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Compatibility and stability of tramadol and dexamethasone in solution and its use in terminally ill patients
Author(s) -
Negro S,
Salama A,
Sánchez Y,
Azuara M. L.,
Barcia E
Publication year - 2007
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2007.00839.x
Subject(s) - tramadol , compatibility (geochemistry) , dexamethasone , terminally ill , medicine , anesthesia , intensive care medicine , palliative care , nursing , engineering , analgesic , chemical engineering
Summary Background: Delivery of drug admixtures by continuous subcutaneous infusion is common practice in palliative medicine, but analytical confirmation of their compatibility and stability is not always available. Objective: To study the compatibility and stability of tramadol hydrochloride and dexamethasone sodium phosphate combined in solution and to report on its use in terminally ill patients. Method: Twelve different solutions containing tramadol hydrochloride (8·33–33·33 mg/mL) and dexamethasone sodium phosphate (0·33–3·33 mg/mL) were prepared in saline and stored in polypropylene syringes for 5 days (25 °C). Analysis was performed on days 1, 3 and 5 days with simultaneous determination by HPLC. pH was measured at 0 and 5 days. Clinical performance was assessed retrospectively in six terminal‐ill oncology patients. Results: Maximum losses of 7% and 6% were observed for tramadol and dexamethasone. Pain was completely controlled in four patients. Local tolerance resulted in haematoma in three patients, which resolved by switching to a butterfly insertion site. Conclusion: Tramadol hydrochloride (100–400 mg/day) and dexamethasone sodium phosphate (4–40 mg/day) are stable for at least 5 days when combined in saline and stored at 25 °C. These results are only valid for the type of syringes and the specific commercial preparations tested.