Recommendations

Standard Concentrations of Neonatal Drug Infusions

The List of Standard Concentrations of Neonatal Drug Infusions are the result of a national effort to create standard concentrations for typical neonatal drug infusions that could be used across all US hospitals for at least 80% of neonatal infusions. (The other 20% of infusions may require different concentrations based on the unique needs of the neonate.) ISMP and the Vermont Oxford Network (VON), a nonprofit voluntary group of healthcare professionals working to improve newborn care, collaborated with representatives from neonatal intensive care units in the US to identify and promote the standard concentrations of typical neonatal drug infusions listed in the table that follows.

Some drugs include two standard concentrations to accommodate various weights of neonates, including low-birth-weight infants. The safety benefits of all hospitals using the same standard concentrations whenever possible for neonates are vast and include the following:

  • Reduce medication error risk when critically-ill neonates are transferred from one facility to another

  • Stimulate development of standardized infusion device drug libraries

  • Provide the demand necessary for manufacturers to offer commercially prepared standard solutions (if not already available), thereby reducing the risk of extemporaneous compounding errors within hospitals.

We urge all hospitals where neonates are treated to join our national effort to reduce the risk of harmful errors when caring for our tiniest patients!

Drug Type(s) of Infusions Recommended Concentrations*
acyclovir intermittent infusion** 7 mg/mL
alprostadil continuous infusion 10 mcg/mL
amphotericin B intermittent infusion** 0.1 mg/mL
amphotericin B liposomal intermittent infusion** 1 mg/mL
ceFAZolin intermittent infusion** 100 mg/mL
cefotaxime intermittent infusion** 100 mg/mL
clindamycin intermittent infusion** 6 mg/mL
digoxin intermittent infusion** 20 mcg/mL 
100 mcg/mL
DOBUTamine continuous infusion 2,000 mcg/mL
DOPamine continuous infusion 1,600 mcg/mL
EPINEPHrine continuous infusion 10 mcg/mL
fentaNYL continuous or intermittent infusion** 10 mcg/mL
fluconazole intermittent infusion** 2 mg/mL
furosemide continuous or intermittent infusion** 2 mg/mL
10 mg/mL
gentamicin intermittent infusion** 2 mg/mL
10 mg/mL
heparin (in 0.45% NaCl) continuous infusion for line patency 0.5 unit/mL
insulin (regular) continuous infusion 0.1 unit/mL
0.5 unit/mL
metroNIDAZOLE intermittent infusion** 5 mg/mL
midazolam continuous and intermittent infusion** 0.5 mg/mL (continuous infusion)
1 mg/mL (intermittent infusion** preservative free)
morphine continuous and intermittent infusion** 0.1 mg/mL (continuous or intermittent infusion**)
0.5 mg/mL (intermittent infusion**)
norepinephrine continuous infusion 16 mcg/mL
PHENobarbita intermittent infusion** 10 mg/mL
65 mg/mL
vancomycin intermittent infusion** 5 mg/mL

*Bolded concentration is commercially available 
**Intermittent infusions are typically administered over 15-30 minutes

More Recommendations

This list includes look-alike and sound-alike name pairs. Use this list to determine which medications require special safeguards to reduce the risk of errors and minimize harm.
This list includes medications that should not be crushed because of their special pharmaceutical formulations or characteristics, such as sustained release.
Wall Chart - Oral Dosage Forms that Should Not be Crushed: $24.95