Administration guidelines for general intravenous medications at SIVUH.pdf (Updated 04Aug2023).pdf

Pharmacy Department. IV Administration Guidelines (Excludes Antimicrobial Drugs) Updated 04 August 2023
This information has been summarised to act as a guide for those administering IV medications at SIVUH only.
These guidelines should be used in conjunction with the drug data sheet (SPC) and BNF for information on dose, adverse effects, cautions contraindications. See www.hpra.ie, www.medicines.ie, or
www.medicines.org.uk for drug data sheets (SPCs) and information leaflets, other references used include Injectable drug information available on Medicines complete.
Drug IV Injection Guidelines IV Infusion Guidelines
Abatacept
250mg
Brand: Orencia
License no:
EU/1/07/389/1‐3
See Intranet: Departments > Pharmacy > Aseptic Services > Orencia®
http://www.sivuh.com/Departments/PharmacyMedicinesManagement/AsepticServices/Page1.html
Acetazolamide
500mg powder
Brand: Diamox
License no: PL 12762/0146
Unlicensed
Reconstitute each vial with 5ml of WFI.
Give slowly over 3 to 5 minutes.
May cause venous irritation and tissue damage. Administer via a
central venous access device where possible. If a central venous
access device is unavailable, administer via a large peripheral vein.
Reconstituting each vial with 10ml WFI may reduce injection pain.
Acetylcysteine
2g/10ml
Brand: Parvolex
License no:
PA1113/008/001
Administer by IV infusion preferably using Glucose 5% as the infusion fluid.
Sodium Chloride 0.9% solution may be used if Glucose 5% is not suitable.
See package insert for information on dosing and infusion rates.
Additrace N
10ml ampoule
Brand: Additrace N
License no:
PA2059/023/002
See Intranet: Departments > Pharmacy > Nutrition and Dietetics > DIET0002ORG
Guideline on the provision of Parenteral Nutrition in adult patients in SIVUH
http://www.sivuh.com/Departments/PharmacyMedicinesManagement/Administration/NutritionandDietetics/
Adenosine
3mg/ml
Brand: Adenocor
License no:
PA0540/139/001
Use the pre‐filled syringe where available.
Use ampoules undiluted. Administer via a rapid IV bolus over 2
seconds either directly into a central or a large peripheral vein
(large bore cannula) or into an IV line. If given into an IV line, it
should be injected as close to the cannulation site as possible, and
followed by a rapid Sodium Chloride 0.9% flush.
Adenosine should only be used where facilities for cardiac
monitoring and cardiorespiratory resuscitation equipment exist.

Adrenaline
1mg/ml (1:1,000)
Brand: Mercury
License no:
PA0073/035/001
Use the pre filled syringe where available.
Dilute 1mg (1ml) ampoule to 10ml with WFI (i.e. use 9ml WFI). Mix
well. Administer via a central venous access device if already in
place, or into a large peripheral vein. IV injection administered via a
peripheral vein should be followed by a 20ml flush of Sodium
Chloride 0.9% to aid entry into the central circulation.
Adrenaline ampoules are compatible with Sodium Chloride 0.9% or Glucose 5%.
For continuous IV infusion prepare a solution containing:
 3mg in 50ml, this contains 60microgram/ml
OR
 6mg in 50ml, this contains 120microgram/ml
Administer at a suitable rate and titrate to response.
Alteplase
2mg
Brand: Actilyse Cathflo
License no: N/A
Unlicensed
Add 2.2ml WFI to each 2mg vial.
For catheters with a lumen volume of >2ml the reconstitued
solution can be further diluted with sterile 0.9% Sodium Chloride to
the desired volume (up to a minimal concetration of 0.2mg/ml), e.g.
for a catether with an internal volume of 2.5ml the total dose of
Actilyse Cathflo would be 2mg in a volume of 2.5ml. Instill in the
dysfunctional central venous access device for 30 mins then follow
the instructions of the product literature.
Alteplase
10mg vial
50mg vial
Brand: Actilyse
License no:
PA0775/011/001 (10mg)
PA0775/011/003 (50mg)
May be administered as an IV bolus over 1‐2 minutes. Dissolve with WFI to obtain either a final concentration of 1 mg/ml or 2 mg/ml:
 10mls WFI to 10mg amp = 1mg/ml
May be diluted further with sterile Sodium Chloride 0.9% up to a minimal
concentration of 0.2 mg/ml. See package insert for further information and
specific detail.
Aminophylline
250mg/10ml
Brand: Mercury
License no:
PA0073/099/001
Slow IV injection should only be used for loading doses at a rate not
exceeding 25mg/min. Typically given over 20‐30 minutes.
Dilute in 100ml Sodium Chloride 0.9% or Glucose 5%. May be given
undiluted in fluid restricted patients, ideally via central line.
Give maintenance doses by IV infusion. Dilute with appropriate volume of
Sodium Chloride 0.9% or Glucose 5% to give a concentration of 1mg/ml.
See SPC for information on rate of infusion which is dependant on dose and
weight of patient.

