Particle contamination in contrast media induced by disposable syringes

Characterization of particles in protein solutions: reaching the limits of current technologies

Recent publications have emphasized the lack of characterization methods available for protein particles in a size range comprised between 0.1 and 10 μm and the potential risk of immunogenicity associated with such particles. In the present paper, we have investigated the performance of light obscuration, flow microscopy, and Coulter counter instruments for particle counting and sizing in protein formulations. We focused on particles 2-10 μm in diameter and studied the effect of silicon oil droplets originating from the barrel of pre-filled syringes, as well as the effect of high protein concentrations (up to 150 mg/ml) on the accuracy of particle characterization. Silicon oil was demonstrated to contribute significantly to the particle counts observed in pre-filled syringes. Inconsistent results were observed between different protein concentrations in the range 7.5-150 mg/ml for particles <10 μm studied by optical techniques (light obscuration and flow microscopy). However, the Coulter counter measurements were consistent across the same studied concentration range but required sufficient solution conductivity from the formulation buffer or excipients. Our results show that currently available technologies, while allowing comparisons between samples of a given protein at a fixed concentration, may be unable to measure particle numbers accurately in a variety of protein formulations, e.g., at high concentration in sugar-based formulations.

The use of asymmetrical flow field-flow fractionation in pharmaceutics and biopharmaceutics

Field-flow fractionation (FFF) is a family of flexible analytical fractionating techniques which have the advantage that the separation of analytes is achieved, solely through the interaction of the sample with an external, perpendicular physical field, rather than by the interaction with a stationary phase. The rapid progress in pharmaceutical biotechnology goes along with an increasing demand in potent, high-efficient analytical methods. Thus, FFF techniques are gaining increasing attention for their ability to separate and characterize populations of polymers, colloids and particles of up to about 100 microm in size. It is the intention of this review to provide an overview on common FFF techniques, to summarize inherent advantages and limitations and to introduce both established and challenging applications in the (bio)pharmaceutical field. Thereby, asymmetrical flow FFF is addressed predominantly, since it is the most versatile applicable FFF technique.

Particulate contamination of lyophilized amphotericin B preparation during reconstitution process

OBJECTIVE

To investigate the effect of the reconstitution methods for the commercial amphotericin B preparation with respect to particulate contamination.

METHODS

The particle counts in amphotericin B solutions reconstituted according to three different methods and amphotericin B fluids made with intravenous fluids after reconstitution were performed using a light extinction method. The particle contaminants were identified with X-ray emission spectrometry attached to a scanning electron microscope.

RESULTS

Amphotericin B in a vial induced particle contamination during the reconstitution process, and the contamination was especially marked by shaking vigorously after injecting water into the vial. From the X-ray analysis, it appeared that the increased number of particles was derived from the amphotericin B-deoxycholate complex containing substances such as silicone released from the vial components. Amphotericin B fluid made with intravenous fluids after reconstitution also contained particles over the acceptable limits according to the Japanese or US pharmacopoeia.

CONCLUSION

These findings suggest that reconstituted solutions should be filtered with membrane filters and diluted fluids with in-line filters.

High speed injection of radiographic contrast media induces severe particulate contamination

In a study of exogenous particulate contamination during angiography, the effect of injection speed of four kinds of radiographic contrast media (RCM) was investigated. The particle count (> or = 10 microns) in all RCM increased in a speed-dependent manner and the increase was especially dramatic at 3 ml s-1. The extent of increase in particulate matter was higher for ioxaglate than for the other three RCM. As particulate matter is unwanted and unnecessary, to prevent the harmful effects in patients much attention should be paid to various factors generating particulate matters, such as characteristics of RCM and plastic syringe.

Evaluation of the in-line filters for the intravenous infusion of amphotericin B fluid

OBJECTIVE

To evaluate the effects of four types of in-line filters on filtration rate, amphotericin B concentration and particulate matter.

METHODS

Filtration rates of amphotericin B fluid through in-line filters under maximum gravity flow were examined. The concentrations of amphotericin B and the particulate matter in the non-filtered and filtered amphotericin B fluid at the flow rate of 500 ml/24 h were measured.

