Medicines Syringe Compatibility Checker
This Medicines Compatibility Checker is a practical guide for mixing medicines for I.V administration.
Many I.V. drug preparations should be mixed together in syringes or infusions. Moreover, some are not compatible to be diluted or even mixed in the same infusion bag. Incompatibility can involve different processes including precipitation of medicine, ionic reactions of contents, evolution of gas and denaturation of biological ingredients. Knowledge of drug compatibility is needed before mixing I.V. drugs.
Mixing drug vial preparations (I.M.) are generally not recommended because of the potential for incompatibility and consequent loss of activity of one or both drugs. However, in some circumstances there may be compelling reasons for mixing two or more parenteral drug solutions in the same syringe, same infusion bag or at a Y-site junction where two or more intravenous lines meet.
Such circumstances may include:
- challenging venous access limiting the number of I.V. lines available for continuous administration of multiple drugs
- multiple drugs requiring parenteral administration within a short time frame (e.g. emergency medicine)
The decision to mix drugs should not be made without knowledge of their compatibility. If intravenous drugs are not mixed but are given consecutively, the infusion line should be flushed through with compatible fluid between each administration.
Incompatibility problems are more likely to arise when small concentrated volumes are mixed in the same syringe rather than in the larger volume of an infusion bag. This is because of higher mutual drug concentrations and potentially greater pH changes in the more concentrated solution. It is important to note that the absence of any visible change to a solution upon mixing does not automatically exclude risk of incompatibility.
Mixing is best avoided. If circumstances are so compelling as to warrant mixing any two or more solutions, there should be support from good quality evidence.
A visual check for precipitation, turbidity or colour change should be carried out before administering the mixture but does not guarantee compatibility.
To view the Medicines Compatibility Checker (Table) click here
References are available on request