Amiodarone
150mg/3ml
Brand: Cordarone X
License no:
PA0540/142/003
Use the prefilled syringe where available.
If unavailable in an emergency: dilute 150‐300mg in 10‐20ml
Glucose 5%. Give as a slow IV injection over a minimum of 3
minutes. This should not be repeated for at least 15 minutes.
Patient should be closely monitored, i.e. in an ICU setting. Flush
with 5% Glucose.
Amiodarone is incompatible with Sodium Chloride 0.9%
Intermittent infusion: dilute dose in 250ml Glucose 5% and give over a period of
20 minutes to 2 hours.
Continuous infusion: dilute dose in 500ml Glucose 5% and give over 24 hours,
the rate of infusion being adjusted on the basis of clinical response.
Amiodarone is incompatible with Sodium Chloride 0.9%
Atenolol
5mg/10ml
Brand: Tenormin
Unlicensed
Can be used undiluted. Give as a slow IV injection (1mg/min). Administer in either Sodium Chloride 0.9% or Glucose 5% over a minimum of 20
minutes.
Atropine
600mcg/ml
Brand: Martindale
License no:
PL 01883/6169R
Use the 0.5mg/5ml prefilled syringes where available.
Ampoules can be used undiluted. Give as a rapid IV injection.
May cause paradoxical bradycardia if given by slow IV injection.
In emergency situations: if using a peripheral line, give the injection
rapidly and flush with 20mls of Sodium Chloride 0.9%.
Calcium Chloride
10mmol/10ml
Brand: Martindale
License no: PL
01883/6174R
Unlicensed
Initial dose can be given by slow IV injection at a rate not exceeding
1 millimole/min (up to 10 millimoles).
Calcium gluconate salt preferred (see below). Contact pharmacy if further
information required.
Calcium Gluconate
2.2mmol/10ml (10%)
Brand: Hameln
Unlicensed
Can be given undiluted as a slow IV push. Give at rate of 2ml (0.45
mmol Calcium)/min.
Monitoring should include heart rate or ECG.
Intermittent infusion: dilute 10ml (1 ampoule) of 10% calcium gluconate with
100ml of Sodium Chloride 0.9% or Glucose 5% and infuse over at least 20
minutes (consider giving more slowly i.e. over 2 hours).
Continuous infusion: dilute 100ml (10 ampoules) with 900ml Sodium Chloride
0.9% or Glucose 5%. Start the infusion at an initial rate of 50ml/hour and adjust
according to response.

Chlorphenamine
10mg/ml
Brand: Kyowa Kirin
License no:
PA2288/001/002
Give as a slow IV injection over at least 1 minute.
Use undiluted or dilute with Sodium Chloride 0.9% to facilitate
administration. Dilute 1ml (10mg) to 10ml with Sodium Chloride
0.9%.
Clonidine
150mcg/ml
Brand: Catapres
License no:
PA2256/002/001
Can be used undiluted. Give as a slow IV injection over 10‐15
minutes.
Dilute in Glucose 5% or Sodium Chloride 0.9% and infused over 10‐15 minutes.
Cyclizine
50mg/ml
Brand: Valoid
License no:
PA1142/001/001
Give as a slow IV injection over at least 3 minutes. Can use
undiluted.
To prevent injection site reactions dilute with 10ml WFI and give by
slow IV injection over 3 to 5 minutes.
Not licensed for administration as an infusion.
Desferoxamine
500mg
Brand: Desferal
License no:
PA0896/008/001
Reconstitute each 500mg vial with 5ml WFI. Further dilute with 100ml Sodium
Chloride 0.9% or Glucose 5% (volume not critical).
See SPC for information on rate of infusion which is dependant on dose and
weight of patient.
Desmopressin
4mcg/ml
Brand: DDAVP
License no:
PA1009/001/002
For treatment of cranial diabetes insipidus the injection may be
used when the intranasal or oral administration is considered
unsuitable. Administer slowly over 3‐5 minutes. Bolus intravenous
injection may only be used for this indication, subcutaneous and
intramuscular routes may be used similarly. See SPC for further
information.
Dilute in 50ml Sodium Chloride 0.9% and give over 20 minutes.
Residual volume in infusion line must be flushed through at the same rate to
avoid significant under‐dosing.
Dexamethasone
8mg/2ml
Brand: Pinewood, KRKA
License no:
PA0281/237/002 (Pinewood)
PA1347/091/001 (KRKA)
Pinewood: Rapid IV injection of large doses may cause
cardiovascular collapse, therefore give slowly over a period of
several minutes.
KRKA: Give as a slow IV injection over 2‐3 minutes.
Dilute in 100ml Sodium Chloride 0.9% or Glucose 5% and administer over 15‐20
minutes.
Administer over 20‐30 minutes if underlying cardiac pathology. See Renal Drug
Handbook 4th Ed for more details.

