Lexicomp Trissels IV Compatibility Databases

Trissel's 2 Clinical Pharmaceutics Content Set

Click on "Trissel's IV Compatibility" to open the module.

Create a Compatibility Chart

To search on compatibility information, begin by typing the desired drug or solution name into the appropriate search box. Possible drug/solution selections will be displayed as you continue to type. Select a drug or solution by clicking the Enter key on your keyboard or by using the Add button. The selected drug(s) and solution(s) will populate the Selected Items in the left pane. To view all solution and drug compatibility results for a single drug, enter the IV Drug and Click "View Compatibility". To view compatibility results for a list of drugs, enter multiple IV drugs and/or solutions then click "Analyze".

The compatibility results are presented in a chart or list view, with the default chart view displaying all methods within the fields for the selected drugs and solutions. In the chart display, each compatibility pair has an indicator for the type of result found. A green “C” means the drugs are compatible. A red “I” means the drugs are incompatible, and an orange “U” symbol means there are conflicting reports. In chart view, you can filter the table to display just the Y site results. Use the reset filter button to go back to the default view.

Definitions for the following types of compatibility testing are as follows:

• Y-site Compatibility - A single drug that is administered simultaneously at a Y-site connection with another drug in a solution
• Solution Compatibility - A single drug in a solution
• Admixture Compatibility - Two drugs in a solution
• Syringe Compatibility - Two drugs in a syringe

The compatibility information presented is based on one of four (4) ratings:

C - Compatible

• No change in visible or electronically determined particulates, haziness or turbidity, frank precipitation, color, or evolution of a gas.
• All drug components in the test samples were found to be chemically stable (less than 10% loss of intact drug) for at least 24 hours under the conditions being tested.
• All drug components in the test samples were found to be chemically stable (less than 10% loss of intact drug) for the entire period of the study under the conditions being tested, even if the study period was less than 24 hours.

I - Incompatible

• A change in visible or electronically (even if not visible) particulates, haziness, or turbidity, frank precipitation, color or gas evolution occurred
• One or more drug components in the test samples exhibited a loss of intact drug greater than 10% within 24 hours under the conditions being tested.

U - Uncertain or Variable

• For research results that do not fit these conventional guidelines, the research results are designated as Uncertain or Variable. Apply judgment in using these results. Examples include:
• A transient precipitation formed upon mixing but then disappeared. The precipitate may or may not show up again later.
• Among repeat test samples, microparticulate formation was electronically determined to have formed in some samples but not others.
• The test drug in a solution was stable in one container type but not another or with some drug delivery devices but not others.
• Compatibility of a drug(s) is dependent on the manufacturer(s) of the products and/or the use of specific product formulations.
• When both compatible and incompatible study results are available for the same drug pair. Many of these may be due to differences in concentrations of either drug or in the solution diluent.
• Any other research result that does not fit the conventional guidelines of compatibility or incompatibility.

X - No data

• No data for administration methods chosen.

In the chart display, find detailed information about a specific pair of drugs and administration route by clicking on the compatibility type link within the table. The link displays the drug concentrations used in the studies, additional information on the vehicle used, and each study’s findings. Drug pairs with conflicting compatibility results may often have different concentrations used or other differences to account for the variability. Return to the chart by clicking the “X” in the top left corner of the study list.

Compatibility analyses can also be viewed in a list display, where results are shown in pairs. You can click on the compatibility icons in the list view to see the same study list and details. You can return to the Chart display by toggling back to “Chart View”.

Single Drug Information

You can also check the IV compatibility of a single drug. Enter one drug and click “View compatibility.” The default compatibility result will display the solution compatibilities for the IV Drug searched.

You can also view different drugs and solutions that are compatible by clicking the drop-down arrows. View the full Trissel’s monograph for more information on the physical and chemical characteristics of the drug.

When a drug or solution name is in the Selected Items section, a link to the Trissel’s monograph for that drug/solution will be displayed. These monographs may include formulation or reconstitution information, stability and storage information, light effects, pH, and/or other details regarding the physical/chemical properties of the drug. You can either click on the X in the top right or press the Close button to return to the previous screen.

You can use the IV Drugs/Solutions search bars on the left at any time to enter new drugs to be screened. New items will appear in the "Selected Items" field. To remove an individual drug or solution, click on the X next to the name. To clear the items from the tool, click the Clear button.