Stability of ganciclovir sodium and amino acids in parenteral nutrient solutions

The stability of ganciclovir sodium and amino acids in parenteral nutrient solutions was studied. Three admixtures of ganciclovir sodium plus parenteral nutrient solution were prepared, one containing ganciclovir sodium 0.83 mg/mL, 1% amino acids, and 10% dextrose injection; one containing ganciclovir sodium 1.4 mg/mL, 2.5% amino acids, and 10% dextrose injection; and one containing ganciclovir sodium 1.4 mg/mL, 5% amino acids, and 25% dextrose injection. The solutions were visually inspected for precipitates, color change, and gas formation and were tested for pH. High-performance liquid chromatography was used to measure the concentration of ganciclovir and 16 amino acids in each admixture immediately and one, two, and three hours after preparation. There was no evidence of visual incompatibility in any of the admixtures, and pH did not vary appreciably during the study. The mean ganciclovir sodium concentration remaining was greater than 100% of the initial concentration for all the admixtures at one, two, and three hours. The mean amino acid concentration remaining in the admixtures with 2.5% or 5.0% amino acids was greater than 90% of the initial concentration for each amino acid at one, two, and three hours. The mean amino acid concentration remaining in the admixture with 1% amino acids was greater than 90% of the initial level at one and two hours. Ganciclovir sodium 0.83 mg/mL was stable for at least three hours in parenteral nutrient solution with 1% amino acids, and ganciclovir sodium 1.4 mg/mL was stable for at least three hours in admixtures with 2.5% or 5% amino acids. Amino acids were stable for up to two hours in admixtures containing ganciclovir sodium 0.83 mg/mL and 1.0% amino acids and for at least three hours in admixtures containing ganciclovir sodium 1.4 mg/mL and 2.5% or 5% amino acids.