Elliotts B®

Elliotts B®
SPL v6
SPL
SPL Set ID 08036dbd-55b3-47b9-9890-000f253544f3
Route
INTRATHECAL
Published
Effective Date 2024-05-06
Document Type 34391-3 HUMAN PRESCRIPTION DRUG LABEL

Drug Facts

Composition & Product

Active Ingredients
Chloride Ion (73 mg) Bicarbonate Ion (19 mg) Anhydrous Dextrose (8 mg) Magnesium Cation (3 mg) Potassium Cation (2 mg) Calcium Cation (10 mL) Phosphate Ion
Inactive Ingredients
Water

Identifiers & Packaging

Marketing Status
NDA Active Since 2013-06-04

Description

Elliotts B ® Solution is a sterile, nonpyrogenic, isotonic solution containing no bacteriostatic preservatives. Elliotts B Solution is a diluent for intrathecal administration of methotrexate sodium and cytarabine. Each 10 mL of Elliotts B Solution contains: Sodium Chloride, USP 73 mg Sodium Bicarbonate, USP 19 mg Dextrose, USP 8 mg Magnesium Sulfate • 7H 2 O, USP 3 mg Potassium Chloride, USP 3 mg Calcium Chloride • 2H 2 O, USP 2 mg Sodium Phosphate, dibasic • 7H 2 O, USP 2 mg Water for Injection, USP qs 10 mL Concentration of Electrolytes: Sodium 149 mEq/liter Bicarbonate 22.6 mEq/liter Potassium 4 mEq/liter Chloride 132 mEq/liter Calcium 2.7 mEq/liter Sulfate 2.4 mEq/liter Magnesium 2.4 mEq/liter Phosphate 1.5 mEq/liter The formulae and molecular weights of the ingredients are: INGREDIENT MOLECULAR FORMULA MOLECULAR WEIGHT Sodium Chloride NaCl 58.44 Sodium Bicarbonate NaHCO 3 84.01 Dextrose C 6 H 12 O 6 180.16 Magnesium Sulfate • 7H 2 O Mg 2 SO 4 • 7H 2 O 246.48 Potassium Chloride KCl 74.55 Calcium Chloride • 2H 2 O CaCl 2 • 2H 2 O 147.01 Sodium Phosphate, dibasic • 7H 2 O Na 2 HPO 4 • 7H 2 O 268.07 The pH of Elliotts B Solution is 6.0-7.5, and the osmolarity is 288 mOsmol per liter (calculated).

Indications and Usage

Elliotts B Solution is indicated as a diluent for the intrathecal administration of methotrexate sodium and cytarabine for the prevention or treatment of meningeal leukemia or lymphocytic lymphoma.

Dosage and Administration

See product labeling for methotrexate sodium and cytarabine. Elliotts B Solution is intended for intrathecal administration only. Elliotts B Solution does not contain antibacterial preservatives and introduction of contaminated solutions into the cerebrospinal fluid may have extremely serious consequences. Therefore, administration of intrathecal solutions should be accomplished as soon as possible after preparation. A sterile filter-needle should be used to withdraw the contents of the ampule. Intrathecal drug products should be inspected visually for particulate matter and discoloration prior to administration. Preparation and Administration Precautions Elliotts B Solution is a diluent for the cytotoxic anticancer agents, methotrexate sodium and cytarabine. Care should be exercised in the handling and preparation of infusion solutions with these products. (See product labeling for methotrexate sodium and cytarabine.)

Contraindications

None known.

Adverse Reactions

Adverse reactions may occur with any given intrathecal injection due to the chemotherapy or the technique of intrathecal administration.  (See product labeling for methotrexate sodium and cytarabine.) Preservative-free methotrexate sodium and cytarabine should be used to minimize adverse reactions due to preservatives. If an adverse reaction does occur, discontinue the administration, evaluate the patient, institute appropriate therapeutic countermeasures and, if possible, save the remainder of the unused solution(s) for examination.

How Supplied

NDC SIZE 55792-007-10 10 mL ampule Elliotts B Solution is available in single-use clear glass ampules, packaged 10 ampules per box. Store at controlled room temperature, 20ºC-25ºC (68ºF-77ºF) [See USP]. Preservative Free.  Discard unused portion.  Use only if solution is clear and ampule is intact. Distributed by: Lukare Medical, LLC Ponte Vedra Beach, FL 32082 1-855-752-9317 www.elliottsbsolution.com


Medication Information

Indications and Usage

Elliotts B Solution is indicated as a diluent for the intrathecal administration of methotrexate sodium and cytarabine for the prevention or treatment of meningeal leukemia or lymphocytic lymphoma.

