Skip to main content

Table 2 Most used medication in the intensive care unit to be diluted for continuous infusion, slow bolus administration or both. The stability of the diluted product is dependent on its end concentration and environmental temperature. The product’s stability in its compatible diluent has been confirmed for the conventional administration times and volumes. For detailed data, we refer to each drug’s SmPC (summary of product characteristics) or relevant databases

From: Fluid-induced harm in the hospital: look beyond volume and start considering sodium. From physiology towards recommendations for daily practice in hospitalized adults

  NaCl 0.9% mandatory G5% or D5% or NaCl 0.9% equally possible G5% or D5% mandatory Administration in its pure form using a syringe pump feasible
Anti-infectives
 Continuous or prolonged (4-8 h) infusion   Benzylpenicillin   
Cefepime dihydrochloride
Ceftazidime pentahydrate
Meropenem trihydratea
Piperacillin–tazobactam
Temocillin
Vancomycinb
 Short infusion (15–90 min, depending on product) Amoxicillin–clavulanatec Benzylpenicillin   
Acyclovird Cefepime dihydrochloride   
  Ceftazidime pentahydrate   
Ciprofloxacine
Flucloxacillin
Meropenem trihydratea
Piperacillin–tazobactam
Sulfamethoxazole–trimethoprimf
Temocillin
Vancomycinb
Vasoactive and antiarrhythmic medication
 Continuous infusion Somatostatin Adrenaline tartrate or HClg Amiodarone HCl Isosorbide dinitrate
  Dobutamine HCl Norepinephrinek Labetalol
Isosorbide dinitrateh   Nicardipine
Labetalol   Nimodipine
Milrinone   Urapidil HCl
Molsidomine   
Nicardipineh   
Urapidil HCl   
Clonidine HCl   
 Short infusion (15–90 min, depending on product)   Labetalol Amiodarone HCl  
Sedatives, analgetics and antiepileptic agents
 Continuous infusion   Alfentanyl   Alfentanyl
Clonidine HCl Fentanyl citrate
Dexmedetomidine HCl Ketamine
Fentanyl citrate Midazolam HCl
Ketamine Morphine HCl
Midazolam HCl Sufentanyl citrate
Morphine HCl  
Remifentanyl  
Sufentanyl citrate  
Thiopental sodium  
Valproate sodium  
 Short infusion (15–90 min, depending on product) Phenytoin sodium Levetiracetam   
Valproate sodium
  NaCl 0.9% mandatory G5% or D5% or NaCl 0.9% equally possible G5% or D5% mandatory Administration in its pure form using a syringe pump feasible
Other common medications used in the ICU
 Continuous infusion   Cisatracurium besylate   Bumetanide
  Concentrated electrolytes (KCl, MgSO4)   Cisatracurium besylate
  Furosemidei   Concentrated electrolytesj
  Heparin sodium   Furosemide
  Methylprednisolone sodium succinate   Heparin sodium
  N-Acetylcysteine   
  Regular insulin   
 Short infusion (15–90 min, depending on product)   Bumetanide   
  Concentrated electrolytes (KCl, MgSO4)   
  Furosemidei   
  N-Acetylcysteine   
  Methylprednisolone sodium succinate   
  1. D5% dextrose 5%
  2. G5% glucose 5%
  3. aSome sources report a stability of less than 4 h in G5%
  4. bAfter reconstitution with aqua
  5. cAfter reconstitution with aqua or NaCl 0.9%
  6. dGlucose 5% possible but probably less stable because of Maillard reaction
  7. eMostly commercially prediluted, solvent differs by brand
  8. fMinimal necessary volume for dilution: 400 mg + 80 mg/5 mL in 75 mL
  9. gpH of G5% needs to be around 5.5, otherwise reduced stability
  10. hAvoid polyvinylchloride (PVC) when diluted in NaCl (sorption to PVC 9 pH of G5% needs to be around)
  11. iPrecipitation possible if pH < 5.5–7
  12. jDepending on the initial concentration
  13. kAlthough strictly not impossible to dissolve in NaCl 0.9%, G5% is recommended for protection against significant drug loss due to oxidation