Impact of the Design of Different Infusion Containers on the Dosing Accuracy of a Therapeutic Drug Product

J Pharm Sci. 2024 Apr;113(4):990-998. doi: 10.1016/j.xphs.2023.10.010. Epub 2023 Oct 7.

Abstract

Residual volumes of infusion solutions vary greatly due to container and dimensional variances. Manufacturers use overfill to compensate, but the exact amounts vary significantly. This variability in overfill - when carrier solutions are used to dilute other parenteral preparations - may lead to variable concentrations and dosing, hence, potential risk for patients. We analyzed the overfill and residual volume of 22 pre-filled infusion containers and evaluated the impact on the (simulated) dosing accuracy of a therapeutic drug product for different handling scenarios. In addition, compendial properties of the diluents (i.e. sub-visible particles, pH, color and opalescence) were assessed. The overfill and residual volume between different containers for the same diluent varied. As container size increased, the relative volume of overfill decreased while the residual volume remained constant. The design and material of the containers (e.g. port systems) defined the residual volume. Different handling scenarios led to differences in dosing accuracy. As a result, no universal approach applicable for all containers can be defined. To ensure the right dose, it is recommended to pre-select the preferred diluent, evaluate fill volumes of carrier solutions, and assess in-use compatibility of the product solution with its diluent in terms of concentration and volume.

Keywords: Antibody drug(s); Cancer chemotherapy; Dose calculation; Formulation; Infusion bag; Infusion container; Injectable(s); Patient dosing; Protein delivery; Protein formulation(s).

MeSH terms

  • Drug Packaging*
  • Humans
  • Infusions, Parenteral