盐酸奥丹西隆与其它药物配伍的稳定性
作者：王明仲
单位：湖北襄樊市中心医院药学部 襄樊 441021
关键词：
中国现代应用药学000233 盐酸奥丹西隆(Ondansetron hydrochloride,Ond)为英国葛兰素公司1989年开 发成功的高度选择性5-HT3受体拮抗剂，商品名为枢复宁(zofran)，用于放疗、化疗时镇 吐效果显著。我国宁波天衡制药厂自1996年正式生产，商品名枢丹。由于肿瘤患者用药的复 杂性，许多学者竟相研究了Ond常用浓度(0.03～0.3mg/ml)下与其它药物的配伍性，本文予 以综合介绍(见表1)，以利用药参考。
表1 盐酸奥丹西隆与其它药物配伍的稳定性 配伍药物
浓度/mg.ml-1
, http://www.100md.com
溶媒
Ond浓度
/mg.ml-1
容器
贮存条件
观察
指标
稳定
时间
参考
文献
10%葡萄糖(10%GS)
, 百拇医药 0.08
d
室温
Y
>24h
1
5%葡萄糖(5%GS)
0.03，0.3
-20℃,5℃,25℃
Y
> 24h
2，3
生理盐水(NS)
, 百拇医药
0.03，0.08，0.3
d
-20℃，5℃，25℃
Y
>24h
1，2
葡萄糖氯化钠注射液
0.08
d
室温
Y
>24h
1
, 百拇医药
复方氯化钠注射液
0.08
d
室温
Y
>24h
1
盐酸阿霉素
0.1，2
5%GS
0.03，0.3
a
室温，日光灯下
, 百拇医药
Y
>24h
4
阿糖胞苷
0.2，40
5%GS
0.03，0.3
a
室温，日光灯下
Y
>24h
4
1Δ
, 百拇医药
达卡巴嗪
1，3
5%GS
0.03，0.3
a,c
4℃，30℃，日光灯 下
Y
4～8h
4，5
依托泊苷
0.1，0.4
5%GS
0.03，0.3
, 百拇医药
a
室温，日光灯下
Y
>24h
4
甲氨蝶呤
0.5，6
5%GS
0.03，0.3
a
室温，日光灯下
Y
>24h
, http://www.100md.com
4
2Δ
硫酸长春新碱
0.014，0.028
NS
0.048，0.096
a,c
4℃，3 0℃
Y
>24h
5
环磷酰胺
0.3，2
, http://www.100md.com
5%GS，NS
0.05，0.4
4℃，25℃
Y
>4d
6，7
紫杉醇
1.2
5%GS
0.3，7.29
b
23℃
Y
, 百拇医药
>4h
8，9
顺铂
0.200，0.455
NS
1.091，0.480
a
2～8℃，30℃
Y
>24h
10
噻替哌
1
, 百拇医药
5%GS
1
b
23℃；高、低照度光
X
>4h
11
哌拉西林-他唑巴坦
40-5，80-10
NS
0.03，0.1，0.3
b
23 ℃,室光
, 百拇医药
Y
>4h
12
氨曲南
20，40
5%GS
0.015，0.15，1
b
25℃
X
>4h
13，14
头孢塔齐定(碳酸钠盐)
, 百拇医药
20
5%GS
0.015，0.15
b
25℃
X
>4h
13
头孢唑啉钠
10
5%GS
0.015，0.15
b
, http://www.100md.com
25℃
X
>4h
1 3
氟康唑
1
NS
0.015，0.15
b
25℃
X
>4h
13
, http://www.100md.com 3Δ
米诺配能(meropenam)
1，20，50
NS
1
b,d
室温，日光灯 下
X
0(沉淀)
15
头孢美唑钠
100
NS
, 百拇医药
2
a,b,c
室温，日光灯下
X
>1h
16
硫酸吗啡
1
NS
0.1，1.0
4℃,22℃
X
>31d
, 百拇医药
17
盐酸二氢吗啡
0.5
NS
0.1，1.0
4℃,22℃
X
>31d
17
remifentanil hydrochloride
0.025，0.25
NS
, http://www.100md.com 1
b
23℃
X
>4h
18
苯碳酸顺阿曲库铵
0.1，2，5
5%GS
1
b
23℃，高低照度光
X
, 百拇医药
>4h
19
TPN(或PN)
NS
0.03，0.3，1
b
室温，日光灯下
Y
>4 8h
20，21
4Δ
CsA
1.5
, 百拇医药
NS
0.32
b,d
室温，日光灯下
X
?
