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AlixaRx Resources

Phlebogenic Medications

 
Some therapies are not appropriate for short peripheral catheter administration and are recommended to be infused via a central venous access device.  Therapies not appropriate for short peripheral catheter administration include continuous vesicant infusions, parenteral nutrition, infusates with a pH of less than 5 or greater than 9, and infusates with an osmolality greater than 600 mOsm/L.   Additional medications are listed below that have a documented history of causing peripheral phlebitis.  
 
 
This reference correlates to the online continuing education courses in our Infusion Section.



MEDICATION GENERIC/BRAND DILUENT pH mOsmol/L
Acyclovir / Zovirax NS @ 5mg/ml 10.5 - 11.6 316
Amiodarone / Cordarone D5W @ 2mg/ml 4.1  
Amphotericin B D5W @ 0.1mg/ml 5.7 256
Amphotericin B / Albecet D5W @ 1-2mg/ml 5.5 - 6 ~280
Amphotericin B / Ambisome D5W @ 1-2mg/ml 5 - 6 ~280
Amphotericin B / Amphotec D5W @ 0.2-0.8mg/ml 5 - 6 ~280
Ampicillin – Sulbactam / Unasyn NS 100ml 9 (8 - 10) ~400
Amrinone / Inocor  NS @ 2.5mg/ml 3.2 - 4 ~300
Azithromycin 500 mg / Zithromax NS @ 2mg/ml 6.4 - 6.8 ~280
Aztreonam/Azactam NS @ 10mg/ml 4.5 - 7.5  
Caspofungin / Cancidas NS @ 0.28-0.35 mg/ml 6.6  
Cefepime / Maxipime NS @ 5mg/ml 4 - 6  
Cefotaxime / Claforan NS @ 20mg/ml 5 - 7.5 350
Cefotetan / Cefotan NS @ 20mg/ml 4.5 -6.5 ~400
Cefoxitin / Mefosine NS @ 20mg/ml 4.2 - 7 ~325
Ceftazidime / Ceptaz NS @ 20mg/ml 5 - 8 330
Ceftizoxime / Cefizox NS @ 20mg/ml 6 - 8 ~400
Cefuroxime / Ceftin NS @ 15mg/ml 4.5 - 7.3 335
Ciprofloxacin 200 mg / Cipro D5W 100 ml 3.3 - 4.6 285
Ciprofloxacin 400 mg / Cipro D5W 200 ml 3.3 - 4.6 285
Cladrabine / Leustatin NS 500 ml 5.7 - 8 ~300
Clindamycin / Cleocin NS @ 6mg/ml 5.7 - 7 ~300
Dexrazoxane / Zinecard NS @ 5mg/ml 3.5 - 5.5  
Dobutamine HCL NS @ 4mg/m1 3.5 (2.5 - 5.5) 280
Docetaxel / Taxotere NS 0.3-0.9mg/ml    
Dolasetron / Anzemet SW @ 20mg/ml 3.2 - 3.8 285
Dopamine HCL D5W 3.3 (2.5 - 4.5) 277
Doxycycline / Vibramycin IV NS @ 1 mg/ml 1.8 - 3.3 310
Erythromycin 500 mg NS 100 ml 7 (6.5 - 7.7) 291
Erythromycin 1 gm NS 250 ml 7 (6.5 - 7.7) 290
Etoposide / VePesid NS 0.2-0.4 mg/ml 3 - 4  
Etoposide phosphate / Etopophos NS 10mg/ml 3 - 4 ~290
Foscarnet / Foscavir SW @ 24mg/ml 7.4 271
Fosphenytoin / Cerebyx NS @1.5-25PE/ml 8.6 - 9  
Fluconazole / Diflucan NS @ 2mg/ml 4 - 7 -300
Ganciclovir < 500 mg / Cytovene NS 100 ml 11.0 320
Gatifloxacin / Tequin (removed from US market) D5W 10mg/ml 3.5 - 5.5  
Hemin for injection / Panhematin SW @ 7mg/ml 8 - 9.5 ~300
Imipenem-cilastatin / Primaxin NS @ 5mg/ml 6.5-7.5 310
Iron Dextran Intravenous / Infed NS @ 50mg/ml 5.2 - 6.5 2000
Iron Dextran Intravenous / Infed NS @ 0.1mg/ml 5.2 - 6.5  
Itraconazole / Sporanox NS 3.3mg/ml 4.8  
Levofloxacin 250 mg / Levaquin D5W 50 ml 3.8 - 5.8 ~250
Levofloxacin 500 mg / Levaquin D5W 100 ml 3.8-5.8 ~250
Meropenem / Merram NS @ 5mg/ml 7.3 - 8.3 ~300
Methicillin 1 gm SWI 10 ml 7.6 (6 - 8.5) 510
Methicillin 2 - 3 gm 100 ml NS 7.6 (6 - 8.5) 371 - 415
Mitoxantrone / Novantrone NS @ 0.2mg/ml 3 - 4.5 ~300
Morphine Sulfate NS 10mg/ml 4 (2.5 - 6.0) 295
Nafcillin 1 - 3 gm NS 100 ml 6-8.5 361 - 398
Nafcillin 1 - 2 gm Frozen Dextrose 50ml 6.7 - 7.2 276 - 324
Oxacillin 1 gm SWI 10 ml 6-8.5 398
Oxacillin 1 - 2 gm NS 100 ml 6-8.5 321 - 356
Oxacillin 1 - 2 gm Frozen Dextrose 50ml 6.8 - 7.2 270 - 324
Pamidronate /Aredia NS @ 0.09mg/ml 6 - 7.4 ~300
Parenteral Nutrition Amino acids-dextrose-fat 5.5 >600
Parenteral Nutrition Amino acids-dextrose 5.3 - 6.3 >800
Pentamidine IV D5W @ < 3mg/ml 4 - 4.4 455
Phenytoin / Dilantin NS @ 5mg/ml 12 312
Potassium chloride premix 0.4 mEq/ml 5.0 800
Potassium chloride premix 0.3 mEq/mi 5.0 600
Quinupristin-dalfopristin/Sinercid 05W @ 2mg/ml 4.5 – 5  
Sulfamethoxazole-Trimethoprim /Bactrim D5W 100ml 10 541
Vancomycin / Vancocin NS @ 5mg/ml 2.5 -4.5 290
Vinorelbine / Navelbine D5W @ 1.5-3mg/ml 3.5  
Zidovudine / Retrovir D5W @ 4mg/ml 5.5 ~260