TABLE OF Y-SITE DRUG COMPATIBILITY

A risk of incompatibility exists whenever any medication is combined or added to an IV fluid. Please note that
compatibility is not solely a function of the drugs themselves, but can also be dependent on a variety of factors including
the concentration, temperature, storage vehicle, infusion solution, order of mixing, and administration technique.
Compatibility differences have even been reported for different brands of the same drug.

There are generally three types of incompatibilities; physical, chemical, and therapeutic. Physical incompatibilities are
the most easily detected and are noted by visible changes, such as particulate formation, haze, precipitation, color
change, and gas evolution. Chemical incompatibilities are those that result in decomposition of a drug. Loss of
potency of greater than 10% over the defined testing period is considered chemical incompatibility. Most chemical
incompatibilities can be detected only with a suitable analytic method. Therapeutic incompatibilities, in which a drug
combination results in undesirable antagonistic or synergistic pharmacologic activity, are beyond the scope of most
compatibility references.

The purpose of this chart is to provide data in an organized, concise format from which compatibility information can be
accessed quickly and conveniently. Although there are differing types of incompatibilities, the type of incompatibility or
compatibility is not specified in this chart. A designation of compatible indicates that the combination evaluated
appears to be compatible based on the tests performed, whether these tests measured physical, chemical, or both
types of compatibility. All conditions that may affect compatibility cannot be included in such a format and it is not
possible to predict all incompatibilities that may arise. If in doubt please call pharmacy at 1917 or 1885 to obtain more
information as needed.

Legend
C Physically compatible
I Incompatible
Blank Conflicting reports or no data available please call pharmacy at 1917 or 1885 to clarify
a Protect from light
b Testing performed with ethlenediaminetetra-acetic acid (EDTA)-free formulation

* Guidelines adopted from 'Compatibility of commonly used IV Drugs' by Lisa Cayo, PharmD, published in Pharmacy Updated Oct 2015
Practice News, September 20131 Drug Information Service
Changi General Hospital
1
 Ampicillin-sulbactam

