From the Research
Yes, adding a multivitamin to an intravenous (IV) saline bag is considered compounding, as it involves combining two separate pharmaceutical products to create a new preparation tailored to specific patient needs. When a healthcare provider adds a multivitamin solution to a saline bag, they are creating a compounded sterile preparation that requires verification of compatibility between the components, proper labeling of the final product with patient information, ingredients, concentration, beyond-use date, and storage requirements 1.
Key Considerations
- The process must be performed using aseptic technique in an appropriate environment, typically a pharmacy clean room or laminar flow hood, to prevent contamination.
- Healthcare facilities follow USP <797> guidelines for sterile compounding to ensure patient safety, as outlined in studies such as 2.
- The rationale for combining vitamins with IV fluids is to provide essential micronutrients to patients who cannot take oral supplements, particularly those with malabsorption issues, on total parenteral nutrition, or otherwise nutritionally compromised.
Evidence-Based Practice
The most recent and highest quality study, 1, published in 2023, emphasizes the importance of using licensed forms of injectable vitamins that are prescription-only medicines, and that they should only be supplied and administered by appropriately qualified healthcare professionals. This study highlights the lack of high-quality evidence to suggest that high-dose vitamin infusions are necessary or offer any health benefit in the absence of a specific vitamin deficiency or medical condition.
Best Practices for Compounding
To ensure accuracy and safety in compounding, studies such as 3 suggest that inversion rather than shaking and dilution in a large volume is a simple procedure for bedside medication preparation that allows better accuracy. Additionally, the number of mixing procedures, such as 3 versus 10, may not significantly impact accuracy, which can be important for time-consuming procedures.