Light Protection for Nitrate Infusions
Nitroglycerin infusions should be protected from light during administration, as recommended by the FDA drug label, which explicitly states "PROTECT FROM LIGHT. RETAIN IN CARTON UNTIL TIME OF USE." 1
FDA Drug Label Requirements
The official FDA labeling for intravenous nitroglycerin clearly mandates light protection throughout storage and use 1. This is a regulatory requirement that supersedes clinical judgment and must be followed in practice.
Practical Implementation
Both the drug reservoir (bag/vial) and the administration set (tubing) require light protection:
- The nitroglycerin solution should remain in its protective carton until the time of actual use 1
- Light-protective covers should be applied to the infusion bag or bottle during administration
- Administration tubing should ideally be covered with opaque material or light-protective sleeves
Supporting Evidence from Parenteral Nutrition Guidelines
While the primary evidence comes from the FDA label, pediatric parenteral nutrition guidelines provide additional context on the importance of light protection for photosensitive infusions:
- Light exposure generates oxidants and peroxides in photosensitive solutions, which can be harmful 2
- Both multi-layer bags and administration sets require protection from ambient light (daylight and artificial ward lighting) 2
- Photo-degradation occurs with exposure to both natural daylight and standard hospital lighting 2
Clinical Rationale
The mechanism of concern involves photo-degradation of the nitroglycerin molecule when exposed to optical radiation, which can:
- Reduce drug potency and therapeutic effectiveness
- Potentially generate undesirable photo-degradation products 3
- Compromise the intended hemodynamic effects needed for angina management
Common Pitfalls to Avoid
- Do not assume that amber-colored IV bags provide adequate protection - explicit light-protective covers are required
- Do not leave the solution exposed during preparation or hanging - minimize light exposure at all stages
- Do not use clear, unprotected tubing - the entire infusion pathway from bag to patient should be shielded
The FDA requirement is unambiguous and non-negotiable: nitroglycerin infusions must be protected from light 1.