Incompatibilities: None known.
Instructions For Use/Handling: Infusion: The required dose of Zovirax IV for infusion should be administered by slow IV infusion over a 1-hour period.
Zovirax IV for infusion should be reconstituted using the following volumes of either water for injections or sodium chloride injection (0.9% w/v) to provide a solution containing Zovirax 25 mg/mL (see Table 3).
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From the calculated dose, determine the appropriate number and strength of vials to be used. To reconstitute each vial, add the recommended volume of infusion fluid and shake gently until the contents of the vial have dissolved completely. After reconstitution Zovirax IV for infusion may be administered by a controlled-rate infusion pump.
Alternatively, the reconstituted solution may be further diluted to give Zovirax IV concentration of not >5 mg/mL (0.5% w/v) for administration by infusion: Add the required volume of reconstituted solution to the chosen infusion solution, as recommended in the following, and shake well to ensure adequate mixing occurs.
For children and neonates, where it is advisable to keep the volume of infusion fluid to a minimum, it is recommended that dilution is on the basis of 4 mL reconstituted solution Zovirax IV 100 mg added to 20 mL of infusion fluid.
For adults, it is recommended that infusion bags containing 100 mL of infusion fluid are used, even when this would give Zovirax IV concentration substantially <0.5% w/v. Thus, one 100 mL infusion bag may be used for any dose between 250 mg and 500 mg Zovirax IV (10 mL and 20 mL of reconstituted solution) but a 2nd bag must be used for doses between 500 mg and 1,000 mg.
When diluted in accordance with the recommended schedules, Zovirax IV for infusion is known to be compatible with the following infusion fluids and stable for up to 12 hours at room temperature (15-25°C): Sodium chloride IV infusion BP (0.45% and 0.9% w/v); sodium chloride (0.18% w/v) and glucose (4% w/v) IV infusion BP; sodium chloride (0.45% w/v) and glucose (2.5% w/v) IV infusion BP; compound sodium lactate IV Infusion BP (Hartmann's solution).
Zovirax IV for infusion when diluted in accordance with the previously mentioned schedule will give Zovirax IV concentration not greater than 0.5% w/v.
When reconstituted as directed, Zovirax IV for infusion has a pH of approximately 11.
Since no antimicrobial preservative is included, reconstitution and dilution must be carried out under full aseptic conditions, immediately before use, and any unused solution should be discarded.
Reconstituted or diluted solutions should not be refrigerated.
Should any visible turbidity or crystallization appear in the solution before or during infusion, the preparation should be discarded.