The FOLFOX regimen—oxaliplatin (L-OHP), fluorouracil (5-FU) and levofolinate calcium (l-LV)—has been approved as first-line chemotherapy for metastatic colorectal cancer. However, the package insert for L-OHP injection states that “it must not be mixed with a sodium chloride solution or other chloride-containing solutions” and “as an infusion solution, it must not be administered simultaneously with basic solutions through the same infusion line”. In our hospital, 5% glucose solution is normally used for diluting L-OHP as well as l-LV and pre-medicated injections.
However, in the present study, we found that the time in contact with sodium chloride in the infusion line was less than 10 seconds, and the stability of L-OHP was not affected by it for at least 10 minutes. We therefore we changed 5% glucose solution to sodium chloride solution for diluting l-LV and other pre-medicated injections. This made it possible to standardize regimens and helped raise medical safety. It also shortened preparation time and outpatient waiting time because pre-medicated injections can be prepared in advance together with those for other regimens. We also consider that dilution with sodium chloride solution would be an option for diabetes patients who need strict glucose control. From the present study, we realized the importance of making efforts to improve our service to patients based on a good understanding of the information we have on medications and a consideration of their needs, as well as that of confirming all of this in practice in the clinical setting.