Calcium gluconate

Dexmedetomidine

Diphenhydramine
Dexamethasone
Anidulafungin

Ciprofloxacin
Azithromycin

Caspofungin

Clindamycin
Amiodarone

Doxycycline
Dobutamine

Epinephrine

Fluconazole
Daptomycin

Furosemide
Ceftazidime

Ceftriaxone

Gentamicin
Eptifibatide
Atracurium

Famotidine
Ceftaroline
Aztreonam

Dopamine
Ampicillin
Acyclovir

Cefepime
Amikacin

Cefazolin

Diltiazem
Cefoxitin

Fentanyl
Esmolol

Heparin
D5W
Acyclovir C C I C C C I C C I C C C C I C I C C C I I C I I I C C C C C
Amikacin C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C I
Amiodarone C I C C I C C C I C C C C C C C C C C C C C C I
Ampicillin C C C I C C I I I I I C I I
Ampicillin-sulbactam I I C C I C I C C I C
Anidulafungin C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Atracurium C C C C C C C C C C I C C C C C C C C C C C C C C C C C C I C
Azithromycin C I C C C C C C C C C C C C C C C C C C C C C C C
Aztreonam I C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Calcium gluconate C C C C C C C C C C C C C I C C I C C C C C C C C C C C C C C
Caspofungin C C I I C C C C I I I I I I C I C I C I C C C C C C C C C C I C I
Cefazolin C C C C C C C I C C C C C C C C C I I I I C C C C C C C
Cefepime I C C C C C I I C C C C C I I C I C C C
Cefoxitin C C C C C C C I C C C C C C C C C I I C I C C C C C C C C
Ceftaroline C C C C C I C C C C C C C C C C C C C
Ceftazidime C C I C I C C I C C C C C C C C C C I C I C C C C C C C
Ceftriaxone C C C C C C I I C C C I C C C C C I I C C C C C C C C
Ciprofloxacin I C I C C C C I C C I C I C C C C C C C C I C I
Clindamycin C C C C C C C I C C C C C I I C C C C C C C C C C C C C C C C C
Daptomycin I C C C C C C C C C C C C C C C C C C I C C C C C C C C C C C C C C
Dexamethasone C C C C C C I I C C C C C C I C C C C C I I C I C C I C C C C I C
Dexmedetomidine C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
D5W C C I C C C C C I C C C C C C C C I C C C C C C C C C C C C C C C
Diltiazem C C C C C C C C C I C C C C C C C C C C C C C C C C C C C C I C
Diphenhydramine C I C C C C C I I I C I I C C C I C C C C C C C C C C C C I C
Dobutamine I C C I C C C C C I I I C C C I C C C C C C C C C C C C C
Dopamine I C C I C C C C C C I C C C C C C C C C C C C C C C C C C C C C C
Doxycycline C C C I I C C C C C C I I I C C C I C C C C C C C C C C C C I C I
Epinephrine I C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Eptifibatide I C C C C C C C C C C C C C C C C C C C C C C C C C C C I C C
Esmolol I C C C C C C C C C C C C C C I C C C C C C C C C C C C I C C
Famotidine C C C C C C C C I C C C C C C C C C C C C C C C C C C C
Fentanyl C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Fluconazole C C C I C C C C C C C C C C C C C C C C C C C C C C C C C C
Furosemide C C C I C C I C C C C C C I C C C C C I I I C I I C I C
Gentamicin C C I C C C C C C C C C C I C C C C C C C C C C C C C I I
Heparin C I I C C C C I C C C C C C I C C C C C C I C C C C C C C I 2
 Ampicillin-sulbactam

Calcium gluconate

Dexmedetomidine

Diphenhydramine
Dexamethasone
Anidulafungin

Ciprofloxacin
Azithromycin

Caspofungin

