Cissabex Caution For Usage

Incompatibilities: Cissabex is not chemically stable when diluted with Lactated Ringer's Injection.
Since Cissabex is stable only in acidic solutions it should not be mixed in the same syringe or administered simultaneously through the same needle with alkaline solutions, e.g., sodium thiopentone. It is not compatible with ketorolac trometamol or propofol injectable emulsion.
Special precautions for disposal and other handling: Cissabex contains no antimicrobial preservative therefore dilution should be carried out immediately prior to use and administration should commence as soon as possible thereafter. Any unused solution diluted in an infusion fluid, or remaining in a used vial or open ampoule, should be discarded.
Diluted Cissabex is physically and chemically stable for at least 24 hours between 2°C-8°C and store below 30°C at concentrations between 0.1 and 2.0 mg/ml in the following infusion fluids: sodium chloride (0.9% w/v) i.v. infusion; dextrose (5% w/v) i.v. infusion; sodium chloride (0.18% w/v) and dextrose (4% w/v) i.v. infusion; sodium chloride (0.45% w/v) and dextrose (2.5% w/v) i.v. infusion; sodium chloride (0.9% w/v) and dextrose (5% w/v) i.v. infusion.
Cissabex has been shown to be compatible with the following commonly used per-operative drugs, when mixed in conditions simulating administration into a running i.v. infusion via a Y-site injection port: alfentanil hydrochloride, droperidol, fentanyl citrate, midazolam hydrochloride and sufentanil citrate. Where other drugs are administered through the same indwelling needle or cannula as Cissabex, it is recommended that each drug be flushed through with an adequate volume of a suitable i.v. fluid, e.g., sodium chloride i.v. infusion 0.9% (w/v).
As with other drugs administered intravenously, when a small vein is selected as the injection site, Cissabex should be flushed through the vein with a suitable i.v. fluid, e.g., sodium chloride i.v. infusion (0.9% w/v).