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Technology (including: robots for production, Incompatibilities, drug production and analytics, CRS)
Microwave freeze-thaw treatment of cytotoxic and hazardous injectable drugs: a review of the literature from 1980 to 2011
  1. J.D. Hecq,
  2. J. Jamart,
  3. L.M. Galanti
  1. 1CHU Mont-Godinne, Hospital Pharmacy, Yvoir, Belgium
  2. 2CHU Mont-Godinne, Scientific support unit, Yvoir, Belgium
  3. 3CHU Mont-Godinne, Medical laboratory, Yvoir, Belgium

Abstract

Background Microwave freeze-thaw treatment (MFTT) of injectable drugs can support the development of centralised intravenous admixtures services (CIVAS).

Purpose The aim of the review was to collect information and results about MFTT of cytotoxic and hazardous drugs.

Materials and methods The scientific literature about drug stability studies was systematically reviewed. The data were presented in a table and described the name of the drug, producer, final concentration, temperature and time of frozen storage, type of microwave oven, thawing power, method of evaluating the concentration and results after treatment or final long-term storage at 2-8°C.

Results From 1980 to 2011, 8 drugs (cyclophosphamide, cytarabine, doxorubicin, epirubicin, fluorouracil, ganciclovir, methotrexate sodium, Mitomycin C) were studied by MFTT and the results were presented in 8 publications. The frozen storage temperature varied from –20°C to – 30°C, the storage time from 11 to 364 days, the microwave power from moderate to full power. The concentrations were mainly found by High Performance Liquid Chromatography. The 8 drugs were stable during and after the treatment. However, mitomycin needs to be stored at – 30°C. Only 2 research teams have tested the long term stability after MFTT, the first for ganciclovir after 7 days, the second for fluorouracil after 28 days. 6 drugs were tested after one to 11 cycles of refreezing and rethawing, with loss < 5%.

Conclusions This review may help hospital pharmacists to undertake the production of 8 dose-banded ready-to-use injectable cytotoxic and hazardous drugs. Freezing enhances their long-term stability. Validated microwave thawing reduces the time taken to defrost these drugs at the concentrations tested without altering their chemical stability.

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