Dexketoprofen
50mg/2ml
Brand: Keral
License no:
PA0865/002/003
Use undiluted.
If necessary 50mg (2ml) can be administered as a slow IV bolus over
at least 15 seconds. Should only be short‐term use and no longer
than 2 days.
(Can also be administered via the IM route – see product
information)
Dilute in 50‐100ml Sodium Chloride 0.9% or Glucose 5%. Administer as a slow IV
infusion over 10‐30 minutes. Protect from light.
Diazepam
10mg/2ml
Brand: Hameln
License no: PL01502/0025
Use undiluted. Give as a slow IV injection, max rate 1ml/min, into a
large vein of the antecubital fossa.
IV injection may be associated with local reactions and
thrombophlebitis and venous thrombosis may occur.
Dilute with 0.9% Sodium Chloride or Glucose 5%.
Add ≤40mg diazepam to 500ml infusion solution (i.e. a maximum concentration
of 80 micrograms diazepam /ml).
Diclofenac
75mg/3ml
Brand: Diclac
License no:
PA0711/009/010
Do NOT administer as IV injection. Dilute one ampoule in 100‐500 ml Sodium Chloride 0.9% or Glucose 5%.
Administer over at least 30 minutes.
Buffer the Sodium Chloride 0.9% or Glucose 5% with Sodium Bicarbonate
injectable solution (0.5ml of 8.4% or 1ml of 4.2% or a corresponding volume of a
different concentration), before adding the Diclac ampoule.
Digoxin
500mcg/2ml
Brand: Lanoxin
License no:
PA1691/001/001
IV infusion is preferred but if essential may be administered as
follows:
 Use 500mcg/2ml injection undiluted and give as a slow IV
injection over at least 5 minutes.
 Slow IV Injection is advised to reduce the risk of
vasoconstriction producing hypertension and/or reduced
coronary flow.
 Can be diluted: dilute with at least 4 times the volume of
infusion fluid to prevent precipitation i.e. add 2ml of
digoxin to at least 6ml of infusion fluid (Glucose 5% or
Sodium Chloride 0.9%), administer over 10‐20 minutes.
Dilute in Sodium Chloride 0.9% or Glucose 5% at a ratio of 1 to 250 (i.e. one 2ml
ampoule containing 500 micrograms added to 500 ml of infusion solution)
Administer the total loading dose in divided doses, with approximately half of
the total dose given as the first dose and further fractions of the total dose given
at intervals of four to eight hours. Give each dose over 10‐20 minutes.
An assessment of clinical response should be performed before giving each
additional dose.

Dobutamine
12.5mg/ml
Brand: Mercury
License no:
PA0073/137/001
Administer by IV infusion only. Dilute with Sodium Chloride 0.9% or Glucose 5%.
See SPC for rate instructions and further information on dilution dependent on
dose etc.
Dopamine
200mg/5ml
Brand: Pfizer
License no:
PA0822/202/001
Administer by IV infusion only. Dilute with Sodium Chloride 0.9% or Glucose 5%.
 Add 5ml of Dopamine to 250ml of diluent to achieve a final
concentration of 800microgram/ml
OR
 Add 5ml of Dopamine to 500ml of diluent to achieve a final
concentration of 400microgram/ml.
Infuse at a rate of 2.5microgram/kg/min (or 5microgram/kg/min in severe
cases). Increase as needed in 5‐10 microgram/kg/min increments up to 20‐50
microgram/kg/min. See SPC for further information.
Ephedrine
30mg/ml
Brand: Ethypharm
License no:
PA0549/027/001
Use undiluted. Administer via slow IV injection
Esmolol
100mg/10ml
Brand: Brevibloc
License no:
PA2299/021/001
Ready‐to‐use solution. See SPC for full information and rates of
infusion.
Ready‐to‐use solution. See SPC for full information and rates of infusion.
Esomeprazole
40mg
Brand: Nexium
License no:
PA2242/013/004
Reconstitute the vial with 5mls Sodium Chloride 0.9%. Give over at
least 3 minutes.
 40mg infusion: dissolve the content of one 40mg vial in up to 100ml
Sodium Chloride 0.9% for IV use. Give over 30 minutes.
 80mg bolus dose: 2 x 40mg vials in up to 100ml Sodium Chloride 0.9%.
Give over 30 minutes.
8mg/hr infusion: see Intranet: Departments > Pharmacy > Administration >
Procedure to prepare esomeprazole solution for infusion
http://www.sivuh.com/Departments/PharmacyMedicinesManagement/Administration/Page1.html

