ABSTRACT
BACKGROUND: Medications are frequently combined in the nebulizer cup, so it is important to determine their chemical and physical compatibility. OBJECTIVE: To determine the chemical and physical compatibility of levalbuterol with ipratropium bromide, cromolyn sodium, acetylcysteine sodium, and budesonide. METHODS: We mixed one dose of levalbuterol inhalation solution concentrate (1.25 mg/0.5 mL) with one dose of ipratropium bromide (0.5 mg/2.5 mL), cromolyn sodium (20 mg/2 mL), acetylcysteine sodium (1,000 mg/5 mL), or budesonide (0.5 mg/2 mL). Immediately after mixing the 2 drugs (time zero [T(0)]), and again after 30 min at room temperature (T(30)), we visually inspected the admixtures, measured their pH, and conducted high-pressure liquid chromatography (HPLC). RESULTS: There was no evidence of physical incompatibility with these drugs combinations. With all the admixtures, both drugs were chemically stable for at least 30-min. Admixture pH had not changed significantly at T(30). Drug recovery was 93.2-102.6% of the initial or control values. CONCLUSIONS: The 2-drug admixtures we studied were compatible for at least 30 min at room temperature.
