From the Guidelines
Flushing Nexviazyme (avalglucosidase alfa) with saline instead of D5W (5% dextrose in water) is not recommended and could potentially compromise the medication's stability and effectiveness. The medication is sensitive to the solution environment, and using saline could potentially cause protein aggregation or degradation of the enzyme. This is because Nexviazyme has specific pH and osmolality requirements that are maintained by D5W but not necessarily by saline solutions. If you have already flushed with saline, contact the healthcare provider immediately as this may affect the therapeutic outcome and patient safety. The requirement for D5W is not arbitrary - many biological medications like Nexviazyme have specific stability profiles that depend on the proper diluent. Always follow the manufacturer's specific instructions for dilution, administration, and flushing of Nexviazyme to ensure optimal therapeutic effect and patient safety. Although there is evidence that saline flushing is not inferior to heparin flushing regarding CVAD occlusion, reflux dysfunction and flow dysfunction 1, this does not apply to the stability and effectiveness of Nexviazyme. Key points to consider:
- Nexviazyme should only be diluted and flushed with D5W as specifically indicated in its administration guidelines
- Using saline could potentially cause protein aggregation or degradation of the enzyme
- The medication has specific pH and osmolality requirements that are maintained by D5W but not necessarily by saline solutions
- Contact the healthcare provider immediately if saline has been used instead of D5W.
From the Research
Administration of Nexviazyme
- The provided studies do not directly address the effects of flushing Nexviazyme (avalglucosidase alfa) with saline instead of D5W (5% Dextrose in Water) 2, 3, 4, 5.
- However, a study on the effectiveness of heparin solution versus normal saline in maintaining patency of intravenous locks in neonates found that using saline as a flush solution is preferable to heparin in peripheral intravenous locks in neonates, given the greater likelihood of complications associated with heparin 6.
- It is essential to note that the stability and compatibility of Nexviazyme with different flush solutions, including saline, should be consulted in the prescribing information or the manufacturer's guidelines.
Stability and Compatibility
- The studies provided do not offer specific information on the stability and compatibility of Nexviazyme when flushed with saline instead of D5W 2, 3, 4, 5.
- In general, the compatibility of a drug with a particular flush solution depends on various factors, including the drug's formulation, the concentration of the flush solution, and the materials used in the administration set.
- To ensure the safe and effective administration of Nexviazyme, it is crucial to follow the recommended guidelines for preparation, administration, and flushing, as specified in the prescribing information or the manufacturer's instructions.