Ferric Carboxymaltose
50mg/ml
Brand: Ferinject
License no:
PA0949/004/001
Administer by IV injection using undiluted solution. IV infusion
preferred.
 For doses between 200mg and 500mg administer over 5
minutes.
 For doses of between 500mg and 1000mg administer over
15 minutes.
A clinical check must be completed by a pharmacist before
Ferinject can be administered. Contact pharmacy for more details.
 For doses between 200mg and 500mg add to 100ml Sodium Chloride
0.9% and administer over 6 minutes.
 For doses of between 500mg and 1000mg add to 250ml Sodium
Chloride 0.9% and administer over 15minutes.
A clinical check must be completed by a pharmacist before Ferinject can be
administered. Contact pharmacy for more details.
Flecainide
10mg/ml
Brand: Tambocor
License no:
PA2010/026/001
Can use undiluted or dilute with Glucose 5%. Administer as a slow
IV injection over at least 10 minutes (max bolus dose 150mg).
Continuous ECG monitoring is required.
Stop injection when there is control of the arrhythmia. Consider
giving over 30mins to patients with a history of cardiac failure or
those with sustained ventricular tachycardia.
Dilute with Glucose 5%. See SPC for information on rate of infusion.
Continuous ECG monitoring is required.
Flumazenil
500mcg/5ml
Brand: Anexate
License no:
PA1868/002/001
Use undiluted. Administer slowly over 15 seconds.
Can also dilute with Sodium Chloride 0.9% or Glucose 5%.
Should be administered IV by an anaesthetist or doctor with
experience in anaesthesiology and in a unit having the appropriate
facilities available.
Dilute with Sodium Chloride 0.9% or Glucose 5%. Give at rate of 100–400
micrograms/hour. The dosage and rate of infusion should be individually
adjusted to achieve the desired level of sedation.
Furosemide
20mg/2ml
Brand: Mercury, Lasix
License no:
PA0073/059/004
(Mercury)
PA0540/052/002 (Lasix)
Use undiluted. Max 50mg via bolus injection. Give as a slow IV
injection at a max rate of 4mg/minute.
Dilute in Sodium Chloride 0.9% to any suitable volume. Give at a max rate of
4mg/minute.

Glyceryl Trinitrate
5mg/ml
Brand: Pfizer
License no:
PA0822/204/001
Do not give by bolus injection. Dilute with Sodium Chloride 0.9% and Glucose 5%.
To obtain an admixture at a concentration of 100 micrograms/ml add 10ml
(50mg) to 490ml Sodium Chloride 0.9% or Glucose 5% to give a final volume of
500ml.
Compatible with glass infusion bottles and rigid infusion packs made of
polyethylene. Incompatible with polyvinylchloride (PVC). Avoid contact with
polyvinylchloride bags. Polyurethane also induces a loss of the active ingredient.
See SPC for more detail.
Granisetron
1mg/ml
Brand: Kytril
License no:
PA22657/003/001
Dilute 1mg to 5ml with Sodium Chloride 0.9%. Give as a slow IV
injection over 30 seconds.
Dilute to 50mls with Sodium Chloride 0.9% or Glucose 5%.
Administer as a 5 minute infusion.
Haloperidol
5mg/ml
Brand: Serenace
License no: N/A
Unlicensed
Use undiluted. Give as a slow IV injection.
Give in a critical care setting with continuous ECG monitoring.
Heparin
1000 units/ml (5ml)
Brand: Wockhardt
License no: PA1339/9/6
Administration by IV infusion is preferred as the effects of heparin
are short‐lived.
The IV injection volume should not exceed 15ml. Use for loading
doses and bolus doses only. Administer undiluted over at least 3
minutes
Continuous IV infusion: dilute with Sodium chloride 0.9% or Glucose 5% to
produce a final volume of 100units/ml. E.g.: add 25ml of 1000 units/ml (25,000
units) to 225ml of diluent.
Invert bag six times to ensure adequate mixing.
Follow dosing and treatment regimen specific for patient
Heparin
10 units/ml (5ml)
Brand: Wockhardt
License no: PA1339/10/1
Only for cleaning indwelling cannulas. Not for systemic use.

