title: Determination of compatibility and stability of drugs used in palliative care.
abstract: BACKGROUND
  Drugs for symptom control in the terminal phase of palliative patients may be used in pump systems.
  
  
  OBJECTIVE
  To investigate the compatibility and stability of solutions of morphine hydrochloride, haloperidol, metoclopramide hydrochloride, atropine sulphate, butylhyoscine bromide and ranitidine hydrochloride, which may be used together under such circumstances.
  
  
  METHODS
  Solutions of the drugs were exposed to ambient light at a temperature of 20 +/- 5 degrees C and +/- 31 degrees C for 24 h and 7 days and the solutions studied by ultraviolet spectrophotometry.
  
  
  RESULTS
  The combination of haloperidol or metoclopramide hydrochloride with different concentrations of morphine hydrochloride seemed to be compatible and stable. The concentration of atropine sulphate or butylhyoscine bromide could not be determined by the study method, but morphine hydrochloride seemed to be stable. The combination of ranitidine hydrochloride and morphine hydrochloride showed a change in colour after 7 days.
  
  
  CONCLUSIONS
  The results suggest that the combination of different concentrations of morphine hydrochloride with haloperidol, metoclopramide hydrochloride, atropine sulphate, butylhyoscine bromide or ranitidine hydrochloride do not affect their stability when stored for 7 days up to 30 degrees C under the influence of ambient light. However, more robust stability-indicating methods are required to confirm these results. The proposed method is more useful for identifying combinations that are clearly incompatible than to identify those that are compatible.
authors.affiliation: Department of Medical Oncology, University Hospital Antwerp, Edegem, Belgium. Dirk.Schrijvers@uza.uia.ac.be
authors.forename: D
authors.initials: D
authors.lastname: Schrijvers
authors.forename: C
authors.initials: C
authors.lastname: Tai-Apin
authors.forename: M C
authors.initials: MC
authors.lastname: De Smet
authors.forename: P
authors.initials: P
authors.lastname: Cornil
authors.forename: J B
authors.initials: JB
authors.lastname: Vermorken
authors.forename: P
authors.initials: P
authors.lastname: Bruyneel
mesh_terms: D001285:Atropine / Q000737:chemistry / Q000627:therapeutic use; D002086:Butylscopolammonium Bromide / Q000378:metabolism / Q000627:therapeutic use; D004347:Drug Interactions; D004355:Drug Stability; D004359:Drug Therapy, Combination; D006801:Humans; D008787:Metoclopramide / Q000737:chemistry / Q000627:therapeutic use; D009020:Morphine / Q000737:chemistry / Q000627:therapeutic use; D010166:Palliative Care; D011899:Ranitidine / Q000737:chemistry / Q000627:therapeutic use; D013727:Terminal Care / Q000379:methods
chemical_list: D002086:Butylscopolammonium Bromide; D009020:Morphine; D001285:Atropine; D011899:Ranitidine; D008787:Metoclopramide