22
盐酸多巴胺
0.8
NS
0.32
b,d
室温，日光灯下
, 百拇医药
X
>5h
22
肝素钠
100u/ml
NS，5%GS
0.32
b,d
室温，日光灯下
X
>5h
22
5Δ
, 百拇医药
苹果汁、橘汁、果酒、樱桃
饮料、碳酸类软饮料
0.067-2
d
-3～28℃
Y
>1h
23，24
盐酸雷尼替丁
0.2，2.0
5%GS
0.03，0.1，0.3
, 百拇医药
b
23℃
Y
>4h
8，25
6Δ
地塞米松
0.20，0.40
NS，5%GS
0.10，0.2，0.4，0.64[ HT6”〗
a
2～6℃，23℃
Y
, 百拇医药
>48h
26～28
劳拉西泮
0.004
5%GS
0.016,0.08
d
25℃
Y
>24h
26
aldesleukin(重组白介素-2)
33800IU/ml
, 百拇医药
5%GS
0.7
b
室温， 日光灯下
Z
>2h
29
amifostine
10
5%GS
1
b
23℃
, 百拇医药
X
>4h
30
注：a-直接混合于PVC袋内；b-模拟输液装置Y部等体积混合贮于PVC袋中 ；c-在聚 异戊二烯输液泵药池中；d-玻璃容器；X-外观；Y-外观及含量；Z-外观、含量及生物效价； 1Δ-Ond、盐酸阿霉素、达卡巴嗪三药配伍，30℃、日光灯下、PVC袋内稳定4～8h，聚异戊 二烯输液泵药池中稳定24h以上；2Δ-Ond、盐酸阿霉素、硫酸长春新碱三药配伍，30℃，日 光灯下，a或c容器内均稳定24h以上；3Δ-Ond 1mg/ml与米诺配能1mg/ml NS溶液配伍无沉淀 ；4Δ-CsA在NS中微粒超限，加入Ond后微粒无明显增加；5Δ-Ond加入热茶(75～85℃)中即 刻变混浊；6Δ-高浓度的Ond(0.64mg/ml)与地塞米松(0.40mg/ml)在聚丙烯注射器中沉淀(低 浓度无)，各浓度在工业聚脂CR3袋内稳定48h以上
, http://www.100md.com
由附表可知，Ond在常用浓度下可与许多药物配伍使用，这对减少患者被穿刺次数、医务人 员工作量、患者不必要液体摄入均具有积极的临床意义。但应用中应注意配伍允许的浓度和 稳定时限。Ond一般不能与米诺配能配伍，与地塞米松配伍不能使用聚丙烯注射器具，Ond可 口服用药但不能加入热茶中饮用，是否能与环孢素A(CsA)配伍尚不明确。
参考文献
1，徐济萍，张桂芳，张鉴.奥丹西隆注射液在4种 输液中的稳定性.中国临床药学杂志，1997，6(1)∶31.
2，Bosso JA,Prince RA,Fox JL.Stability of on dansetron hydrochloride in injectable solutions at -20,5,25℃.Am J Hosp Pharm,19 92,49∶2225.
3，Thee SS,Jeona EWS,Chin A,et al.Stability of ondanstron hydrochloride stored in a disposable elastomeric in fu sion device at 4℃.Am J Hosp Pharm,1993,50∶1920.
, 百拇医药
4，王明仲摘.盐酸奥丹西隆与五种抗肿瘤药的配伍 稳定性.国外医药-合成药、生化药、制剂分册，1997，18(3)∶189.
5，Stewart JT,Warren FW,King DT,et al.Stability of ondansetron hydrochloride,doxorubicin hydrochloride,and dacar bazine or vincristine sulfate in elastomeric portable infusion devices and polyv inyl chloride bags.Am J Health-Syst Pharm,1997,54∶915.
6，Fleming RA,Olsen DJ,Savage PD,et al .Stability of ondansetron hydrochloride and cyclophosphamide.Am J Health- Syst Pharm,1995,52(5)∶516.
