title: Stability of Bevacizumab Divided in Multiple Doses for Intravitreal Injection.
abstract: OBJECTIVE
  To investigate the stability of bevacizumab in multiple doses divided from a single-use vial for intravitreal injection after storage at 4°C for up to six months and under drug transfer condition in tropical climate.
  
  
  METHODS
  Five syringes (0.1 mL, 2.5 mg) of bevacizumab were withdrawn each from five new bevacizumab single-use vials (4 mL, 100 mg) under sterile technique. The concentration of bevacizumab in each syringe was measured at two dilutions (2 x 10(6) and 4 x 10(6) fold) using enzyme-linked immunosorbent assay at baseline and after storage at 4°C for 1-, 3-, and 6-month. Each assay was performed at least twice. To simulate the drug transfer condition, bevacizumab was placed in a brown plastic bag and put in another transfer plastic bag with an ice cube for 30 minutes prior to the assay at 1-, 3-, and 6-month.
  
  
  RESULTS
  The concentrations of bevacizumab (mean ± standard deviation) at baseline, 1-, 3-, and 6-month were 26.24 ± 1.95, 25.43 ± 3.80, 27.87 ± 2.81, and 24.25 ± 2.00 mg/mL, respectively. The lowest lower limit of 95% confidence interval for the mean concentration was 23.32 mg/mL at 6-month storage, which was 89% of the mean baseline concentration and considered to be non-inferior to the baseline concentration.
  
  
  CONCLUSIONS
  Bevacizumab in a single-use vial could be divided into multiple small doses for intravitreal injection with sufficient stability when refrigerated at 4°C for up to six months and under the drug transfer condition in tropical climate.
authors.forename: Nopasak
authors.initials: N
authors.lastname: Phasukkijwatana
authors.forename: Jutalai
authors.initials: J
authors.lastname: Tanterdtham
authors.forename: Daroonporn
authors.initials: D
authors.lastname: Lertpongparkpoom
mesh_terms: D020533:Angiogenesis Inhibitors / Q000737:chemistry*; D061067:Antibodies, Monoclonal, Humanized / Q000737:chemistry*; D000068258:Bevacizumab; D004355:Drug Stability; D004356:Drug Storage; D004797:Enzyme-Linked Immunosorbent Assay; D058449:Intravitreal Injections
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab