How to

The monographs follow a standard layout. Each section of this standard layout is explained here in detail.

Title of monograph

NoIDs uses generic medicine names in line with the New Zealand Universal List of Medicines (NZULM).

Extravasation warning

Given if a medicine is known as a vesicant, an irritant or an irritant with vesicant properties.

For more on extravasation read the Extravasation Guide in the page header above.

Hazardous medicine

Applicable if a medicine is known as a hazardous medicine.

Hazardous medicines require the person handling the medicine to take precautions to minimise the occupational hazard.

Cytotoxic medicines are excluded from NoIDs.

Non-cytotoxic hazardous medicines require extra precautions when handling or preparing the medicine. Standard precautions are usually sufficient when administering these medicines to patients. Refer to relevant local guidelines for handling precautions.

Monoclonal antibodies (MABs) differ considerably in their structure and pharmacological properties. Many MABs are no longer classified as hazardous. Where identified as hazardous, this is indicated in the individual monograph.

Reproductive hazardous medicines have not been specifically labelled in NoIDs, but we recommend that if pregnant or trying to conceive, refer to local policies. Guidance often refers to harm from therapeutic doses rather than the considerably limited occupational exposure.

Synonym(s)

Other names of the medicine including British Approved Name (BAN) and the salt or hydrate form.

Drug class

Therapeutic group.

Trade/brand name (Sponsor)

Brand name as marketed in New Zealand or as made available under Section 29 of the Medicines Act.

In instances where the Hospital Medicines List permits ‘Any brand’, we have included products that are available in New Zealand at the time of writing. We recognise that brand changes can occur at short notice.

Unless otherwise stated, the information provided in each monograph is not brand specific. When a brand name is used, it is to highlight that the corresponding information is brand specific e.g. sodium content.

Presentation

Strengths and dose form available in New Zealand.

Solution preparations are described as total amount of medicine and total volume.

Commercially produced, funded presentations can be found under Other Information in the Additional information section.

Storage

Recommended storage condition of the commercial preparations as per product information.

Method of administration table

Visual guide for the available, appropriate administration methods.

Five standard routes of administration are included.

For antibiotics, the ability to administer as outpatient intravenous administration using a commercially prepared elastomeric infuser device is also indicated. See below for more information.

We recognise that critical care and other specialist services may administer injectable medicines outside of the recommendations in these monographs.

Paediatric information is not applicable to neonates.

Routes of administration that have a preferential method of administration have been indicated in the text.

Unless otherwise stated, polyvinyl chloride (PVC) infusion sets or consumables can be used.

Administer medicines using a non-touch technique.

IV – direct injection

Sometimes referred to as a bolus injection.

Given directly into vein or line over less than 10 minutes. Injection duration or rate is included in the monograph if information available.

Flush the cannula between administration of different medicines with sufficient fluid volume (usually around 5–10 mL or for paediatrics at least twice the volume of the catheter) at the same rate used to administer the original medicine. Sodium chloride 0.9% or glucose (dextrose) 5% are commonly used to flush the line; check individual monograph for compatible fluids.

For some medicines, it is not appropriate to flush the lines; check local guidelines for more information.

Patient-controlled analgesia (PCA) is not included.

IV – intermittent infusion

Administered over a set time period.

Sometimes referred to as a short infusion or an extended infusion.

Flush the line between administration of different medicines with sufficient fluid volume (usually around 20 mL or for paediatrics at least twice the volume of the catheter) at the same rate used to administer the original medicine. Sodium chloride 0.9% or glucose (dextrose) 5% are commonly used to flush the line; check individual monograph for compatible fluids.

For some medicines, it is not appropriate to flush the lines; check local guidelines for more information.

Smart infusion pumps with an updated drug library allow medicines to be delivered at controlled rates and concentrations, minimising errors and adverse drug events. Smart rate-controlled infusion pumps (volumetric pumps or syringe drivers) are specifically recommended in some monographs where it is deemed essential for medication safety.

IV – continuous infusion

Flush the line between administration of different medicines with sufficient fluid volume (usually around 20 mL or for paediatrics at least twice the volume of the catheter) at the same rate used to administer the original medicine.

