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Reconstituting VELETRI® (epoprostenol) for Injection

Bootle and wet wipeThoroughly wash your hands with soap and warm water for at least one minute, then dry. To help prevent infection, clean your work surface with disinfectant wipes or 70% alcohol.

 

Removing bottle capRemove the caps from the vial of VELETRI and from the normal saline (NS) or sterile water (SW).

If you are using the 0.5 mg vial of VELETRI, the cap will be white.

 

Cleaning bottle capClean the rubber stoppers of the vials of VELETRI and NS or SW with a disinfectant or antiseptic pad, or a pad with 70% alcohol.

Important: VELETRI is stable only when reconstituted as directed using Sterile Water for Injection, USP, or Sodium Chloride 0.9% Injection, USP. VELETRI must not be reconstituted or mixed with any other intravenous medications or solutions prior to or during administration. The same solution must be used for both reconstituting and diluting VELETRI. Do not combine sterile water with normal saline when preparing VELETRI.

These solutions are commercially available and can be purchased from either regular or specialty pharmacies.

Needle with plunger pulled backHold the 5-mL or 10-mL syringe with needle and draw back the plunger to the 5-mL mark to draw in air.

Be careful to avoid touching the plunger shaft.

Confirm that the needle is tightly attached to the syringe before removing the needle cap.

 

Needle inserted to bottleInsert the needle's tip bevel up (see inset) into the NS or SW vial at a 45-degree angle. Push the needle into the core of the vial. Press down on the plunger to inject the air from the syringe into the solution.

 

Bottle and needleWith the needle still inserted into the vial, turn the vial upside down.

Position the needle tip below the fluid level, and draw the prescribed amount of NS or SW into the syringe.

 

Bottle and needle with plunger pulledGently pull the syringe out of the vial.

 

Bottle and needleTo add the prescribed amount of NS or SW to the powdered VELETRI medication vial, insert the needle's tip bevel up (see inset) at a 45-degree angle into the rubber stopper.

 

Bottle and needle plunger pushing upSlowly inject the NS or SW, making sure to prevent turbulence and foaming of the medication.

 

Bottle and needle horizontalDO NOT SHAKE. Gently roll the vial of VELETRI in your hands until the powder is completely dissolved and the solution is clear.

Turn the vial upside down to trap any undissolved powder that may be present near the top of the vial. Cloudiness and particles should not be present in the solution.

 

Bottle and needle togetherDraw back the appropriate amount of medication from the vial into the 5-mL or 10-mL syringe based on the desired concentration.

Recap the syringe and put it down on your clean work surface. You are now ready to fill the medication cassette.

Note: Please advise your patients to be cautious when re-capping the needle. There are alternatives to re-capping the needle, so please discuss this step with your patients.

Repeat steps 2 through 11 if more than one vial of VELETRI is being used.

Note: The same solution must be used for both reconstituting and diluting VELETRI. Do not combine sterile water with normal saline when preparing VELETRI.