A Copy of IV MASTER FORMULA as of 11.10.2017

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
ACYCLOVIR (Withdrawl Vol) CONC. D5W VOLUME RATE
(ZOVIRAX®) 500 mg 50 mg/mL NS Dose < 500mg: 100 mL ROOM TEMP. REFRIG.
AMIKACIN 1 Gm 10 mL 250 mg/mL D5W Dose >500mg: 250 mL 60 mins
AMPICILLIN 1 Gm/20 mL 20 mL 100 mg/mL NS 60 mins 24 hrs _ Room Temp. *The reconstituted vial solution should be used within 12hrs.
500 mg/2mL (Max Conc: 7 mg/mL) *Refrigeration of reconstituted solution may result in the formation
AMPICILLIN/SULBACTAM 1 Gm/4mL _ 375 mg/mL
(UNASYN®) 500 mg Dose ≤ 500 mg: 100 mL of a precipitate which will redissolve at room temp.
1 Gm _ 5 mg/mL Dose > 500 mg: 250 mL
2 Gm 3.33 mg/mL (Max Conc: 5 mg/ml) 60 mins 48 hrs 14 days Refrigerate *IV or IM
5 mL 90 mins *Store the reconstituted vial @ REFRIG,
10 mL 60 min. 30mg/mL: 24hrs in
20 mL Up to 30mg/mL: 8hrs N.S. discard after 14days
100 mL 60 min. in N.S. Up to 20mg/mL:
NS Only (Max Conc: 30 mg/mL) 10-20mg/mL: 1hr in 48hrs in N.S. Refrigerate *IV or IM

D5W Up to 20mg/mL: 1hr
in D5W

*45 (30 AMP/15 *45 (30 AMP/15
SULB) mg/mL: 8 hrs SULB) mg/mL: 48 hrs
1.5 Gm 3.2 mL (4 mL) in N.S. in N.S.

NS Only 100 mL *30 (20 AMP/10 *30 (20 AMP/10 Refrigerate
SULB) mg/mL: 2hrs in SULB) mg/mL: 72 hrs
D5W in N.S.
3 Gm 6.4 mL (8 mL) *3 (2 AMP/1 SULB) *30 (20/10): 4 hrs in

mg/mL: 4hrs in D5W D5W

AMPHOTERICIN B 50 mg 10mL S.W. Only D5W Only 500 mL D5W for IV INF. 4-6 hrs 24 hrs 7 days Refrigerate *Not compatible w/ N.S
(FUNGIZONE®) (dose: should NOT FOR IV INF. (Max Conc: 0.1mg/ml) over 24 hrs *REFRIGERATE Unreconstituted Vial & PROTECT FROM LIGHT
exceed 1.5mg/kg/day) S.W. FOR *Reconstituted solution kept in dark: 24hrs @ Room Temp, 7
IRRIGATION 1L S.W. FOR IRRIGATION
days @ Refrig.

50 mg 15 mL 50 mL 45 mins *REFRIGERATE unreconstituted vial.
100 mg 30 mL D5W (infusion vol = 65 mL) 90 mins *Reconstituted solution: 24hrs @ Room Temp.
ANIDULAFUNGIN (ERAXIS®) NS 48 hrs 72 hrs Refrigerate *Diluted solutions: stable for up to 48hrs @ Room Temp or
100 mL
(infusion vol = 130 mL) for 72hours if stored frozen. *IV ONLY

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
(Withdrawl Vol) CONC. VOLUME RATE
ROOM TEMP. REFRIG.

100 mg/ 20 mL 500 mL D5W *Not compatible w/ N.S.
Suspension (final Conc: 1mg/ml) *FLUSH IV Line with D5W injection BEFORE & AFTER Infusion. If this
cannot be done, then a separate IV line must be used. Make/send
AMPHOTERICIN B LIPID (3-5mg/kg/dose IV _ 5 mg/mL D5W Only * For pediatric pt & pt w/ 3 hrs 6 hrs 48 hrs Refrigerate 10 mL DEXTROSE FLUSH SYRINGES for each dose (1 before/1 after
COMPLEX (ABELCET®) Q24hrs) cardiovascular disease, the
final concentration may be 2 dose)
*Refrigerate Unreconstituted Vial & PROTECT FROM LIGHT
mg/ml.
Filtration and Dilution:

•Prepare the admixture for infusion by first shaking the vial until
there is no evidence of yellow sediment on the bottom of the vial.
•Transfer the appropriate amount of drug from the required number
of vials into one or more sterile syringes using an 18-gauge needle.
•Attach the provided 5-micron filter needle to the syringe; inject the

syringe contents through the filter needle, into the appropriate
amount of D5W injection. Each filter needle may be used on the

contents of no more than four 100 mg vials.