Sodium chloride 0.9% or glucose (dextrose) 5% are commonly used to flush the line; check individual monograph for compatible fluids.

For some medicines, it is not appropriate to flush the lines; consult monographs and local guidelines for more information.

Smart infusion pumps with an updated drug library allow medicines to be delivered at controlled rates and concentrations, minimising errors and adverse drug events. Smart rate-controlled infusion pumps (volumetric pumps or syringe drivers) are specifically recommended in some monographs where it is deemed essential for medication safety.

Patient-controlled analgesia (PCA) is not included.

Intramuscular

For adults, most commonly given into the thigh or the gluteal muscle, and occasionally into the deltoid muscle.

Site	Recommended volume
Deltoid	0.5–2 mL
Ventrogluteal	1–4 mL
Dorsogluteal	1–5 mL
Vastus Lateralis	1–4 mL

 

For children, the vastus lateralis muscle is most commonly used.

The volume of intramuscular injection and appropriate needle length in children is dependent on the age and size of the child.

Age	Preferred site	Recommended volume
Infant less than 18 months	Vastus Lateralis	1–3 mL
Infant or child 18 months to 3 years	Vastus Lateralis or Deltoid	1–2 mL
Child or adolescent 3 to 11 years	Deltoid	1–2 mL
Infant, child or adolescent greater than 7 months	Ventrogluteal	Up to 3 mL
Infant, child or adolescent	Dorsogluteal	Up to 4 mL

 

Many intramuscular formulations are oil-based injections. It is therefore important to ensure, by aspiration before injection, that inadvertent intravascular entry does not occur.

Where evidence is available to support safe administration and stability of medicines reconstituted with lidocaine for intramuscular administration, this has been stipulated in individual monographs.

Subcutaneous

Diluents are used to reduce site irritation and ease medicine administration.

Subcutaneous injections for adults are commonly given in the outer or anterior aspect of the upper arm, abdomen below the costal margins to the iliac crests, anterior aspect of the thigh, anterior chest wall or scapular area.

For subcutaneous infusions for adults – the minimum infusion volume recommended is 20 mL. Total volume is dependent on the total volume of medicines, infusion pump used, intended infusion time and rate of delivery. Always consult local guidelines.

For subcutaneous injections in children the recommended volume is dependent on the selected site.

Age	Preferred site	Recommended volume
Below 2 years	Anterior upper thigh	1.5 mL
Greater than 12 months	Anterior upper arm	1.5 mL
Greater than 2 years	Anterior abdominal wall	Up to 3 mL

 

For subcutaneous infusions – preferred sites in children are the abdomen, upper thigh or upper arm where there is more subcutaneous tissue. The volume is dependent on age of child, recommended drug dilution, infusion time and rate of delivery. Always consult local guidelines.

Medicines commonly given as a continuous subcutaneous infusion in palliative care are indicated as such in individual monographs.

Undiluted solution

For solution preparations.

Physical description of the commercial preparation is included if the information is available in the product information.

Visually inspect all injectable preparations for particulate matter; do not use if present.

Recommended storage conditions for the partially used product is included under Stability in the Additional Information section, if available from product information.

Reconstitution

Instructions for reconstituting powder preparations.

Reconstitute immediately before use.

Use aseptic non-touch technique to prepare the medicine.

Unless otherwise stated, shake the vial until the powder has dissolved.

Physical description for the reconstituted solution is provided if the information is available in the product information.

Visually inspect all injectable preparations for particulate matter; do not use if present.

Recommended storage conditions for the reconstituted solution is included under Stability in the Additional Information section, if available from product information.

Displacement volume is included to assist with calculating and preparing part doses. In the case where the displacement volume is presumed to be negligible, the concentration of the reconstituted solution is included. Displacement volume is brand specific.

Dilution

Instructions for medicines which can or must be further diluted before administration.

Dilute immediately before use.

Use aseptic non-touch technique to prepare the medicine.

Invert the container several times to ensure thorough mixing of the solution.

The volume of intravenous fluids to be used and/or desired final concentrations provided are intended for use in general wards, unless specifically stated.

