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Kinet-Poleur A, Colsoul ML, Catry E, Bihin BP, Sneyers BE, Hubert J, Jamart J, Soumoy L, Galanti LM, Hecq JD, Closset M. Long-term stability of esketamine in polypropylene syringes at 5 ± 3°C. Eur J Hosp Pharm 2024:ejhpharm-2024-004227. [PMID: 39084689 DOI: 10.1136/ejhpharm-2024-004227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE Esketamine (Vesierra) is a molecule, used alone or in combination, to induce and maintain general anaesthesia and to relieve pain in emergency medicine. The aim of this study is to evaluate the long-term physicochemical stability of a 1 mg/mL solution of esketamine diluted in 0.9% sodium chloride (NaCl) and stored in polypropylene syringes at 5±3°C during 65 days (64+1 day at 22±3°C) and 72 hours at 22±3°C (room temperature), in order to centralise preparation under aseptic conditions in hospital pharmacy. METHODS Ten syringes were prepared under aseptic conditions. Five syringes were stored at 22±3°C for 3 days, and the five others were stored at 5±3°C for 64 days (+ 1 day at room temperature). The stability was periodically investigated. Particle appearance or colour changes were checked by visual inspection. A research of crystals was performed under the microscope. pH was followed to assess its stability. The turbidity of the solutions was estimated by a measure of optical densities at 350, 410 and 550 nm. The molecule concentrations were measured by ultra-high performance liquid chromatography (UHPLC) coupled with a photodiode array detection (PDA), using a newly developed method. RESULTS Based on microscopic examination, no crystals were observed, during the observation period. pH and absorbances at 350, 410 and 550 nm were also stable. Macroscopically, there was no change in colour and appearance of opacity, turbidity or precipitation. Statistical analysis indicates that 1 mg/mL esketamine solutions were chemically stable under these conditions, given that less than 5% of the solutions have lost more than 10% of their initial content during the study based on the prediction interval. CONCLUSIONS One mg/mL solutions of esketamine hydrochloride are physically and chemically stable after production, for at least 72 hours at 22±3°C and 64 days at 5±3°C (+ 1 day at room temperature).
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Affiliation(s)
- Amélie Kinet-Poleur
- Department of Medical Laboratory, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
| | - Marie-Lise Colsoul
- Department of Medical Laboratory, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
| | - Emilie Catry
- Department of Medical Laboratory, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
| | - Benoît P Bihin
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
- Scientific Support Unit, CHU UCL Namur, Yvoir, Belgium
| | - Barbara E Sneyers
- Department of Pharmacy, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
| | - Justine Hubert
- Department of Pharmacy, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
| | - Jacques Jamart
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
- Scientific Support Unit, CHU UCL Namur, Yvoir, Belgium
| | - Laura Soumoy
- Department of Pharmacy, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
| | - Laurence M Galanti
- Department of Medical Laboratory, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
| | - Jean-Daniel Hecq
- Department of Pharmacy, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
| | - Mélanie Closset
- Department of Medical Laboratory, CHU UCL Namur, Yvoir, Belgium
- Drug Stability Research Group, CHU UCL Namur, Yvoir, Belgium
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Usman MA, Donald OU, Salahu D, Akhideno II. Physicochemical Stability of Ketamine After Reconstitution for Injection: A Scoping Review. Anesth Analg 2024; 138:e29-e31. [PMID: 38621287 DOI: 10.1213/ane.0000000000006956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Affiliation(s)
- Mohammed Adinoyi Usman
- Department of Clinical Pharmacology and Therapeutics, Federal University Dutse, Dutse, Jigawa State, Nigeria, ,
| | - Orshio Uga Donald
- Department of Anaesthesiaßederal Medical Centre, akurdi, Benue State, Nigeria
| | - Dalhat Salahu
- Department of Anaesthesia, Aminu Kano Teaching Hospital, Kano, Nigeria
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Should Ketamine Not Be Banned? A Scoping Review. Disaster Med Public Health Prep 2021; 17:e47. [PMID: 34664549 DOI: 10.1017/dmp.2021.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Although the importance of ketamine in clinical practice and in resource-poor settings and disaster zones, several attempts were made to reschedule it because of the issues around its misuse. Resisting future moves to reschedule ketamine is important for its continuous availability where needed. This scoping review addresses the question of whether ketamine should or should not be banned and the state of preparedness of low resource settings if ketamine petitions become successful in the future. METHODS A search was performed using PubMed and Google Scholar to identify articles published in the English language from March 2015 to August 2020. The articles were searched with a wide range of priori search terms related to the research questions. The selection of articles was based on relevance and eligibility. RESULTS Seventy-five articles were selected and grouped into 4 ethical themes. The search revealed that several articles addressed the importance of ketamine, pharmacology, misuse, supply, and consequences of a ketamine ban; however, none addressed how resource-poor countries should prepare for a future without the overreliance of ketamine. CONCLUSION Four ketamine petitions in about 10 years are an indication that another may resurface soon; therefore, it is important to continue to study the clinical importance of ketamine while discouraging its overreliance for clinical practice.
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Ingle RG, Fang WJ. Prefilled dual chamber devices (DCDs) - Promising high-quality and convenient drug delivery system. Int J Pharm 2021; 597:120314. [PMID: 33540011 DOI: 10.1016/j.ijpharm.2021.120314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/14/2021] [Accepted: 01/23/2021] [Indexed: 12/22/2022]
Abstract
Prefilled dual chamber devices (DCDs) are combination products containing freeze-dried drug and diluent in two separate chambers of the device. DCDs provide high stability and convenience to patients and doctors, thus significantly improving product quality, patient compliance and market competitiveness. DCDs should also provide seal integrity, sterility and compatibility with biopharmaceuticals and avoid leachability and needle stick injuries. DCDs are promising alternatives to traditional containers or devices for biopharmaceuticals. The regulatory and medical practice to choose plastic DCDs as better alternatives over well-established glass syringes will be addressed here. The impact and major issues during processing, manufacturing, and storage of DCDs are also highlighted. Further discussion clears its business potential, composition, stability testing, and quality standard requirements to deal with market competition. It also covers major role of extractables and leachables in storage stability of the product.
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Affiliation(s)
- Rahul G Ingle
- Institute of Drug Metabolism and Pharmaceutical Analysis, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; Hangzhou Institute of Innovative Medicine, Zhejiang University, Hangzhou 310016, China
| | - Wei-Jie Fang
- Institute of Drug Metabolism and Pharmaceutical Analysis, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; Hangzhou Institute of Innovative Medicine, Zhejiang University, Hangzhou 310016, China.
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