AMPHOTERICIN B LIPOSOMAL 50 mg (Amphotericin 12 mL S.W. Only (12.5 4 mg/mL D5W Only 500 mL 3 hrs Use ASAP *IV ONLY *Not compatible w/ N.S.
(AMBISOME®) B Liposomal Dose= 3- mL) (Final Conc: 1-2 mg/mL) *Injection of AmBisome should commence within 6 hours of *FLUSH IV Line with D5W BEFORE & AFTER Inf. If this cannot be
(Final Conc. for Peds: 0.2- done, then a separate IV line must be used. Send 10 mL DEXTROSE
5mg/kg/day) dilution with 5% Dextrose Injection.
0.5mg/mL) *The reconstituted vial: stored for up to 24 hrs @ Refrig. FLUSH SYRINGES for each dose (1before/1after dose)
*Unopened vials of lyophilized material to be stored @ * SEND TPN 1.2 MICRON FILTER.
*RECONSTITUTION:
temperature up to 25° C
1. Add 12 mL of S.W. to AmBisome (Conc. 4mg/mL)
2. Immediately SHAKE THE VIAL VIGOROUSLY for 30 seconds to

completely disperse the AmBisome.
**FILTRATION & DILUTION:

1. After Reconstiitution, withdraw the amount of reconstituted
AmBisome into a sterile syringe.

2. Attach the 5-micron filter provided to the syringe. Inject the
syringe contents through the filter, into the amount of 5% Dextrose.

(Use only 1filter/vial.)
3. AmBisome s/b diluted with 5% Dextrose to a final conc. 1 -2
mg/mL prior to administration. DISCARD PARTIALLY USED VIALS.

AZITHROMYCIN (ZITHROMAX®) 500 mg 4.8 mL (5 mL) 100MG/ML NS, D5W 250 mL 90 mins 24 hrs 7 days Refrigerate *IV ONLY
AZTREONAM (AZACTAM®) 1 Gm 10 mL 100 mg/mL NS, D5W (Max Conc: 2 mg/mL)
2 Gm 1.5 mL 200 mg/mL 60 mins 48 hrs 7 days Refrigerate *IV or IM *Shake immediately and vigorously
BELIMUMAB (BENLYSTA®) 120 mg NS ONLY 100 mL
4.8 mL (5 mL) 80 mg/mL (Max 20 mg/mL) 60 mins (the *The total time from *The total time from *Store vial @ Refrig. *Solutions of BENLYSTA diluted in
400 mg diluted reconsitution to reconsitution to N.S.may be stored at 2° to 8°C (36° to 46°F) or room temp
250 mL completion of completion of Refrigerate OR *When reconstituting, direct the stream of S.W.toward the
solution of infusion should not infusion should not room temp side of the vial to minimize foaming. Gently swirl the vial.
BENLYSTA s/b Allow the vial to sit at room temp, gently swirling the vial. Do
administered exceed 8 hours. exceed 8 hours. not shake. *IV INFUSION ONLY (NO IV-PUSH or Bolus) *Must
by IV inf only, be administered only by healthcare providers due to risk of
over a period anaphylaxis. *If not used immediately, protect solution from

of 1 hour.) direct sunlight, refrigerate.

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
CASPOFUNGIN (CANCIDAS®) 50 mg (Withdrawl Vol) CONC. NS Only VOLUME RATE
70 mg 5 mg/mL ROOM TEMP. REFRIG.
CEFAZOLIN 500 mg 10 mL N.S. Only 7 mg/mL 250 mL 90 mins
(ANCEF®, KEFZOL®) 1 Gm (NTE 0.5 mg/mL) 60 mins 24 hrs 48 hrs Refrigerate *Unreconstituted vial: REFRIGERATE
5 mL 100 mg/mL *Reconstituted solution: up to 1 hr @ R.T.
CEFEPIME (MAXIPIME®) 10 Gm 9.6 mL (10 mL) 60 min.
45 mL (51 mL) 200 mg/mL NS, D5W 100 mL 24 hrs 10 days Refrigerate *Unreconstitued Vial: PROTECT FROM LIGHT
1 Gm 96 mL (102 mL) 100 mg/mL (Max Conc: 20 mg/mL) *Reconstitued Vial: stable for 24 hrs @ Room Temp, 10 days
100 mg/mL
2 Gm 10 mL @ Refrig.
200 mg/mL *Cefazolin 10Gm Bulk Vial: Discard vial within 4 hours after

initial entry
*For I.M. Cefazolin 1gm: add 2.5mL S.W., shake well,

withdraw entire contents, provides volume ~3mL
(approximate Conc. 330mg/mL)

NS, D5W 100 mL 24 hrs 7 days Refrigerate *Unreconstitued Vial: PROTECT FROM LIGHT
*Reconstitued Vial: 24 hrs @ Room Temp, 7 days @ Refrig.
*IM only for mild to mod. uncomplicated or complicated UTI’s

due to E. coli when the IM is a more appropriate route.

