Stability and Compatibility of Diphenhydramine Hydrochloride in Intravenous Admixtures: A New Look at an Old Drug

Purpose: Intravenous (IV) admixtures of diphenhydramine are widely used in hospitalized patients to prevent or treat hypersensitivity reactions. However, there is limited data to support the admixture preparation in this manner. This study was designed to investigate the stability and compatibility of diphenhydramine in IV admixtures with a goal to establish a 14-day beyond-use dating with storage under refrigeration. Methods: The commercially available 50 mg/mL diphenhydramine hydrochloride injection vials were used to prepare the 0.2 and 1.0 mg/mL IV admixtures in 0.9% sodium chloride injection and 5% dextrose injection in 50 mL polyvinyl chloride (PVC) bags. The IV bags were sealed and stored under refrigeration (2°C-8°C) for the stability study. At each predetermined time point, samples were taken for visual inspection, pH measurement, and analysis by a stability-indicating high-performance liquid chromatography (HPLC) method. Results: The freshly prepared IV admixtures appeared clear, colorless, and particulate-free with pH readings of 4.44 to 4.60. The initial drug concentrations of all samples were confirmed by HPLC to be within 101.8% to 103.6% of the label claims. Over the 14 days of the study period, there was no significant change in the appearance or pH values for all stability samples. The HPLC results also confirmed that there was no more than ±2% change of the initial drug concentration in any stability samples. Conclusion: Diphenhydramine hydrochloride IV admixtures of 0.2 and 1.0 mg/mL are compatible with 0.9% sodium chloride injection and 5% dextrose injection in PVC bags. These IV admixtures are stable chemically and physically for up to 14 days when stored under refrigeration (2°C-8°C).