Clindamycin
Amiodarone

Doxycycline
Dobutamine

Epinephrine

Fluconazole
Daptomycin

Furosemide
Ceftazidime

Ceftriaxone

Gentamicin
Eptifibatide
Atracurium

Famotidine
Ceftaroline
Aztreonam

Dopamine
Ampicillin
Acyclovir

Cefepime
Amikacin

Cefazolin

Diltiazem
Cefoxitin

Fentanyl
Esmolol

Heparin
D5W
Hydrocortisone C C I C C C C C C C C C C C I C C C C C I C I C C C C C C
Imipenem-cilastatin C C I C C C C C C C I C I C C C C C C C C C C C C C C
Insulin, regular C C C C C C C I C C C C C C C C I C C C C C
Labetalol I C C C C C C C C I I C I C I C C C C C C C C C C C C C C
Levofloxacin I C I C C C C C C C I C I C C C C C C C C C C C C C C C C C C C I C I
Linezolid C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Lorazepam C C C I I C C C I C C C C C C C C C C C C C C C C C C C C C C C C C C
Magnesium sulfate C C I C C C C I C C I I C C I C C C C C C C C C C C C C C
Mannitol C C C C C C C C C C I C C C C C C C C C C C C C C C C C C C C C C
Meropenem C C C C C C I C C C C C C C C C
Methylprednisolone C C C I C C C C I I C C I C C C I C C C C I C C I C C C C C C C
Metoclopramide C C C C C C C C I C C C C C C C C C C C C C C C C C C C C C C C
Metronidazole C C C C C C C C I C C C C C C C C C I C C C C C C C C C C C C C C C C
Midazolam I C C I I C C I C C C C I C C I C C C I C C C C C C C C C C C C I C C
Morphine sulfate C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Nicardipine I C C I I C C I C C C C C C C I C C C C C C C C C C C C C I C
Nitroglycerin C C C C C C C C C C C C C C I C C C C C C C C C C C C C C C
I C C C C C I C C I C C C C C C C I C C C C C C C C C C C
a
Nitroprusside
Norepinephrine C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Octreotide C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Ondansetron I C I I C C C C C C C I C C C C C C C C C C C C C C C C C C C I C C
Pantoprazoleb C C C I C I I C C I I I I C I I I C I I I I
Penicillin G C C C C C C C C C C C C C C C C I C I C C C C C C C C
Phenylephrine I C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Phenytoin I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I
Piperacillin-tazobactam I C I C C C I C I C C C C C I C I C I C C C I C C C C
Potassium chloride C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Propofol C I C C C C C C C I C C C C C C C C C C C I C
Ringers, lactated C C I C C C C C C C C I C C C C C C C C C C C C C C C
Sodium bicarbonate C C I I I I C C I I C C I C C C I C C C C C I I I I I C C C C C C C C
Sodium chloride 0.9% C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Tacrolimus I C C C C C C C C C I C C C C C C C C C C C C C C C C C C C C
Tigecycline C C I C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Tobramycin C C C C C C C C C C C I C C I C C C C C C C C C C C C C C C I
TMP-SMX C I I I C C I I I C I C I I I C I C C I I I I I C I I I I I I
Vancomycin C C C C C C C C C I C C C C C C C C C C C C C I C I
Vasopressin C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
Voriconazole C C C C C C C C C C C I C C C C C C C C C C C C C C C C C C C C C C C 3
 Hydrocortisone sod. succ.

