Kadcyla Caution For Usage

Special Instructions for Use, Handling and Disposal: Appropriate aseptic technique should be used. Appropriate procedures for the preparation of chemotherapeutic drugs should be used.
The reconstituted product contains no preservative and is intended for single use only. Discard any unused portion.
Using a sterile syringe, slowly inject 5 ml of Sterile Water for Injection into the 100 mg vial, or 8 mL of sterile water for injection into the 160 mg Kadcyla vial.
Swirl the vial gently until completely dissolved. DO NOT SHAKE!
Store reconstituted Kadcyla at 2-8ºC; discard unused Kadcyla after 24 hours.
Reconstituted solution should be inspected visually for particulate matter and discoloration prior to administration. The reconstituted solution should be free of visible particulates, clear to slightly opalescent. The color of the reconstituted solution should be colorless to pale brown. Do not use if reconstituted solution contains visible particulates, or is cloudy, or is discolored.
Instructions for Dilution: Determine the volume of the solution required based on a dose of 3.6 mg Kadcyla/kg body weight (see Dose Reduction Schedule under Dosage & Administration):

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The appropriate amount of solution should be withdrawn from the vial and added to an infusion bag containing 250 ml of 0.45% sodium chloride or 0.9% sodium chloride. Dextrose (5%) solution should not be used. 0.45% sodium chloride may be used without a 0.2 or 0.22 micron in-line polyethersulfone (PES) filter. If 0.9% sodium chloride is used for infusion, a 0.2 or 0.22 micron in-line polyethersulfone (PES) filter is required. Once the infusion is prepared it should be administered immediately. If not used immediately, the infusion can be stored for up to 24 hours in a refrigerator at 2°C-8°C. Do not freeze or shake the infusion during storage.
Disposal of unused/expired medicines: The release of pharmaceuticals in the environment should be minimized. Medicines should not be disposed of via wastewater and disposal through household waste should be avoided. Use established "collection systems", if available in the location.
The following points should be strictly adhered to regarding the use and disposal of syringes and other medicinal sharps: Needles and syringes should never be reused.
Place all used needles and syringes into a sharps container (puncture-proof disposable container).
Local requirements should be followed for the disposal process of unused/expired medicines or waste material.
Incompatibilities: Dextrose (5%) solution should not be used since it causes aggregation of the protein.
Kadcyla should not be mixed or diluted with other drugs.