More concentrated solutions may be permitted in certain areas; consult a pharmacist or medicines information service for more information.

For combination products (e.g. Piperacillin + Tazobactam), the final concentration is expressed as the total amount (e.g. 15–90 mg/mL of the piperacillin/tazobactam combination), unless specifically stated.

Unless otherwise stated, intravenous fluids in PVC containers can be used.

Visually inspect all injectable preparations for particulate matter; do not use if present.

Recommended storage condition for the diluted solution is provided under Stability in the Additional information section, if the information is available from the product information.

Additional information – Incompatibilities

Incompatible drug(s) as per product information.

This is not an exhaustive list; consult a pharmacist or medicines information service for more information including Y-site compatibility and compatibility with parenteral nutrition.

Additional information – Monitoring

Includes monitoring recommendations related to injection or infusion related adverse effects for a particular medicine.

NoIDs users should consult relevant reference resources for full monitoring requirements before, during and after treatment.

Monitor all patients for signs and symptoms of extravasation, anaphylactic and hypersensitivity reactions.

Monitor all infusions throughout administration to ensure that the infusion is being administered at the correct rate, that the infusion pump or device is working as intended, and that the patient is responding to the infusion therapy as intended.

Additional information – Stability

Recommended storage conditions for undiluted, reconstituted and/or diluted solutions, if the information is available from the product information.

Storage conditions may be brand specific.

Additional information – Other information

pH value of solution preparations or reconstituted solutions is only included if information available in the product information.

Commercially produced, funded products are listed here.

Sodium and potassium content per unit vial, if deemed clinically relevant.

Excipients which are likely to cause allergy or significant side effects.

Therapeutic drug monitoring, if applicable.

Off-label or unapproved use of a medicine

The off-label or unapproved use of a medicine is when an approved medicine is used outside of the approved indication, dose range or route of administration, such as stated in the manufacturer’s product information.

Unapproved use of medicines occurs commonly and may be considered as part of usual practice. Many medicines administered to children are considered unapproved.

NoIDs has not specifically identified any unapproved use in individual monographs. All monographs are extensively reviewed against best available literature and current clinical practice. Therapeutic decision making and responsibility for unapproved use lies with prescribers.

Outpatient intravenous antibiotic administration

Antibiotics may be administered in the community setting using IV injections, intramuscular injections or subcutaneous administration.

When referred to in NoIDs monographs the outpatient intravenous antibiotic administration refers specifically to 24-hour continuous infusions with elastomeric (balloon) infusors.

Stability is dependent on drug concentration, temperature and diluent fluid, with/without a buffer.

Elastomeric infusors require manufacturing under sterile conditions to ensure stability greater than 24 hours. These infusers are commonly supplied by licensed manufacturers and provide extended stability at various conditions.

Unless otherwise stated, NoIDs does not specify stability, concentration or storage conditions for elastomeric infusors as this is proprietary information from licensed manufacturers.

Consult a pharmacist or a medicines information service for more information pertaining to elastomeric infusors.

Non-PVC and non-DEHP information

Some medicines interact with PVC and DEHP plastic. Monographs may recommend using non-PVC or non-DEHP bags or giving sets.

PVC is a plastic that is the main component of many IV infusion bags, giving sets, syringes etc. DEHP is a plasticiser that is used to make some PVC products more flexible.

Medicines can interact with DEHP or PVC by either adsorbing onto the surface of the plastic (less medicines administered to the patient) or by leaching DEHP from the plastic into the infusion (DEHP is administered to the patient).

Many factors can affect the amount of leaching from the plastic and adsorption of the drug, including the contact time, drug concentration and the infusion time.

Note that non-PVC will also be non-DEHP; but non-DEHP may still contain PVC.

Low-sorbing infusion sets may be available, but although these address the adsorption interaction, they are not considered DEHP-free, i.e. they will not affect the leaching interaction if this is a concern.

