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IV Drug
| Generic | Brand | Side adverse effect | Pharmacy Category | Consideration |
|---|---|---|---|---|
| Bumetanide | Bumex | Hyperuricemia Hypochloremia Hypokalemia | Loop Diuretics Antihypertensive | |
| Furosemide | lasix | Hyperuricemia Hypochloremia Hypokalemia | Loop Diuretics Antihypertensive | |
| Mannitol | Osmitrol | Nausea Dysuria | Osmotic diuretic Genitourinary irritant Chất kích thích sinh dục | May crystalize at room temperature, but this does not indicate that drug is unusable. Inspect for crystals prior to administration; crystals can be dissolved by warming solution. For mannitol concentrations ≥20%, use a ≤5 micron filter. |
| Magnesium sulfate | Flushing sweating CNS depression | electrolyte supplement magnesium salt | ISMP High-alert For IV administration, must dilute to a ≤20% solution for IV continuous infusion or IV push (IV push is only for ventricular fibrillation/pulseless ventricular tachycardia associated with torsades de pointes). | |
| Potassium Chloride | Nausea/vomiting Rash Pain during injection Hyperkalemia | Electrolyte supplement | ISMP High-alert must be diluted to parenteral. For IV infusion only; do NOT IV push. The max rate of for peripheral infusion is 10 mEq/hour. ECG monitoring is recommend for infusion >10mEq/hours Central line: 20-40mEq/100ml at max 40mEq/h safely | |
| Sodium Bicarbonate | Neut | Hypernatremia hypoCa HypoK metabolic ALKAlosis | Antacid Electrolyte Supplement Alkalinizing Agent | Sodium content of drug should be counted when determining the osmolarity of compounded solution as this will effect the type of IV line required. Hypertonic/hypotonic solutions should be administered via central line. |
| Sodium Chloride | Phlebitis Viêm tĩnh mạch Extravasation Sodium disorders | Genitourinary Irrigant Electrolyte Supplement Sodium Salt Ocular Lubricant | Hypotonic/hypertonic saline solutions should be given via central line. | |
| Iron - sodium ferric gluconate | Ferrlecit | Hypotension OR hypertension Injection site reactions Muscle cramps | Iron Preparations | A test dose should be administered in patients with history of drug allergies. |
| Alteplase | Activase Cathflo | Intracranial hemorrhage GI hemorrhage | Thrombolytic Agent | ISMP High-alert medication Cathflo version (2 mg) is used to de-clot central venous catheters |
| Heparin | Major bleeding Heparin-induced thrombocytopenia | Anticoagulant | ISMP High-alert medication | |
| Argatroban | Major bleeding | Anticoagulant Direct Thrombin Inhibitor | ISMP High-alert medication | |
| Bivalirudin | Angiomax | Major bleeding | Anticoagulant Direct Thrombin Inhibitor | ISMP High-alert medication |
| Fondaparinux | Arixtra | 1. Major bleeding 2. Injection site reactions | 1. Anticoagulant 2. Factor Xa Inhibitor 3. Synthetic Pentasaccharide | ISMP High-alert medication |
| Enoxaparin | Lovenox | 1. Major bleeding 2. Heparin-induced thrombocytopenia 3. Injection site reactions | 1. Anticoagulant 2. Low Molecular Weight Heparin | ISMP High-alert medication |
| Eptifibatide | Integrilin | 1. Major bleeding 2. Thrombocytopenia | 1. Antiplatelet 2. Glycoprotein IIb/IIIa Inhibitor | ISMP High-alert medication |