Human Normal
Immunoglobulin
100mg/ml
Brand: Kiovig
License no:
EU/1/05/329/003 (5g)
EU/1/05/329/004 (10g)
EU/1/05/329/005 (20g)
EU/1/05/329/006 (30g)
Use undiluted at initial rate of 0.5ml/kg/hour for 30 minutes. Rate may gradually
be increased to a maximum of 6ml/kg/hour.
If dilution prior to infusion is required, dilute with Glucose 5% to a final
concentration of 50mg/ml. To obtain this concentration, dilute Kiovig with an
equal volume of the Glucose 5% solution.
It is recommended that during dilution the risk of microbial contamination is
minimised.
Hydralazine
20mg
Brand: Amdipharm
Unlicensed
Reconstitute each ampoule with 1ml WFI. Once reconstituted dilute
further with 10ml Sodium Chloride 0.9% and administer as a slow IV
injection.
Continuous infusion: Dilute with 500ml Sodium Chloride 0.9%. Begin with a flow
rate of 200‐300 micrograms/min. Maintenance flow rates must be determined
individually and are usually within the range 50‐150 micrograms/min.
Hydrocortisone
100mg
Brand: Solu‐Cortef
License no:
PA0822/137/001
Add 2ml WFI to 100mg vial, shake, and withdraw for use. Give as a
slow IV injection over 1‐10 minutes.
Add the reconstituted solution to at least 100ml (up to a max 1,000 ml) of
Sodium Chloride 0.9% or Glucose 5%. Administer over 20‐30 minutes.
Hyoscine Butylbromide
20mg/ml
Brand: Buscopan
License no:
PA23180/016/001
Give as a slow IV injection over 3 to 5 minutes. Rapid
administration may cause a marked drop in blood pressure.
Use undiluted or dilute to a convenient volume with Sodium
Chloride 0.9% or Glucose 5% to facilitate slow administration.
Ibuprofen
4mg/ml
Brand: B Braun
License no:
PA0736/041/001
Already in solution. Administer as an IV infusion over 30 minutes.

Idarucizumab
2.5g/50ml
Brand: Praxbind
License no:
EU/1/15/1056/001
Administer 5g (2 vials of 2.5g/50ml) undiluted as two consecutive IV
boluses over 5 to 10 minutes each. Flush the line pre and post with
Sodium Chloride 0.9%. No other infusion should be administered in
parallel via the same intravenous access.
Infliximab
100mg
Brand: Inflectra
License no:
EU/1/13/854/001‐005
See Intranet: Departments > Pharmacy > Aseptic Services > Inflectra®
Isosorbide dinitrate
10mg/10ml
Brand: Isoket
License no:
PA2118/003/001
Must be diluted prior to use. Dilute with an equal volume of
Sodium Chloride 0.9% or Glucose 5%.
Never inject the diluted solution directly in the form of a bolus
except via the intra‐coronary route prior to balloon inflation.
Continuous infusion: dilute 25mg with 25ml of Sodium Chloride 0.9% or Glucose
5% and administer at a rate adjusted according to response.
If patient is fluid restricted see SPC on guidance for administration in reduced
fluid intake.
Labetalol
100mg/20ml
Brand: Trandate
License no:
PA1638/006/001
Emergency use only. If essential to reduce blood pressure quickly,
(e.g. in hypertensive encephalopathy), give by IV injection over a
period of at least one minute. A 50mg dose should be used. May be
repeated at 5 minute intervals to a max total dose of 200mg.
See SPC for further information on dosing.
Dilute the contents of two ampoules (200mg) to 200ml with Glucose 5% to a
concentration of 1mg/ml.
For hypertension: infuse the prescribed dose at a rate of 2mg/min until a
satisfactory response is achieved. Use a rate controlled infusion pump. Avoid
upright position during and for 3 hours after IV administration.
See SPC for further information on dosing and use in other indications.
Lacosamide
10mg/ml
Brand: Vimpat
License no:
EU/1/08/470/16
Administer IV without further dilution. Give over a period of 15‐60 minutes. For
doses ≥200mg give over at least 30 minutes. See SPC for detail on dosing.
May be further diluted with Sodium chloride 0.9% or Glucose 5%.
Levetiracetam
100mg/ml
Brand: Keppra
License no:
EU/1/00/146/033
Dilute in at least 100ml of Sodium Chloride 0.9% or Glucose 5% and administer
over 15 minutes.

