Preparation of Admixture for Infusion: Shake the vial gently until there is no evidence of any yellow sediment at the bottom. Withdraw the appropriate dose of amphotericin b from the required number of vials into one or more sterile syringes using an 18-gauge needle. Remove the needle from each syringe filled with amphotericin b and replace with the 5-micron filter needle supplied with each vial. Each filter needle may be used to filter the contents of up to four 100 mg vials. Insert the filter needle of the syringe into an IV bag containing 5% Dextrose Injection USP, and empty the contents of the syringe into the bag. The final infusion concentration should be 1 mg/mL. For pediatric patients and patients with cardiovascular disease the drug may be diluted with 5% Dextrose Injection to a final infusion concentration of 2 mg/mL. Before infusion, shake the bag until the contents are thoroughly mixed. Do not use the admixture after dilution with 5% Dextrose Injection if there is any evidence of foreign matter. Vials are for single use. Unused material should be discarded. Aseptic technique must be strictly observed throughout handling of amphotericin b, since no bacteriostatic agent or preservative is present.
Do not dilute with saline solutions or mix with other drugs or electrolytes as the compatibility of amphotericin b with these materials has not been established. An existing intravenous line should be flushed with 5% Dextrose Injection before infusion of amphotericin b, or a separate infusion line should be used. Do not use an in-line filter.
The diluted ready-for-use admixture is stable for up to 48 hours at 2° to 8°C (36° to 46°F) and an additional 6 hours at room temperature.
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