| Epoprostenol | Flolan Veletri | 1. Flushing 2. Headache 3. Tachycardia 4. Flu-like symptoms 5. Hypotension | 1. Prostacyclin 2. Prostaglandin 3. Vasodilator | ISMP High-alert medication Half-life is 6 minutes - stopping drug abruptly is potentially life threatening (have back-up epoprostenol cassette immediately available for use) |
| Phenylephrine | 1. Cardiac arrhythmias loạn nhịp tim 2. Hypertension 3. Limb ischemia Thiếu máu cục bộ ở chi | Alpha-Adrenergic Agonist | ISMP High-alert medication Vesicant; should administer via a central line; avoid extravasation | |
| Epinephrine | Adrenalin | 1. Cardiac arrhythmias loạn nhịp tim 2. Hypertension 3. Limb ischemia Thiếu máu cục bộ ở chi | Alpha-/Beta- Agonist | ISMP High-alert medication Vesicant; should administer via a central line; avoid extravasation |
| Norepinephrine | Levophed | 1. Cardiac arrhythmias loạn nhịp tim 2. Hypertension 3. Limb ischemia Thiếu máu cục bộ ở chi | Alpha-/Beta- Agonist | ISMP High-alert medication Vesicant; should administer via a central line; avoid extravasation |
| Dexmedetomidine | Precedex | 1. Bradycardia 2. Hypotension 3. Respiratory depression | Sedative Alpha2-Adrenergic Agonist | ISMP High-alert medication |
| Diltiazem | Cardizem | 1. Peripheral edema 2. Headache 3. Heart block 4. Bradycardia | 1. Antihypertensive 2. Antianginal Agent 3. Antiarrhythmic Agent, Class IV 4. Calcium Channel Blocker 5. Calcium Channel Blocker, Nondihydropyridine | ISMP High-alert medication |
| Enalaprilat | Vasotec | 1. Hypotension 2. Angioedema | 1. Antihypertensive 2. Angiotensin-Converting Enzyme (ACE) Inhibitor | |
| Verapamil | 1. Headache 2. Constipation 3. Hypotension | 1. Antihypertensive 2. Antianginal Agent 3. Antiarrhythmic Agent, Class IV 4. Calcium Channel Blocker 5. Calcium Channel Blocker, Nondihydropyridine | ISMP High-alert medication | |
| Nicardipine | Cardene | 1. Peripheral edema 2. Flushing 3. Hypotension | 1. Antihypertensive 2. Antianginal Agent 3. Calcium Channel Blocker 4. Calcium Channel Blocker, Nondihydropyridine | |
| Labetalol | Trandate | 1. Orthostatic hypotension 2. Dizziness 3. Bradycardia | 1. Antihypertensive 2. Beta-Blocker with Alpha-blocking Activity | ISMP High-alert medication |
| Hydralazine | Apresoline | 1. Reflex tachycardia 2. Hypotension 3. Lupus-like reaction | 1. Antihypertensive 2. Vasodilator | |
| Nitroprusside | Nipride | 1. Cyanide toxicity 2. Methemoglobinemia 3. Hypotension | 1. Antihypertensive 2. Vasodilator | ISMP High-alert medication Protect solution from light |
| Dobutamine | 1. Tachycardia 2. Cardiac arrhythmias | 1. Inotrope 2. Adrenergic Agonist Agent | ISMP High-alert medication | |
| Dopamine | 1. Cardiac arrhythmias 2. Hypertension 3. Limb ischemia | 1. Inotrope 2. Adrenergic Agonist Agent | ISMP High-alert medication Vesicant; administer via a central line; avoid extravasation | |
| Milrinone | 1. Tachycardia 2. Cardiac arrhythmias 3. Thrombocytopenia | 1. Inotrope 2. Phosphodiesterase-3 Enzyme Inhibitor | ISMP High-alert medication | |
| Nitroglycerin | 1. Headache 2. Hypotension 3. Dizziness | 1. Antianginal Agent 2. Antidote Thuốc giải độc 3. Vasodilator | Must be prepared in glass bottle or EXCEL bag as adsorption occurs with PVC diluent bags | |
| Amikacin sulfate | Amikin | 1. Nephrotoxicity 2. Ototoxicity | 1. Aminoglycoside Antibiotic | |
| Gentamicin | Garamycin | 1. Nephrotoxicity 2. Ototoxicity | 1. Aminoglycoside Antibiotic | |
