iltration Guidelines for the Administration of Intravenous Medications UK Pharmacy Services Revised 8/2010 SUMMARY O CHANGES: Green = Added from literature (Lexi-Comp, Micromedex, pkg inserts) Yellow = Confirmed in literature = Removed IV Medications Requiring iltration During Administration ORMULARY Drug Name Generic (Brand) ilter Size (micron) STATUS Abatacept (Orencia) 0.22 to 1.2 Abciximab (ReoPro) 0.22 Agalsidase Beta (abrazyme) 0.22 15 dispensed with Albumin * filter tubing Alglucerase (Ceredase) 0.22 Alglucosidase Alfa (Myozyme) 0.22 Alpha-1 Proteinase Inhibitor, Human (Zemaira) 5 Amiodarone Hydrochloride (Cordarone) 0.22 Restricted Amphotericin B Liposomal (Ambisome) 1 Antithymocyte Globulin, Rabbit (Thymoglobulin) 0.22 Asparaginase (Elspar) 5 200 tubing located Blood Solutions on floors Botulinism Immune Globulin, Human (BabyBIG) 18 Cetuximab (Erbitux) 0.22 Restricted Cytomegalovirus Immune Globulin (CytoGam) 15 or 0.22 Diazepam (Valium) 0.22 or 0.5 Digoxin Immune ab (Digibind) 0.22 Etoposide (VePesid,Toposar) 0.22 erumoxides (eridex IV) 5 RATIONALE May use in-line filter with mean pore diameter 1 Galsulfase (Naglazyme) 0.22 Ganciclovir (Cytovene) 0.22 iltration
Gemtuzumab Ozogamicin (Mylotarg) 1.2 Ibritumomab (Zevalin) 0.22 Idursulfase (Elaprase) 0.22 Imiglucerase (Cerezyme) 0.22 15 dispensed with Immune Globulin (Polygam, Gammagard) filter tubing 1.2 0.22 dispensed with non- Infliximab (Remicade) PVC tubing 0.22 to 1.2 non- Ixabepilone (Ixempra) PVC tubing Lansoprazole (Prevacid) 0.22 (oral only) Laronidase (Aldurazyme) 0.22 Lipids 1.2 dispensed with filter tubing Lorazepam (Ativan) 0.22 Lymphocyte Immune Globulin, Antithymocyte Globulin, Equine (Atgam) 0.22 to 1 Mannitol (Osmitrol) 0.22 Muromonab-CD3 (Orthoclone OKT 3) 0.22 0.22 non-pvc Paclitaxel (Taxol) tubing Panitumumab (Vectibix) 0.22 Parenteral Nutrient Solutions (without lipids) 0.22 Parenteral Nutrient Solutions (with lipids) 1.2 5 Phenytoin (Dilantin) 0.22 5 non-pvc Temsirolimus (Torisel) tubing Total Parenteral Nutrition (without lipids) 0.22 Urokinase (Abbokinase) 0.45 0.22 Vaccinia Immune Globulin (CNJ-016) 0.22 Verteporfin (Visudyne) 1.2 requirement not stated in Lexi-Comp, Micromedex, or pkg insert. Gammagard does not require filtration per pkg insert; Polygam DSC. Moved under TPN (see below). Not available at UK. * Recommended, but the filtration of albumin in not required in the NICU.
