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Pre-filled syringes for palliative care require sterility

June 9, 2021
Government-sponsored drug plans have added pre-filled syringes to palliative benefits. 

Effective June 1, 2021, pre-filled syringes have been added to the palliative benefits under the government-sponsored drug plans. This benefit includes disposable syringes and related supplies as well as the service of prefilling the syringe with an injectable prescription drug. Please refer to the Alberta Blue Cross Pharmacy Benefact 962.

Pursuant to ACP’s Standards for Pharmacy Compounding of Hazardous and Non-hazardous Sterile Preparations, sterility is required for reconstitution and certain manipulations (according to manufacturers’ instructions) of sterile products approved by Health Canada and for the repackaging of approved sterile products, regardless of the route of administration. This includes pre-filled syringes.

It is the responsibility of the compounder to assign appropriate beyond use dates (BUDs) to these pre-filled syringes according to risk level of sterile compounding and the environment in which the compounding takes place. In addition to sterility, stability of the contents and compatibility with the syringe must be considered. To assist with determining stability and compatibility, references that may be helpful include the King® Guide to Parenteral Admixtures® or Trissel’s Stability of Compounded Formulations. Contact the manufacturer of the syringe as needed to also confirm compatibility. Administration of compounded sterile preparations, including pre-filled syringes, must begin before the BUD has passed.

For more information on sterility requirements, please view our sterile compounding webpage and our Standards for Pharmacy Compounding of Hazardous and Non-hazardous Sterile Preparations.

Health professionals and administrators of medical facilities must be aware of safe practices and ensure that appropriate policies and procedures, knowledge, training, and equipment are available for handling medications, vaccines, and administration of injections. Hazardous drugs must be handled, stored, and used safely. For more information, please view our Guidelines for Medication and Vaccine Injection Safety.