BC CANCER CHEMOTHERAPY PREPARATION AND …

1 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 1/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes Leucovorin 50 mg/5 mL 500 mg/50 mL (Hospira) (F)(PFL) no preservative1 N/A 10 mg/mL1 50 mg: discard unused portion2 500 mg: 8 h1 syringe3 7 d F,3 48 h RT3,4 mg/mL NS, D5W, Ringer s, LR, D10W, D5NS1,2 ( , 50-250 mL*) NS, D5W, LR, Ringer s: 24 h RT1 D10W, D5-NS: 8 h RT1 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 2/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes Leucovorin 50 mg/5 mL 500 mg/50 mL (Teva) (F)(PFL) no preservative5 N/A 10 mg/mL1 discard unused portion1 syringe 8 h6,7 - mg/mL NS, D5W8 ( , 50-250 mL*) 72 h F, RT8 - mg/mL NS, D5W5 NS: 24 h RT5 D5W: 12 h RT5 - 1 mg/mL Ringer s, Lactated Ringer s, D10W, D10NS5 Ringer s, LR: 24 h RT5 D10W: 12 h RT5 D10NS: 6 h RT5 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 3/40 Activation Date: 2 March 2006 Revised Date.

2 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes Leucovorin 50 mg/5 mL 500 mg/50 mL (Pfizer) (F)(PFL) no preservative9 N/A 10 mg/mL9 8 h9 syringe 8 h RT9 10 mg/mL NS, D5W, LR, Ringer s, D10W, D5NS9 ( , 50-250 mL*) NS, D5W, LR, Ringer s: 24 h RT9 D10W, D5NS: 8 h RT9 Mechlorethamine 10 mg (Ovation/Merck) (RT,PFL) no preservative10 do NOT use if discoloured or water droplets form in vial before reconstitution10 10 mL SWI or NS10 record time of reconstitution 1 mg/mL10 use within 4 h of reconstitution RT7,11 syringe10 complete administration within 4 h of reconstitution RT7,10,11 100 mL NS10,12 complete administration within 4 h of reconstitution RT7,10,12 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 4/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give.

3 Vial Stability Product Product Stability Special Precautions/Notes Melphalan 50 mg (GSK) (RT)(PFL) no preservative13 10mL supplied diluent13 immediately after adding diluent, shake vigorously13 record time of reconstitution 5 mg/mL13 2 h RT13 do NOT refrigerate mg/mL in NS only13 ( , greater than 45 mg and less than or equal to 110 mg in 250 mL NS)* complete administration within 60 min from time of initial reconstitution at RT11 Mesna 400 mg/4 mL 1000 mg/10 mL (Baxter) (RT) no preservative14 N/A 100 mg/mL14 (use filter needle to withdraw from ampoule) discard unused portion14 greater than 1 mg/mL in D5W, D5 NS, NS, LR14-16 complete administration within 24 h RT14 Mesna 1000 mg/10 mL 5000 mg/50 mL (Baxter) (RT) preservative14 N/A 100 mg/mL14 8 days RT14 (vial may be punctured up to 4 times)14 greater than 1 mg/mL in D5W, D5 NS, NS, LR14-16 complete administration within 24 h RT14 Mesna 1000 mg/10mL (Fresenius Kabi) (RT) preservative17 N/A 100 mg/mL17 14 d RT,F17,18 greater than or equal to 1 mg/mL in NS or D5W19 24 h RT, 48 h F17 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 5/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give.

4 Vial Stability Product Product Stability Special Precautions/Notes Methotrexate 50 mg/2mL 500 mg/20mL 1 g/40mL g/100 mL (Pfizer/Hospira) (RT)(PFL) no preservative20 N/A 25 mg/mL20 50mg: discard unused portion20 500 mg, 1 g, or g: 8 h RT20 syringe use within 8 h RT of initial puncture20 - for high-dose regimens ( , 1-12 g/m2 as a single dose)21-25: use preservative-free methotrexate20 - do not use for IT injection 2 mg/mL NS, D5W20 (100 mL* NS, D5W) use within 24 h RT of initial puncture20 **(PFL) high dose ( , 1-12 g/m2 as a single dose)21-25: 1000 mL* NS use within 24 h RT of initial puncture20 **(PFL) Methotrexate IT Injection Only preservative free methotrexate may be administered by the intrathecal route26 50 mg/2mL (Pfizer/Hospira) (RT)(PFL) no preservative20 N/A 25 mg/mL20 discard unused portion20 qs to 6 mL with preservative free NS27,28 use within 4 h of initial puncture18 - auxiliary info29: IT - label to include route in full ( , INTRATHECAL injection) attached to both syringe and outer ziplock bag29 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 6/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With.

5 To Give: Vial Stability Product Product Stability Special Precautions/Notes Methotrexate 50 mg/2mL 500 mg/20mL (Pfizer/Hospira) (RT)(PFL) preservative20 N/A 25 mg/mL20 14 d F18,20 syringe 14 d F18 - contains benzyl alcohol20 - do NOT use for high-dose regimens ( , 1-12 g/m2 as a single dose) 20 - do NOT use for IT injection20 2 mg/mL NS, D5W20 (100 mL* NS, D5W) 24 h RT20 Mitomycin 20 mg (Accord) (RT)(PFL) no preservative30 40 mL SWI30 shake well30 mg/mL30 6 h RT, 72 h F30 **(PFL)30 syringe 6 h RT, 72 h F30 **(PFL)30 Mitomycin intravesical 20 mg (Accord) (RT)(PFL) no preservative30 40 mL SWI30 shake well30 mg/mL30 6 h RT, 72 h F30 **(PFL)30 syringe 6 h RT, 72 h F30 **(PFL)30 10 mL SWI31 shake well30 2 mg/mL31 use immediately after PREPARATION to prevent precipitation32 syringe use immediately after PREPARATION to prevent precipitation32 - may precipitate due to low solubility32,33 - do NOT refrigerate32 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 7/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes Mitomycin intraperitoneal 20 mg (Accord) (RT)(PFL) no preservative30 40 mL SWI30 shake well30 mg/mL30 6 h RT, 72 h F30 **(PFL)30 mg/mL30 NS, sodium lactate30 NS.