Levomepromazine
25mg/ml
Brand: Nozinan
License no:
PA0540/115/001
Dilute with an equal volume of Sodium Chloride 0.9% before use.
Give slowly over 3 to 5 minutes.
Lidocaine
1%
Brand: BBraun
License no:
PA0179/037/001
Bolus IV injections for use in pain management should only be
carried out by personnel adequately skilled in the respective
anaesthetic technique.
Continuous IV infusion for use in pain management should only be carried out by
personnel adequately skilled in the respective anaesthetic technique.
Lidocaine
2%
Brand: BBraun
License no:
PA0179/037/004
For anti‐arrhythmic therapy: use undiluted for loading dose at a
rate of 25 to 50 mg per minute. Flush immediately with 20ml
Sodium Chloride 0.9%.
If the therapeutic effect of the first dose is insufficient within the
first 5 to 10 minutes, repeat the initial dose once or twice up to a
maximum dose of 200‐300mg in 1 hour.
For anti‐arrhythmic therapy: for maintenance infusion add 1000mg
(corresponding to 50ml of Lidocaine 2%) to 500ml Glucose 5% or Sodium
Chloride 0.9%. Infuse at a rate of 1‐4 mg/minutes depending on stage of
treatment. Constant ECG monitoring is recommended during therapy.
See SPC for more details.
Lorazepam
4mg/ml
Brand: Macure
License no:
PA23199/002/001
Dilute required volume with an equal volume of Sodium Chloride
0.9% or Glucose 5%. The injection rate should not exceed
2mg/minute.
Directions for use:
 Extract the desired amount of Lorazepam into the syringe.
 Slowly suck the desired volume of diluent.
 Retract the piston slightly to provide an additional mixing
space.
 Immediately mix the contents by repeatedly twisting the
syringe until a homogeneous solution has formed.
 Do not shake vigorously as this will cause air bubbles.

Magnesium Sulphate
50% w/v (1g/2ml)
Brand: Martindale
License no:
PA0549/020/001
To prevent further seizures associated with eclampsia: Give as an
IV loading dose. Dilute prior to use. See SPC for more details.
Dilute with Sodium Chloride 0.9% or Glucose 5% prior to administration.
Maximum concentration for peripheral use is 5% (50mg/ml) (can use 10%
(100mg/ml) if fluid restricted). Mix thoroughly, inverting the bag at least 5 times
to avoid ‘layering’.
See Intranet: Departments > Pharmacy > Clinical Resources > Electrolytes >
Magnesium: Guidance on the management of acute hypomagnesaemia in adults
http://www.sivuh.com/Departments/PharmacyMedicinesManagement/ClinicalResources/Electrolytes.html
Methylprednisolone
125mg, 500mg, 1000mg
Brand: Solu‐Medrone
License no:
PA0822/136/002
(125mg)
PA0822/136/003
(500mg)
PA0822/136/004
(1000mg)
Add contents of diluent (sterile water) to 125mg vial. Give doses
˂250mg over at least 5 minutes by IV Injection.
To prepare 125mg Act‐O‐Vial:
 Press down on plastic activator to force solvent into the
lower compartment.
 Gently agitate to effect dissolution. Use solution
immediately.
 Remove plastic tab covering centre of stopper.
 Sterilise top of stopper with a suitable germicide.
 Insert needle squarely through centre of plunger‐stopper
until tip is just viable. Invert vial and withdraw dose.
Add contents of diluent (sterile water) to 125mg vial. 500mg and 1000mg vials
already in solution.
Infuse doses ≥250mg over at least 30 minutes in 50‐100ml of Sodium Chloride
0.9% or Glucose 5%.
Metoclopramide
10mg/2ml
Brand: Mercury
License no:
PA0073/084/001
Use undiluted. Give as a slow IV injection over at least 3 minutes.
Metoprolol
5mg/5ml
Brand: Betaloc
License no:
PA1404/007/001
Use undiluted. Dose and rate of administration determined by
indication. Usually administered by slow IV injection.
See SPC for further information.

