How do you give a 1 hour infusion of Flagyl?
Our pharmacy has no information that this drug is compatible with D5W, Normal Saline, or any other typical IV solutions, therefore we must consider them to be incompatible. The drug is mixed in water.
Patient's with central lines we will use a carrier solution and piggyback the Flagyl in it as to allow complete infusion of the Flagyl. Now that this issue has been brought to the surface regarding compatibilities I have been asked "what to do".
I am not sure what your pharmacy is looking at, but Gahart's Intravenous Medications, plainly states that it can be diluted with NS, D5W or LR. I have given rivers of this as a piggyback into many lines. There is a statement in this book about the manufacturer's statement of "Administer separately, discontineu the primary IV during administration, and do not introduce additives into the solution." This seems to be in conflict with the other statements about dilution with the other solutions. Have you called the drug manufacturer for clarification? I would. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Our pharmacy cannot use nursing sources r/t drug administration. Mosby's had the same statement that you referenced. Our pharmacy stated the "gold standard" is Trissel's. What's interesting is that Trissel's 2011 book states it has been tested with sodium chloride (which ours is premixed in) and Dextrose 5%. Another online source supported by Trissel's states (that our pharmacy subscribes to) states the drug has not been tested with these or other standard IV solutions. The investigation continues.
Trissel is the final word on compatibility information. Let us know what you decide. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Can we assume this is ready to use Flagyl? If so then what is used to dilute it in the powdered form? According to Trissel (hand book 11th Ed.) Page 891
single dose lyophilized vials containing Metroindazole 500mg as hydrochloride and mannitol 415mg. The correct order of mixing must be followed in preparing the dose for administration....
add 4.4ml of one of the following dilutents to the vial and mix throughly: sterile water for injection, bacteriostatic water for injection, sodium chloride 0.9%, bacteriostatic sodium chloride 9%.
The resulting solution volume of 5ml will contain 100mg/ml ..... Further dilute the reconstituted solution to a concentration no greater 8mg/ml in one of the following solutuions:
Dextrose 5% in water
Ringers injection lactated
Sodium Chloride 0.9%
Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.