Harmanjeet Harmanjeet, Zaidi Syed Tabish R, Ming Long Chiau, Wanandy Troy, Patel Rahul P
Division of Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Pharmacy Department, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Eur J Hosp Pharm. 2018 Oct;25(e2):e88-e92. doi: 10.1136/ejhpharm-2016-001170. Epub 2017 Apr 10.
Voriconazole is the drug of choice for invasive aspergillosis (IA), a leading cause of mortality and morbidity in immunocompromised patients. Prolong intravenous administration of voriconazole is often needed in such patients due to high incidence of oral mucositis and unreliable bioavailability of oral dosage form. Administration of voriconazole through elastomeric pump may facilitate early hospital discharge of clinically stable immunocompromised patients needing prolonged intravenous treatment. Therefore, we investigated the physicochemical stability of voriconazole in one of the commonly used elastomeric pumps at three different temperatures for various time points.
A total of 18 elastomeric pumps were prepared and 6 containing 2 mg/mL of voriconazole (3 in 0.9% sodium chloride and 3 in 5% glucose) were stored at either 4°C for 96 hours, 25°C for 4 hours or at 35°C for 4 hours. An aliquot withdrawn immediately before storage (time 0) and at various time points was analysed for chemical stability using high-performance liquid chromatography and for physical stability using visual, pH and microscopic analyses.
Voriconazole was stable for at least 96 hours, 4 hours and 4 hours at 4°C, 25°C and 35°C, respectively, when admixed with either 0.9% sodium chloride or 5% glucose. No evidence of particle formation, colour change or pH change was observed throughout the study period.
These findings would allow early hospital discharge using elastomeric intravenous administration of voriconazole in patients in whom oral route of administration is not available.
伏立康唑是侵袭性曲霉病(IA)的首选药物,IA是免疫功能低下患者发病和死亡的主要原因。由于此类患者口腔黏膜炎发生率高且口服剂型生物利用度不可靠,常需长期静脉输注伏立康唑。对于需要长期静脉治疗的临床稳定的免疫功能低下患者,通过弹性泵给药可能有助于早期出院。因此,我们研究了伏立康唑在一种常用弹性泵中于三个不同温度下在不同时间点的物理化学稳定性。
共制备18个弹性泵,其中6个含有2mg/mL伏立康唑(3个在0.9%氯化钠中,3个在5%葡萄糖中),分别在4℃储存96小时、25℃储存4小时或35℃储存4小时。在储存前(0时间点)和不同时间点取出的等分试样,用高效液相色谱法分析化学稳定性,用视觉、pH和显微镜分析物理稳定性。
当与0.9%氯化钠或5%葡萄糖混合时,伏立康唑在4℃、25℃和35℃分别至少稳定96小时、4小时和4小时。在整个研究期间未观察到颗粒形成、颜色变化或pH变化的迹象。
这些发现将使无法采用口服给药途径的患者能够通过弹性静脉输注伏立康唑实现早期出院。