, 百拇医药
7，徐济萍，张鉴，张桂芳.昂丹司琼注射剂与环磷 酰胺注射剂的配伍稳定性.中国医院药学杂志，1997，17(6)∶263.
8，Burm JP,Jhee SS,Chin A,et al. Stability of paclitaxel with ondansetron hydrochloride or ranitidine hydrochlori de during simulated Y-site administration.Am J Hosp Pharm,1994,51∶1201.
9，Trissel LA,Martinez JF.Turbidimetric as sessment of the compatibility of taxol with 42 other drugs during simulated Y-s ite injection.Am J Hosp Pharm,1993,50∶300.
, 百拇医药
10，Henry DW,Marshall JL,Nazzaro D,et al .Stability of cisplatin and ondansetron hydrochloride in admixtures for continuo us infusion.Am J Health-Syst Pharm,1995,52∶2570.
11，Trissel LA,Martinez JF.Compatibility of thiotepa (lyophilized) with selected drugs during simulated Y-site administration.Am J H ealth-Syst Pharm,1996,53∶1041.
12，Chung KC,Moon YSK,Chin A,et al.Compa tibility of ondansetron hydrochloride and piperacillin sodium-tazobactam sodium during simulated Y-site administration.Am J Health-Syst Pharm,1995,52∶1554.
, 百拇医药
13，Bosso JA,Prince RA,Fox JL,et al.Compatibility of ondansetron hydrochloride with fluconazole,ceftazidime,azt reonam,and cefazolin sodium under simulated Y-site conditions.Am J Hosp Pharm,1 994,51∶389.
14，Trissel LA,Martinez JF.Compatibility of aztreona m with selected drugs during simulated Y-site administration.Am J Health-Syst Pharm,1995,52∶1086.
15，Patel PR.Compatibility of meropenam with commonl y used injectable drugs.Am J Health-Syst Pharm,1996,53∶2853.
, 百拇医药
16，Hutchings SR,Rusho Wj,Tyler LS.Compatibility of cefmetazole sodium with commonly used drugs during Y-Site delivery.Am J Health -Syst Pharm,1996,53∶2185.
17，Trissel LA,Xu QY,Martinez JF,et al.C ompatibility and stability of ondansetron hydrochloride with morphine sulfate an d with hydromorphine hydrochloride in 0.9% sodium chloride injection at 4,22,and 32℃.Am J Hosp Pharm,1994,51∶2142.
18，Trissel LA,Gilbert DL,Martinez JF,et al.Compatibility of remifentanil hydrochloride with selected drugs during simul ated Y-site administration.Am J Health-Syst Pharm,1997,54∶2192.
, 百拇医药
19，Trissel LA,Martinez JF,Gilbert DL.Compatibility of cisatracurium besylate with selected drugs during simulated Y-site administr ation.Am J Health-Syst Pharm,1997,54∶1735.
20，Kirkham JC,Rutherford ET,Cunningham GN,et al.Stability of ondansetron hydrochloride in a total parenteral nutrient a dmixture.Am J Health-Syst Pharm,1995,52∶1557
21，Trissel LA,Gilbert DL,Martinez JF,et al.Compatibility of parenteral nutrient solutions with selected drugs during si mulated Y-site administration.Am J Health-Syst Pharm,1997,54∶1295.
, http://www.100md.com
22，Najari Z,Rusho Wj.Compatibility of commonly used bone marrow transplant drugs during Y-site delivery.Am J Health-Syst Pharm,19 97,54∶181.
23，Graham CL,Dukes GE,Fox JL,et al.Stab ility of ondansetron hydrochloride injection in extemporaneously prepared oral s olutions.Am J Hosp Pharm,1993,50∶106.
24，Yamreudeewong W,Danthi SN,Hill RA,et al.Stability of ondansetron hydrochloride injection in various beverages.Am J H ealth-Syst Pharm,1995,52∶2011.
, http://www.100md.com
25，Pompilio FM,Fox JL,Inagaki K,et al.S tability of ranitidine hydrochloride with ondansetron hydrochloride or fluconazo le during simulated Y-site administration.Am J Hosp Pharm,1994,51∶394.