CEFOTAXIME (CLAFORAN®) 1 Gm 9.6 mL (10 mL) 100 mg/mL NS, D5W 100 mL 60 min. 24 hrs 5 days Refrigerate *Reconstituted Vial: stable for 12 hrs @ Room Temp, 7 days
2 Gm 9.4 mL (10 mL) 200 mg/mL @ Refrig. *PROTECT FROM LIGHT

1 Gm 9.5mL (10 mL) 100 mg/mL
19mL (20 mL)
CEFOTETAN (CEFOTAN®) 2 Gm NS, D5W 100 mL 60 min. 24 hrs 96 hrs Refrigerate Reconstituted Vial: stable for 24 hrs @ Room Temp, 96 hrs @
Refrig. *PROTECT FROM LIGHT
CEFOXITIN (MEFOXIN®) 10GM BULK VIAL 100 mL 60 min. 18 hrs
CEFTAROLINE (TEFLARO®) 50 (55 mL) or 180 or 95 mg/mL 90 min. 6 hrs
CEFTAZIDIME (FORTAZ®, 1 Gm 100 mL (105 mL) 250 mL 60 min. 12 hrs
2 Gm 100 mL
TAZICEF®) 400 mg 10 mL (10.5 mL) 95 mg/mL NS, D5W (Max Conc: 40 mg/mL) 48 hrs Refrigerate Reconstituted Vial: stable for 6 hrs @ Room Temp,
600 mg 10 mL (11.1 mL) 180 mg/mL 24 hrs 1 WEEK @ Refrig.
500 mg 3 days
1 Gm 20 mL 20 mg/mL NS, D5W Refrigerate *Mix gently to constitute, then look closely to see that the
2 Gm NS, D5W contents have dissolved completely. Constitution time is < 2
5.3ML (5.7ML) 30 mg/mL
10ML (10.8ML) 100 mg/mL minutes. *IV USE ONLY
10ML (11.5ML) 100 mg/mL
170 mg/mL Refrigerate *Reconsituted Vial: stable for 12 hrs @ Room Temp,
3 DAYS @ Refrig.

*PROTECT FROM LIGHT

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
(Withdrawl Vol) CONC. VOLUME RATE
ROOM TEMP. REFRIG.

CEFTAZIDIME + AVIBACTAM 2.5 Gm 10 mL (12mL) Ceftazidime 0.167 NS, D5W 250 mL 2 hours 12 hrs 24hrs Refrigerate * Volume to withdraw from constituted vial:
(AVYCAZ®) (2 gm Ceftazidime and g/mL & Avibactam For dose of 2.5 gm (12 mL entire content),
1.25 gm (1 g ceftazidime & 0.25 g avibacta: 6 mL),
0.5 gm avibactam) 0.042 g/mL 0.94 gm (0.7 5g ceftazidime & 0.19 g avibactam: 4.5 mL)

*IVPB only
* NO IV-push *PROTECT FROM LIGHT

CEFTOLOZANE + TAZOBACTAM 1.5 Gm (1g + 0.5g) 10 mL (entire contents Ceftolozane NS, D5W 100 mL 1 hour 24 hrs 7days Refrigerate * 1.5gm vial contains 1 g of ceftolozane and 500 mg of
(ZERBAXA®) 11.4mL) 0.0877 g/mL & 10 days Refrigerate tazobactam
dose of 750mg NS, D5W 100 mL 60 min. 2 days 7 days
CEFTRIAXONE (ROCEPHIN®) (500mg +250mg) 5.7mL to withdraw Tazobactam NS, D5W (Max Conc: 40mg/mL) 60 min. 24 hrs 14 days *reconstituted soluntion may be stored for 1 hour prior to
CEFUROXIME (ZINACEF®, dose of 375mg 0.0439 g/mL D5W* 60 min. Use Immediately further dilution. Do not freeze
KEFUROX®, CEFTIN®) (250mg +125mg) 2.9 mL to withdraw preferred, 100 mL once overwrap is 14days
CIPROFLOXACIN Max Conc: 2 mg/mL 60 min. removed * Diluted solution: 24 hours @ Room Temp or 7 days @
(CIPRO®) dose of 150mg 1.2 mL to withdraw NS (NTE 30 24 hrs Refrigeration
(100mg + 50mg) 100 mL mg/min.) 48 hrs
CLINDAMYCIN (CLEOCIN®) 2.4 mL (2.5 mL) 100 mg/mL NS, D5W (Max Conc: 18 mg/mL) *ZERBAXA vials should be stored refrigerated at 2 to 8°C (36
250 mg 4.8 mL (5 mL) 100 mg/mL to 46°F) and PROTECTED FROM LIGHT.
500 mg 9.6 mL (10 mL) *Powder Vial: PROTECT FROM LIGHT
1 Gm 19.2 mL (20 mL)
2 Gm *After Reconstitution, No Protection from light Necessary
750 mg 7ML *Reconstituted solutions may be stored for 2 days at room
1.5 Gm 14ML
200 mg/100mL temp or for 10 days in the refrig.
DEXTROSE
Refrigerate Unreconstituted Vial: PROTECT FROM LIGHT, 24 hrs @ Room
400 mg/200mL Temp, 7 DAYS @ Refrig.
DEXTROSE
Ready-To-Use Bag 2 mg/mL Room Temp *Single dose flexible plastic container.
600 mg/4mL vial *Do NOT remove unit from overwrap until ready for use.

