Repeated injuries and several deaths have prompted the Institute for Safe Medication Practices (ISMP) to issue special alerts on the use of lipid-based drugs and on the improper dilution of albumin.
The ISMP said medication errors continue to occur from confusion between lipid-based drugs and their conventional counterparts. The particular drug pairs named were lipid-based forms of amphotericin B (Abelcet, Amphotec, and Ambisome) and the conventional form for injection (generic and Fungizone); the pegylated liposomal form of doxorubicin (Doxil) and its conventional counterpart, doxorubicin hydrochloride (Adriamycin and Rubex); and a liposomal form of daunorubicin (DaunoXome, daunorubicin citrate liposomas) and conventional daunorubicin hydrochloride (Cerubidine).
Dosages of lipid-based drugs can differ substantially from their conventional counterparts, the ISMP emphasized. Safety measures should include not storing the two forms of drugs together, posting warnings in conspicuous places, and noting that lipid-based drugs have a milky rather than a clear appearance.
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