26，Mcguire TR,Narducci WA,Fox JL.Compatibility an d stability of ondansetron hydrochloride,dexamethasone,and lorazepam in injectab le solutions.Am J Hosp Pharm,1993,50(7)∶1410.
27，Evrard B,Ceccato A,Gaspard O,et al.S tability of ondansetron hydrochloride and dexamethasone sodium phosphate in 0.9% sodium chloride injection and in 5% dextrose injection.Am J Health-Syst Pharm, 1997,54∶1065.
, http://www.100md.com
28，Hagan RL,Mallett MS,Fox JL.Stability of ondanset ron hydrochloride and dexamethasone sodium phosphate in infusion bags and syring es for 32 days.Am J Health-Syst Pharm,1996,53∶1431
29，Alex S,Gupta SL,Minor JR,et al.Compa tibility and activity of aldesleukin(recombinant interleukin-2) in presence of selected drugs during simulated Y-site administration:Evaluation of three metho ds.Am J Health-Syst Pharm,1995,52∶2423.
30，Trissel LA,Martinez JF.Compatibility of amifosti ne with selected drugs during simulated Y-site administration.Am J Health-Syst Pharm,1995,52∶2208.
收稿日期：1998-04-06, http://www.100md.com
单位：湖北襄樊市中心医院药学部 襄樊 441021
关键词：
中国现代应用药学000233 盐酸奥丹西隆(Ondansetron hydrochloride,Ond)为英国葛兰素公司1989年开 发成功的高度选择性5-HT3受体拮抗剂，商品名为枢复宁(zofran)，用于放疗、化疗时镇 吐效果显著。我国宁波天衡制药厂自1996年正式生产，商品名枢丹。由于肿瘤患者用药的复 杂性，许多学者竟相研究了Ond常用浓度(0.03～0.3mg/ml)下与其它药物的配伍性，本文予 以综合介绍(见表1)，以利用药参考。
表1 盐酸奥丹西隆与其它药物配伍的稳定性 配伍药物
浓度/mg.ml-1
, http://www.100md.com
溶媒
Ond浓度
/mg.ml-1
容器
贮存条件
观察
指标
稳定
时间
参考
文献
10%葡萄糖(10%GS)
, 百拇医药 0.08
d
室温
Y
>24h
1
5%葡萄糖(5%GS)
0.03，0.3
-20℃,5℃,25℃
Y
> 24h
2，3
生理盐水(NS)
, 百拇医药
0.03，0.08，0.3
d
-20℃，5℃，25℃
Y
>24h
1，2
葡萄糖氯化钠注射液
0.08
d
室温
Y
>24h
1
, 百拇医药
复方氯化钠注射液
0.08
d
室温
Y
>24h
1
盐酸阿霉素
0.1，2
5%GS
0.03，0.3
a
室温，日光灯下
, 百拇医药
Y
>24h
4
阿糖胞苷
0.2，40
5%GS
0.03，0.3
a
室温，日光灯下
Y
>24h
4
1Δ
, 百拇医药
达卡巴嗪
1，3
5%GS
0.03，0.3
a,c
4℃，30℃，日光灯 下
Y
4～8h
4，5
依托泊苷
0.1，0.4
5%GS
0.03，0.3
, 百拇医药
a
室温，日光灯下
Y
>24h
4
甲氨蝶呤
0.5，6
5%GS
0.03，0.3
a
室温，日光灯下
Y
>24h
, http://www.100md.com
4
2Δ
硫酸长春新碱
0.014，0.028
NS
0.048，0.096
a,c
4℃，3 0℃
Y
>24h
5
环磷酰胺
0.3，2
, http://www.100md.com
5%GS，NS