900 mg/6mL vial *PROTECT FROM LIGHT.
*PROTECT FROM FREEZING
300 mg/50mL
150 mg/mL Refrigerate *Infusion rates should not exceed 30 mg/minute
600 mg/50mL 150 mg/mL compounded * CLEOCIN PHOSPHATE IV Solution in Galaxy plastic
_ 6 mg/mL Room temp containers is a sterile solution of clindamycin phosphate with
12 mg/mL (premix bags)
5% dextrose, s/b stored @ ROOM TEMP.

900mg/50mL 18 mg/mL

COLISTIMETHATE (COLISTIN®) 150 mg 2ML S.W. Only 75 mg/mL NS, D5W, 100 mL 60 min. 24 hrs Refrigerate *SWIRL GENTLY TO AVOID FROTHING
D51/2NS *If not used immediately, store Reconstituted solution in
REFRIGERATOR or @ ROOM TEMP & use within 7 DAYS

*SINGLE USE VIAL

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
(Withdrawl Vol) CONC. VOLUME RATE
ROOM TEMP. REFRIG.

DAPTOMYCIN (CUBICIN®) 500 mg 10ML N.S. Only 50 mg/mL NS Only 100 mL 60 min. 12 hrs 72 hrs Refrigerate *UNRECONSTITUED VIAL: REFRIGERATE
*RECONSTITUTED VIAL: 12HRS @R.T., 48HRS @REFRIG
*SLOWLY ADD 0.9% NS AGAINST THE INSIDE WALL OF THE
VIAL, Ensure all of the powder is wetted by gently rotating

the vial.
* Allow the vial to sit undisturbed for 10 minutes.
* GENTLY SWIRL the vial for a few minutes to obtain

complete reconstitution.
*AVOID SHAKING the vial to minimize foaming.

*Incompatible w/ D5W

DEXAMETHASONE SODIUM UP TO 100 mg (stock: _ _ NS, D5W 100 mL 60 min. 24 hrs 24 hrs Room Temp *PROTECT FROM LIGHT
PHOSPHATE (DECADRON®) 10 mg/mL) 25 mg/mL NS, D5W 60 min. 12hrs in NS *GENTLY SHAKE TO FORM A SUSPENSION
50 mg/mL NS, D5W 100 mL 4hrs in D5W
DORIPENEM (DORIBAX®) 250 mg 10ML S.W. or NS 1 hr 72hrs in NS Refrigerate
500 mg NS Only 0 to 100 mg: 100 mL 2 hrs 48 hrs 24hrs in D5W
Up to 200 mg: 250 mL
DOXYCYCLINE 100 mg 10 mL 10 mg/mL (Conc: 0.1-1 mg/mL) 60 min. 6 hrs 72 hrs Refrigerate *PROTECT FROM LIGHT

ERTAPENEM (INVANZ®) 1 Gm IVPB: 10 mL S.W. or 100 mg/mL 100 mL 24 hrs Refrigerate *IM: Reconstitute 1gm with 3.2mL Lidocaine 1%, then use
NS. 280 mg/mL within 1 hr after prepration *Storage after dilution: Use

IVP: 3.2ML of 1% within 6 hours if stored at room temp. The diluted solution
LIDOCAINE may be refrigerated for 24 hours and used within 4 hours

after removal from refrigeration.

500 mg 10ML S.W. only up to 500 mg: 100 mL 1 hr 8 hrs (The final 8 hrs (The final *Reconstitute w/ S.W. only as other diluents may cause
20ML S.W. only 501- 1000 mg: 250 mL 2 hrs diluted solution of diluted solution of precipitation, reconstituted vial is stable 24hrs @Room Temp,
1 Gm 14days @Refrig. *The final diluted solution of erythromycin
ERYTHROMYCIN 20 mg 50 mg/mL NS Only s/b completely s/b completely Room Temp lactobionate s/b completely administered within 8 hours in
FAMOTIDINE (PEPCID®) 40 mg administered administered
within 8 hrs) within 8 hrs) order to assure proper potency & since it is not suitable for
storage *NO IM. *IV ONLY

NS, D5W 20mg IVPB: 100 mL 40mg IVPB: 30mins 7 days 48 hrs *IV-Push: Dilute 20mg w/ compatible soln to a total volume
_ _ IVPB: 250 mL Room Temp of 5 mL or 10 mL
(Conc. 0.2 mg/mL)

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
(Withdrawl Vol) CONC. VOLUME RATE
1 hr ROOM TEMP. REFRIG.
50 mL 1 hr
100 mg/50mL NS 100 mL 2 hrs *PROTECT FROM FREEZING.
200 mL *Avoid excessive heat.
FLUCONAZOLE (DIFLUCAN®) 200 mg/100 mL NS Ready-To-Use Bag NS Use Immediately _ Room Temp
_ (compatible once overwrap is * Intact containers: Refer to the expiration date on the
package
with D5W) removed
*Maximum IV rate: 200 mg/hr.
400 mg/200 mL NS *Do NOT remove unit from overwrap until ready for use.