Piperacillin-tazobactam
Penicillin G Potassium

Sodium chloride 0.9%

Sodium bicarbonate
Methylprednisolone
Imipenem-cilastatin

Potassium chloride
Magnesium sulfate

Ringers, lactated
Morphine sulfate
Metoclopramide

Norepinephrine
Insulin, regular

Phenylephrine
Nitroprussidea
Metronidazole

Pantoprazoleb

Voriconazole
Ondansetron
Nitroglycerin
Levofloxacin

Vasopressin
Vancomycin
Tobramycin
Meropenem

Nicardipine

Tigecycline
Tacrolimus
Lorazepam

Midazolam

Octreotide

Phenytoin

TMP-SMX
Labetalol

Linezolid

Propofol
Mannitol
Acyclovir C C C I I C C C C C C I I C I C I C I I I C C C C C I C C C C C C
Amikacin C C C C C C C C C C C C C C C C C C C C C I C C I C C C C C C I C C C
Amiodarone I C C I C C C C C C C C C C C I C I C I C C C C
Ampicillin C C I C C I I C I C C I C I C C I C
Ampicillin-sulbactam I C C I C I I C I C I C C I C
Anidulafungin C C C C C C C I C C C C C C C C C C C C C C C I C C I C C C C C C C
Atracurium C C C C C C C C C C C C C C C C C C I C C I C I I C C C C C C
Azithromycin C C C C C C C C C C I I C C C C C C I C C C C C C C C C
Aztreonam C C C C C I C C C C I C C C C C C C C I C C I C C C C C C C C C C C
Calcium gluconate C C C C C C I C C C C C C C C C C C C I C C C C I C C C C I C C C
Caspofungin C C C C C C C C C I C C C C C I C C C C I I C C I C C C C I C C C
Cefazolin C C C I C C C C C C C C C C C C C C C C I C C C C C C C I C C
Cefepime C C C C C I I C I C I C I I I C C C C I C C C I
Cefoxitin C C I I I C C C C I C C C C C C C C C C C C I C C C I C C C C I C C
Ceftaroline C C I C C C C C C C C C C C C C C C C C C C C
Ceftazidime C C C C C C C C C C C C I C C I C C C C I C C C C C C C I C C
Ceftriaxone C I C I C C I C C C C C C C C C C C C C I C C I C C C C I I C C
Ciprofloxacin I C C I I C C C C C C C I I I C I C I C C C C C C
Clindamycin C C C C C C C C C C C C C C C C C C C I C C C C C C C C I C C C
Daptomycin C I C C C C C C C C C C I C C C I C C C C I C I C C C C C C C C C I C C
Dexamethasone C C C I C C C I C C C C C I C I C C C C C I C C I C C C C C C C I I C C
Dexmedetomidine C C C C C C C C C C C C C C C C C C C C C I C I C C C C C C C C C C C C C
D5W C C C C C C I C C C C C C C C C C C I C C C C C C C C C C
Diltiazem C C C C C C C C C C C C C C C C C C I C C I I C C C C C C C C C
Diphenhydramine C I C C C C C C C I C C C C C C I C C C I C C I C C C C I C C C C I C C C
Dobutamine I C C C C C C C C C C C C C C C I I C I I C C I C C C C I C C C
Dopamine C C C C C C C C C C C C C C C C C C C C C C I C C C I C C C C I C C C
Doxycycline I C C C C C C C C I C C C C C C C C C C C I C I I C C I C C C I C C C
Epinephrine C C C C C C C C C C C C C C C C C C C C C I C C C I C C C C I C C C
Eptifibatide C C C C C C C C C C C C C C C C C C C C I C C C C C C C
Esmolol C C C C C C C C C C C C C C C C C C I C C C C C C C C C C C C C C
Famotidine C C C C C C C C C C C C C C C C C C C I C C I C C C C C C C C I C C C
Fentanyl C C C C C C C C C C C C C C C C C C C C I C C I C C C C C C C C C I C C C
Fluconazole C C C C C C C C C C C C C C C C C C C C I C C C C C C C C C C C I C C C
Furosemide C C I C C C C C C I I C C I C I C C C C C C C C I I C
Gentamicin C C C C C C C C C C C C C C C C C C C C C I C I C C C C C C I C C C
Heparin C C I C C C C C C C C C C C C C C C I C C C C C C C I I I C C 4
 Hydrocortisone sod. succ.

