, NS
1473
1469
1469
RC
Peoxacin
4g
10 g
Sodium bicarbonate
2.74%
10, 20,
50 g
8.4%
10, 20,
50 g
Name /bks_51512_trissel/51512_a_0001
06/21/2012 08:29AM
Plate # 0-Composite
pg 88 # 88
88/AMOXICILLIN SODIUM
Mfr
Conc
Mfr
Conc
Remarks
Ref
C/I
Lorazepam
WY
0.33 mg/mLa
SKB
50 mg/mL
1855
Midazolam HCl
RC
5 mg/mL
SKB
50 mg/mL
1855
1767
TPN #189
50 mg/mL
AMOXICILLIN SODIUMCLAVULANATE
(CO-AMOXICLAV)
AHFS 8:12.16.08
Products Amoxicillin sodiumclavulanic acid is available in 600mg vials containing amoxicillin sodium 500 mg and clavulanic acid
100 mg as the potassium salt and in 1.2-g vials containing amoxicillin
sodium 1 g and clavulanic acid 200 mg as the potassium salt. Reconstitute the 600-mg vials with 10 mL and the 1.2-g vials with 20 mL
of sterile water for injection. (38; 115)
Sodium and Potassium Content Amoxicillin sodiumclavulanic acid
contains 3.1 mmol of sodium and 1 mmol of potassium in 1.2 g of
drug product. The 600-mg vials contain 1.55 mmol of sodium and
0.5 mmol of potassium. (38)
Trade Name(s) Augmentin, Clavulin, Flanamox.
Administration Amoxicillin sodiumclavulanic acid may be administered by intravenous injection or intermittent infusion. It is not suitable for intramuscular administration. When given by intravenous
injection directly into a vein or via a drip tube, it should be injected
slowly over three to four minutes. For intravenous infusion, add the
contents of the 600-mg or 1.2-g vial to 50 or 100 mL, respectively,
of sterile water for injection or sodium chloride 0.9% and then infuse
over 30 to 40 minutes, completing the administration within four
hours of reconstitution. (38; 115)
Stability Amoxicillin sodiumclavulanic acid in intact vials should
be stored at 25 C or below. The injection should be used within 20
minutes after reconstitution with sterile water for injection. (38; 115)
Name /bks_51512_trissel/51512_a_0001
06/21/2012 08:29AM
Plate # 0-Composite
pg 89 # 89
AMOXICILLIN SODIUMCLAVULANATE / 89
Compatibility Information
Solution Compatibility
Amoxicillin sodiumclavulanic acid
Solution
Mfr
Mfr
Conc/L
Remarks
Ref
C/I
Dextrose 5%
BTa
BE
8.33 +
1.67 g
1474
Ringers injection
BTa
BE
8.33 +
1.67 g
1474
Ib
BTa
BE
8.33 +
1.67 g
1474
Ib
BTa
BE
8.33 +
1.67 g
1474
Ib
BTa
BE
8.33 +
1.67 g
1474
Ib
Sodium lactate 16 M
BTa
BE
8.33 +
1.67 g
1474
Ib
Ref
C/I
Precipitates immediately
1473
1920
1473
a
b
Additive Compatibility
Amoxicillin sodiumclavulanic acid
Drug
Mfr
Conc/L
Ciprooxacin
BAY
10 + 2 g
5g
Peoxacin
Test
Soln
Conc/L
2g
Metronidazole
Mfr
BE
Remarks
20 + 2 g
4g
10 + 2 g
D5W, NS
Mfr
Conc
Mfr
Conc
Remarks
Ref
C/I
Amiodarone HCl
SAN
12.5 mg/mL
GSK
10 + 2 mg/
mL
2727
Clarithromycin
AB
4 mg/mLa
BE
20 + 4 mg/
mLa
2174
Lorazepam
WY
0.33 mg/mLb
SKB
20 + 2 mg/
mL
1855
Midazolam HCl
RC
5 mg/mL
SKB
20 + 2 mg/
mL
1855
a
b