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Safety, sterility and stability of direct‐from‐vial multiple dosing intravitreal injection of bevacizumab
Author(s) -
Das Taraprasad,
Volety Srinivas,
Ahsan Saad M,
Thakur Abhay K,
Sharma Savitri,
Padhi Tapas R,
Basu Soumyava,
Rao Ch Mohan
Publication year - 2015
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12489
Subject(s) - vial , medicine , bevacizumab , high performance liquid chromatography , chromatography , dosing , sterility , surgery , pharmacology , chemistry , chemotherapy , biology , genetics
Background This study aims to determine the stability, sterility and safety of bevacizumab multiple dosing from a single vial without prior aliquoting. Methods In‐vitro and human study. Six bevacizumab vials, used in multiple patients on a single day by direct withdrawal from the vial, and stored in 4°C up to a variable period, were tested for stability (high‐performance liquid chromatography; [ HPLC ]), sterility (culture), conformational stability by circular dichroism and fluorescence spectroscopy and the rubber cork structural integrity (electron microscopy [ EM] ). Results HPLC of all six samples of used bevacizumab and the control bevacizumab sample were similar; culture was negative; and the EM of rubber corks did not show an open communication. Spectroscopic studies indicated drug conformational stability. Further, there was no infection or inflammation in 221 consecutive patients (973 injections) when bevacizumab was stored at 4°C and used for one week. Conclusion Bevacizumab does not lose stability when stored at 4°C. It may be used for a week by direct withdrawal from the vial without fear of infection or inflammation if all standard precautions related to intravitreal injection are adhered to.