6 3 h RT, 18 h F30 sodium lactate: 3 h RT, 6 h F30 Mitomycin 20 mg (Teva/Novopharm) (RT)(PFL) no preservative34 40 mL SWI34 shake well34 mg/mL34 6 h RT, 72 h F34 **(PFL)34 syringe 6 h RT, 72 h F34 **(PFL)34 Mitomycin intravesical 20 mg (Teva/Novopharm) (RT)(PFL) no preservative34 40 mL SWI34 shake well34 mg/mL34 6 h RT, 72 h F34 **(PFL)34 syringe 6 h RT, 72 h F34 **(PFL)34 10 mL SWI31 shake well34 2 mg/mL31 use immediately after PREPARATION to prevent precipitation32 syringe use immediately after PREPARATION to prevent precipitation32 - may precipitate due to low solubility32,33 - do NOT refrigerate32 Mitomycin intraperitoneal 20 mg (Teva/Novopharm) (RT)(PFL) no preservative34 40 mL SWI34 shake well34 mg/mL34 6 h RT, 72 h F34 **(PFL)

7 34 mg/mL34 NS, sodium lactate34 NS: 6 h RT, 18 h F34 sodium lactate: 6 h RT, F34 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 8/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes mitoXANTRONE 20 mg/10 mL (Fresenius Kabi) (RT) no preservative35 N/A 2 mg/mL35 discard unused portion35 NS, D5W35 Greater than or equal to *50 mL35 24 h RT35 mitoXANTRONE 20 mg/10 mL 25 mL (Hospira) (RT)(PFL) no preservative36 N/A 2 mg/mL36 discard unused portion36 mg/mL36 NS, D5W36 Greater than or equal to *50 mL36 NS.

8 24 h F, RT36 **(PFL)36 mitoXANTRONE 20 mg/10 mL (Teva/Novopharm) (RT)(PFL) no preservative37 N/A 2 mg/mL37 discard unused portion37 Greater than or equal to *50 mL NS, D5W37 24 h RT37 **(PFL)38 Nivolumab 40 mg/4 mL 100 mg/10 mL (BMS) (F)(PFL) do not shake no preservative39 N/A 10 mg/mL39 discard unused portion39 1-10 mg/mL NS, D5W39 (50-100* mL) mix by gentle inversion; do not shake39 complete administration within 8 h RT or 24 h F39 **(PFL)39 - administer with a to micron in-line filter39 - discard if cloudy or has pronounced colour change (should be clear to pale yellow)39 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 9/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes oBINutuzumab 1000 mg/40 mL (Hoffman-La Roche) (F)(PFL)** do not shake no preservative40 N/A 25 mg/mL40 discard unused portion2 100 mg: in 100 mL NS40 900 mg: in 250 mL NS40 1000 mg.

9 In 250 mL NS40 24 h F, 48 h RT40,41 -once removed from the fridge, diluted product is stable for an additional 48 h RT40,41 - do NOT shake40 - do NOT use dextrose containing solutions40 Octreotide 50 mcg/mL 100 mcg/mL 500 mcg/mL (Omega) (F)(PFL) no preservative42 N/A 50 mcg/mL42 100 mcg/mL42 500 mcg/mL42 Use within 4 h42 NS42 volume adjusted to ensure a continuous infusion of octreotide at 25 mcg/hour42 24 h RT42 Octreotide multidose vial: 1000 mcg/5 mL (Omega) (F)(PFL) preservative42 N/A 200 mcg/mL42 15 d F42 NS42 volume adjusted to ensure a continuous infusion of octreotide at 25 mcg/hour42 24 h RT42 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 10/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes Octreotide 50 mcg/mL 100 mcg/mL 500 mcg/mL (Teva/Novopharm) (F)(PFL) no preservative43 N/A 50 mcg/mL43 100 mcg/mL43 500 mcg/mL43 discard unused portion43 SC syringe43 use within 4 h43 infusion: NS43 24 h RT43 Octreotide multidose vial: 1000 mcg/5 mL (Teva/Novopharm) (F)(PFL) preservative43 N/A 200 mcg/mL43 14 d F43,44 SC syringe use within 14 d F43,44 infusion.

10 NS43 24 h RT43 Octreotide (SANDOSTATIN ) 1000 mcg/5 mL (Novartis) (F)(PFL) preservative45 N/A 200 mcg/mL45 discard unused portion46 50 200 mL NS11,47,48 SC infusion: adjust volume to ensure infusion rate of 25 mcg/h47 24 h RT47 BC CANCER CHEMOTHERAPY PREPARATION and Stability chart version 11/40 Activation Date: 2 March 2006 Revised Date: 18 March 2019 BC CANCER CHEMOTHERAPY PREPARATION AND STABILITY chart DRUG & STRENGTH (Storage Prior to Use, Manufacturer, Preservative Status) Reconstitute With: To Give: Vial Stability Product Product Stability Special Precautions/Notes Octreotide (SANDOSTATIN ) 50 mcg/1 mL 100 mcg/1 mL 5