*Do NOT Compound (transfer) in pharmacy.
*HAZARDOUS DRUG-DISPOSE PROPERLY.

FUROSEMIDE (LASIX®) 20 mg/2 mL _ _ NS ONLY 100 mL 60 mins 24 hrs _ Room Temp *IV, IV-push, IM
GENTAMICIN 40 mg/4 mL _ _ (max Conc: 10mg/mL) (NTE 4 4 days
(GARAMYCIN®) 100 mg/10 mL mg/min)
40 mg/mL _
80 mg/2mL NS, D5W 100 mL 60 min. 24HRS Refrigerate *IV, IM
100 mg/10mL 24HRS
48 hrs
100 mg/2mL ACT-O- 50 mg/mL 24HRS *Diluted solution: stable for 4 hours & PROTECT FROM
VIAL 125 mg/mL (Conc. 1mg/mL) _ LIGHT, s/b given IVPB or IV-PUSH.
250 mg/mL
HYDROCORTISONE SODIUM 250 mg /2mL ACT-O- 2 mL Bacteriostatic NS, D5W 100 mL 60 mins 4HRS Room Temp *Unused solution s/b discarded after 3 days.
SUCCINATE (SOLU-CORTEF®) VIAL N.S. provided in ACT-O- (Conc. 2mg/mL - *Press down on plastic activator to force diluent (2 mL
Bacteriostatic N.S.) into the lower compartment. Gently
Vial 60mg/mL) agitate to effect solution. Remove plastic tab covering center
of stopper, and sterilize the stopper top. Insert needle
500 mg/2mL ACT-O- squarely through center of stopper until tip is just visible.
VIAL
Invert vial and withdraw dose.

IMIPENEM-CILASTATIN 250 mg 10 mL N.S. only 25 mg/mL NS Only up to 500mg: 100 mL 60 mins 4HRS Refrigerate *IV or IM
(PRIMAXIN®) 500 mg 50 mg/mL up to 1 Gm: 250 mL 90 mins *IV formulation: available in 250mg, 500mg.
NS, D5W 60 mins 48 hrs Refrigerate *IM formulation: available in 500mg and 750mg.
KETOROLAC (Toradol®) 15 - 60 mg _ _ NS, D5W 100 mL 15 mins 24HRS Room Temp
100ML *IM formulation is not for IV use.
LEVETIRACETAM (KEPPRA®) 500 mg/5 mL _ 100MG/ML *IV & IM use only
*For IV use only.

250 mg/50 mL D5W 250 mg: 50mL 60 mins

LEVOFLOXACIN (LEVAQUIN®) 500 mg/100 mL D5W Ready-To-Use Bag 5 mg/mL NS, D5W 500 mg: 100 mL 60 mins Use Immediately _ Room Temp *No dilution necessary
once overwrap is *Do NOT remove unit from overwrap until ready for use.

removed

750 mg/150 mL D5W > 500 mg: 150 mL 90 mins

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
LINEZOLID (ZYVOX®) (Withdrawl Vol) CONC. D5W VOLUME RATE
MEROPENEM (MERREM®) 400 mg/200 mL NS Only 200 mL ROOM TEMP. REFRIG.
600 mg/300 mL Ready-To-Use Bag _ 300 mL 90 mins
50 mg/mL 2 hrs Use Immediately _ Room Temp *PROTECT FROM LIGHT *single-dose container *Do NOT
500 mg 10 mL N.S. or S.W. 100 mL (max conc: once overwrap is freeze. *Do NOT remove unit from overwrap until ready for
1 Gm 20 mL N.S. or S.W. 20mg/mL)
removed use.

