Download © Information - Universitätsmedizin Mainz

yr
ig
Mixing different inhalation solutions and
suspensions for simultaneous inhalation
is one possibility to shorten this time
timeconsuming procedure. However, mixing
the inhalation solutions in the nebulizer
is only recommended if compatibility of
the admixtures is proven.
C
op
Wolfgang Kamin, M.D. Ph.D.
[email protected]
utherian Hospital,
Pediatric Department, Lu
Werler Straße 130, D-59063 Hamm, Germany
University Medical Cente
er Mainz
Langenbeckstraße 1, D--55131 Mainz, Germany
Incompatibility of
mixtures is proven
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e authors, especially the
right to reproduction and
d distribution as well as
translation in any langua
age. This leaflet is
intended for p
private p
purp
poses by
p
y patients
p
– anyy
other use needs written consent of the authors.
Version Sep 2014
Information
Compatibility
of inhalation solution admixtures©
14
©
ai
U
Compatibility of mixtures
has not been studied yet
For further references please contact the authors.
M
ni
Compatibility of
mixtures is proven
nz
Kamin W et al. Inhalation solutions: which one are
allowed to be mixed? Phyyysico-chemical
compatibility of drug soluttions in nebulizers. J Cyst
Fibros 2006; 5(4): 205-13
3.
Which ones may be mixed?
20
rs
Unused mixtures must be discarded.
Do not mix
Kamin W et al. Inhalation solution: Which ones
ma be mi
may
mixed?
ed? Physico-c
Ph sico chemical
c
compatibility
compatibilit of
drug solutions in nebulize
ers - Update 2013. J Cyst
Fibros. 2014; 13(3): 243-5
50.
ve
Please follow the recommendations:
itä
References
Attention: These admixtures are not
licensed drugs.
drugs The advices are based
on in vitro studies concerning only
stability
and
physico-chemical
compatibility of the mixtures.
Do not mix
harm.D.
Hannah Walz-Jung, Ph
hannah.walz-jung@unim
medizin-mainz.de
University Medical Cente
er
Johannes Gutenberg-Un
niversity Mainz
Langenbeckstraße 1, D--55131 Mainz, Germany
This leaflet provides information about
the compatibility of selected drug
solution mixtures.
Please find the information in table
format, visualized by the traffic light
principle.
Mixable
Irene Krämer, Ph.D.
[email protected]
ts
m
ed
iz
ht
Your inhalation therapy requires a lot of
time and discipline.
in
If you have any quesstions or problems
don`t hesitate to con
ntact the authors
Dear Patient,
Compatibility of inhalation solutions/suspen
nsions ©
in
ht
Choose your drug in the top line and the second one in the column on the
t left. In the field where the line and the column intersect,
yyou will find information about the compatibility
p
y of the eligible
g
combinattion according
g to the traffic light
g p
principle
p ((legend
g
see reverse side).
)
Mixable #
C
op
Gernebcin® 160 mg
Colistimethate
Colistin CF®
Ipratropium
Atrovent®**
Albuterol
Sultanol®**
Budesonide
Pulmicort®
Fluticasone
Flutide®
Cromolyn
Intal®
Hypertonic saline
5.85% NaCl-solution
Do not mix
Pulmicort®
Flutide®
Intal®
5.85% NaClsolution
Do not mix
Do not mix
Do not mix
Mixable
Do not mix
Do not mix
Do not mix
Mixable
M
Mixable
Mixable
Mixable
Mixable
Do not mix
Do not mix
Mixable
M
Mixable
Mixable
Mixable
Mixable
Do not mix
Do not mix
Mixxable **
Mixable **
Mixable
Mixable
Do not mix
Mixable
Mixable #
Mixable
Mixable #
Mixable **
Do not mix
Mixable
Mixable #
Mixable **
Do not mix
*
Mi bl
Mixable
Mi bl
Mixable
Do not mix
Do not mix
Do not mix
Mixable
Mixable
Do not mix
Mixable
Mixable
Do not mix
Mixable
Mixable
Mixable **
Mixxable #
Mi bl
Mixable
Mi bl
Mixable
Mi bl
Mixable
Mi bl
Mixable
M bl
Mi
Mixable
Mi bl
Mixable
Do not mix
Mixable
Mixable
Mixable
Mixxable #
Mixable #
*
Do not mix
Do not mix
Do not mix
Do not mix
Mixxable **
Mixable **
Mixable
Do not mix
Do not mix
Do not mix
Mixable
Do not mix
Do not mix
Mixable
Do not mix
Mixable **
Do not mix
ni
* Mixtures not recommended from a clinical point of view ** Compatibility is only proven for preservative free dosage forms
# unchanged aerosol characteristics and unchanged drug output is proven
Compatibility of the following triple and quadripartite admix
xtures is proven:
Do not mix
Do not mix
14
Tobramycin
Do not mix
Colistin CF®
nz
Tobramycin
Bramitob® TOBI®
Bramitob®,TOBI®
Mixable #
160 mg
Sultanol®,
Sultanol®
unit dose
dose**
2.5 mL
itä
Pulmozyme®
Gernebcin®
Hypertonic
saline
ovent®,
Atro
Atrrovent®
uniit dose
dose**
2 mL
rs
Dornase alfa
Pulmozyme®
ve
Tested brands
Bramitob®,
TOBI®
TOBI®,
Gernebcin®
Fluticasone-17propionate
Cromolyn
ts
m
ed
iz
yr
ig
Dornase alfa Tobramycin Tobramycin Colistimethate Iprattropium Albuterol Budesonide
20
ai
M
U
 Ipratropium (Atrovent®) + Albuterol (Sultanol®) + Tobramycin (TOBI® orr GERNEBCIN®)
 Ipratropium + Fenoterol (Berodual®) + Budesonide (Pulmicort®)
nate (Flutide®)
 Ipratropium (Atrovent®) + Albuterol (Sultanol®) + Fluticasone-17-propion
 Ipratropium (Atrovent® unit dose 2 ml) + Albuterol (Sultanol® unit dose 2
2.5
5 ml) + Cromolyn (e
(e.g.
g Intal®)
 Ipratropium (Atrovent® unit dose 2 ml) + Albuterol (Sultanol® unit dose 2.5
2 ml) + Fluticasone-17-propionate (Flutide®)+Colistimethate (Colistin CF®)
Prepare your inhalation solution mixture only immediately before the nebulization. Remaining unused admixtures are to be discarded.