Stability of fluconazole and amino acids in parenteral nutrient solutions.
The stability of fluconazole and amino acids in parenteral nutrient (PN) solutions was studied. Amino acids at three concentrations (1.0%, 2.5%, and 5.0%) with 25% dextrose injection were combined with a high (1.75 mg/mL) or a low (0.5 mg/mL) concentration of fluconazole to form six combinations of PN solution and fluconazole. The solutions were visually inspected for precipitate, color change, or gas formation and tested for pH. By using high-performance liquid chromatography, the solutions were assayed for fluconazole concentration at zero, one, and two hours after preparation. The PN solution containing fluconazole 1.75 mg/mL and 5.0% amino acids was assayed for 14 amino acids at the same time points. There was no visual evidence of incompatibility in any of the fluconazole and PN solutions, and the pH of the solutions did not vary appreciably throughout the study period. The mean percentage of initial fluconazole concentration remaining at one and two hours was greater than 97% for all of the solutions studied. The mean percentage of initial amino acid concentration remaining at one and two hours was greater than 93% for each of the 14 amino acids assayed. When fluconazole 0.5 mg/mL or 1.75 mg/mL is mixed with PN solution containing 1.0%, 2.5%, or 5.0% amino acids and 25% dextrose injection, both fluconazole and amino acids are stable for up to two hours.
Couch
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Parenteral and Enteral Nutrition Team, University of Michigan Medical Center, Department of Pharmacy Services, Ann Arbor 48109-0008.
Jacobson
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Johnson
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D000596:Amino Acids / Q000032:analysis*; D002851:Chromatography, High Pressure Liquid; D004344:Drug Incompatibility; D004355:Drug Stability; D015725:Fluconazole / Q000032:analysis*; D006863:Hydrogen-Ion Concentration; D010289:Parenteral Nutrition, Total
D000596:Amino Acids; D015725:Fluconazole