AHFS Class:

10:00 Antineoplastic Agents

Amsacrine is available in ampuls containing 1.5 mL of a 50-mg/mL solution (75 mg total) in anhydrous N,N-dimethylacetamide (DMA). It is packaged with a vial containing 13.5 mL of 0.0353 M L-lactic acid diluent.¹

To prepare the drug for use, aseptically add 1.5 mL of the amsacrine solution to the vial of L-lactic acid diluent. The resulting orange-red solution contains amsacrine 5 mg/mL in 10% (v/v) N,N-dimethylacetamide and 0.0318 M L-lactic acid. This concentrated solution must be diluted in dextrose 5% for infusion; do not use chloride-containing solutions.¹

Direct contact of amsacrine solutions with skin or mucous membranes may result in skin sensitization and should be avoided.²³⁴

Trade Name(s)

Amsidine, Amsidyl

Amsacrine is administered by central vein infusion over 60 to 90 minutes after the dose is diluted in 500 mL of dextrose 5%.¹

Amsacrine in intact ampuls should be stored at room temperature.¹ When mixed with the L-lactic acid diluent, the amsacrine solution is physically and chemically stable for at least 48 hours at room temperature under ambient light.²³⁴

Light Effects

The effect of diffuse daylight and fluorescent light on amsacrine 150 mcg/mL in dextrose 5% was studied for 48 hours at 19 to 21°C; no loss due to light exposure occurred.¹³⁰⁸

Syringes

Glass syringes are recommended for the transfer of amsacrine concentrate to the L-lactic acid diluent.¹¹⁵ The DMA solvent may extract UV-absorbing species from plastics and rubber.⁹⁶⁷

The compatibility of amsacrine (Gödecke) concentrated solution in DMA with rubber-free plastic syringes (Injekt, B. Braun) was evaluated at 37°C and ambient temperature. Storage of the DMA diluent in the plastic syringes resulted in no visible changes to the drug or syringes and did not adversely affect the performance of the syringes. Analysis found a trace amount of oleic acid amide lubricant, about 50 mcg in the 2-mL syringe content, after storage for 24 hours at 37°C. Storage at ambient temperature resulted in substantially lower amounts of oleic acid amide. The authors concluded the rubber-free Injekt plastic syringes were acceptable alternatives to glass syringes to transfer the amsacrine concentrate. Other plastic syringes incorporating rubber components are not recommended because of the extraction of materials into the drug solution.²²⁸⁴

Sorption

Amsacrine 150 mcg/mL in dextrose 5% did not undergo sorption to cellulose propionate and methacrylate butadiene styrene burette chambers and PVC and polybutadiene tubing.¹³⁰⁸

Solution Compatibility

Additive Compatibility

Y-Site Injection Compatibility (1:1 Mixture)

For a list of references cited in the text of this monograph, search the monograph titled References.

ASHP^® Injectable Drug Information^TM. Selected Revisions March 31, 2024. © Copyright, 2024. American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.