| Ertapenem | Invanz | 1. Diarrhea 2. Hypersensitivity; anaphylaxis | 1. Carbapenem Antibiotic | |
| Meropenem | Merrem | 1. Diarrhea 2. Hypersensitivity; anaphylaxis | 1. Carbapenem Antibiotic | |
| Cefazolin | Ancef | 1. Local pain at injection site 2. Diarrhea 3. Hypersensitivity; anaphylaxis | 1. Cephalosporin (First Generation) Antibiotic | |
| Cefepime | Maxipime | 1. Positive direct Coombs test (without hemolysis) 2. Diarrhea 3. Hypersensitivity; anaphylaxis | 1. Cephalosporin (Fourth Generation) Antibiotic | |
| Ceftriaxone | Rocephin | 1. Induration at injection site (higher with IM) 2. Diarrhea 3. Hypersensitivity; anaphylaxis | 1. Cephalosporin (Third Generation) Antibiotic | Do not co-administer with calcium-containing solutions (e.g., lactated ringer's solution, calcium gluconate/chloride infusions). |
| Ceftazidime and avibactam | Avycaz | 1. Positive direct Coombs test (without hemolysis) 2. Diarrhea 3. Hypersensitivity; anaphylaxis | 1. Cephalosporin Combination | |
| Daptomycin | Cubicin; Cubicin RF | 1. Increased creatinine phosphokinase (CPK) 2. Insomnia 3. Chest pain | 1. Cyclic Lipopeptide Antibiotic | |
| Ciprofloxacin | Cipro | 1. GI side effects (nausea/vomiting/diarrhea) 2. QTc prolongation 3. CNS stimulation (headache, dizziness) 4. Tendonitis and tendon rupture | 1. Fluoroquinolone Antibiotic | |
| Levofloxacin | Levaquin | 1. GI side effects (nausea/vomiting/diarrhea) 2. QTc prolongation 3. CNS stimulation (headache, dizziness) 4. Tendonitis and tendon rupture | 1. Fluoroquinolone Antibiotic | |
| Clindamycin | Cleocin | 1. Clostridioides difficile -associated diarrhea 2. GI upset (diarrhea, nausea, vomiting) 3. Rash 4. Hypersensitivity | 1. Lincosamide Antibiotic | |
| Azithromycin | Zithromax | 1. GI side effects (nausea/vomiting/diarrhea) 2. QTc prolongation | 1. Macrolide Antibiotic | |
| Metronidazole | Flagyl | 1. Headache 2. Nausea 3. Diarrhea 4. Peripheral neuropathy | 1. Miscellaneous Antibiotic 2. Amebicide 3. Antiprotozoal, Nitroimidazole | |
| Aztreonam | Azactam | 1. Local pain at injection site 2. Diarrhea 3. Hypersensitivity; anaphylaxis | 1. Monobactam Antibiotic | |
| Linezolid | Zyvox | 1. Diarrhea 2. Thrombocytopenia 3. Peripheral neuropathy | 1. Oxazolidinone Antibiotic | |
| Ampicillin and sulbactam | Unasyn | 1. Local pain at injection site 2. Diarrhea 3. Hypersensitivity; anaphylaxis | 1. Penicillin Antibiotic | |
| Tobramycin | 1. Nephrotoxicity 2. Ototoxicity | 1. Aminoglycoside Antibiotic | ||
| Vancomycin | Vancocin | 1. Red man syndrome 2. Hypotension 3. Nephrotoxicity | 1. Glycopeptide | Too rapid infusion can cause Red Man Syndrome\hypotension - note that this is NOT an allergic reaction and does not contraindicate use; it is a reaction specifically related to too rapid of an infusion time. |
| Tigecycline | Tygacil | 1. GI side effects (nausea/vomiting/diarrhea) 2. Phlebitis 3. Acute pancreatitis 4. Hepatic dysfunction/failure | 1. Glycylcycline Antibiotic | |
| Trimethoprim and sulfamethoxazole | Bactrim | 1. Diarrhea, nausea 2. Hyperkalemia 3. Increased SCr 4. Toxic epidermal necrolysis/Stevens-Johnson syndrome | 1. Miscellaneous Antibiotic 2. Sulfoamide Derivative Antibiotic | Do not refrigerate solutions diluted for infusion. Stability duration is concentration-dependent. |
