IV DRUG DILUTION FOR NEONATES

STRENGTH/ DRUG VOLUME DILUENT FINAL VOLUME FINAL MAXIMUM DILUENT

BRAND GENERIC NAME REMARKS
DILUENT (ML) VOLUME (ML) (ML) CONCENTRATION CONCENTRATION USED
ACYCLOVIR ACYCLOVIR 250MG/10ML WFI 4 16 20 5MG/ML NS
AMINOPHYLLINE AMINOPHYLLINE 250MG/10ML 1 9 10 2.5MG/ML 25MG/ML NS
CAFFEINE CITRATE CAFFEINE CITRATE 40MG/2ML 0.5 0.5 1 10MG/ML 20MG/ML (undiluted) D5W
CAFFEINE BASE CAFFEINE 20MG/2ML 1 1 2 5MG/ML 10MG/ML(undiluted) D5W
DEXAMETHASONE DEXAMETHASONE 4MG/ML 1 3 4 1MG/ML 4MG/ML NS,D5W
PHENYTOIN PHENYTOIN 250MG/5ML AS REQUIRED 0 AS REQUIRED 50MG/ML 50MG/ML
LANOXIN DIGOXIN 500MCG/2ML 1 9 10 25MCG/ML 100MCG/ML NS WFI
FUROSEMIDE FUROSEMIDE 20MG/2ML 1 9 10 1MG/ML 10MG/ML NS RM TEMP
PHENOBARBITONE SOD PHENOBARBITONE 200MG/ML 0.1 9.9 10 2MG/ML 40MG/ML NS
HYDROCORTISONE
SOLU-CORTEF 100MG/2ML NS 0.2 9.8 10 1MG/ML 50MG/ML NS
SOD SUCCINATE

IBUPROFEN IBUPROFEN 20MG/2ML 1 1 2 5MG/ML NS AVOID GIVING VIA SAME LINE AS TPN

DILUTE FURTHER WITH

LIPOSOMAL. D5 TO:
AMBISOME 50MG/12ML WFI 1 9.5 10 0.4MG/ML 0.2 – 0.5MG/ML (PAED) D5W 6HR Stability
AMPHOTERICIN B.
1 – 2MG/ML (ADULT)

IV ANTIBIOTIC DILUTIONS FOR NEONATES

STRENGTH/ DRUG VOLUME DILUENT FINAL VOLUME FINAL MAXIMUM DILUENT
BRAND GENERIC NAME REMARKS STABILITY
DILUENT (ML) VOLUME (ML) (ML) CONCENTRATION CONCENTRATION USED
AMIKIN AMIKACIN 500MG/2ML 0.4 19.6 20 5MG/ML 5MG/ML NS 7 DAYS
500MG/5ML WFI 8 HOURS RM
AMPICILLIN AMPICILLIN 2 8 10 20MG/ML 30MG/ML NS
(4.7ML) TEMP
CLAFORAN CEFOTAXIME 500MG/5ML WFI - - 5 100MG/ML 100MG/ML WFI 5 DAYS
24 HOURS RM
DIFLUCAN FLUCONAZOLE 100MG/50ML 1 1 2 1MG/ML 2MG/ML D5 DEXTROSE 5%
TEMP
AVOID GIVING WITH
GENTAMICIN GENTAMICIN 80MG/2ML 1 19 20 2MG/ML 10MG/ML NS PENICILLINS /
CEPHALOSPORINS
MERONEM MEROPENEM 500MG/10ML WFI 1 4 5 10MG/ML 20MG/ML NS Diluted: 48hrs