Dosage and Administration

See product labeling for methotrexate sodium and cytarabine.

Elliotts B Solution is intended for intrathecal administration only. Elliotts B Solution does not contain antibacterial preservatives and introduction of contaminated solutions into the cerebrospinal fluid may have extremely serious consequences. Therefore, administration of intrathecal solutions should be accomplished as soon as possible after preparation.

A sterile filter-needle should be used to withdraw the contents of the ampule.

Intrathecal drug products should be inspected visually for particulate matter and discoloration prior to administration.

Preparation and Administration Precautions

Elliotts B Solution is a diluent for the cytotoxic anticancer agents, methotrexate sodium and cytarabine. Care should be exercised in the handling and preparation of infusion solutions with these products. (See product labeling for methotrexate sodium and cytarabine.)

Contraindications

None known.

Adverse Reactions

Adverse reactions may occur with any given intrathecal injection due to the chemotherapy or the technique of intrathecal administration.  (See product labeling for methotrexate sodium and cytarabine.)

Preservative-free methotrexate sodium and cytarabine should be used to minimize adverse reactions due to preservatives.

If an adverse reaction does occur, discontinue the administration, evaluate the patient, institute appropriate therapeutic countermeasures and, if possible, save the remainder of the unused solution(s) for examination.

How Supplied

NDC

SIZE

55792-007-10

10 mL ampule

Elliotts B Solution is available in single-use clear glass ampules, packaged 10 ampules per box.



Store at controlled room temperature, 20ºC-25ºC (68ºF-77ºF) [See USP].



Preservative Free.  Discard unused portion.  Use only if solution is clear and ampule is intact.



Distributed by:

Lukare Medical, LLC

Ponte Vedra Beach, FL 32082

1-855-752-9317

www.elliottsbsolution.com

Description

Elliotts B® Solution is a sterile, nonpyrogenic, isotonic solution containing no bacteriostatic preservatives. Elliotts B Solution is a diluent for intrathecal administration of methotrexate sodium and cytarabine.

Each 10 mL of Elliotts B Solution contains:

Sodium Chloride, USP

73 mg

Sodium Bicarbonate, USP

19 mg

Dextrose, USP

8 mg

Magnesium Sulfate • 7H2O, USP

3 mg

Potassium Chloride, USP

3 mg

Calcium Chloride • 2H2O, USP

2 mg

Sodium Phosphate, dibasic • 7H2O, USP

2 mg

Water for Injection, USP

qs 10 mL



Concentration of Electrolytes:

Sodium

149 mEq/liter

Bicarbonate

22.6 mEq/liter

Potassium

4 mEq/liter

Chloride

132 mEq/liter

Calcium

2.7 mEq/liter

Sulfate

2.4 mEq/liter

Magnesium

2.4 mEq/liter

Phosphate

1.5 mEq/liter

The formulae and molecular weights of the ingredients are:

INGREDIENT

MOLECULAR

FORMULA

MOLECULAR

WEIGHT

Sodium Chloride

NaCl

58.44

Sodium Bicarbonate

NaHCO3

84.01

Dextrose

C6H12O6

180.16

Magnesium Sulfate • 7H2O

Mg2SO4 • 7H2O

246.48

Potassium Chloride

KCl

74.55

Calcium Chloride • 2H2O

CaCl2 • 2H2O

147.01

Sodium Phosphate, dibasic • 7H2O

Na2HPO4 • 7H2O

268.07



The pH of Elliotts B Solution is 6.0-7.5, and the osmolarity is 288 mOsmol per liter (calculated).

General

Particular attention should be taken to assure the maintenance of sterile technique throughout the procedure. (See DOSAGE AND ADMINISTRATION.)

Warnings

Intrathecal administration of drugs such as methotrexate sodium and cytarabine should be performed by personnel skilled in the technique of lumbar puncture under the supervision of a physician who is experienced in the use of cancer chemotherapeutic agents. The labeling for methotrexate sodium and cytarabine should be consulted.

Packaging

Ampule labeling:

Box labeling:

Overdosage

Elliotts B Solution is a diluent. In the event of a drug, fluid or solute overload following administration, evaluate the patient's condition, and institute appropriate corrective treatment. (See product labeling for methotrexate sodium and cytarabine.)

