Chemical and visual compatibility of fluconazole injection with parenteral medications used in neonatal intensive care settings

OBJECTIVE: To investigate the chemical and visual compatibility of fluconazole injection with 44 secondary intravenous (IV) drugs and 6 two-in-one parenteral nutrition (PN) solutions used in neonatal intensive care unit settings. METHODS: Fluconazole (2 mg/mL) was mixed 1:1 with each secondary IV drug or PN solution to simulate Y-site co-administration. Visual compatibility was evaluated by observation for up to 4 hours and chemical compatibility was determined from fluconazole concentrations, using high performance liquid chromatography (HPLC). RESULTS: Fluconazole injection was visually compatible with all 44 secondary IV drugs and 6 PN solutions tested and chemically compatible with 42 IV drugs. Due to unresolved interference by the secondary drug in the HPLC assay, the chemical compatibility of fluconazole with ampicillin or flucloxacillin injections could not be confirmed. CONCLUSION: Fluconazole injection solution was chemically and visually compatible with 42 secondary IV drugs and 6 PN solutions for up to 4 hours.