Piperacillin-tazobactam
Penicillin G Potassium

Sodium chloride 0.9%

Sodium bicarbonate
Methylprednisolone
Imipenem-cilastatin

Potassium chloride
Magnesium sulfate

Ringers, lactated
Morphine sulfate
Metoclopramide

Norepinephrine
Insulin, regular

Phenylephrine
Nitroprussidea
Metronidazole

Pantoprazoleb

Voriconazole
Ondansetron
Nitroglycerin
Levofloxacin

Vasopressin
Vancomycin
Tobramycin
Meropenem

Nicardipine

Tigecycline
Tacrolimus
Lorazepam

Midazolam

Octreotide

Phenytoin

TMP-SMX
Labetalol

Linezolid

Propofol
Mannitol
Hydrocortisone C C I C C C C C C C C C C C C C C C I C C C C C C C C I C C
Imipenem-cilastatin C C C C C I C I C C C C I C C C C C C C I C I I C C C I C C
Insulin, regular C C I C C C C C C C C C C C C I I I C C C C C I C C
Labetalol I C I C C C C C C C C C C C C C C C C I C I I C C C C C C C C C C
Levofloxacin C C C C C C C C C C C I I C C I C C I I C I C C C C C C C C C
Linezolid C C C C C C C C C C C C C C C C C C C C I C I C C C C C C C C C C C
Lorazepam C I C C C C C C C C C C C C C C C I I C I C C C C C C C C C C C
Magnesium sulfate C C C C C C C I C C C C C C C C C C C C I C C C C C C C C C C C
Mannitol C I C C C C C C I C C C C C C C C C C C C C I C C C C C C C I C C C
Meropenem C C C C I C C C I C C I I I C C C C C
Methylprednisolone C C C C C C I C C C C C C C C C I C C I C I C C C C I C C
Metoclopramide C C C C C C C C C C C C C C C C C C C C C C I C C I C C C C C C I C C C
Metronidazole C C C C C C C C C C C C C C C C C C C C I C I C C I C C C C C C C C
Midazolam C C C C C C C C C C C C C C C I C C I I C I C C C C I C C C
Morphine sulfate C C C C C C C C C C C C C C C C C C C C C I C C C C C C C C C C C
Nicardipine C I C C C C C I C C C C C C C C C C I C C I I C I I C C I C C C C
Nitroglycerin C C C C I C C C C C C C C C C C C C C C C I C C C C C C C I C C C
Nitroprussidea C C C I C C C C C C C C C C C C C C C C I C C C C C C C C C I C C I
Norepinephrine C C C C C C C C C C C C C C C C C C C C I C C C C I C C C C I C C C
Octreotide C C C C C C C C C C C C C C C C C C C C C I C C C C C C C C C C C
Ondansetron C C C C C I C C C C C C C C C C C I C C I C C C C I C C C C I C C C
Pantoprazoleb C I I I I I I I I I I C I C C C C C I
Penicillin G C C C C C C C C C C C C C C C C I C C C C C I C
Phenylephrine C C I C C C C C C C C C C C C C C C C C C C I C C C C C C C C I C C C
Phenytoin I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I
Piperacillin-tazobactam C I I I C C C C C C C I C I C C C C C C I C C C C C C I C C C
Potassium chloride C C C C C C C C C C C C C C C C C C C C C I C C C C C C C C I C C C
Propofol C C C C I C C I I I C C C C I C C C C I
Ringers, lactated C I C C C I C C I C C C C C C I C C C C C C
Sodium bicarbonate C I C C C C C C I C C C I C I C C I C I C I C C C C C C C I C
Sodium chloride 0.9% C C C C C C C C C C C C C C C C C C C C C C C
Tacrolimus C C C C C C C C C C C C C C C C C C C C C C C I C C C C C C C C
Tigecycline C C C C C C C C C C C C C C I C C C C C C C I C C C C C C C C C C
Tobramycin C C C C C C C C C C C C C C C C C C C C I I C I C C C C C I C C C
TMP-SMX I I I C C I I I C I I I I C I I I I C I I C I I C
Vancomycin C C C C C C C C C C C C C C C C C C C I C C C C C C I C C
Vasopressin C C C C C C C C C C C C C C C C C C C C C C C I C C C C C C C C
Voriconazole C C C C C C C C C C C C C C C C C I C C C I C I C C C C C C C C 5
References

1. Cayo L. Compatibility of commonly used IV Drugs. Pharmacy Practice News. 2013:40:39-46 (adopted from) (Assessed via
http://www.pharmacypracticenews.com/download/IV_drugs_ppnse13_WM.pdf on 9 October 2015)
2. Bertsche T, Mayer Y, Stahl R, Hoppe-Tichy T, Encke J, Haefeli WE. Prevention of intravenous drug incompatibilities in an
intensive care unit. Am J Health Syst Pharm. 2008;65(19):1834-1840
3. Cohen MR, Smetzer JL. ISMP medication error report analysis-drug stability and compatibility; proper use of single-dose vials;
what drugs are present on nursing units?; Arixtranot a hemostat; PradaxaPlavix mix-up. Hosp Pharm. 2012;47(8):578-582
4. Kanji S, Lam J, Johanson C, et al. Systematic review of physical and chemical compatibility of commonly used medications
administered by continuous infusion in intensive care units. Crit Care Med. 2010;38(9):1890-1898
5. DRUGDEX System (Internet database). Greenwood Village, CO: Thomson Reuters (Healthcare) Inc
6. Nemec K, Kopelent-Frank H, Greif R. Standardization of infusion solutions to reduce the risk of incompatibility. Am J Health Syst
Pharm. 2008;65(17):1648-1654
7. Newton DW. Crux of drug compatibility and incompatibility. Am J Health Syst Pharm. 2010;67(2):108-112
8. Singh BN, Dedhiya MG, DiNunzio J, et al. Compatibility of ceftaroline fosamil for injection with selected drugs during simulated Y-
site administration. Am J Health Syst Pharm. 2011;68(22):2163-2169
9. Trissel LA. Handbook on Injectable Drugs, 17th Ed, American Society of Health-System Pharmacists, USA, 2013