title: Stability, compatibility and plasticizer extraction of quinine injection added to infusion solutions and stored in polyvinyl chloride (PVC) containers.
abstract: The stability of quinine was determined in various diluents and in polyvinyl chloride (PVC) containers. The release of diethyhexyl phthalate (DEHP) from PVC bags into intravenous infusions of quinine was also measured. We used an injection of two doses of quinine; quiniforme at 500 mg and quinimax at 400 mg in either 250- or 500-ml PVC infusion bags containing 5% dextrose, to give initial nominal concentrations of 2 or 1 mg ml(-1) quiniforme and 1.6 or 0.8 mg ml(-1) quinimax, the mean concentrations commonly used in clinical practice. Samples were assayed by stability-indicating high-performance liquid chromatography (HPLC) and the clarity was determined visually. Experiments were conducted to determine whether the stability and compatibility of quinine would be compromised, and whether DEHP would be leached from PVC bags and PVC administration sets during storage and simulated infusion. There was no substantial loss of quiniforme and quinimax over 1- or 2-h simulated infusion irrespective of the diluent, and storage during 8 h at 22 degrees C, 48 or 72 h at 4 degrees C and 96 h at 45 degrees C. Leaching of DEHP was also detected during simulated infusion delivery using PVC bags and PVC administration sets. The quantity was less than 2 microg ml(-1). During storage at 4 degrees C and room temperature the leaching of DEHP was low, but when the temperature was 45 degrees C the quantity was high, 21 microg ml(-1). To minimise patient exposure to DEHP, quinine solutions with all drugs should be infused immediately or stored for a maximum of 48 h at 4 degrees C.
authors.affiliation: Laboratoire de Pharmacologie, Pharmacocinétique et Pharmacie Clinique, Faculté des Sciences Pharmaceutiques et Biologiques, Lille, France. faouziabbes@hotmail.com
authors.forename: M A
authors.initials: MA
authors.lastname: Faouzi
authors.forename: F
authors.initials: F
authors.lastname: Khalfi
authors.forename: T
authors.initials: T
authors.lastname: Dine
authors.forename: M
authors.initials: M
authors.lastname: Luyckx
authors.forename: C
authors.initials: C
authors.lastname: Brunet
authors.forename: B
authors.initials: B
authors.lastname: Gressier
authors.forename: F
authors.initials: F
authors.lastname: Goudaliez
authors.forename: M
authors.initials: M
authors.lastname: Cazin
authors.forename: J
authors.initials: J
authors.lastname: Kablan
authors.forename: A
authors.initials: A
authors.lastname: Belabed
authors.forename: J C
authors.initials: JC
authors.lastname: Cazin
mesh_terms: D000962:Antimalarials / Q000032:analysis* / Q000737:chemistry; D002851:Chromatography, High Pressure Liquid; D004051:Diethylhexyl Phthalate / Q000737:chemistry; D004344:Drug Incompatibility; D004349:Drug Packaging; D004355:Drug Stability; D004356:Drug Storage; D007262:Infusions, Intravenous; D010968:Plasticizers; D011143:Polyvinyl Chloride / Q000737:chemistry; D011803:Quinine / Q000032:analysis* / Q000737:chemistry; D012996:Solutions / Q000737:chemistry; D013696:Temperature; D013997:Time Factors
chemical_list: D000962:Antimalarials; D010968:Plasticizers; D012996:Solutions; D011143:Polyvinyl Chloride; D011803:Quinine; D004051:Diethylhexyl Phthalate