60 mins 4 hrs in N.S. 24 hrs in N.S. Refrigerate *Reconstitued Vial with S.W. (up to 50mg/mL): 3 hrs @ Room
Temp, 13 hrs @ Refrig. *IV-PUSH: doses up to 1gm over 3-
5mins * continuous IV *Intermittent IV

40 mg/1mL 1mL Bacteriostatic 40 mg/mL *DO NOT REFRIGERATE / STORE @ ROOM TEMP
Water provided in ACT- *PROTECT FROM LIGHT *May be given IM/IVP/IVPB

O-VIAL *Reconstituted Vial: use within 48 hrs
1.Remove protective cap. 2.Cleanse stopper with suitable
METHYLPREDNISOLONE NS, D5W 50-100mg: 50mL 30 min 24 hrs Do NOT Refrigerate Room Temp
SODIUM SUCCINATE (SOLU- 101-500mg: 100mL as directed germicide.
505-1250mg: 250mL as directed 3.Aseptically add 1 mL Bacteriostatic Water for Inj. USP (with
MEDROL®)
benzyl alcohol) for the 40 mg vial or 2 mL Bacteriostatic
125 mg/2mL 2mL Bacteriostatic 62.5 mg/mL Water for Inj., USP (with benzyl alcohol) for the 125 mg vial.
Water provided in ACT-
4.Agitate to effect solution. 5.Invert vial. Insert needle
O-VIAL through target area of stopper until tip is just visible.

*EQUIVAENCY: Methylpred dose/0.8 = Prednisone dose

METOCLOPRAMIDE (REGLAN®) 10 mg/2 mL _ _ NS, D5W 100 mL 60 mins 48 hrs 48 hrs Refrigerate *PROTECT FROM LIGHT
Ready-To-Use Bag 5 mg/mL NS Only 100 mL 60 mins Use Immediately _
METRONIDAZOLE (FLAGYL®) 500 mg/100 mL 100 mL 60 mins once overwrap is _ Room Temp *PROTECT FROM LIGHT *Protect from freezing *Single-dose
_ container *Do NOT remove unit from overwrap util ready for
removed
7 days use.
24 hrs
MICAFUNGIN (MYCAMINE®) 50 mg N.S. 50 mg/mL NS, D5W 48 hrs Room Temp *Reconstituted Vial: stable for 24hrs @ Room Temp
MOXIFLOXACIN (AVELOX®) 100 mg *PROTECT FROM LIGHT
NAFCILLIN (NAFCIL®, UNIPEN®)
400 mg/250mL Ready-To-Use Bag _ 0.8% saline 250 mL 90 mins Use Immediately Room Temp *DO NOT REFRIGERATE - product precipitates upon
premix bag once overwrap is refrigeration

500 mg removed *Do not remove unit from overwrap until ready for use.
1 Gm
2 Gm 1.7 mL 250 mg/mL NS, D5W 100 mL 60 mins 24 hrs Refrigerate * Reconstituted vial: stable for 3 days at Room Temp, 7 days
9.6 mL 100 mg/mL (max Conc: 40 mg/mL) @ Refrig. or 12 weeks when frozen
19.2 mL 100 mg/mL
* For I.V. inf in NS or D5W, stable for 24 hours at Room Temp,
96 hrs @ Refrig.

NEOMYCIN & POLYMIXIN B 40 mg Neomycin, _ _ NS Only 1000 mL over 24 hrs _ Refrigerate *REFRIGERATE ampules (undiluted vial) & Mixed Irrigation
SULFATE 200,000units Solution

Polymyxin B/mL *PROTECT ampules FROM LIGHT
*IRRIGATION USE ONLY (Urinary Bladder Irrigation)
*The mixed Irrigation Solution s/b refrigerated & used within

48 hrs

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
OCTREOTIDE ACETATE (Withdrawl Vol) CONC. NS, D5W VOLUME RATE Room Temp * REFRIGERATE AMPULES & MULTIPLE-DOSE VIAL
0-200 mcg 100 mL ROOM TEMP. REFRIG.
(SANDOSTATIN®) 600 mcg _ _ 250 mL 60-90 mins (use within 14 days)
ONDANSETRON (ZOFRAN®) 1250 mcg 250 mL 24 hrs _ *PROTECT AMPULES FROM LIGHT

OXACILLIN 4 mg/mL 50 mL *IV & SUB-Q ONLY

PAMIDRONATE (AREDIA®) 500 mg _ _ NS, D5W 100 mL 15 mins 24 hrs 24 hrs Room Temp *PROTECT FROM LIGHT *stable @ room temp for 48hrs after
1 Gm dilution with NS, D5W. However, after dilution, do not use
2 Gm 5 mL 500-1000 mL
4 Gm 10 mL beyond 24hrs (b/c diluents generally do not conttaine
10 Gm 20 mL preservative).
30 mg 40 mL
90 mg 93 mL 10-100mg/mL: 4 days 10-100mg/mL: 7
in NS days in NS
10 mL 0.5-2mg/mL: 6 hrs in 10-30mg/mL: 4 days *Reconstitued Vial: Stable for 7 days @ Refrig,
100 mg/mL NS, D5W 60 mins D5W in D5W Refrigerate 4 days @ Room Temp.

10-30mg/mL: 24 hrs 10-30mg/mL: 4 days Exception to 10 Gm vial stable for 4 hrs @ Refrig

in D51/2NS in D51/2NS

3 mg/mL NS, D5W 24 hrs 24 hrs 24 hrs Refrigerate *IV via slow IV infusion *IV inf.: due to renal toxicity risk,
9 mg/mL single dose not to exceed 90mg and IV inf. duration s/b 2-
24hrs. *Admin. in an IV line separate from all other drugs.

