IV Compatibility Checker

Methodology & Sources

This page explains exactly how the IV Compatibility Checker decides what to show. The short version: a verdict only appears when it is backed by peer-reviewed research or FDA labeling, every verdict shows its source and the conditions it was tested under, and anything without qualifying evidence stays a "?" rather than a guess.

What it covers — and what it doesn't

• Y-site (co-infusion) compatibility for common ICU and med-surg infusions and IV pushes. It is not an admixture (same-bag) compatibility guide.
• Physical compatibility (precipitation, haze, color change) is the primary endpoint; where a study also tested chemical stability (drug potency), that is noted in the verdict's conditions.
• Data may come from adult or paediatric studies; the population and tested concentrations are shown with each verdict, because compatibility can differ between them.
• It does not replace pharmacy consultation, your facility's compatibility table, or the package insert.

How verdicts are graded

Every shown verdict carries an evidence tier:

• Confirmed  Agreement across 3 or more independent peer-reviewed studies (or peer-reviewed studies plus FDA labeling).
• Limited evidence — double-check  Based on 1–2 peer-reviewed studies. Treat as a lead, not a guarantee, and confirm for your concentrations.
• ?  No qualifying study found. This is neither "safe" nor "unsafe" — only that the evidence isn't established. Verify with pharmacy.

Verdicts are one of compatible, incompatible, or conditional (compatible only under specific concentrations or diluents — the most important nuance, and the reason a pair like vancomycin + piperacillin-tazobactam can be either depending on how it's mixed).

Which sources we use — and which we don't

• Included: peer-reviewed primary Y-site compatibility studies (located via PubMed) and U.S. FDA prescribing information / labeling.
• Not used: proprietary aggregators such as Trissel's Handbook on Injectable Drugs, Lexidrug (formerly Lexicomp), and Micromedex. This tool is not affiliated with, and does not reproduce, those products.
• Why: compatibility findings are facts drawn from the primary literature, and we cite those primary sources directly. That keeps the tool transparent, independently verifiable, and free to publish — rather than re-printing a licensed database.

How a verdict is produced

• Relevant Y-site studies are identified in PubMed and read for the specific drug pair.
• The tested conditions are recorded with the verdict — drug concentrations, diluent, mixing ratio, contact time, the method used (visual, turbidity, pH, particle count, HPLC), whether physical and/or chemical compatibility was tested, and the study population.
• Each entry is checked by an automated evidence gate before publishing: it is rejected unless it has a verdict, the tested conditions, and at least one resolvable citation matching its tier. Nothing reaches the page uncited.

Recency & re-review

The dataset shows the date its evidence was last reviewed (above). Verdicts whose newest source is more than 10 years old are flagged inline with a "⏳ older evidence" note so you know to re-verify. The dataset is re-reviewed on a recurring basis, and flagged pairs are re-checked against newer literature.

Limitations to keep in mind

• Most studies use simulated Y-site testing on the bench; a few drugs behave differently during actual infusion (this is noted where known).
• Compatibility is concentration- and diluent-dependent — a verdict is only valid within the tested conditions shown.
• Absence of evidence is not evidence of safety. A "?" means no qualifying study was found, not that a combination is fine.

Clinical review status

Full source list

Every cited verdict links to one of these peer-reviewed studies or FDA labels (located via PubMed):

1. Loading sources…