When to use the Extension Set with 0.22 Micron Filter During delivery of the following medications: |
Antithymocyte globulin (ATG) Etoposide Mannitol Reteplase TPN without lipids Thymoglobulin |
Medications that require special filters: |
Asparaginase: Use a 5 micron needle filter Infliximab: Use a 1.2 micron filter Itraconazole IV: Use filtered infusion set provided from the company which contained a 0.2 micron filter Mannitol (5 micron needle filter to draw up contents from a 25% vial. 0.22 micron in-line filter during administration) Paciltaxel (TaxolÒ): Must be administered using Taxol Administration Set/Cassette which is DEHP-free and has a built-in 0.22 micron filter. It also utilizes a special TaxolÒ IV Pump. Teniposide: Use NON-DEHP IV tubing with build-in 0.22 micron in-line filter TPN with lipids or Lipids alone: Use NON-DEHP IV tubing with a build-in 1.2 micron filter |
Medications that require the use of IV filters under special circumstances: |
Amiodarone (only use filter when drug concentration other than 900mg/500ml) Pentobarbital (use 0.22 micron filter when diluted) Phenobarbital (use 0.22 micron filter when diluted) Phenytoin (use 0.22 micron filter when diluted) H:SPA/Forms/Filters 5/24/00 |
Drug |
Types of IV Filters |
Reasons |
Recommendations |
References |
|
Preparation |
Administration |
||||
| Abciximab | 0.22 micron filter | Decrease antigenicity | Recommend using a 0.22 micron filter either upon admixture or administration. | 1, 2 | |
| ABLCÒ (Amphotericin B Lipid Complex) |
5 micron filter needle (Provided) | Each filter needle may be used to filter contents of up to 4 vials. Flush IV line w/ D5W before and after amphotericin infusion. | 1, 2 | ||
| AmBisomeÒ (Amphotericin B Liposome) | 5 micron filter needle (Provided) | Use only one filter per vial of AmBisomeÒ per manufacturer. Flush IV line w/ D5W before and after amphotericin infusion. | 1, 2 | ||
| Amiodarone | 0.22 micron in-line filter (see comment) | May precipitate when diluted | Do not require the use of in-line filter during administration when use the standard concentration of 900mg/500ml. Recommend using a 0.22 micron in-line filter during administration for other concentrations. | 1, 2, 3 | |
| Antithymocyte globulin (ATG) | 0.22 micron in-line filter | Slight granular or flaky deposits may develop during storage | 1, 4 | ||
| Asparaginase | 5 micron filter needle | Gelatinous fibers may develop on standing | 1, 2, 3 | ||
| Cladribine | 0.22 micron filter (see comment) | Recommend using a 0.22 micron filter to prepare a 7-day infusion (infusor) only. It is not necessary to use a 0.22 micron filter for preparation of single daily dose. Do not use D5W as a diluent as it increase cladribine degradation. | 1, 2, 3 | ||
| Etoposide | 0.22 micron in-line filter | incidence of precipitation w/ concentration > 0.4mg/ml |
1, 2, 3 | ||
| Factor VIII products: | |||||
| Human | |||||
Humate-PÒ |
Filter needle (Provided) | Use one filter needle per vial. | 1, 2 | ||
Monarc-M TM (Monoclonal) |
5 micron filter needle (Provided) | Use one filter needle per vial. | 1, 2 | ||
Monoclate-PÒ (Monoclonal) |
5 micron filter needle or 5 micron vented filter spike (Provided) | Use one filter needle per vial. | 1, 2 | ||
| Recombinant | |||||
HelixateÒ |
5 micron filter needle (Provided) | Use one filter needle per vial. | 1, 2 | ||
RecombinateTM |
5 micron filter needle (Provided) | Use one filter needle per vial. | 1, 2 | ||
| Anti-Factor VIII Inhibitor | |||||
FEIBAÒ |
5 micron filter needle (Provided) | Use one filter needle per vial. | 2 | ||
| Factor IX products: | |||||
| Human | |||||
ProfilnineÒ SD (Factor IX Complex) |
20 micron filter (Provided) | Use one filter per vial. | 1, 2 | ||
| Recombinant | |||||
BeneFixTM |
One filter spike (Provided) | Use one filter needle per vial. | 1, 2 | ||
| Imiglucerase | 0.22micron in-line non-protein binding particulate filter (optional) | To remove protein and deposits | 2, 9 | ||
| Infliximab | 1.2 micron filter | 2 | |||
| Itraconazole | Filtered infusion set (provided by the company which contained a 0.2 micron filter) | 2 | |||
| Mannitol | 5 micron filter needle | 0.22 micron in-line filter | incidence of crystallization w/ concentration > 20% | Recommend using a 5 micron filter needle with the 25% diluted mannitol during preparation and a 0.22 micron in-line filter during administration for all mannitol parenteral solutions. | 1, 2, 3, 10 |
| Muromonab-CD3 | 0.22 micron filter | 1, 2 | |||
| Paclitaxel | 0.22 micron in-line filter | Recommend using the NON-DEHP IV tubing with the build-in 0.22 micron in-line filter during administration. | 1, 2, 3 | ||
| Pentobarbital | 0.22 micron in-line filter | May precipitate when diluted | When diluted, recommend to use with a 0.22 micron in-line filter during administration. | 3 | |
| Phenobarbital | 0.22 micron in-line filter | May precipitate depending on the concentration and pH | When diluted, recommend to use with a 0.22 micron in-line filter during administration. | 3 | |
| Phenytoin | 0.22 micron in-line filter (see comment) | May precipitate due to drug’s low solubility and at low pH | Phenytoin is preferably administered by direct IV injection. It is not require to use filter for undiluted phenytoin. The rate of IV injection should be < 50mg/min. If dilution is needed, mix phenytoin with 0.9% NS and use 0.22 micron in-line filter during administration. | 1, 2, 3 | |
| Reteplase | 0.22 micron filter | 2 | |||
| Streptokinase | 5 micron filter needle | Formation of filament | 1, 2, 3 | ||
| Teniposide | 0.22 micron in-line filter | incidence of precipitation w/ high concentration | Prepare teniposide in
a NON-DEHP container. Recommend using the NON-DEHP IV tubing with the build-in 0.22 micron in-line filter during administration. |
1, 2, 3, 12 | |
| Thiotepa | 0.22 micron filter | May undergo polymerization forming insoluble polymeric derivatives. | 1, 2, 3 | ||
| Thymoglobulin | 0.22 micron in-line filter | 2 | |||
| TPN | |||||
Without lipids |
0.22 micron in-line filter | 1, 13 | |||
With lipids |
1.2 micron in-line filter | 1, 13 | |||
Lipid alone |
1.2 micron in-line filter | 13 | |||
| Urokinase | 0.22 micron filter | Formation of filament | 1, 2 | ||
| Solution from glass amp | 5 micron filter needle | 14 | |||
References:
H:SPA/Forms/Ivfilter
. |