title: Visual compatibility of caspofungin acetate with commonly used drugs during simulated Y-site delivery.
abstract: OBJECTIVE
  The physical compatibility of i.v. caspofungin with other commonly used i.v. medications was tested.
  
  
  METHODS
  Two methods were used to combine caspofungin and the secondary drugs. For drugs administered by i.v. push, caspofungin was delivered through a poly-vinyl chloride (PVC) i.v. solution set with secondary drugs injected into the Y-site of the i.v. extension set. For drugs given by i.v. infusion (over 10 minutes), secondary drugs were infused into the Y-site of the i.v. solution set through microbore PVC tubing. The two drugs shared 39 in of tubing. Attached to each end of the i.v. extension set were 0.8-mum filter disks. All drug combinations were tested three times; after each infusion, the filters were bubble-point tested. Drug combinations were considered physically compatible if no visible precipitate was seen and no color change was noted by the unaided eye during the infusion, or if the number of particles found on the filter under a microscope did not exceed the number stated in United States Pharmacopeia guidelines for particulate levels of large-volume parenteral fluids.
  
  
  RESULTS
  A total of 8 of the 31 drugs tested (acyclovir, ceftriaxone, cefazolin, clindamycin, furosemide, heparin, pantoprazole, and piperacillin-tazobactam) were found to be physically incompatible with caspofungin.
  
  
  CONCLUSIONS
  Caspofungin acetate was physically compatible during Y-site injection with 23 of 31 medications tested.
authors.affiliation: University of Utah Healthcare, Salt Lake City, USA.
authors.forename: Chad K
authors.initials: CK
authors.lastname: Condie
authors.forename: Linda S
authors.initials: LS
authors.lastname: Tyler
authors.forename: Brian
authors.initials: B
authors.lastname: Barker
authors.forename: David M
authors.initials: DM
authors.lastname: Canann
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage / Q000737:chemistry*; D000077336:Caspofungin; D011232:Chemical Precipitation; D002626:Chemistry, Pharmaceutical; D003116:Color; D004340:Drug Contamination; D004344:Drug Incompatibility; D054714:Echinocandins / Q000008:administration & dosage / Q000737:chemistry*; D007262:Infusions, Intravenous; D055666:Lipopeptides; D010316:Particle Size; D010602:Pharmacopoeias as Topic; D011143:Polyvinyl Chloride / Q000737:chemistry; D013997:Time Factors; D014481:United States
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011143:Polyvinyl Chloride; D000077336:Caspofungin