IV Medications NOT Requiring iltration During Administration Drug Name Generic (Brand) Amphotericin B (ungizone) Amphotericin B Lipid Complex (Abelcet) Amphotericin B Liposomal (Ambisome) Daunorubicin Citrate Liposomal (Daunoxome) Denileukin Diftitox (ONTAK) Digitoxin Doxorubicin Hyodrochloride Liposomal (Doxil) Etanercept (Enbrel) Insulin Preparations Morphine Sulfate Extended-Release Liposomal (DepoDur) Nesiritide (Natrecor) Nitroglycerin Palifermin (Kepivance) Plicamycin (Mithracin) Rasburicase (Elitek) Sargramostim (Leukine) Teniposide (Vumon) Vincristine (Oncovin) ORMULARY STATUS Restricted Restricted Moved to list of meds requiring filter per pkg insert (says it may be used ). References: 1. Micromedex. 2. Am J HSP Vol 58; Jan 15, 2001. 3. Chen & Martinez; Am J HSP; 1998;55:1313-14. 4. Lexi-Comp. IVfiltration.doc 9/2004 P225
iltration Guidelines for the Administration of Intravenous Medications UK Pharmacy Services Revised 10/2008 IV Medications Requiring iltration During Administration DRUG NAME [Generic (Brand)] ILTER SIZE [Micron] Abatacept (Orencia) 0.22 to 1.2 Abciximab (ReoPro) 0.22 Agalsidase Beta (abrazyme) 0.22 Albumin * 15 dispensed with filter tubing Alglucerase (Ceredase) 0.22 Alglucosidase Alfa (Myozyme) 0.22 Alpha-1 Proteinase Inhibitor, Human (Zemaira) 5 Amiodarone Hydrochloride (Cordarone) 0.22 Amphotericin B Liposomal (Ambisome) 1 Antithymocyte Globulin, Rabbit (Thymoglobulin) 0.22 Asparaginase (Elspar) 5 Blood Solutions 200 tubing located on floors Botulinism Immune Globulin, Human (BabyBIG) 18 Cetuximab (Erbitux) 0.22 Cytomegalovirus Immune Globulin (CytoGam) 15 or 0.22 Diazepam (Valium) 0.22 or 0.5 Digoxin Immune ab (Digibind) 0.22 Etoposide (VePesid,Toposar) 0.22 erumoxides (eridex IV) 5 Galsulfase (Naglazyme) 0.22 Gemtuzumab Ozogamicin (Mylotarg) 1.2 Ibritumomab (Zevalin) 0.22 Idursulfase (Elaprase) 0.22 Imiglucerase (Cerezyme) 0.22 Infliximab (Remicade) 1.2 dispensed with non-pvc tubing Ixabepilone (Ixempra) 0.22 to 1.2 non-pvc tubing Lansoprazole (Prevacid) 0.22 Laronidase (Aldurazyme) 0.22
Lipids Lorazepam (Ativan) 0.22 Lymphocyte Immune Globulin, Antithymocyte Globulin, Equine (Atgam) 0.22 to 1 Mannitol (Osmitrol) 0.22 Muromonab CD3 (Orthoclone OKT 3) 0.22 Paclitaxel (Taxol) Panitumumab (Vectibix) 0.22 Phenytoin (Dilantin) 0.22 1.2 dispensed with filter tubing 0.22 non-pvc tubing Temsirolimus (Torisel) 5 non-pvc tubing Total Parenteral Nutrition (without lipids) 0.22 Urokinase (Abbokinase) 0.45 Vaccinia Immune Globulin (CNJ-016) 0.22 Verteporfin (Visudyne) 1.2 * Recommended, but the filtration of albumin in not required in the NICU.
IV Medications NOT Requiring iltration During Administration DRUG NAME Generic (Brand) Amphotericin B (ungizone) Amphotericin B Lipid Complex (Abelcet) Daunorubicin Citrate Liposomal (Daunoxome) Denileukin Diftitox (ONTAK) Digitoxin Doxorubicin Hyodrochloride Liposomal (Doxil) Etanercept (Enbrel) Insulin Preparations Morphine Sulfate Extended-Release Liposomal (DepoDur) Nesiritide (Natrecor) Nitroglycerin Palifermin (Kepivance) Plicamycin (Mithracin) Rasburicase (Elitek) Sargramostim (Leukine) Teniposide (Vumon) Vincristine (Oncovin) References: 1. Micromedex. 2. Am J HSP Vol 58; Jan 15, 2001. 3. Chen & Martinez; Am J HSP; 1998;55:1313-14. 4. Lexi-Comp. IVfiltration.doc 9/2004 P225