Stability of human recombinant epoetin alfa in commonly used neonatal intravenous solutions

OBJECTIVE: To measure epoetin alfa concentrations after adding it to a variety of commonly used neonatal intravenous fluids to determine the stability of epoetin alfa over time. DESIGN: Epoetin alfa was added to the following fluids: sterile water; NaCl 0.9%; dextrose 10% in water; dextrose 10% with albumin at concentrations of 0.01%, 0.05%, and 0.1%; and total parenteral nutrition solution containing either 0.5% or 2.25% amino acids. The fluid was administered through intravenous tubing, a T-connector, and catheter, and samples were collected at 0, 2, 4, 8, and 24 hours. MAIN OUTCOME MEASURES: Epoetin alfa concentrations were compared with the measured original preinfusion concentration and recorded as the percentage recovered. RESULTS: Concentrations declined significantly in all fluids containing less than 0.05% protein, but remained stable over 24 hours in fluids containing 0.05% or more protein. CONCLUSIONS: We conclude that epoetin alfa should be mixed in intravenous fluids containing at least 0.05% protein.

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