Midazolam
1mg/ml, 10mg/2ml,
10mg/5ml
Brand: Accord, Hypnovel
License no:
PA2315/063/001 (1mg/ml)
PA2239/007/001
(10mg/2ml)
PA2239/007/002
(10mg/5ml)
Use undiluted. Give as a slow IV injection at a rate of approximately
2mg/ml.
Compatible with 0.9% Sodium Chloride or 5% Glucose.
See SPC or package insert for further information.
Naloxone
400mcg/ml
Brand: Mercury
License no:
PA0073/111/002
Use undiluted and give over a few seconds. 2mg (5 ampoules) can be added to 500ml Sodium Chloride 0.9% or Glucose 5%
to give a 4 microgram/ml (or 0.004mg/ml) solution. Titrate rate in accordance
with response.
Noradrenaline
1:1000
Brand: Pfizer
License no:
PA0822/219/001
Dilute 2ml with 48ml of Glucose 5% (or Glucose 5% with Sodium Chloride 0.9%)
or dilute 20ml with 480ml of infusion fluid.
See SPC for infusion rate and further detail.
Ondansetron
4mg/2ml
Brand: Zofran
License no:
PA0896/036/001
Give doses ≤8mg undiluted. Give as a slow IV injection over not less
than 30 seconds.
Dilute doses of 9‐16mg in 50‐100ml Sodium Chloride 0.9% or Glucose 5%. Give
over at least 15 minutes.
Continuous infusion: administer at a rate of 1mg/hr for up to 24hrs.
Pabrinex
I and II (1 pair)
Brand: Pabrinex IV
License no:
PA2288/001/001
To be administered by drip infusion only. 1 pair of ampoules = No. 1 and No.2.
Draw up the contents of the required number of pairs into the same syringe, mix
and add to 50‐100ml of Sodium Chloride 0.9% or Glucose 5%. Infuse over 30
minutes.

Pantoprazole
40mg
Brand: Protium
License no:
PA2229/010/003
Reconstitute with 10ml of Sodium Chloride 0.9%. Give as an IV
injection over at least 2 minutes.
Reconstitute the 40mg vial with 10ml of Sodium Chloride 0.9%. Further dilute
the reconstituted solution with 100ml Sodium Chloride 0.9& or Glucose 5%.
Infuse over 15 minutes.
Papaverine
60mg/2ml
Brand: Martindale
License no: N/A
Unlicensed
Administer by slow IV injection over 1‐2 minutes.
Paracetamol
1g/100ml
Brand: Accord
License no:
PA2315/218/001
Use undiluted. Infuse over 15 minutes.
For patient’s ≤10kg: withdraw the appropriate volume from the vial and
administer over 15 minutes. If the total volume is small this may be further
diluted with Sodium Chloride 0.9% or Glucose 5% to a maximum dilution of one‐
tenth (1 volume Paracetamol into max 9 volumes diluent) for ease of
administration over 15 minutes.
Parecoxib
40mg
Brand: Dynastat
License no:
EU/1/02/209/005
Reconstitute 40mg vial with 2ml Sodium Chloride 0.9%. Give as a
rapid IV bolus injection. Flush the line pre and post with Sodium
Chloride 0.9%.
Phenobarbitone
200mg/ml
Brand: Aspen, Martindale
License no: N/A
Unlicensed
Dilute the required volume with 10 times its volume of WFI i.e. a 1:10 dilution
with WFI. Administer at a rate of 50‐100mg/min. Maximum rate of 100mg/min.
Phenylephrine
100mcg/ml
Brand: Aguettant
Use undiluted. An IV bolus dose should not exceed 100
micrograms. Administer over 3‐5 minutes.
Use undiluted. The initial rate is 25‐50 micrograms/min. Can be increased up to
100 micrograms/min or reduced according to response.
See SPC for more details.

License no:
PA1968/007/002
Phenytoin
250mg/5ml
Brand: Epanutin
License no:
PA23055/003/006
Because of the risk of local toxicity, give by slow IV injection
directly into a large vein through a large‐gauge needle or IV
catheter. Each IV injection should be preceded and followed by an
injection of sterile Sodium Chloride 0.9% through the same needle
or catheter to avoid local venous irritation due to alkalinity of the
solution.
Can give as an IV bolus in intensive care setting with ECG and blood
pressure monitoring. The max rate is 50mg/min.
Each IV infusion should be preceded and followed by an injection of sterile
Sodium Chlorine 0.9% through the same needle or catheter to avoid local
venous irritation due to alkalinity of the solution.
Dilute in 50‐100 ml Sodium Chloride 0.9%. Final concentration must not exceed
10mg/ml (therefore doses >1000mg must be diluted in 250ml).
Administration should commence immediately after the mixture has been
prepared and must be completed within one hour. The infusion mixture should
not be refrigerated. Use an in‐line filter (0.22‐0.50 microns). ECG and blood
pressure monitoring required.
Phytomenadione
10mg/ml
Brand: Konakion
License no:
PA2239/002/001
Use undiluted. Give as a very slow IV injection over 3 to 5 minutes Dilute with 50ml Glucose 5%. Infuse slowly over 15 to 30 minutes. Protect the
infusion from light.
Potassium Chloride
Various products available
See Intranet for further details: Departments > Pharmacy > Clinical Resources >
Electrolytes > Potassium Chloride: Guidance on the administration of IV
Potassium Chloride to Adult patients
http://www.sivuh.com/Departments/PharmacyMedicinesManagement/ClinicalResources/Electrolytes.html
See also PPPG PHARHIGHRISKMED0001ORG for more details
Procyclidine
10mg/2ml
Brand: Auden McKenzie
Unlicensed
Give the required dose undiluted as a slow IV injection over 3 ‐ 5
minutes.
Promethazine
25mg/ml
Brand: Phenergan
License no: N/A
Usually given IM. Avoid IV administration if possible.