1G/9.6ML 10 15 25
AVOID GIVING WITH CA-
ROCEPHIN CEFTRIAXONE 500MG/4.8ML 5 7.5 12.5 40MG/ML 40MG/ML NS WFI CONTAINING SOLUTIONS
10 DAYS
250MG/2.5ML 2.5 3.75 6.25
PIPERACILLIN & 4500MG/20ML
TAZOCIN 1 9 10 22.5MG/ML WFI
TAZOBACTAM (17ML)
SULBACTAM SOD
UNASYN 750MG/5ML 5 20 25 30MG/ML NS WFI 72 HRS
AMPICILLIN SOD
VANCOCIN VANCOMYCIN 500MG/10ML 1 9 10 5MG/ML 5MG/ML NS 14 DAYS
NB: FOR AMINOGLYCOSIDES, MINIMUM VOLUME ALLOWED IS 1ML PROVIDED FINAL CONC DOES NOT EXCEED THE MAX
HELPFUL
CONC/ML.
HINT
NS = SODIUM CHLORIDE 0.9% WFI = WATER FOR INJECTION TO GET WITHIN MAXIMUM CONCENTRATION (EG. 5MG/ML):
1) FROM RECONSTITUTED VIAL, DRAW VOL CORRESPONDING TO THE DOSE REQUIRED ‘X’ (EG. 10MG = 0.2ML)
REFERENCES: 2) DIVIDE ‘X’ BY THE MAXIMUM CONC/ML TO GIVE FINAL DILUTED VOLUME ( 10MG = 2ML)
1. TRISSEL. HANDBOOK ON INJECTABLE DRUGS. 8TH ED. 3) HENCE, DRAW 0.2ML AND MAKE UP TO 2ML WITH APPROPRIATE DILUENT 5MG/ML
2. PHELPS SJ, COCHRAN EB: GUIDELINES FOR ADMINSTRATION OF IV MEDICATIONS TO PAEDIATRIC PATIENTS
3. DILUTION OF INTRAVENOUS MEDICATIONS FOR NEONATES. AJHP JUNE 15 1995
4. LEXI-COMP PEDIATRIC DOSAGE HANDBOOK INTERNATIONAL. 13TH ED. 5 LEXI-COMP DOSAGE HANDBOOK INTERNATIONAL V. 2.7.5 Updated: 01/08/20

RECONSTITUTION GUIDELINES

STABILITY
STRENGTH/
GENERIC NAME BRAND DILUENT FINAL CONC/ML REMARKS
DILUENT 4OC 25OC

MAX 1:20 DO NOT REFRIGERATE.

CYCLOSPORINE SANDIMMUNE 50MG/ML NS USE NON-PVC TUBING.
(2.5MG/ML) Protect from light.
ALL CONC TO BE
Hydration (Pre- & Post-infusion of 1L NS);
DILUTED IN
CIDOFOVIR VESTIDE 75MG/ML DIL 100ML NS 2G Probenecid 3 hours Pre-inf, 1g at 2
100ML NS
and 8 hours post-inf.
(8MG/ML)
DEFIBROTIDE 200MG/2.5ML
FURTHER DO NOT REFRIGERATE.
GANCICLOVIR CYMEVENE 500MG/10ML WFI NS 5 DAYS
DILUTE TO RECONST. VIAL

METHYPREDNISOLONE SOLU-MEDROL 500MG/50ML NS NS 10MG/ML 21 DAYS 4 DAYS

FURTHER DO NOT REFRIGERATE;
500MG/14ML
MYCOPHYENOLATE CELLCEPT D5W DILUTE TO 12 HOURS
D5W do not admix with other drugs
6MG/ML
+ Albumin 4G, D5W (Give premeds).
MUROMONAB CD3 OKT 3 5MG/5ML 1MG/ML
USE 0.2µM FILTER.
DO NOT FILTER.
PALIFERMIN KEPIVANCE 6.25MG/1.2ML WFI 5MG/ML 24 HOURS 1 HOUR Protect from light.
Do not shake vigorously.
USE 0.2µM FILTER.
THYMOGLOBULIN ATG (RABBIT) 25MG/5ML WFI NS D5W 25MG/50ML 24 HOURS 4 HOURS
Protect from light.
TACROLIMUS PROGRAF 5MG/ML NS D5W 0.004-0.02MG/ML 24 HOURS USE NON-PVC INF TUBING.
Protect from light.