{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T01:59:44Z","timestamp":1768701584152,"version":"3.49.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T00:00:00Z","timestamp":1662940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>There is a lack of information on the compatibility of remimazolam with opioid analgesics, muscle relaxants, and other sedatives. This study aimed to evaluate the physical compatibility of remimazolam with these drug classes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Remimazolam was combined with 1 or 2 target drugs (remifentanil, fentanyl, rocuronium, vecuronium, dexmedetomidine, and midazolam). Ten physical compatibility tests were conducted, including four 3-drug compatibility tests. Remimazolam was dissolved in 0.9% sodium chloride injection to a final concentration of 5 mg\/mL. Other medications were diluted in 0.9% sodium chloride injection to obtain clinically relevant concentrations. Compatibility tests were conducted with 3 test solutions, wherein remimazolam and the target drugs were compounded at equal volume ratios (1:1 or 1:1:1). Visual appearance was assessed and testing of Tyndall effect, turbidity, and pH was performed immediately after mixing and then again 1 hour and 4 hours after mixing. Appearance and turbidity were evaluated by comparison with the control solution of each target drug diluted with 0.9% sodium chloride injection to the same concentration as the test solution.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All drugs tested were determined to be compatible with remimazolam. The drug combination with the highest change of turbidity was remimazolam and vecuronium (a mean increase of 0.16 NTU relative to the remimazolam control solution), 4 hours after mixing. The combination with the highest pH was remimazolam, fentanyl, and vecuronium (mean [SD], 3.76 [0.01]), 4 hours after mixing. The combination of remimazolam and fentanyl showed a larger change in pH at 4 hours after mixing (a mean increase of 2.6%) than immediately after mixing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Remifentanil, fentanyl, rocuronium, vecuronium, dexmedetomidine, and midazolam are physically compatible with remimazolam during simulated Y-site administration.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxac262","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T16:06:24Z","timestamp":1662998784000},"page":"e53-e58","source":"Crossref","is-referenced-by-count":8,"title":["Physical compatibility of remimazolam with opioid analgesics, sedatives, and muscle relaxants during simulated Y-site administration"],"prefix":"10.1093","volume":"80","author":[{"given":"Masayoshi","family":"Kondo","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chie","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Tagami","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Nippon Medical School Musashi Kosuigi Hospital , Kanagawa , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazumi","family":"Horikawa","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazutoshi","family":"Sugaya","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisamitsu","family":"Takase","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital , Tokyo , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,9,12]]},"reference":[{"issue":"12","key":"2022121509185034400_CIT0001","first-page":"929","article-title":"Remimazolam, a short-acting gaba(a) receptor agonist for intravenous sedation and\/or anesthesia in day-case surgical and non-surgical procedures","volume":"13","author":"Rogers","year":"2010","journal-title":"IDrugs"},{"issue":"6","key":"2022121509185034400_CIT0002","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/s40265-020-01299-8","article-title":"Remimazolam: first approval","volume":"80","author":"Keam","year":"2020","journal-title":"Drugs"},{"key":"2022121509185034400_CIT0003","article-title":"Package insert","author":"Anerem (remimazolam).","year":"2020"},{"issue":"5","key":"2022121509185034400_CIT0004","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1213\/ANE.0000000000003668","article-title":"Multimodal general anesthesia: theory and practice","volume":"127","author":"Brown","year":"2018","journal-title":"Anesth Analg"},{"key":"2022121509185034400_CIT0005","article-title":"Package insert","author":"Byfavo (remimazolam).","year":"2020"},{"issue":"4","key":"2022121509185034400_CIT0006","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00540-020-02788-6","article-title":"Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase iib\/iii trial","volume":"34","author":"Doi","year":"2020","journal-title":"J Anesth"},{"issue":"3","key":"2022121509185034400_CIT0007","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1016\/j.bja.2020.11.021","article-title":"Ringer\u2019s acetate solution-induced precipitation of remimazolam","volume":"126","author":"Sasaki","year":"2021","journal-title":"Br J Anaesth"},{"issue":"4","key":"2022121509185034400_CIT0008","doi-asserted-by":"crossref","first-page":"e241622","DOI":"10.1136\/bcr-2021-241622","article-title":"Incompatibility of remimazolam besylate with ringer\u2019s acetate infusion resulting in total occlusion of an intravenous catheter","volume":"14","author":"Matsuo","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2022121509185034400_CIT0009","volume-title":"JPXVII: The Japanese Pharmacopoeia Seventeenth Edition, English version, 2016","author":"Ministry of Health, Labour and Welfare."},{"issue":"14","key":"2022121509185034400_CIT0010","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1093\/ajhp\/zxaa118","article-title":"Y-site physical compatibility of hydrocortisone continuous infusions with admixtures used in critically ill patients","volume":"77","author":"Foushee","year":"2020","journal-title":"Am J Health-Syst Pharm"},{"issue":"3","key":"2022121509185034400_CIT0011","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.clinthera.2020.01.017","article-title":"Y-site administration of imipenem\/cilastatin\/relebactam with common intravenous medications","volume":"42","author":"Ghazi","year":"2020","journal-title":"Clin Ther"},{"issue":"14","key":"2022121509185034400_CIT0012","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.2146\/ajhp170839","article-title":"Physical compatibility of plazomicin with select i.v. drugs during simulated Y-site administration","volume":"75","author":"Asempa","year":"2018","journal-title":"Am J Health-Syst Pharm"},{"issue":"1","key":"2022121509185034400_CIT0013","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s40981-020-00401-z","article-title":"Intraoperative responses of motor evoked potentials to the novel intravenous anesthetic remimazolam during spine surgery: a report of two cases","volume":"6","author":"Kondo","year":"2020","journal-title":"JA Clin Rep"},{"key":"2022121509185034400_CIT0014","author":"American Society of Health-System Pharmacists."}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxac262\/46202950\/zxac262.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/80\/1\/e53\/47884542\/zxac262.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/80\/1\/e53\/47884542\/zxac262.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T21:53:47Z","timestamp":1671141227000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/80\/1\/e53\/6696308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,12]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,9,12]]},"published-print":{"date-parts":[[2023,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxac262","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,1,1]]},"published":{"date-parts":[[2022,9,12]]}}}