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NICU Y-SITE COMPATIBILITY SUMMARY: MEDICATIONS ADMINISTERED WITH DRIPS

Norepinephrine
Aminocaproic

Dobutamine

Vecuronium
Epinephrine

Furosemide
Alprostadil

Octreotide
Dopamine

Morphine
Milrinone
Albumin

Esmolol

Insulin
Lipids
NVN

Acid
10
Acyclovir I I I I I I I C C C C C I
19
Amiodarone I C C C C C C C C C C C
11 12 12
Amphotericin B I I C I I C I C C I I I C I
1 1 13 15 2 2 2
Ampicillin C C C C I I C C C C C C I C C
Caffeine Citrate C C C C C C I C
3
Calcium Chloride V I C C C C C C C C C C C C C
3 1
Calcium Gluconate C C C C C C C C C C C C C C
Caspofungin I I C C C C I C C C C C C
Cefazolin C C C C I I C C C C C C C C C
Cefepime C C I I C C C I C I
12
Cefotaxime C C C C C C C C C C C C C C I
Cefoxitin C C C I C C C C I C C C C C
Chlorothiazide I C I I
Dexamethasone C C C C I C C I C C C C C C C
Famotidine C C C C C C C I I C C C C C
Fenoldopam C C C C C I C C C C C C
Fentanyl C C C C C C C C C C C C C C C
Fluconazole C C C C C C C I C C C C C C
Fosphenytoin C C
4 5 18
Furosemide C C C C C I C C I C I I C C I
Ganciclovir I I I I I I I C C C I I C I
1 2
Gentamicin C C C C C C C C I C C C C C C
2 2 2 15 2 2 15
Hydralazine C C C C C I C C C C C C
16
Hydrocortisone C C C C I C C C C C C C C C C
Ibuprofen I I
Indomethacin I I I I I C C I I
6 7 8
Insulin C C C I C C C C C I C C
Linezolid C C C C C C C C C C C C C
Lorazepam I I C C C C C C C C C C C C C
Meropenem C C C C C C C C C C C C
15
Methylprednisolone C C C C C C C C C C C C C C I
Metronidazole C C C C C C C C C C C C C C C
9 8
Morphine C C C C C C C C I C C C C C
17
Nafcillin C C C C C C C I C C C C I
13 14
Pantoprazole I C C I C C I C C I C I C I
Phenobarbital I I C C I C I I C C C C I C C
Piperacillin/Tazobactam C C C I C C C C I C C C C I
Propranolol C C C C C C I C C C C C
Sodium Bicarbonate I C C I I I C C C C C I C C
Theophylline C C C C C C C C C C C
Vancomycin C C I C C C C C C I C C C C C C
Vecuronium C C C C C C C I C C C C C
C= Compatible (if footnoted, read footnote on next page for conditions required for compatibility); I= Incompatible; Blank= no information available

Revised: Drug Information Center, Sarah Tierney, PharmD: 3/12


1-Compatible with lipids/NVN together; not compatible with NVN or lipids alone
2-Compatible only if both in NS base (not dextrose)
3-Compatibility depends on the concentrations of both calcium & phosphate in NVN
4-Make sure in-line filter is below the y-site
5-Compatible with furosemide concentrations ≤ 5 mg/ml and dopamine concentrations ≤ 12.8 mg/ml in NS; compatible in D5W if citrate is not in
the dopamine product (Hospira and Baxter products do not contain citrate and are compatible)
6-Compatible with insulin concentrations ≤ 1 unit/ml and dobutamine concentrations ≤ 4 mg/ml
7-Compatible with epinephrine concentrations ≤ 0.5 mg/ml and insulin concentrations ≤ 50 units/ml in NS only; not compatible in D5W
8-Compatible with insulin concentrations ≤ 1 unit/ml and morphine concentrations ≤ 5 mg/ml
9-Compatible if morphine concentration is 1 mg/ml.
10-Compatible with morphine concentration ≤ 0.08 mg/ml and acyclovir concentration ≤ 5 mg/ml
11-Compatible with amphotericin B concentration ≤ 0.4 mg/ml and epinephrine concentration ≤ 0.008 mg/ml
12-Compatible only if both in D5W; incompatible in NS or D5½NS
13-Compatible with morphine concentrations ≤ 10 mg/ml
14-Compatible with pantoprazole concentrations ≤0.8 mg/ml and octreotide ≤0.005 mg/ml in D5W only
15-Compatible when esmolol or norepinephrine in NS; incompatible when in D5W
16-Compatible when esmolol concentration ≤ 10 mg/ml in D5W; incompatible when in NS
17-Compatible when both products are in NS or both products in D5W
18-Compatible when furosemide undiluted (10 mg/ml) and norepinephrine in D5W
19-Compatible when furosemide concentration ≤ 1 mg/ml in D5W

The compatibility information shown in this chart refers to the combination of these drugs in D5W, NS, or combinations of D5W and NS. Do NOT
administer the solution if any physical change is noted (i.e., precipitate, color change, foaming, haziness). All NVN combinations are for standard
NVNs (dextrose, amino acids, multivitamins, trace elements, with standard electrolytes). If the NVN has additional additives, call pharmacy for
compatibility information. Compatibility information for other drugs may be obtained by calling pharmacy.

