Is clindamycin phosphate compatible with 0.9% normal saline (sodium chloride) for intravenous administration?

Compatibility of Clindamycin Phosphate with 0.9% Normal Saline

Yes, clindamycin phosphate is compatible with 0.9% normal saline (sodium chloride) for intravenous administration. This compatibility is well-documented in both the FDA drug labeling and multiple compatibility studies.

Evidence for Compatibility

According to the FDA drug labeling for clindamycin phosphate:

• Physical and biological compatibility studies have demonstrated no inactivation or incompatibility with the use of clindamycin injection in IV solutions containing sodium chloride 1
• Specifically, clindamycin phosphate at concentrations of 6,9, and 12 mg/mL in 0.9% sodium chloride injection has demonstrated physical and chemical stability for:
  • At least 16 days at room temperature (25°C)
  • At least 32 days when refrigerated (4°C) 1

Concentration Guidelines

The FDA labeling provides important guidance on concentration limits:

• The concentration of clindamycin in diluent for infusion should not exceed 18 mg/mL
• Infusion rates should not exceed 30 mg per minute 1

Research Support

Multiple independent research studies confirm this compatibility:

• A 1985 study demonstrated that clindamycin phosphate maintained stability in 0.9% sodium chloride for 24 hours at room temperature in both glass bottles and PVC bags 2
• Another 1985 study showed clindamycin phosphate was stable for at least 48 hours when mixed in 0.9% sodium chloride injection 3

Clinical Applications

In clinical practice, this compatibility is utilized in various settings:

• The British Thoracic Society guidelines mention that when administering nebulized amikacin, it should be mixed with sodium chloride 0.9%, demonstrating the common use of normal saline as a diluent 4
• For specific clinical applications like raltitrexed administration in colorectal cancer treatment, guidelines specifically recommend using "50-250ml 0.9% sodium chloride injection" as the diluent 4

Important Considerations

When administering clindamycin in normal saline:

1. Follow proper dilution techniques to ensure the concentration does not exceed 18 mg/mL
2. Be aware of the recommended infusion rates (not exceeding 30 mg per minute)
3. Use proper visual inspection for particulate matter and discoloration prior to administration
4. Note that while clindamycin is compatible with normal saline, it is physically incompatible with certain other medications including ampicillin sodium, phenytoin sodium, barbiturates, aminophylline, calcium gluconate, and magnesium sulfate 1

Storage Recommendations

If preparing in advance:

• Room temperature storage: Stable for at least 16 days at 25°C
• Refrigerated storage: Stable for at least 32 days at 4°C
• Frozen storage: Stable for at least 8 weeks at -10°C (should be thawed at room temperature and not refrozen) 1

This compatibility information allows for safe and effective administration of clindamycin phosphate using 0.9% normal saline as the diluent in intravenous therapy.