Preservative-free Vials and Preserved, Multiple Dose Vials
McGuff Compounding Pharmacy Services, Inc. is taking this opportunity to inform you of the difference between preservative-free vials and vials containing a preservative:
Vials of injectable preparations are sterile when you receive them. It is only after you penetrate the stopper with the needle that bacteria or other microbes may be inadvertently introduced into the vial. It is essential that you use proper aseptic technique throughout the process of administering an injection regardless whether the vial is preservative-free or contains a preservative.
Vials that will be used more than once should be stored in the refrigerator after they have been opened (with the possible exception of some minerals that may precipitate at cold temperatures). Refrigeration will retard the growth of microbes that may be inadvertently introduced into the vial via the needle.
These vials contain no preservative. These vials should be penetrated only once and then discarded.
However, some doctors may have instructed their patients to use a preservative-free vial more than one time. These physicians may be concerned that the patient is allergic to preservatives or that the patient may experience an adverse effect from the preservative. Because these vials contain no antimicrobial preservative, there is nothing to inhibit the growth of bacteria that may be inadvertently introduced when the stopper is penetrated by the needle. Strict aseptic technique must be followed in these instances.
Preserved, Multiple Dose Vials
"Multiple Dose Vials" are intended to be used more than once. They contain antimicrobial preservative agents to help retard the growth of bacteria that may be introduced when the stopper is penetrated via the needle. The great majority of patients can use medications containing preservatives without any problem.
Use after Initial Puncture
Preservative-free vials should be penetrated only once and then discarded.
For multiple dose vials (vials that contain an antimicrobial preservative) the USP states that the effectiveness of antimicrobial preservatives cannot be ensured beyond 28 days following initial penetration of the stopper, unless specified otherwise by the manufacturer. In general, you should date the vial upon initial penetration of the stopper, store the vial in the refrigerator, and discard it 28 days later. An unopened vial may be retained for use until the date indicated on the label if properly stored.
Basic steps to follow to properly manipulate injectable medications for administering intramuscular or subcutaneous injections
It is of utmost importance that the medication vial and the materials used for withdrawing and injecting the medication are sterile before use and that all precautions are taken to ensure that the medication and the materials are not contaminated during the procedure.
To begin, you should have a clean, well-lighted space, which is clear of clutter. Assemble all of the materials you will need: vial of medication, sterile alcohol pads, syringes, needles, and sharps container for used needles and syringes. Wash your hands with soap and dry them well.
If the vial of medication should be shaken before use, shake now. This will allow time for the bubbles to disperse. Remove the flip-top cap from the vial and wipe the rubber stopper with a sterile alcohol pad. Rub well using pressure, and use a new pad for each vial. Allow to air dry while completing the next steps. Assemble the proper syringes/needles for the dose you will be using.
Remove the outer wrapper from the syringe and needle (if applicable) and discard. Remove the plastic cover from the needle end of the syringe and set the cover aside. Be careful not to touch the needle to any surface except for the sanitized rubber stopper of the vial.
Pull back on the syringe plunger to the same volume as the dose you are going to prepare. This allows air to go into the syringe. Slowly push the needle into the rubber stopper at an angle. Invert the vial and push the air into the vial. Draw back on the plunger to the correct dose as measured on the side of the syringe. Invert the vial to its original position and remove the needle.
When you have removed the needle from the vial, carefully recap the needle with the plastic cover without injuring yourself. Allowing the dose of medication to come to room temperature may help to reduce discomfort during administration.
Wipe the injection site on your skin well with a new sterile alcohol pad. Allow the skin to air dry. Remove the plastic cover from the end of the needle and inject the medication in the manner you were shown in the physician’s office. When the entire dose has been injected, remove the needle from the skin and place the entire syringe/needle assembly into the sharps container for used needles and syringes. It is not necessary to recap the needle with the plastic cover. Any materials you used which may have come in contact with blood or are sharp should be discarded in the container. You may place a bandage on the injection site if you wish.
If you will be reusing the vial of medication, store it in the refrigerator. Consult a pharmacist if you are unsure which type of medication should be refrigerated or stored at room temperature.
Note: This information is not intended to cover all aspects of intramuscular or subcutaneous injections.
If you have further questions, please call us at 877-444-1133. Pharmacists are available for consultation from 8 AM to 5 PM, Pacific Standard Time.