References:

1. Cradock JC, et al. Evaluation of some pharmaceutical aspects of intrathecal methotrexate sodium, cytara‑bine and hydrocortisone sodium succinate.  American Journal of Hospital Pharmacy (1978); 35:402.

Rev. 05/2024

Usage in Pregnancy

All components of Elliotts B Solution are normal body constituents. Animal reproduction studies have not been conducted with Elliotts B Solution.

Clinical Pharmacology

Elliotts B Solution provides a buffered salt solution for use as a diluent for the intrathecal administration of methotrexate sodium and cytarabine. It has been demonstrated that Elliotts B Solution is comparable to cerebrospinal fluid in pH, electrolyte composition, glucose content, and osmolarity:

Comparison of Electrolyte Composition, pH and Nonelectrolytic Constituents of Elliotts B Solution and CSF

Solution

Na+

mEq/L

K+

mEq/L

Ca++

mEq/L

Mg++

mEq/L

HCO3 -

mEq/L

Cl-

mEq/L

pH

Phosphorus

mg/dL

Glucose

mg/dL

Cerebrospinal Fluid

117-137

2.3-4.6

2.2

2.2

22.9

113-127

7.31

1.2-2.1

45-80

Elliotts B Solution

149

4

2.7

2.4

22.6

132

6.0-7.5

2.3

80

The approximate buffer capacity of Elliotts B Solution is 1.1 X 10-2 equivalents when the challenge solution is 0.01 N HCl and 7.8 X 10-3 equivalents when the challenge solution is 0.01 N NaOH.1

Compatibility studies with methotrexate sodium and cytarabine indicate these drugs are physically compatible with Elliotts B Solution.

Drug Abuse and Dependence

There is no potential for drug abuse or drug dependence.

Carcinogenesis, Mutagenesis, Impairment of Fertility

No standard mutagenicity or carcinogenicity studies have been conducted with Elliotts B Solution.


Structured Label Content

General

Particular attention should be taken to assure the maintenance of sterile technique throughout the procedure. (See DOSAGE AND ADMINISTRATION.)

Warnings (WARNINGS)

Intrathecal administration of drugs such as methotrexate sodium and cytarabine should be performed by personnel skilled in the technique of lumbar puncture under the supervision of a physician who is experienced in the use of cancer chemotherapeutic agents. The labeling for methotrexate sodium and cytarabine should be consulted.

Packaging (PACKAGING)

Ampule labeling:

Box labeling:

Overdosage (OVERDOSAGE)

Elliotts B Solution is a diluent. In the event of a drug, fluid or solute overload following administration, evaluate the patient's condition, and institute appropriate corrective treatment. (See product labeling for methotrexate sodium and cytarabine.)

Description (DESCRIPTION)

Elliotts B® Solution is a sterile, nonpyrogenic, isotonic solution containing no bacteriostatic preservatives. Elliotts B Solution is a diluent for intrathecal administration of methotrexate sodium and cytarabine.

Each 10 mL of Elliotts B Solution contains:

Sodium Chloride, USP

73 mg

Sodium Bicarbonate, USP

19 mg

Dextrose, USP

8 mg

Magnesium Sulfate • 7H2O, USP

3 mg

Potassium Chloride, USP

3 mg

Calcium Chloride • 2H2O, USP

2 mg

Sodium Phosphate, dibasic • 7H2O, USP

2 mg

Water for Injection, USP

qs 10 mL



Concentration of Electrolytes:

Sodium

149 mEq/liter

Bicarbonate

22.6 mEq/liter

Potassium

4 mEq/liter

Chloride

132 mEq/liter

Calcium

2.7 mEq/liter

Sulfate

2.4 mEq/liter

Magnesium

2.4 mEq/liter

Phosphate

1.5 mEq/liter

The formulae and molecular weights of the ingredients are:

INGREDIENT

MOLECULAR

FORMULA

MOLECULAR

WEIGHT

Sodium Chloride

NaCl

58.44

Sodium Bicarbonate

NaHCO3

84.01

Dextrose

C6H12O6

180.16

Magnesium Sulfate • 7H2O

Mg2SO4 • 7H2O

246.48

Potassium Chloride

KCl

74.55

Calcium Chloride • 2H2O

CaCl2 • 2H2O

147.01

Sodium Phosphate, dibasic • 7H2O

Na2HPO4 • 7H2O

268.07



The pH of Elliotts B Solution is 6.0-7.5, and the osmolarity is 288 mOsmol per liter (calculated).