| Nafcillin | 1. Diarrhea 2. Hypersensitivity; anaphylaxis 3. Increased LFTs | 1. Penicillin Antibiotic | ||
| Penicillin-G | Pfizerpen | 1. Diarrhea 2. Injection site reaction 3. Hypersensitivity; anaphylaxis | 1. Penicillin Antibiotic | |
| Piperacillin and tazobactam | Zosyn | 1. Diarrhea 2. Hypersensitivity; anaphylaxis | 1. Penicillin Antibiotic | |
| Amphotericin B desoxycholate | 1. Anemia 2. Electrolyte deficiencies 3. Nephrotoxicity 4. Hepatotoxicity | 1. Antifungal Agent | ISMP High-alert medication The conventional formulation (desoxycholate) is more nephrotoxic than lipid formulations. The mg/kg dosing is substantially different between formulations. | |
| Amphotericin B liposomal | AmBisome | 1. Anemia 2. Electrolyte deficiencies 3. Nephrotoxicity 4. Hepatotoxicity | 1. Antifungal Agent | ISMP High-alert medication Lipid formulations are substantially less nephrotoxic than the conventional formulation (desoxycholate). The mg/kg dosing is substantially different between conventional, liposomal, and lipid complex formulations. |
| Fluconazole | Diflucan | 1. Rash 2. Dizziness 3. Headache | 1. Antifungal Agent 2. Antifungal Agent, Azole Derivative | |
| Voriconazole | Vfend | 1. Hallucination 2. Encephalopathy 3. Visual disturbances | 1. Antifungal Agent 2. Antifungal Agent, Azole Derivative | |
| Micafungin | Mycamine | 1. Phlebitis 2. Renal failure 3. Abnormal LFTs 4. Vomiting | 1. Antifungal Agent 2. Echinocandin | |
| Acyclovir | Zovirax | 1. Phlebitis 2. Acute renal failure 3. Hives/itching | 1. Antiviral Agent | Do not refrigerate solutions diluted for infusion as they may precipitate. |
| Foscarnet | Foscavir | 1. Anemia 2. Diarrhea 3. Fever 4. Hypokalemia, hypocalcemia, hypophosphatemia 5. Granulocytopenia | 1. Antiviral Agent | Do not co-administer with other drugs via the same IV catheter, as foscarnet is chemically incompatible with many drugs (chelating properties). |
| Ganciclovir | Cytovene | 1. Anemia, leukopenia, thrombocytopenia, neutropenia 2. Fever 3. Hyperhidrosis 4. Increased SCr | 1. Antiviral Agent | |
| Epoetin alfa | Procrit | 1. Nausea, vomiting 2. Hypertension 3. Headache 4. Pruritus/skin rash | 1. Colony Stimulating Factor 2. Erythropoiesis-Stimulating Agent 3. Hematopoietic Agent | |
| Filgrastim | Neupogen | 1. Nausea 2. Chest pain | 1. Colony Stimulating Factor 2. Hematopoietic Agent | |
| Acetylcysteine | Acetadote | 1. Anaphylaxis | 1. Antidote 2. Mucolytic Agent | Should be administered through an in-line filter |
| Atropine | Atropine | 1. Anticholinergic side effects (dry mucous membranes, urinary retention) 2. Tachycardia | 1. Antidote 2. Anticholonergic Agent 3. Antispasmodic Agent | |
| Flumazenil | Romazicon | 1. Vomiting 2. Tremor 3. Ataxia | 1. Antidote | May precipitate seizures in patients who have been on longterm benzodiazepine therapy |
| Leucovorin | 1. GI side effects (NVD) 2. fatigue | 1. Antidote 2. Chemotherapy Modulating Agent 3. Chemotherapy rescue agent 4. Water soluable vitamin | ||
| Naloxone | narcan | 1. Dizziness 2. Flushing 3. Injection site reactions 4. Nausea/ Vomiting | 1. Antidote 2. Opioid Antagonist | Short t1/2. it may need to be administered multiple times until opioid wears off |
| Octreotide | Sandostatin | 1. Abdominal pain/ diarrhea, flatulence 2. Hyperglycermia | 1. Antidote 2. Antidiarrheal 3. Somatostatin analog | |
