Adverse reactions
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Drowsiness, lethargy - sucking reflex may be impaired and feeding may be poor. Respiratory depression, apnoea. Hypotension, laryngospasm, bronchospasm, apnoea - if IV administration is too rapid. Phlebitis, tissue necrosis if extravasation occurs.GI intolerance. Physical dependence and tolerance. May occur with prolonged use: Folate deficiency, hepatitis, hypocalcaemia.
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Compatibility
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Fluids: Sodium chloride 0.45%, sodium chloride 0.9%, glucose 5%, glucose 10%.
Y-site: Amino acid solutions. Amikacin, atropine, calcium chloride, fentanyl, furosemide, magnesium sulfate, milrinone, phenytoin, piperacillin/tazobactam.
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Incompatibility
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Fluids: Lipid emulsions.
Y-site: Adrenaline (epinephrine) hydrochloride, aminophylline, atracurium, benzylpenicillin, buprenorphine, caspofungin, cefotaxime, cefoxitin, chlorpromazine, ciclosporin, dobutamine, dolasetron, ephedrine, erythromycin, esmolol, haloperidol lactate, hydralazine, hydrocortisone sodium succinate, hydromorphone, ketamine, lidocaine (lignocaine), midazolam, mycophenolate mofetil, noradrenaline (norepinephrine), ondansetron, pentamidine, pethidine, phentolamine, prochlorperazine mesilate, promethazine, protamine, ranitidine, suxamethonium, verapamil.
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Stability
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Use diluted/opened solution as soon as possible.
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Storage
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Protect from light. Store below 25°C. Schedule 4 Appendix D (S4D) medication.
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