Physical Compatibility of Mesna Injection with Intravenous Drugs during Simulated Y-site Administration
Objective To assess the physical compatibility of Mesna Injection during simulated Y-site administration with 20 selected intravenous drugs.Methods Mesna Injection solution was diluted in 0.9%sodium chloride(NS)or 5%glucose injection to drug concentration of 20 mg/ml.All other intravenous drugs were reconstituted and diluted to the range of concentrations used clinically according to manufacturers'recommendations.Y-site administrations were simulated by independently mixing Mesna solution with other tested drug solutions in glass tubes at a 1:1 ratio.Physical characteristics,Tyndall effect,the change of turbidity and pH were investigated immediately(at 0 h)and at 0.5 h,1 h,2 h,3 h,and 4 h after mixing.Medication mixtures were considered physically incompatible during the 4 h observation period if there was visual evidence of haze,precipitation,gas evolution,color change,a positive Tyndall test at any time or a turbidity change of≥0.5 nephelometric turbidity units(NTU),or pH change≥10%compared to 0 h.Results Of the 20 intravenous drugs tested,the combination of Mesna and acyclovir formed haze and showed a change in turbidity of＞0.5 NTU compared to 0 h after mixing.The mixed solution of Mesa and 19 other intravenous drugs clarified within 4 h without producing turbidity,precipitation,color change,gas or Tyndall effect.The change in turbidity compared to 0 h was less than 0.5 NTU,and the change in pH compared to 0 h was less than 10%.Conclusion During simulated Y-site administration,Mesna is physically incompatible with acyclovir in both NS and 5%GS,and other 19 intravenous drugs are found to be physically compatible with Mesna.
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