| Zoledronic acid | Reclast; Zometa | 1. Bone pain 2. Arthralgia 3. Hypotension | 1. Bisphosphonate Derivative | Administer through a separate IV line. Do not mix with any Calcium or divalent cation containing solution |
| Dexamethasone | Decadron | 1. Fluid Retention 2. Fragile Skin 3. Hyperglycemia 4. Hypertension 5. Mood changes | 1. Corticosteroid 2. Anti-inflammatory agent 3. Antiemetic | |
| Hydrocortisone | Solu-Cortef | 1. Fluid Retention 2. Fragile Skin 3. Hyperglycemia 4. Hypertension 5. Mood changes | 1. Corticosteroid | |
| Methylprednisolone Sodium Succinate | Solu-Medrol | 1. Fluid Retention 2. Fragile Skin 3. Hyperglycemia 4. Hypertension 5. Mood changes | 1. Corticosteroid | |
| Diphenhydramine | Benadryl | 1. sedation 2. Anticholinergic effects (urinary retention, dry mouth) | 1. Histamine H1 antagonist, 1st generation 2. Ethanolamine Derivative | INjection can cause local skin necrosis and should never be given subcutaneous or intradermal. For IM injections, make sure they are given deep IM |
| Promathazine | Phenergan | 1. Bradycardia 2. Sedation 3. Phlebitis | 1. H1 antagonist, 1st generation 2. Phenothiazine Derivative 3. Antiemetic | ISMP High-alert medication Vesicant, can cause severe tissue damage/ necrosis. should NOT be administered IM or IV push. Should be diluted and administered slowly as an IV intermittent infusion or via central line to avoid extravastation |
| Ranitidine | Zantac | 1. Contipation 2. Diarrhea 3. Nausea | 1. Histamine H2 antagonist | |
| Ondansetron | Zofran | 1. Constipation 2. Dirrhea 3. Headache | 1. Selected 5-HT 3 receptor antagonist 2. Antiemetic | |
| Pantoprazole | Protonix | 1. Constipation 2. Diarrhea 3. Headache | 1. PPI 2. Substitude benzimidazole | |
| Infliximab | Remicade | 1. Infusion-related reactions (chills, fever, rigors, myalgias,headache, cough) 2. upper respiratory tract infection | 1. Immunospressant agent 2. TNF blocking agent 3. Antirheumatic 4. Gastrointestinal agent 5. monoclonal antibody | ISMP high alert medication Short-stability medication, use solution within 3 h and use in-line ≤1.2 micron low protein binding filter. Donot infuse/mix w other solutions/medications. require premedications prior to infusion to infusion-related reactions. |
| Rituximab | Rituxan | 1. Infusion-related reactions (e.g., chills, fever, rigors, myalgias, headache, cough) 2. Fatigue | 1. Immunospressant agent 2. Antineoplastic agent 3. Antirheumatic 4. monoclonal antibody | ISMP High-alert medication Patients should be premedicated prior to infusion and infusions should be titrated upwards to decrease infusion-related reactions. |
| Oxytocin | Picotin | 1. Headache 2. Nausea/ Vomiting | 1. Oxytocic agent | ISMP High-alert medication NIOSH recommends using double gloves and wearing protective gown when preparing solutions. Many institutions develop an oxytocin infusion protocol in order to improve maternal-fetal safety and reduce medication errors. |
| Ketorolac | Toradol | 1. Dyspepsia 2. GI symptoms (nausea, abdominal pain, constipation, diarrhea) 3. GI bleeding (rare but serious) | 1. Analgesic, NonOpioid 2. Nonsteroidal Anti-inflammatory Drug | |
| Hydromorphone C-II | Dilaudid | 1. Constipation 2. Flushing 3. Hypotension 4. Itching 5. Respiratory depression | 1. Analgesic, Opioid | ISMP High-alert medication |
