Preparation of Solution for Infusion
- The recommeded diluent for CYANOKIT® is 100 mL of 0.9% Sodium Chloride injection (0.9% NaCl)
- Lactated Ringers injection and 5% Dextrose injection (D5W) have also been found to be compatible with hydroxocobalamin and may be used if 0.9% of NaCl is not readily available
- Use the sterile transfer spike to add 100 mL of diluent to the lyophilized powder, then repeatedly invert but do not shake the vial for at least 30 seconds in order to mix the solution prior to infusion
- CYANOKIT® solutions should be visually inspected for particulate matter and color prior to administration
- Discard solution if particulate matter is present or solution is not dark red
- Caution should be exercised when administering other cyanide antidotes simultaneously with CYANOKIT®, as safety has not been established.
If a decision is made to administer another cyanide antidote with CYANOKIT®, these drugs should not be administered concurrently in
the same IV line
CYANOKIT® IV Line Incompatibility29
- Physical incompatibility (particle formation) and chemical incompatibility were observed with the mixture of CYANOKIT® in solution with selected drugs that are frequently used in resuscitation efforts
- CYANOKIT® is chemically incompatible with sodium triosulfate and sodium nitrite
- Reported incompatibility with ascorbic acid
- Simultaneous administration of CYANOKIT® and blood products through the same line is not recommended
NOTE: Do not administer these agents simultaneously in the same IV line. Administer concurrently through separate lines.
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