Physical Compatibility of Pantoprazole with Selected Medications: RESULTS part 2

octreotide

Pantoprazole and Midazolam

All mixtures of midazolam with pantoprazole 0.16 mg/mL and 0.40 mg/mL were initially clear and colourless but turned slightly yellow within 15 min of preparation. Mixtures of midazolam with pantoprazole 0.16 mg/mL turned a darker yellow and those with pantoprazole 0.40 mg/mL turned light brown by 12 h. A reddish brown precipitate was also observed in the mixtures containing pantoprazole 0.40 mg/mL. Mixtures of all 3 concentrations of midazolam (1.0 mg/mL, 1.5 mg/mL, and 2.0 mg/mL) with pantoprazole 0.80 mg/mL turned cloudy immediately upon mixing and gradually turned a light brown colour, eventually producing a reddish brown precipitate.

Because an incompatibility was observed between pantoprazole and midazolam, a total of 75 additional mixtures, with pantoprazole concentrations ranging from 0 to 0.80 mg/mL and midazolam concentrations ranging from 0 to 2.0 mg/mL, were prepared; the resulting compatibility profile is shown in Figure 3. Solutions of pantoprazole and midazolam were physically incompatible over a wide concentration range. In general, mixtures of midazolam and pantoprazole must contain a final concentration of less than 0.1 mg/mL midazolam and/or a final concentration of less than 0.01 mg/mL pantoprazole if they are to be physically compatible (see Figure 3). These concentrations are too dilute to be clinically useful for either drug.  viagra 50 mg

Figure 3. Observed compatibility

Figure 3. Observed compatibility of midazolam with pantoprazole at 12 h after mixing. Because all of the initial 9 pantoprazole-midazolam mixtures turned slightly yellow within 15 min of preparation or produced a reddish brown precipitate within 12 h (or both), a total of 75 mixtures of these 2 drugs were prepared to evaluate the range of incompatibility. Mixtures of pantoprazole and midazolam were physically incompatible over a wide concentration range. In general, the final midazolam concentration must be less than 0.1 mg/mL or the final pantoprazole concentration must be less than 0.01 mg/mL (or both) for the combination to be physically compatible. These concentrations are generally too dilute to be clinically useful. ppt = precipitate.

Pantoprazole and Norepinephrine

Two of the mixtures tested (pantoprazole 0.40 mg/mL and 0.80 mg/mL with norepinephrine 64 pg/mL) turned cloudy immediately upon mixing. All other combinations tested were clear and colourless throughout the 12-h study period.

Because physical incompatibility was observed for some combinations, a total of 54 additional mixtures were prepared, with pantoprazole concentrations ranging from 0 to 0.80 mg/mL and norepinephrine concentrations ranging from 0 to 64 pg/mL; the resulting compatibility profile is shown in Figure 4. The final concentration of pantoprazole must be less than 0.10 mg/mL for this drug to be physically compatible with norepinephrine at final concentrations of 64 pg/mL or less; alternatively, the final concentration of norepinephrine must be less than 13 pg/mL for this drug to be physically compatible with pantoprazole at final concentrations of 0.80 mg/mL or less (see Figure 4).
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Figure 4. Observed compatibility

Figure 4. Observed compatibility of norepinephrine with pantoprazole at 12 h after mixing. Because combinations of equal parts of a solution containing 64 |jg/mL of norepinephrine with either 0.40 mg/mL or 0.80 mg/mL of pantoprazole turned cloudy immediately upon mixing, a total of 54 mixtures of these 2 drugs were prepared to evaluate the range of physical incompatibility. In general, the final pantoprazole concentration must be less than 0.10 mg/mL to be physically compatible with any norepinephrine concentration of 64 jg/mL or less, or the final norepinephrine concentration must be less than 13 jg/mL to be physically compatible with any pantoprazole concentration of 0.80 mg/mL or less.

Pantoprazole and Octreotide

All combinations of octreotide with pantoprazole 0.16 mg/mL were clear and colourless at time 0 and then turned slightly yellow within 15 min of preparation. Mixtures containing pantoprazole 0.40 mg/mL in combination with octreotide 5.0 pg/mL, 7.5 pg/mL, or 10.0 pg/mL turned slightly yellow at 12 h, 4 h, and 15 min after preparation, respectively. Pantoprazole 0.80 mg/mL combined with octreotide 7.5 pg/mL or 10.0 pg/mL started to turn slightly yellow 4 h after mixing. However, the mixture of pantoprazole 0.80 mg/mL with octreotide 5 pg/mL remained clear and colourless throughout the entire 12-h study period. No precipitate was observed in any of the pantoprazole- octreotide mixtures. However, for all of the mixtures showing a colour change, the intensity of the yellow colour gradually intensified with time. buy cialis soft tabs

Figure 5. Observed compatibility

Figure 5. Observed compatibility of octreotide with pantoprazole at 12 h after mixing. Because a colour change was observed after mixing for 6 of the 9 pantoprazole-octreotide mixtures prepared initially, a total of 62 mixtures of these 2 drugs were prepared to evaluate the range of incompatibility. In general, the final octreotide concentration must be less than 1.5 jg/mL to be physically compatible with any final pantoprazole concentration under 0.80 mg/mL. Alternatively, the final pantoprazole concentration must be more than 0.50 mg/mL to be physically compatible with a final octreotide concentration of 4.0 jg/mL or less. ppt = precipitate.

Because a colour change was observed with the pantoprazole-octreotide combinations, additional mixtures, with pantoprazole concentrations ranging from 0 to 0.80 mg/mL and octreotide concentrations ranging from 0 to 10.0 pg/mL, were prepared to more definitively determine the range of physical compatibility and incompatibility. A total of 62 mixtures were prepared to evaluate this relationship, and the resulting compatibility profile is shown in Figure 5. Solutions of pantoprazole and octreotide were physically incompatible over a wide concentration range. In general, the final concentration of octreotide must be less than 1.5 pg/mL for this drug to be physically compatible with pantoprazole at any final concentration less than 0.80 mg/mL; alternatively, the final concentration of pantoprazole must be more than 0.50 mg/mL for this drug to be physically compatible with octreotide at any final concentration of 4.0 pg/mL or less (see Figure 5).
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Category: Drugs

Tags: compatibility, dobutamine, esmolol, midazolam, norepinephrine, octreotide, pantoprazole, Y-site

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