0.05，0.4
4℃，25℃
Y
>4d
6，7
紫杉醇
1.2
5%GS
0.3，7.29
b
23℃
Y
, 百拇医药
>4h
8，9
顺铂
0.200，0.455
NS
1.091，0.480
a
2～8℃，30℃
Y
>24h
10
噻替哌
1
, 百拇医药
5%GS
1
b
23℃；高、低照度光
X
>4h
11
哌拉西林-他唑巴坦
40-5，80-10
NS
0.03，0.1，0.3
b
23 ℃,室光
, 百拇医药
Y
>4h
12
氨曲南
20，40
5%GS
0.015，0.15，1
b
25℃
X
>4h
13，14
头孢塔齐定(碳酸钠盐)
, 百拇医药
20
5%GS
0.015，0.15
b
25℃
X
>4h
13
头孢唑啉钠
10
5%GS
0.015，0.15
b
, http://www.100md.com
25℃
X
>4h
1 3
氟康唑
1
NS
0.015，0.15
b
25℃
X
>4h
13
, http://www.100md.com 3Δ
米诺配能(meropenam)
1，20，50
NS
1
b,d
室温，日光灯 下
X
0(沉淀)
15
头孢美唑钠
100
NS
, 百拇医药
2
a,b,c
室温，日光灯下
X
>1h
16
硫酸吗啡
1
NS
0.1，1.0
4℃,22℃
X
>31d
, 百拇医药
17
盐酸二氢吗啡
0.5
NS
0.1，1.0
4℃,22℃
X
>31d
17
remifentanil hydrochloride
0.025，0.25
NS
, http://www.100md.com 1
b
23℃
X
>4h
18
苯碳酸顺阿曲库铵
0.1，2，5
5%GS
1
b
23℃，高低照度光
X
, 百拇医药
>4h
19
TPN(或PN)
NS
0.03，0.3，1
b
室温，日光灯下
Y
>4 8h
20，21
4Δ
CsA
1.5
, 百拇医药
NS
0.32
b,d
室温，日光灯下
X
?
22
盐酸多巴胺
0.8
NS
0.32
b,d
室温，日光灯下
, 百拇医药
X
>5h
22
肝素钠
100u/ml
NS，5%GS
0.32
b,d
室温，日光灯下
X
>5h
22
5Δ
, 百拇医药
苹果汁、橘汁、果酒、樱桃
饮料、碳酸类软饮料
0.067-2
d
-3～28℃
Y
>1h
23，24
盐酸雷尼替丁
0.2，2.0
5%GS
0.03，0.1，0.3
, 百拇医药
b
23℃
Y
>4h
8，25
6Δ
地塞米松
0.20，0.40
NS，5%GS
0.10，0.2，0.4，0.64[ HT6”〗
a
2～6℃，23℃
Y
, 百拇医药
>48h
26～28
劳拉西泮
0.004
5%GS
0.016,0.08
d
25℃
Y
>24h
26
aldesleukin(重组白介素-2)
33800IU/ml
, 百拇医药
5%GS
0.7
b
室温， 日光灯下
Z
>2h
29
amifostine
10
5%GS
1
b
23℃
, 百拇医药
X
>4h
30
注：a-直接混合于PVC袋内；b-模拟输液装置Y部等体积混合贮于PVC袋中 ；c-在聚 异戊二烯输液泵药池中；d-玻璃容器；X-外观；Y-外观及含量；Z-外观、含量及生物效价； 1Δ-Ond、盐酸阿霉素、达卡巴嗪三药配伍，30℃、日光灯下、PVC袋内稳定4～8h，聚异戊 二烯输液泵药池中稳定24h以上；2Δ-Ond、盐酸阿霉素、硫酸长春新碱三药配伍，30℃，日 光灯下，a或c容器内均稳定24h以上；3Δ-Ond 1mg/ml与米诺配能1mg/ml NS溶液配伍无沉淀 ；4Δ-CsA在NS中微粒超限，加入Ond后微粒无明显增加；5Δ-Ond加入热茶(75～85℃)中即 刻变混浊；6Δ-高浓度的Ond(0.64mg/ml)与地塞米松(0.40mg/ml)在聚丙烯注射器中沉淀(低 浓度无)，各浓度在工业聚脂CR3袋内稳定48h以上
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由附表可知，Ond在常用浓度下可与许多药物配伍使用，这对减少患者被穿刺次数、医务人 员工作量、患者不必要液体摄入均具有积极的临床意义。但应用中应注意配伍允许的浓度和 稳定时限。Ond一般不能与米诺配能配伍，与地塞米松配伍不能使用聚丙烯注射器具，Ond可 口服用药但不能加入热茶中饮用，是否能与环孢素A(CsA)配伍尚不明确。
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收稿日期：1998-04-06, http://www.100md.com