Example of non-PVC containers	Polyolefin
	Polyethylene
	Ethylene-vinyl acetate
	Glass
Example of non-PVC giving sets	Polyurethane
	Polyethylene
Example of DEHP-free giving sets	Polyurethane
	Polyethylene
	DEHP-free PVC
Examples of low-sorbing infusion sets	Polyurethane
	PVC outer with polyethylene lining

°C	degree Celsius
CNS	central nervous system
DEHP	di-2-ethylhexyl phthalate (plasticiser)
eGFR	estimated glomerular filtration rate
ECG	electrocardiography
EEG	electroencephalogram
g	gram(s)
IV	intravenous
kg	kilogram(s)
L	litre(s)
mg	milligram(s)
mL	millilitre(s)
mm	millimetre(s)
mmol	millimole
%	percentage
PVC	polyvinyl chloride
pH	scale measuring acid/alkaline nature of solution
v/v	volume per volume
VF	ventricular fibrillation
VT	ventricular tachycardia

Each monograph has been developed based on a range of commonly used standard medicine information resources and pharmaceutical textbooks. The following standard references were consulted for all monographs:

• Manufacturer’s Medicine Data Sheet available from medsafe.govt.nz
• New Zealand Formulary via nzf.org.nz
• New Zealand Formulary for Children via nzfchildren.org.nz
• Martindale: The Complete Drug Reference via micromedexsolution.com
• Merative Micromedex® via micromedexsolution.com
• The Royal Children’s Hospital Melbourne Paediatric Injectable Guidelines via pig.rch.org.au
• The Australian Injectable Drugs Handbook via Therapeutics Guidelines TG.org.au
• NOISH List of Hazardous Drugs in Healthcare settings (2024). Cincinnati, Ohio: US Centers for Diseases Control and Prevention, National Institute for Occupational Safety and Health. 2025

These standard references are not cited within the individual monograph.

Additional references consulted may include:

• ASHP Injectable Drug Information: a comprehensive guide to compatibility and stability. Bethesda, MD: American Society of Health-System Pharmacists, 2021
• British National Formulary via medicinescomplete.com
• British National Formulary for Children via medicinescomplete.com
• Lexicomp Online, Paediatric and Neonatal Lexi-Drugs Online via uptodate.com
• PCF9 Palliative Care Formulary (9th ed.) via medicinescomplete.com
• Pediatric Injectable Drugs. The Teddy Bear Book (12th ed.). Bethesda, MD: American Society of Health-System Pharmacists, 2024
• Product information supplied with medicines obtained under Section 29 of the Medicines Act 1981
• VicTAG Victorian Framework for the handling of Hazardous Medicines. 2021

If consulted, these references are cited online in the reference view of the monograph.

Here is a complete listing of all the injectable drug monographs with the date when their information was last updated. You can use this at any time to check that you are looking at the current version.

Current version control list

Any changes made to monographs after the latest book was printed are also documented at noids.nz/updates .

This Updates webpage is freely available to everyone.  Where a change is clinically significant a full copy of the revised monograph is provided there for non-subscribers. For other changes the monograph is identified and the change(s) described.

All changes made and any new monographs added since the last time the book was printed are always reflected in the monographs available online for subscribers only.

You should be able to access the Notes on Injectable Drugs website, www.noids.nz, from anywhere within your organisation through any browser, although the larger the screen you use the easier it is to read. You can use your browser settings to adjust font size and where the information appears on your screen.

The first time you access the website on a device there is a check to see if you are using an IP address registered to your organisation or if your device is located at one of the addresses nominated by your organisation.  If your browser asks to allow Location access for the noids.nz website, please say OK.

Sometimes this location check can’t run because of your IT policies, in which case you will be asked to enter an organisation password.  You can probably get this password from your Pharmacy Department in a large organisation or from your Office Manager/Administrator.

If you are off site out of hours and don’t know the organisation password you’ll be asked for some contact information and given temporary access.

Start typing the medicine name.  You need to type the first 5 letters and then you’ll see all the medicines that match and can select the one you really want.

You can use an alternate name for a medicine. For instance, if you start to type in augmentin you will be given the Amoxicillin + Clavulanic Acid monograph as the result.

Then choose whether you want the information on administration to Adult patients or to Paediatric patients.

The website always shows the most recent version of the information for each medicine.

