Physical compatibility of Xuebijing injection with 53 intravenous drugs during simulated Y-site administration

• DOI: 10.1371/journal.pone.0299694
• Publication Date: 2024-03-22T17:30:27Z
• Authors: Tong Tong; Peifang Li; Haiwen Ding; Ying Huang; Sheng Liu
• Keywords: Pharmacology; Biological Properties of Aloe Vera and Related Compounds; Pharmacology, Toxicology and Pharmaceutics; Chromatography; Science; Q; R; Life Sciences; Geology; Plant Science; FOS: Earth and related environmental sciences; Oceanography; Agricultural and Biological Sciences; Turbidity; Chemistry; Pharmacokinetics of Antibiotics in Critically Ill Patients; Health Sciences; Pharmacology of Aconitum Alkaloids in Traditional Medicine; Medicine; Continuous Infusion; Research Article

ObjectiveXuebijing injection (XBJ) is a commonly used herbal medicine injection in China. However, the physical compatibility of XBJ with other intravenous drugs remains unclear. The purpose of this research is to evaluate physical compatibility of Xuebijing injection (XBJ) with 53 intravenous drugs (including 31 Chinese medicine injections and 22 chemicals) during simulated Y-site administration.MethodsY-site administration was simulated in vitro by admixing 0.33 ml/ml XBJ with an equal volume of other diluted 53 intravenous drugs, respectively. Physical compatibility including visual inspection, Tyndall beam, particle limits, turbidity, pH, chromacity value, spectroscopic absorption of 550 nm and 420 nm (A550 nmand A420 nm) were observed and assessed at 0, 1, 2, and 4 h. Physical compatibility was defined as all solutions with no color changes, no gas evolution, particulate formation and no Tyndall beam within 4 hours, turbidity changes <0.5 nephelometric turbidity unit (NTU) compared to 0 h, particle limits allowed by the Chinese Pharmacopoeia (Ch.P) 2020 edition, pH changes <10% compared to 0, chromacity value changes <200 compared to 0 h, or photometrical changes of A420 nm<0.0400 or A550 nm<0.0100 compared to 0 h.ResultsXBJ was physically incompatible with 27 of the 53 intravenous drugs tested, 26 were compatible with XBJ for 4 h.ConclusionsXBJ should not be simultaneously co-administered with 27 of the 53 intravenous drugs during simulated Y-site. If coadministration was inevitable, flushing tube with NS or D5W before and after infusion of XBJ was needed. Assessment included visual inspection, Tyndall beam, turbidity measurement, particle counts, pH measurement, chromacity value measurement and absorption of A550 nmwere proved to be valid and robust for the quality control of infusion and compatibility of Chinese herbal injection.