Hospital Pharmacist
Vol 9 No 4 p91-92
April 2002

News summary

Related websites
Department of Health (www.doh.gov.uk)

DoH now releases clarification on intrathecal chemotherapy guidance

The Department of Health has provided further information in answer to questions on the national guidance on the safe administration of intrathecal chemotherapy, published last November.

On the dilution of vincristine for patients over the age of 10 years, the DoH states that the guidance (which stipulates a maximum concentration of 0.1mg per ml) should take precedence over the checklist to the guidance (which specifies a concentration of 0.1mg per ml). The minimum volume that should be administered is 10ml.

According to the DoH: "this means that the concentration should be less than or equal to 0.1mg per ml. Thus 1mg vincristine to be given intravenously must be diluted in at least a volume of 10ml; a dose of 0.9mg would therefore also be diluted to 10ml, not 0.1 mg per ml which would give a final volume less than 10ml [in this case 9ml]; 2mg vincristine to be given intravenously, must be diluted in at least 20ml."

The Department also confirmed that separate registers have to be kept for personnel who have been trained and certified competent in one or more of the tasks of prescribing, dispensing, checking and administering.

The training of health professionals in administering intrathecal chemotherapy is another area that has caused some concern (see HP, Nov/Dec 2001, p263). The DoH states that consultants who choose not to undergo training in the use of intrathecal chemotherapy "should not prescribe or administer chemotherapy, nor should they supervise the training of others."

In terms of providing a designated area for administering intrathecal chemotherapy, the Department recognises that trusts may not be able to put aside an area solely for this purpose but stress that "under no circumstance should [the area] be used for the storage or administration of cytotoxic drugs for intravenous use."

The clarifications can be found on the DoH website.

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