STABILITY AND COMPATIBILITY OF ADMIXTURES OF INTRAVENOUS CIPROFLOXACIN AND SELECTED DRUGS

The stability and compatibility of ciprofloxacin with selected drugs i n intravenous admixtures were studied. Ciprofloxacin 2 mg/mL in 5% dex trose was combined with each of 22 other drugs at concentrations commo nly used in clinical practice. Each combination was maintained at room temperature (approximately 22 degrees C) in constant fluorescent ligh t. Immediately after preparation and at 6 and 24 hours, each admixture was examined visually in normal fluorescent room light and the pH val ue was determined. For samples lacking visible precipitates or having pH changes of not more than 1 unit, ciprofloxacin concentration was as sayed by using high-performance liquid chromatography. When combined w ith ciprofloxacin, 14 of the study drugs did not alter the concentrati on of ciprofloxacin, including amikacin sulfate, atracurium besylate, aztreonam, cimetidine hydrochloride, dobutamine hydrochloride, flucona zole, gentamicin sulfate, metronidazole (intravenous, ready to use), m idazolam hydrochloride, norepinephrine bitartrate, pancuronium bromide , potassium chloride, tobramycin sulfate, and vecuronium bromide. Ther e were five drugs that were determined to be incompatible with ciprofl oxacin because of precipitate formation (amphotericin B, ampicillin so dium/sulbactam sodium, cefuroxime sodium, piperacillin sodium, and sod ium bicarbonate). Incompatibility with ciprofloxacin based on pH chang es of more than 1 unit was found with four drugs: ampicillin sodium/su lbactam sodium, ceftazidime, metronidazole hydrochloride (powder only) , and ticarcillin disodium/clavulanate potassium. Intravenous ciproflo xacin 2 mg/mL admired in 5% dextrose was stable and compatible with 14 of the 22 test drugs for up to 24 hours at room temperature. The othe r eight drugs should not be combined with ciprofloxacin.