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.