References: (REFERENCES:)

1. Cradock JC, et al. Evaluation of some pharmaceutical aspects of intrathecal methotrexate sodium, cytara‑bine and hydrocortisone sodium succinate.  American Journal of Hospital Pharmacy (1978); 35:402.

Rev. 05/2024

How Supplied (HOW SUPPLIED)

NDC

SIZE

55792-007-10

10 mL ampule

Elliotts B Solution is available in single-use clear glass ampules, packaged 10 ampules per box.



Store at controlled room temperature, 20ºC-25ºC (68ºF-77ºF) [See USP].



Preservative Free.  Discard unused portion.  Use only if solution is clear and ampule is intact.



Distributed by:

Lukare Medical, LLC

Ponte Vedra Beach, FL 32082

1-855-752-9317

www.elliottsbsolution.com

Adverse Reactions (ADVERSE REACTIONS)

Adverse reactions may occur with any given intrathecal injection due to the chemotherapy or the technique of intrathecal administration.  (See product labeling for methotrexate sodium and cytarabine.)

Preservative-free methotrexate sodium and cytarabine should be used to minimize adverse reactions due to preservatives.

If an adverse reaction does occur, discontinue the administration, evaluate the patient, institute appropriate therapeutic countermeasures and, if possible, save the remainder of the unused solution(s) for examination.

Contraindications (CONTRAINDICATIONS)

None known.

Usage in Pregnancy

All components of Elliotts B Solution are normal body constituents. Animal reproduction studies have not been conducted with Elliotts B Solution.

Clinical Pharmacology (CLINICAL PHARMACOLOGY)

Elliotts B Solution provides a buffered salt solution for use as a diluent for the intrathecal administration of methotrexate sodium and cytarabine. It has been demonstrated that Elliotts B Solution is comparable to cerebrospinal fluid in pH, electrolyte composition, glucose content, and osmolarity:

Comparison of Electrolyte Composition, pH and Nonelectrolytic Constituents of Elliotts B Solution and CSF

Solution

Na+

mEq/L

K+

mEq/L

Ca++

mEq/L

Mg++

mEq/L

HCO3 -

mEq/L

Cl-

mEq/L

pH

Phosphorus

mg/dL

Glucose

mg/dL

Cerebrospinal Fluid

117-137

2.3-4.6

2.2

2.2

22.9

113-127

7.31

1.2-2.1

45-80

Elliotts B Solution

149

4

2.7

2.4

22.6

132

6.0-7.5

2.3

80

The approximate buffer capacity of Elliotts B Solution is 1.1 X 10-2 equivalents when the challenge solution is 0.01 N HCl and 7.8 X 10-3 equivalents when the challenge solution is 0.01 N NaOH.1

Compatibility studies with methotrexate sodium and cytarabine indicate these drugs are physically compatible with Elliotts B Solution.

Indications and Usage (INDICATIONS AND USAGE)

Elliotts B Solution is indicated as a diluent for the intrathecal administration of methotrexate sodium and cytarabine for the prevention or treatment of meningeal leukemia or lymphocytic lymphoma.

Dosage and Administration (DOSAGE AND ADMINISTRATION)

See product labeling for methotrexate sodium and cytarabine.

Elliotts B Solution is intended for intrathecal administration only. Elliotts B Solution does not contain antibacterial preservatives and introduction of contaminated solutions into the cerebrospinal fluid may have extremely serious consequences. Therefore, administration of intrathecal solutions should be accomplished as soon as possible after preparation.

A sterile filter-needle should be used to withdraw the contents of the ampule.

Intrathecal drug products should be inspected visually for particulate matter and discoloration prior to administration.

Preparation and Administration Precautions

Elliotts B Solution is a diluent for the cytotoxic anticancer agents, methotrexate sodium and cytarabine. Care should be exercised in the handling and preparation of infusion solutions with these products. (See product labeling for methotrexate sodium and cytarabine.)

Drug Abuse and Dependence (DRUG ABUSE AND DEPENDENCE)

There is no potential for drug abuse or drug dependence.

Carcinogenesis, Mutagenesis, Impairment of Fertility

No standard mutagenicity or carcinogenicity studies have been conducted with Elliotts B Solution.


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