Which medication should not be mixed with dextrose 5% in water (D5W)?

Daptomycin is a medication that should not be mixed with dextrose 5% in water (D5W) due to potential stability issues. When daptomycin is exposed to D5W, it can lead to a decreased efficacy of the drug, as its stability is compromised in that diluent. This is particularly critical in compounded sterile preparations, where maintaining medication integrity and effectiveness is paramount.

In addition, specific characteristics of daptomycin's formulation necessitate careful handling and appropriate mixing with compatible solutions. For instance, it is often recommended to use normal saline or lactated Ringer's solution instead of D5W, which helps to preserve the activity of daptomycin.

Understanding the compatibility of various drugs with diluents is essential for a CSPT, as improper mixing can lead to adverse effects or treatment failures in patients.