Preparation of Ready To Administer Medicines, COVID-19 Wave 2 Update

Ready To Administer (RTA) Medicines

The provision of RTA medicines supports releasing time to care for nursing staff during the COVID-19 pandemic. Guidance on the options for Pharmacy to support clinical areas in the preparation of RTA medicines can be found here.

Ready to administer products prepared in licenced units should be sourced where possible, either via the national product list, direct request to licensed NHS units or commercial compounders. An updated list of available products compounded from bulk PMU supply may be found on the NHS Pro-file website FAQ page.

If unable to obtain supply from a licenced unit, section 10 batch preparation is  permissible, limited to the COVID-19 period and subject to conditions and RQA oversight.

Vial Sharing in Aseptic Services

During the COVID-19 period Aseptic Units operating under Section 10 may be requested to prepare a range of ready-to-use medicines to support clinical staff and release time to care. To ensure that these are prepared safely, and are available when required, units may need to prepare some products either by campaign dispensing OR preparation for stock. Guidance designed to support units undertaking these activities can be found here

S10 Batch Preparation

A formal written request to your regional quality assurance (RQA) pharmacist is required before commencing batch production for stock. This must include details on the specific products to be made.

Supply across legal boundaries can only happen if the unit has a Low risk rating from their most recent EL audit. Please inform your RQA pharmacist if you plan to supply across legal boundaries.

The worksheets below have been developed and approved by the Pharmaceutical Quality Assurance Committee (PhQAC) to support unlicensed aseptic units to safely prepare small batches of critical medicines used in ICU over the current COVID-19 emergency period.

For further details on product shelf life, storage conditions and stability references sources used, please see the Stability reference table

For additional support on the use of these worksheets, see the guidance document COVID-19: Worksheets for batch preparation of ICU medicines in unlicensed aseptic units

A blank product template is available here to allow units to develop worksheets for products which are not listed. If a new product worksheet is developed locally it must be approved by your RQA Pharmacist.

Please direct further questions or feedback to RegionalQAQueries@rlbuht.nhs.uk

Product Final concentration Version / Format Available
Alfentanil

25mg in 50ml in Glucose 5%

500 microgram/ml Worksheet V1.0 PDF

Worksheet V1.0 Excel Format

Atracurium

500mg in 50ml

10mg/ml Worksheet V1.0 PDF

Worksheet V1.0 Excel Format

Cisatracurium

150mg in 30ml

5mg/ml Worksheet V1.0 PDF

Worksheet V1.0 Excel Format

Fentanyl

500 micrograms in 10ml

50 microgram/ml Worksheet V1.0 PDF

Worksheet V1.0 Excel Format

Insulin(Actrapid)

50 units in 50ml  in Sodium Chloride 0.9%

1unit/ml Worksheet V1.0 PDF

Worksheet V1.0 Excel Format

Insulin (Humulin S)

50 units in 50ml  in Sodium Chloride 0.9%

1unit/ml Worksheet V1.0 PDF

Worksheet V1.0 Excel Format

Metaraminol

25mg in 50ml in Sodium Chloride 0.9%

500 microgram/ml Worksheet V1.1 PDF

Worksheet V1.1 Excel Format

Midazolam

100mg in 50ml

2 mg/mL Worksheet V1.0 PDF

Worksheet V1.0 Excel Format

Morphine sulphate

100mg in 50ml in Sodium Chloride 0.9%

2mg/ml Worksheet V1.1 PDF

Worksheet V1.1 Excel Format

Noradrenaline

8mg in 50ml in Glucose 5%

160 microgram/ml Worksheet V1.0 PDF

Worksheet V1.0 Excel Format

Propofol

400mg in 40ml

10mg/ml Worksheet V1.1 PDF

Worksheet V1.1 Excel Format

Rocuronium  

100mg in 10ml

10 mg/ml Worksheet V1.1 PDF

Worksheet V1.1 Excel Format

Suxamethonium 

100mg in 2ml

50 mg/ml Worksheet V1.1 PDF

Worksheet V1.1 Excel Format

Thiopental Sodium

250mg in 20ml Water for Injection

12.5 mg/ml Worksheet V1.1 PDF

Worksheet V1.1 Excel Format

In Development – Coming Soon
Fentanyl

2.5mg in 50ml

50 microgram/ml In Development – Coming Soon
Remifentanyl

2mg in 50ml in Sodium Chloride 0.9%

50 microgram/ml In Development – Coming Soon

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