PP-007 Stability of diluted and reconstituted antineoplastic drugs: updated 2014

Background The lack of studies published on stability of antineoplastic drugs and the contradictory character of the information available increased the need to carry out an internal review in our hospital. Purpose To investigate the physical-chemical stability of vials of antineoplastic drugs included in the hospital’s Therapeutic Prescription Guide after opening and/or reconstitution. Material and methods We reviewed all information available in the Spanish Medicines Agency Technical Data Sheets, Micromedex, Stabilis, papers on PubMed and updated guides published by other hospitals in order to establish the physical-chemical stability of these types of drugs. Results The following storage conditions and maximum storage times were found for 35 cytostatic drugs in use in the hospital: 24 months refrigerated (α 2-B interferon), 90 days at room temperature (RT) (cetuximab), 90 days refrigerated and protected from light (PL) (bevacizumab), 31 days refrigerated PL (pemetrexed), 30 days refrigerated and PL (methotrexate, rituximab, vinorelbine), 28 days at RT (eribulin, etoposide, paclitaxel), 28 days at RT and PL (cisplatin, docetaxel, fluorouracil), 28 days refrigerated (vinblastine), 28 days refrigerated and PL (doxorubicin, pegylated liposomal doxorubicin), 26 days at RT and PL (fludarabine), 22 days refrigerated (mitoxantrone), 21 days refrigerated and PL (carboplatin, ifosfamide), 14 days refrigerated and PL (cyclophosphamide, epirubicin, oxaliplatin, topotecan, mitomycin, vincristine), 8 days frozen with WFI (water for injection) (azacitidine), 7days at RT (carmustine, irinotecan), 7 days refrigerated (cytarabine), 7 days refrigerated and PL (dactinomycin, daunorubicin, gemcitabine, non-pegylated liposomal doxorubicin and idarubicin). Conclusion The storage protocol was modified for cytostatic vials that had been opened/reconstituted under aseptic conditions using a vertical laminar flow cabin depending on their maximum stabilities. The resulting document was thereafter incorporated into regular working practice. The updated protocol resulted in the medicines being used safely and significant savings on these costly drugs. References and/or acknowledgements Oncology Department No conflict of interest.