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Volume 42, Number 4, pp 378–382 2007 Wolters Kluwer …

378 Volume 42, April 2007 Special ResourceHospital PharmacyVolume 42, Number 4, pp 378 3822007 Wolters Kluwer Health, to be Used with a Filter for Preparation and/or AdministrationDrugs that Require a FilterDrug Class Filter SizeaCommentsAbatacept (Orencia) to micronAdminister with an infusion set and a sterilenonpyrogenic, low-protein-binding (ReoPro)Glycoprotein or micronFor a bolus injection, filter prior to inhibitoradministration; for continuous infusion, filtereither upon admixture (using a sterile, nonpyro-genic, low-protein-binding filter) or uponadministration (using an inline, sterile, nonpyro-genic, low-protein-binding filter).Agalsidase beta micronDo not use filter needles during the preparation (Fabrazyme)of the infusion; diluted solution should be fil-tered through an inline low-protein-binding fil-ter during alfa micronDo not use filter needles during the preparation (Myozyme)of the infusion; diluted solution should be fil-tered through an inline low-protein-binding fil-ter during Respiratory enzymeSee individual proteinase package insertsinhibitor (eg, Prolastin,Aralast, Zemaira)Amiodarone Antiarrhythmic agentNot

380 Volume 42, April 2007 Special Resource Drugs that Require a Filter Drug Class Filter Sizea Comments Hyaluronidase Enzyme 5 micron Use a filter needle when withdrawing the powder for reconstituted solution from the vial.

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Transcription of Volume 42, Number 4, pp 378–382 2007 Wolters Kluwer …

1 378 Volume 42, April 2007 Special ResourceHospital PharmacyVolume 42, Number 4, pp 378 3822007 Wolters Kluwer Health, to be Used with a Filter for Preparation and/or AdministrationDrugs that Require a FilterDrug Class Filter SizeaCommentsAbatacept (Orencia) to micronAdminister with an infusion set and a sterilenonpyrogenic, low-protein-binding (ReoPro)Glycoprotein or micronFor a bolus injection, filter prior to inhibitoradministration; for continuous infusion, filtereither upon admixture (using a sterile, nonpyro-genic, low-protein-binding filter) or uponadministration (using an inline, sterile, nonpyro-genic, low-protein-binding filter).Agalsidase beta micronDo not use filter needles during the preparation (Fabrazyme)of the infusion; diluted solution should be fil-tered through an inline low-protein-binding fil-ter during alfa micronDo not use filter needles during the preparation (Myozyme)of the infusion; diluted solution should be fil-tered through an inline low-protein-binding fil-ter during Respiratory enzymeSee individual proteinase package insertsinhibitor (eg, Prolastin,Aralast, Zemaira)Amiodarone Antiarrhythmic agentNot specifiedUse a micron inline filter during(Cordarone)administration.

2 Recommended by source suggests no significant loss ofdrug potency with the use of a micron cel-lulose ester membrane ,2 Amphotericin B Antifungal agent1 micron or larger Filter may be used during mean pore (Amphocin, diameter (inline Fungizone)membrane filter)Antihemophilic Antihemophilic agentNot specifiedUse filtered needle provided by (eg, Adurate,Kogenate)Antihemophilic Antihemophilic factor Not specifiedUse filter for withdrawal from the combinationWillebrand Factor Complex (Humate P)(continued)Prepared by: Wolters Kluwer Health/Facts and ComparisonsDate: March 9, 2007 Disclaimer: While every effort has been made to ensure the accuracy and completeness of the informationpresented in this chart, the reader is advised that the authors or Wolters Kluwer Health cannot be respon-sible for the currency of the information, for any errors or omissions, or for any consequences that mayarise.

3 The reader should consult the product package insert for the most up-to-date information. Hospital Pharmacy 379 Special ResourceDrugs that Require a FilterDrug Class Filter SizeaCommentsAntithymocyte Immune micronglobulin inline filter(Thymoglobulin)Antithrombin III Antithrombin agentNot specifiedUse filter needle provided by manufacturer.(Thrombate III)Asparaginase Antineoplastic agent5 micronFilter during intravenous (IV) administration.(Elspar)Botulism immune Immune globulin18 micronUse inline or syringe-tip sterile, disposable IV (BabyBIG)Busulfan (Busulfex)Antineoplastic agent5 micronDo not use polycarbonate syringes or polycar-bonate filter needles with busulfan; only use the5 micron nylon1filter needle provided.

4 Use onefilter per (Erbitux)Monoclonal micron inlinefilter Citric acid, glucono-Urinary irrigantNot specifiedAfter thorough mixing, filter the solution delta-lactone, andthrough a coarse carbonate (Renacidin)Cladribine (Leustatin)Antineoplastic micronWhen preparing the 7-day infusion solution,both cladribine and the diluent should be passedthrough a sterile disposable hydrophilic syringefilter as each solution is being introduced intothe infusion (Clolar)Antineoplastic micronFilter prior to Immune globulin15 micron inline A micron filter is also globulin IV, filter human (CytoGam)Digoxin immune Detoxification micron Fab (Digibind)membrane filterEpoprostenol sodium micronAn inline filter was used during clinical trials.(Flolan)Ferumoxides Diagnostic agents5 micron(Feridex IV)Galsulfase micron Do not use a filter during preparation of the (Naglazyme)solution; administer with a polyvinyl chloride(PVC) infusion set equipped with an inline, low-protein-binding Monoclonal micron terminal Can be given through central or peripheral ozogamicin filterline; administer through a separate line(Mylotarg)equipped with a low-protein-binding, to terminal filter; manufacturer states: Thefollowing filter membranes are qualified: micron polyether sulfone (PES) Supor; acrylic copolymer hydrophilic filter (Ver-sapor); micron cellulose mixed ester (acetateand nitrate) membrane.