RESULTS

Filtration through a 1.2 microm or 0.2 microm polyethersulphone (PES) filter under maximum gravity flow took less than 40 min. The 0.2 microm positively charged nylon 66 and 0.2 microm nylon 66 filters took 70 and 100 min, respectively, to filter 500 ml of amphotericin B fluid. The 0.2 microm positively charged nylon 66 filter and the 0.2 microm nylon 66 filter, but not the PES filter (1.2 and 0.2 microm), decreased the concentrations of amphotericin B in the filtered fluid by 100% within 1 h and by 66% within 24 h after the start of filtration, respectively. The particulate count in the non-filtered amphotericin B fluid was 27+/-5 particles/ml, exceeding the limit defined by USP XXIII. The 1.2 microm and 0.2 microm PES filters significantly decreased particulate matter by 83 and 97%, respectively, just after filtration.

CONCLUSION

The present results indicate that the 0.2 microm PES filter is optimal for intravenous infusion of amphotericin B fluid to minimize the introduction of particulate matter, microbial contaminants and endotoxin into patients.

Contrast medium-induced pulmonary edema is aggravated by silicone contamination in rats

PURPOSE

To examine the effect of silicone contamination, which occurs in clinical settings during vial preparation with disposable syringes, on contrast medium-induced pulmonary edema in rats.

MATERIALS AND METHODS

Ioxaglate, ioversol, and iohexol, silicone-containing physiologic saline solutions, and three silicone-containing contrast media were separately, intravenously injected at 1.5 mL/min in rats. Pulmonary edema was evaluated as changes in the relative lung weight and in the water, sodium, and potassium contents of the lung.

RESULTS

Intravenous injection of ioxaglate induced marked pulmonary edema, even with a dose of only 4 g of iodine per kilogram of body weight. In contrast, ioversol and iohexol induced significant pulmonary edema only after the injection of large doses (6 g of iodine per kilogram; P < .05). The injection of 4 microL/mL silicone-containing physiologic saline at a dose of 18.75 mL/kg also produced marked pulmonary edema, whereas doses of 6.25 and 12.5 mL/kg showed no significant influence. The addition of an ineffective dose (12.5 mL of physiologic saline per kilogram of body weight) of silicone in contrast medium substantially aggravated the pulmonary edema induced by the contrast medium alone; this phenomenon was also confirmed with morphologic observation.

CONCLUSION

Ionic contrast media are more toxic to the endothelial cells than are nonionic contrast media. Silicone contamination might be one of the causes of pulmonary edema after intravenous injection. However, caution must be exercised in extrapolating these results to humans.

Quality evaluation by capillary electrophoresis of amphotericin B injection after filtration through various membrane filters

The determination of amphotericin B, an antifungal agent, was developed using micellar electrokinetic capillary chromatography (MEKC) with a diode array detector. Repeatability and intermediate precision of MEKC analysis were acceptable. A high correlation was found between amphotericin B levels in pharmaceutical solutions obtained by MEKC and those by high-performance liquid chromatography (HPLC) (r = 0.994). This MEKC method is therefore useful for the determination of amphotericin B. The concentration of amphotericin B did not significantly change after filtration through polyethersulfone (PES, 0.2 microm) and polyvinylidene difluoride (PVDF, 0.45 microm) membrane filters. When the Fungizone injection was filtered through PES (0.2 microm) and added to 5% dextrose for injection (500 mL), particulate matters larger than 10 microm decreased by 64% to a level under the standard defined by United States Pharmacopoeia (USP XXIII). PVDF filtration (0.45 microm) did not have this effect. Our results suggest that filtration of Fungizone injection through PES (0.2 microm) membrane filters is recommended for the preparation of intravenous amphotericin B fluid.

Quality evaluation of radiographic contrast media in large-volume prefilled syringes and vials

RATIONALE AND OBJECTIVES

The authors compared the particle contaminations of radiographic contrast media packaged in large-volume prefilled syringes and vials.

MATERIALS AND METHODS

Particle counting was performed for four contrast media packaged in large-volume prefilled syringes (iohexol, ioversol, ioversol for angiography, and ioxaglate) and three contrast media packaged in vials (iohexol, ioversol, and ioxaglate). X-ray emission spectrometry was performed to characterize the individual particles. The amount of silicone oil in the syringe was quantified with infrared spectrophotometry.

RESULTS

The particle contamination in syringes containing ioversol was higher than that in syringes containing iohexol or ioxaglate. Particle contamination in the vials was relatively low, except with ioxaglate. X-ray emission spectrometry of the components of the syringe and vial showed that the source of particles was internal material released from the rubber stopper or inner surface.

CONCLUSION

The particle counts for contrast media packaged in syringes and vials varied considerably among the different contrast media and were related to the amount of silicone oil on the inner surface and rubber piston of the syringe.