If you want to use the Notes on Injectable Drugs information in local protocols or in other software it is strongly recommended that you use a link to the relevant URL rather than copying information that may change later without you realising.

The URL for each injectable drug is constant and does not change when the information changes and the monograph is updated.

The URL format is www.noids.nz/drug/drugname/?ref=adult or www.noids.nz/drug/drugname/?ref=paediatric depending on whether you want the monograph on administration to adult patients or to paediatric patients.

The drugname to use for each medicine is found in the URL master list below. A few of the URL drugnames changed in 2026 and these are marked with an asterisk in the URL master list.

URL master list

Note that the URL formats changed in 2026. However, if you used the previous format of www.noids.nz/drug/drugname/?pdf=standard then that will automatically redirect to www.noids.nz/drug/drugname/?ref=adult i.e. to the adult information webpage. If that is an acceptable result for you then you do not need to do anything more.

The URL www.noids.nz/drug/drugname/?pdf=ref (monographs with references to supporting literature) is no longer in use. If you have previously used this URL in documentation or other software then you will need to change it to one of the new formats.

Use the Search Index page to find the medicine you want and you should see the option there to Submit Feedback.

Please fill out this contact form and we’ll get back to you as soon as possible

Contact Us

Notes on Injectable Drugs (NoIDs) is intended to assist in the preparation and safe administration of injectable medicines.

Noids.nz was launched in November 2020 to enable regular review of NoIDs content to meet user needs. During 2026, 82 monographs were updated and 7 new monographs were published online in response to user feedback or to changes in medicine supply or practice.

These monographs are not intended to replace local guidelines, nor to provide prescribing information. NoIDs users should consult local guidelines, manufacturer’s Medicine Data Sheets and New Zealand Formulary for full prescribing information.

 

New monographs in 2026

Benralizumab	Mepolizumab
Bumetanide	Omalizumab
Ferric derisomaltose	Rituximab
Liothyronine

The medicines documented are ones available and in use in New Zealand.

The medicines and the uses described are relevant to adult and paediatric patients in a general medical/surgical setting.

Information on medicines that are only used within a specialised ward or in a way that only occurs in specialised circumstances is not included. This means that neonatal, oncology, ICU and Emergency Department use, along with other less common specialisations, is excluded unless that medicine or usage is more generally applied.

The current version of Notes on Injectable Drugs was created by:

Chief Editor           

Tanya du Plessis _{BPharm MScID PGDipID PGCertPharmPres}

Business Manager 

Lee Miller _{MA AM(Harvard) MBA}

Editors                   

Michaela Beattie _{BPharm PGDipClinPharm PGCertPharm}

Kristin Gray _{BPharm PGDipClinPharm}

Rebecca Greening _{BPharm PGDipClinPharm}

Adele Harrex _{BPharm PGDipClinPharm PGCertPharmPres}

Stephanie Murphy _{BPharm PGDipClinPharm}

Preetika Prakash _{BPharm PGDipPharm}

Jacqui Reynolds _{DipPharm PGDipClinPharm}

Alanna Tan-Adams _{BPharm(Hons) PGDipClinPharm}

 

Acknowledgements

We would like to acknowledge the following people and groups whose contributions have continued to shape Notes on Injectable Drugs:

• Past governance group members, editors, contributors and members of the New Zealand Hospital Pharmacy Association
• Clinical advisory group members and users of Notes on Injectable Drugs
• Medicines information services
• Special Interest Groups from the New Zealand Hospital Pharmacy Association
• Pharmac

 

We thank the Steering Group members for sharing their time and expertise.

Kim Brackley	Jacky Chan	Veronica Christie
Annie Egan	Sarah Salman	Vidhya Sritharan
Mary Young

 

We acknowledge the contributions made by the Clinical Advisory Group.

Rebecca Greening	Jacqui Reynolds	Lynette Lennox
Claire McGuinniety	Jolene Reid	Sherry Yeh

 

Finally, Notes on Injectable Drugs would not have been possible without the initial work of the pharmacists at Napier, Hastings Memorial and Whanganui Hospitals in 1987. Their vision and input form the basis of this and any future editions of Notes on Injectable Drugs.