PANTOPRAZOLE (PROTONIX®) 40 mg 10 mL NS only 4 mg/mL NS, D5W 100 mL 60 mins 6 hrs 24 hrs Room Temp * Reconstituted Vial: stable for 6 hrs @ Room Temp
Dose 80mg: 250 mL 90mins 24 hrs *IV Infusion s/ b used within 24 hrs from the time of initial
(7 mL/min.)
100 mL 60 mins 24 hrs reconstitution.
(Max Conc: 90 mg/mL) _ *PROTECT THE VIAL FROM LIGHT


PENICILLIN G POTASSIUM (PEN 5 Million Units 8.2 mL 500,000 units/mL NS, D5W 100 mL 48 hrs 7 days Refrigerate *Reconstitued 5 MU vial: stable for 3 days @ Refrig,
G K®) 10 Million Units 16 mL 60mins 20 MU vial: stable for 7 days @ Refrig
20 Million Units 500 mL
33 mL 3 hrs
PIPERACILLIN/TAZOBACTAM 2.25 Gm 10 mL 225 mg/mL *Reconstituted Vial: stable for 24hrs @ Room temp, 48 hrs @
(ZOSYN®) 3.375 Gm 15 mL (Piperacillin Refrig. *Bulk Vial:
20 mL 200mg/mL NS, D5W 7 days Refrigerate 24hrs @ Room Temp, 48hrs @ Refrig. *Ambulatory IV
4.5 Gm 152 mL Tazobactam
(180mL total) 25 mg/mL) 72 hrs infusion pump (Cadd pump): 12 hrs @ Room Temp.
_
40.5 Gm Bulk Vial 10 mL

POLYMYXIN B 500,000 Units/Vial 50,000 Units/mL D5W only Refrigerate *PROTECT FROM LIGHT
*After Reconstitution: Refrigerate, any unused portion should

be discarded after 72 hrs

RANITIDINE (ZANTAC®) 50 mg/2mL _ _ NS, D5W 100 mL 60 mins Room Temp. *PROTECT THE VIAL FROM LIGHT

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
RIFAMPIN ® 600 mg (Withdrawl Vol) CONC. NS Only VOLUME RATE Room Temp. *SWIRL GENTLY TO DISSOLVE
100 mL ROOM TEMP. REFRIG. *Reconstituted Vial: stable for 24 hrs @ Room Temp
60 mins
10 mL 60 mg/mL 24 hrs _ *PROTECT FROM LIGHT

SODIUM BICARBONATE 50 mEq/50 mL _ _ NS, D5W 1000 mL _ 24 hrs _ Room Temp. *Stock Conc.: 50 mEq/50 mL

SODIUM FERRIC GLUCONATE 62.5 mg/5mL Ampule *If diluted in saline, Use ASAP After Dilution
(FERRLECIT®) **Max 125 mg 5mL (62.5mg) / 250mL 1.5 hr *Do NOT infuse w/ TPN or any IV fluid other than NS
_ _ NS ONLY 10mL (125mg) / 500mL 3 hrs 24 hrs _ Room Temp. *Ferrlecit® may be administered undiluted as a SLOW IV
Elemental IRON/dose 24 hrs
(10 mL FERRLECIT®) inj.(at a rate of up to 12.5 mg/min).

TICARCILLIN/CLAVULANATE 3.1 Gm 13 mL SW or NS 200 mg/mL NS, D5W 100 mL 60 mins 72 hrs (D5W) or 7 Refrigerate * CanNOT be given IM. *The reconstituted solution is stable
(TIMENTIN®) Ticarcillin days (NS) for up to 6 hours at room temp or up to 72 hours under
6.7 mg/mL refrig.
Clavulanic Acid

TIGECYCLINE (TYGACIL®) 50 mg 5.3 mL NS only 10 mg/mL NS ONLY 100 mL 60 mins 24 hrs 48 hrs Refrigerate *Tygacil should NOT be reconstituted with S.W.
(withdrawal vol: 5mL (Max Conc: 1 mg/mL) *The vial should be GENTLY SWIRLED until the drug dissolves.
due to 6% overage)
*Reconstituted Vial: stable for 6 hrs @ Refrig.