If the medication is designated as incompatible with the corresponding IV fluids (IVF), it may be appropriate to obtain an order to interrupt
the IVF for intermittent medication administration. Turn stop-cock off to IVF and clear the line with flush before and after administering
the medication over the recommended delivery time. If micro-tubing is used, enough flush will be required to clear the micro-tubing of
medication after administration, then open the stop-cock and resume IVFs. Refer to specific medications in "Pediatric IV Medication
Administration Guidelines" in the Formulary and Handbook.

Revised: Drug Information Center, Sarah Tierney, PharmD: 3/12


NICU Y-SITE COMPATIBILITY SUMMARY: DRIP- DRIP SUMMARY

Norepinephrine
Albumin (25%)

Aminocaproic

Dobutamine

Vecuronium
Epinephrine

Furosemide
Alprostadil

Octreotide
Dopamine

Morphine
Milrinone
Esmolol

Insulin
D10W
Lipids

D5W
NVN

Acid
1 2
NVN C C C C C C C C C C C C C C C
4 3 4
Lipids C C I C C C C C C C

D5W C C C C C C C C C C C C C C C C
4
D10W C C C C I C C C C C

Albumin (25%) C I C C C
1
Alprostadil C C I C C C C C C

Aminocaproic Acid C C C C C C C C C C C
5
Dobutamine C C C C C C C C I C C C C C C
6
Dopamine C C C C C C C C C C I C C C C C
7
Epinephrine C C C C C C C C C C C C C C C

Esmolol C C C C C I C I C C C C
2 6 9
Furosemide C C C C C C C I C C I C I I C C I
5 7 8
Insulin C C C C C I C C C C C I C C

Milrinone C C C C C C I I C C C C C
3 8
Morphine C C C C C C C C C I C C C C C
9
Norepinephrine C C C C C C C C I C C C C
4
Octreotide C C C C C C C C C C C C C C

Vecuronium C C C C C C C C I C C C C C

C = Compatible (if footnoted, read footnote for conditions required for compatibility); I = Incompatible; Blank = no information available

1-NVN with max dextrose of 20%


2-Make sure in-line filter is below the y-site
3-Compatible if morphine concentration is ≤ 1 mg/ml.
4-Compatible with lipids/NVN together; not compatible with lipids alone
5-Compatible with insulin concentrations ≤ 1 unit/ml and dobutamine concentrations ≤ 4 mg/ml
6-Compatible with furosemide concentrations ≤ 5 mg/ml and dopamine concentrations ≤ 12.8 mg/ml in NS; compatible in D5W if citrate is not in
the dopamine product (Hospira and Baxter products do not contain citrate and are compatible)
7-Compatible with epinephrine concentrations ≤ 0.5 mg/ml and insulin concentrations ≤ 50 units/ml in NS only; not compatible in D5W
8-Compatible with insulin concentrations ≤ 1 unit/ml and morphine concentrations ≤ 5 mg/ml
9-Compatible when furosemide undiluted and norepinephrine in D5W

The compatibility information shown in this chart refers to the combination of these drugs in D5W, NS, or combinations of D5W and NS. Do NOT
administer the solution if any physical change is noted (i.e., precipitate, color change, foaming, haziness). All NVN combinations are for standard
NVNs (dextrose, amino acids, multivitamins, trace elements, with standard electrolytes). If the NVN has additional additives, call pharmacy for
compatibility information. Compatibility information for other drugs may be obtained by calling pharmacy.

References:
Am J Hosp Pharm.1984; 41:893-911.
J Pediatr Pharmacol Ther. 2006; 11:233-36.
Journal of Parenteral and Enteral Nutrition. 1999; 23:67-74.
Micromedex® Healthcare Series [Internet database]. Greenwood Village, CO: Thomson Reuters (Healthcare) Inc. Updated periodically
Neofax 23rd edition, 2010
Trissels 16th edition, 2011
Revised: Drug Information Center, Sarah Tierney, PharmD: 3/12

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