5 Micron celluloseacetate (Panhematin)Hemin micron or smaller terminal filter(continued)380 Volume 42, April 2007 Special ResourceDrugs that Require a FilterDrug Class Filter SizeaCommentsHyaluronidase Enzyme5 micronUse a filter needle when withdrawing the powder for reconstituted solution from the (Vitrase)Idursulfase micronFilter to be used with an infusion set.(Elaprase)Imiglucerase micronDiluted solution may be filtered through an (Cerezyme)inline, low-protein-binding filter during Immune globulinSee individual globulin IV package inserts(eg, Gammagard, Flebogamma)In-111 ibritumomabRadioimmunotherapeutic micronA low-protein-binding filter should be inlinetiuxetan and Y-90monoclonal antibodybetween the syringe and infusion port prioribritumomab tiuxetanto injection of each component.(Zevalin)Infliximab (Remicade)Monoclonal micron or smaller inline filterInulinDiagnostic agentNot specifiedAdminister through a Antifungal agentNot specifiedUse infusion set with filter provided by the (Sporanox) Proton pump micronAdminister using inline filter provided.

6 (Prevacid IV)Laronidase micronDo not use a filter during preparation of the (Aldurazyme)solution; administer with a PVC infusion setequipped with an inline, low-protein-binding Immune to 1 micronimmune globulin, antithymocyte globulin (Atgam)Mafenide Topical burn preparation micronFilter reconstituted solution prior to use; topical (Sulfamylon)use Osmotic diuretic5 micron inline filterTo be used when infusing concentrated mannitol(20% or more).Methacholine Diagnostic micronA sterile, bacterial-retentive filter should be used (Provocholine)when transferring a solution from each vial (atleast 2 mL) to a nebulizer; initial use sulfate micronPrepare soluble tablets in sterile water and filtersoluble tablets for prior to sulfate Opioid5 micron or smallerFilter through a microfilter before injecting for intrathecal into the microinfusion device; intrathecal useadministration only.

7 (Infumorph)Muromonab-CD3 Monoclonal or micronDraw solution into a syringe through a low-(Orthoclone OKT3)protein-binding (Taxol, Antineoplastic micron or Administer through an inline filter; use of a Onxol)smallerfilter is not recommended for Monoclonal or micronAdminister by an IV infusion pump using a (Vectibix)low-protein-binding inline filter.(continued)Special ResourceDrugs that Require a FilterDrug Class Filter SizeaCommentsPentetate calcium Detoxification agentNot specifiedMay be filtered using a sterile filter if particles trisodiumare seen subsequent to opening of the AnticonvulsantNot specified Although not recommended, some studies sodium, (inline filter)ndicate that an IV infusion of phenytoin mayparenteral be feasible if proper precautions are observed,such as a suitable vehicle (eg, sodiumchloride or Ringer s lactated injection), appro-priate concentration, preparing the infusionshortly before administration, and using aninline filter; according to most studies, a inline filter is required1,3.

8 Phenytoin sodi-um (250 mg/5mL in a 5 mL syringe) was filteredat a rate of 1 mL/min through a 5 micron stain-less steel depth filter without significant reduc-tion in Vascular endothelial5 micronWithdraw the solution from the vial through a (Lucentis)growth factor 5-micron, 19-gauge filter needle attached to a antagonist1 mL tuberculin syringe; for intravitreal injec-tion Immune globulinLarger than An inline filter may be used for RSV-IGIV syncytial virus 15 micron globulin, IV (RSV-IVIG)(RespiGam)Streptokinase Thrombolytic micron or larger(Streptase)Thiotepa Antineoplastic micronFilter prior to administration; polysulfone (Thioplex)membrane (Gelman s Sterile Acrodisc, SingleUse) or triton-free mixed ester of cellulose/PVC(Millipore s MILLEX-GS Filter Unit) are recom-mended by the Radioimmunotherapeutic micron Administer via IV tubing set with an inline filter. and iodine 131 monoclonal antibodyThe same IV tubing set and filter must be used I-tositumomab throughout the entire dosimetric or therapeutic(Bexxar)step; a change in filter can result in loss of immune Immune micronAdminister VIGIV via an IV catheter with an globulin IV (VIGIV)administration set that contains an inline filter.

9 Verteporfin micronAdminister using a syringe pump and inline (Visudyne)phototherapy agentfilter; use of an inline filter (pore size to ) is required for : For consistency, the term micron is used to encompass all terms meaning the same (eg, micrometer, mcm, mm)References1. Gahart BL, Nazareno AR. Intravenous Medications: A Handbook for Nurses and Health Professionals. 23rd ed. St. Louis, MO:Mosby Elsevier; Trissel on Injectable Drugs. 4th ed. Bethesda, Maryland: American Society of Health-System Pharmacists; Facts and Comparisons. Drug Facts and Comparisons [online]. 2007 . Available from Wolters Kluwer Health, March 9, 42, April 2007382 Volume 42, April 2007 American Health PackagingPravastatin ..321 HospiraHospira ..79 Hospira WorldwideMagnesium Sulfate ..307 Janssen PharmaceuticalInvega ..288a 290, 368a 370 King PharmaceuticalsThrombin JMI ..300 302KV PharmaceuticalsInveAmp.

10 311 Medi-Dose, Dose Packaging ..285 Ortho BiotechProcrit ..Cover 4 Pfizer, IM ..315 316 Schering PloughNoxafil ..293 296, 361 364 TEVA Pharmaceuticals USAA zithromycin ..281 Wyeth PharmaceuticalsTygacil ..Cover 2, 273-274 INDEX TO ADVERTISERS


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