TOBRAMYCIN 40 mg/mL _ _ NS, D5W 100 mL 60 mins 24 hrs 4 days Refrigerate *Reconstituted Vial: stable for 96 hrs @ Refrig., 24hrs @
1.2 Gm Powder 30mL 40 mg/mL 4 hrs _ Room Temp
60 mins 24 hrs
0 to 80 mg TMP _ _ 100 mL 90 mins 14 days *Stock: 80 mg-16mg/mL *Min Conc. of diluent bag: 80 mg
90 mins
TRIMETHOPRIM/SULFAMETHOX 10 mL 50 mg/mL TMP/75 mL
AZOLE (SMX-TMP DS®, 20 mL 2 hrs *After initial entry into the vial, the remaining contents must
BACTRIM® SEPTRA®) 81 to 120 mg TMP D5W only 150 to 250 mL 1 hr Room Temp be used within 48hrs *The solution should be
121 to 240 mg TMP 250 mL 1.5 hrs
2 hrs mixed just prior to use and should be administered within 2
3 hrs hours. *If a dilution of 5 mL per 100 mL of 5%
dextrose in water is desired, it s/b used within 4 hours.
241 to 450 mg TMP 500 mL

VANCOMYCIN (VANCOCIN®) 500 mg NS, D5W < or = 500 mg: 100 mL Refrigerate *Reconstituted Vial: stable for 96hrs @ Refrig *Bulk Vials
1 Gm (Max Conc: 5 > 501~1499 mg: 250 mL (5gm & 10gm):MAX of 4HRS from initial penetration may be
allowed to complete fluid aliquoting/transferring operations
mg/mL) 1500 mg: 250 mL
1501 mg: 500 mL before discarding the container.

Skilled Nursing Pharmacy Sterile Compounding Master Formula LAST UPDATE: 11/10/2017

EQUIPMENT/SUPPLIES TO BE USED: Syringes, Alcohol Prep Pads, Needles, Pharmassist Pump, ISO Class 5 Hood (LAFWs), Exactamix (for TPN) INACTIVE INGREDIENTS: n/a
CLEAN ROOM GEAR TO BE USED: Bouffant Cap, Mask, Gown, Gloves, Shoe Cover ACTIVE DRUG IN LIQUID FORM:
STEPS IN PREPARING PRODUCT: ACTIVE DRUG IN POWDER FORM 1) Withdraw exact amount of active ingredient
1) Using ASEPTIC TECHNIQUE (w/ minimizing coring), reconstitute powder with STERILE WATER unless indicated otherwise. SHAKE WELL until completely dissolved 2) Add withdrawn amount and inject into prescribed solution listed in this table Inspect final product.
EXCEPT following drugs: CUBICIN®, COLISTIN®, RIFAMPIN®, TYGACIL® (Swirl the vial until the drug is dissolved) 3) Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution
2) Inspect reconstituted solution visually to make sure the powder is completely dissolved. 4) Label bag
3) Add reconstituted solution into prescribed solution listed in table, again minimizing coring. **BUD (Beyond Use Date) Reference: ASHP's Handbook on Injectable Drugs, 18th edition & the United States Pharmacopeia (USP) Chapter <797>
4) Inspect final product. Pharmacist to verify the accuracy of the drug, amount of active ingredient and solution. 5) Label bag Pharmaceutical Compounding – Sterile Preparations

DRUG STRENGTH RECONSTITUTION FINAL FLUID FLUID INFUSION STABILITY (BUD)** LABEL Comments
(Withdrawl Vol) CONC. VOLUME RATE
10 mg/mL ROOM TEMP. REFRIG.

VORICONAZOLE (VFEND®) Dose 200 - 400 mg 19 mL (20 mL) 20 mg/mL NS, D5W 100 mL 1-2 hrs _ 24 hrs Use immediately *Single Dose Vial
IRON SUCROSE (VENOFER®) _ _ NS ONLY (Max *Reconstituted Vial: USE ASAP. If not used immediately, ok
Above 400 mg 250 mL 3mg/kg/hr)
** Stock: 200 mg (Max Conc: 5 mg/mL) for 24 hrs @ Refrig.
*INCOMPATIBLE w/ Sodium Bicarbonate IV
100 mg 100 mL *Do NOT mix of co-infuse with other meds or TPN.
300 mg - 500 mg 250 mL *HAZARDOUS DRUG-DISPOSE PROPERLY

**Stock: *Do NOT Compound in pharmacy
50 mg Elemental *RN to ADD to bag PRIOR to infusion

Iron/2.5mL > 15mins 7 days _ Room Temp *Slow IV injection or Continuous IV infusion
100 mg Elemental _ *SINGLE USE VIAL (Discard any unused portion)

Iron/5mL *Do NOT DILUTE to Conc. < 1mg/mL.
200 mg Elemental *Slow IV injection: 100—200 mg of undiluted solution (100
mg per 5 mL) may be administered by slow IV injection (into
Iron/10mL the dialysis line for hemodialysis patients) over 2—5 minutes.

ZOLEDRONIC ACID (ZOMETA®) 4 mg/5mL _ NS, D5W 100 mL 15 - 30 mins _ 24 hrs Refrigerate * IV INFUSION ONLY
*SINGLE USE VIAL
*HAZARDOUS DRUG-DISPOSE PROPERLY
*DO NOT COMPOUND IN PHARMACY
*RN TO ADD _MG(=_ML) TO NS 100mL BAG PRIOR TO

INFUSION