Pharmaceutical issues: preparation, administration, stability, and compatibility with other medications

In conclusion, paclitaxel, a very active anticancer agent, is dissolved in a polyoxyethylated castor oil/alcohol vehicle, which poses some interesting challenges for drug preparation and administration. Physicians, nurses, and pharmacists should become knowledgeable about solution containers, intravenous administration sets, in-line filters, and access devices compatible with paclitaxel administration. Chemical stability studies show that paclitaxel diluted to clinically used concentrations in customary infusion fluids is stable for at least 27 hours at room temperature, which enables a 24-hour supply to be prepared in a single container. Paclitaxel has been demonstrated to be visually and turbidimetrically compatible with many other drugs during Y-site simulation studies; however, evidence of chemical compatibility for the majority of these combinations is lacking.