| Morphine C-II | Duramorph, Infumorph | 1. Constipation 2. Drowsiness 3. Nausea/vomiting 4. Respiratory depression | 1. Analgesic, Opioid | ISMP High-alert medication Use only preservative-free solutions for epidural administration |
| Buprenorphine C-III | Buprenex | 1. Respiratory depression 2. Dizziness 3. Sedation | 1. Analgesic, Opioid 2. Analgesic, Opioid Partial Agonist | ISMP High-alert medication |
| Fentanyl C-II | Sublimaze | 1. Constipation 2. Confusion/dizziness 3. Respiratory depression | 1. Analgesic, Opioid 2. Anilidopiperidine Opioid 3. General Anesthetic | ISMP High-alert medication |
| Ketamine C-III | Ketalar | 1. Prolonged emergence from anesthesia (confusion, delirium, dreamlike state, hallucinations, vivid imagery) | 1. General Anesthetic 2. Antidepressant | ISMP High-alert medication |
| Propofol | Diprivan | 1. Apnea 2. Hypotension 3. Injection site pain 4. Hypertriglyceridemia | 1. General Anesthetic | ISMP High-alert medication Expires 12 hours from opening. All tubing and unused portions should be discarded at that time. |
| Lidocaine | Xylocaine | 1. Dizziness 2. Nausea/vomiting 3. Paresthesia 4. Hypotension | 1. Local Anesthetic 2. Antiarrhythmic Agent | ISMP High-alert medication |
| Fosphenytoin | Cerebyx | 1. Ataxia 2. Nystagmus 3. Somnolence | 1. Antiseizure (Anticonvulsant) Agent | 1.5 mg fosphenytoin is approximately =1 mg phenytoin. doses of fosphenytoin are always expressed as their phenytoin sodium =(PE). Thus, 1mg PE= 1 mg phenytoin sodium. Do not change the recommended doses when fosphenytoin for phenytoin or vice versa as th |
| Levetiracetam | Keppra | 1. Hypertension 2. Vomiting 3. Somnolence | 1. Antiseizure (Anticonvulsant) Agent | |
| Phenytoin | Dilantin | 1. Exfoliate dermatitis 2. Stevens-Johnson syndrome 3. Blood dyscrasias 4. CNS toxicity | 1. Antiseizure (Anticonvulsant) Agent | Rate of infusion: do not infuse faster than 50 mg/minute |
| Valproate | Depacon | 1. Thrombocytopenia 2. Tremor 3. Diplopia | 1. Antiseizure (Anticonvulsant) Agent 2. Antimanic Agent 3. Histone Deacetylase Inhibitor | |
| Haloperidol lactate | Haldol | 1. Extrapyramidal reactions 2. Hyperkinesia 3. Akathisia | 1. First Generation (Typical) Antipsychotic | Note salt formulation: haloperidol lactate can be administered IM or IV; haloperidol decanoate is a long-acting formulation and is only for IM injection - should never be given IV. |
| Olanzapine | Zyprexa | 1. Drowsiness 2. Extrapyramidal symptoms | 1. Second Generation (Atypical) Antipsychotic 2. Antimanic Agent | |
| Ziprasidone | Geodon | 1. Drowsiness 2. Extrapyramidal symptoms | 1. Second Generation (Atypical) Antipsychotic 2. Antimanic Agent | |
| Diazepam C-IV | Valium | 1. Drowsiness 2. Slow breathing rate | 1. Antiseizure (Anticonvulsant) Agent, Benzodiazepine | |
| Lorazepam C-IV | Ativan | 1. Drowsiness 2. Slow breathing rate | 1. Antiseizure (Anticonvulsant) Agent, Benzodiazepine | ISMP High-alert medication |
| Midazolam C-IV | Versed | 1. Drowsiness 2. Slow breathing rate 3. Decreased tidal volume | 1. Antiseizure (Anticonvulsant) Agent, Benzodiazepine | ISMP High-alert medication Some formulations contain benzyl alcohol; use a preservative- free injection formulation in neonates. |
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