Unlicensed In an emergency: Dilute the contents of one ampoule in 10ml WFI.
Give as a slow IV injection at a max rate of 25mg/min. Maximum
100mg per course.
Protamine
1400 units/ml (10mg/ml)
Brand: Leo Pharma
License no:
PA1025/002/001
Administer as a slow IV injection over 10 minutes. The largest
single injection (bolus dose) should not exceed 5ml (7000
units/50mg protamine sulphate). Dose should be guided by blood
coagulation studies.
Can be administered as a constant, slow intravenous infusion diluted in Sodium
Chloride 0.9%. Maximum rate 5mg/min
Salbutamol
500mcg/ml
Brand: Ventolin
License no:
PA1077/049/001
500mcg (1ml) may be diluted to 10ml with WFI.
5ml of the diluted preparation (250mcg per 5ml) may be
administered by slow IV injection over 3 to 5 minutes.
A suitable solution for infusion may be prepared by diluting 5mg of Ventolin
Concentrate Solution for Intravenous Infusion to 500ml of Sodium Chloride 0.9%
or Glucose 5%.
Infusion rates of 3 to 20 micrograms per minute (0.3 to 2ml/minute) are
generally adequate but in patients with respiratory failure, higher dosage has
been used with success.
Sodium Valproate
400mg
Brand: Epilim
License no:
PA0540/150/013
Reconstitute with diluent provided (4ml). Final concentration
95mg/ml. Give appropriate dose as a slow IV injection over 3‐5
minutes.
After reconstitution, dilute with at least 50ml Sodium Chloride 0.9% or Glucose
5% and give over 60 minutes at a rate ≤20mg/min.
Solivito
10ml
Brand: Solivito N
License no:
PA2059/064/001
Terlipressin
1mg
Brand: Glypressin
License no:
PA1009/004/001
Reconstitute using the solvent provided. Give by slow IV injection
into a large vein over 3‐5 minutes
(N.B. very acidic ‐ will cause tissue damage if extravasates ‐ admin
via a central access device where possible monitor the injection
site closely)

Tetracosactide
250mcg/ml
Brand: Synacthen
License no:
PA2206/002/001
Intended for administration for diagnostic purposes only as a single
IM or IV dose.
Give by slow IV injection administered over 2 minutes.
Tocilizumab
80mg/4ml, 200mg/10ml,
400mg/20ml
Brand: RoActemra
License no:
EU/1/08/492/001‐006
See Intranet: Departments > Pharmacy > Aseptic Services > RoActemra®
Tramadol
100mg/2ml
Brand: Tradol
License no:
PA0711/029/003
Use undiluted. Give as a slow IV injection over 2‐3 minutes. If required dilute with Sodium Chloride 0.9% or Glucose 5%.
Tranexamic Acid
500mg/5ml
Brand: Cyklokapron
License no:
PA0822/117/001
Can use undiluted. Give as a slow IV injection. Administer at a
maximum rate of 1ml (100mg)/min.
Dilute dose to a convenient volume of Sodium Chloride 0.9% or Glucose 5%, e.g.
100ml. Mix well.
Give loading dose over 10 minutes followed by an infusion administered over 8
hours.
This is used for the unlicensed indication of significant haemorrhage following
trauma.
Verapamil
5mg/2ml
Brand: Isoptin
License no:
PA2010/003/004
Use undiluted. Give slowly. Administer over at least 2 minutes (3
minutes in the elderly).
Keep the patient under constant observation with ECG and blood
pressure monitoring.
Can be diluted with Sodium Chloride 0.9% or Glucose 5%.
See SPC for full information as dose and rate of infusion can vary for indication
and patients being treated.

Vitlipid
10ml
Brand: Vitlipid
License no:
PA2059/067/001
Zoledronic Acid
4mg/100ml
Brand: Zerlinda
License no:
PA1986/119/001
Give as a single IV infusion over ≥15 minutes.
If patient has impaired renal function, see SPC for appropriate dilution in Sodium
Chloride 0.9% or Glucose 5%.
A pharmacist must complete a clinical check before Zerlinda can be administered
for the treatment of osteoporosis. Contact pharmacy for more details.

Administration guidelines for general intravenous medications at SIVUH.pdf (Updated 04Aug2023).pdf

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Administration guidelines for general intravenous medications at SIVUH.pdf (Updated 04Aug2023).pdf