USP 797 guidelines: TPN (Clinimix) w/ added infuvite BUD vs. Exp dating vs. hang time?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

PharmDBro2017

Full Member
7+ Year Member
Joined
Dec 1, 2015
Messages
1,769
Reaction score
1,801
Looking for some clarity here. I'm pretty confused with BUD vs. Expiration dating vs. Hang time with the new USP 797 guidelines, and I tend to overthink things.

Scenario: Sterile compounding of TPN 2000mL to be infusing at 83.3mL/hour over 24 hours: (Clinimix + MVI Infuvite + Trace elements + NaCl + KCl + other electrolytes etc) made in a ISO 5 PEC, at 10/19/19 @1200. To my knowledge, once you add MVI, stability is 24 hours (can anyone confirm?)

So onto my next question:

In this case, the BUD would be 10/20/19 @1200, correct?

Meaning the nurse can hang the bag anytime from 10/19/19 @1200 to 10/20/19 @1200?

So if it's compounded at 10/19/19 @1200 and then stored in the fridge, and it's timed to start hanging at 10/19/19 @2100 (ie new bag replaced the following day 10/20@2100), is that in compliance with the new guidelines and BUD? This would be considered a Category 2 BUD (aseptic prep in a PEC and fridge gives 10 day BUD, but stability of MVI makes it a BUD of 24 hours?)

Members don't see this ad.
 
From my understanding, the BUD is when the infusion STARTS infusing, so it would be in compliance.
 
  • Like
Reactions: 1 user
It is good because it’s spiked before the specified BUD.
But if there if there’s a stability issue then the BUD must be reconsidered.
 
  • Like
Reactions: 1 user
Members don't see this ad :)
In practice, this is always the way it's been done, spike within 24hrs, then hang for 24hrs. But I agree, when I read the 797 guidelines, it doesn't seem to be supporting that. It seems like 24hrs only starting from the prep date. This would be a PITA, if we have to go to 12 hr bags of TPNs.
 
  • Like
Reactions: 1 user
It is good because it’s spiked before the specified BUD.
But if there if there’s a stability issue then the BUD must be reconsidered.

Kind of what I’m afraid of.

Can anyone confirm stability of clinimix after adding infuvite? Having trouble finding any literature on it, but I’ve always been told it’s 24 hours once mixed.


Sent from my iPhone using SDN mobile
 
Last edited:
Top