May 26, 2017
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Serotonin Syndrome

Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. Warn patients of the symptoms of serotonin syndrome and to seek medical attention right away if symptoms develop. Instruct patients to inform their healthcare providers if they are taking, or plan to take serotonergic medications, [see DRUG INTERACTIONS].


Advise patients of the potential for severe constipation, including management instructions and when to seek medical attention [see ADVERSE REACTIONS].

Healthcare professionals can telephone Fresenius Kabi USA, LLC at 1-800-551-7176 for information or to report adverse events on this product.

Instructions For Use

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Do not use if color is darker than pale yellow, if it is discolored in any other way or if it contains a precipitate.

CAUTION: Certain glass syringes may malfunction, break or clog when connected to some Needleless Luer Access Devices (NLADs) and needles. This syringe has a larger internal syringe tip and an external collar (luer collar). The external collar must remain attached to the syringe. Data show that the syringe achieves acceptable connections with the BD Eclipse™ Needle and the Terumo SurGuard2™ Safety Needle and with the following non-center post NLADs: Alaris SMARTSITE™, B-Braun ULTRASITE™, BD-Q SYTE™, Maximum MAX PLUS™, and B-Braun SAFSITE™. The data also show acceptable connections are achieved to the center post ICU Medical CLAVE.. However, spontaneous disconnection of this glass syringe from needles and NLADs with leakage of drug product may occur. Assure that the needle or NLAD is securely attached before beginning the injection. Visually inspect the glass syringe-needle or glass syringe .NLAD connection before and during drug administration. Do not remove the clear plastic wrap around the external collar. (See Figure 1)

Figure 1

The syringe - Illustration

  1. Inspect the outer packaging (blister pack) by verifying:
    • blister integrity
    • drug name
    • drug strength
    • dose volume
    • route of administration
    • expiry date to be sure that the drug has not expired
    • sterile field applicability
    Do not use if package has been damaged.
  2. Peel open the paper (top web) of the outer packaging that displays the product information to access the syringe. Do not pop syringe through. (See Figure 2)
  3. Bend the plastic part of the outer packaging (thermoform) so as to present the plunger rod for syringe removal. Once the syringe is removed, if applicable, discard the StabilOxR CANISTER contained at the end of the blister pack.
  4. Figure 2

    Removing the syringe - Illustration

  5. Perform visual inspection on the syringe by verifying:
    • absence of syringe damage
    • absence of external particles
    • absence of internal particles
    • proper drug color
    • expiration date to be sure that the drug has not expired
    • drug name
    • drug strength
    • dose volume
    • route of administration
    • integrity of the plastic wrap around the external collar
  6. Do not remove plastic wrap around the external collar. Push plunger rod slightly to break the stopper loose while tip cap is still on.
  7. Do not remove plastic wrap around the external collar. Remove tip cap by twisting it off. (See Figure 3)
  8. Figure 3

    Remove tip cap - millustration

  9. Discard the tip cap.
  10. Expel air bubble.
  11. Adjust dose into sterile material (if applicable).
  12. Connect the syringe to appropriate injection connection depending on route of administration. Before injection, ensure that the syringe is securely attached to the needle or NLAD.
  13. Depress plunger rod to deliver medication. Ensure that pressure is maintained on the plunger rod during the entire administration.
  14. Remove syringe from NLAD (if applicable) and discard into appropriate receptacle. If delivering the medication with a needle, to prevent needle stick injuries, do not recap needle.


  • All steps must be done sequentially
  • Do not autoclave syringe
  • Do not use this product on a sterile field
  • Do not introduce any other fluid into the syringe at any time
  • This product is for single dose only

For more information concerning this drug, please call Fresenius Kabi USA, LLC at 1-800-551-7176.

To report SUSPECTED ADVERSE REACTIONS, contact Fresenius Kabi USA, LLC at 1-800-551-7176 or FDA at 1-800-FDA-1088 or

Last reviewed on RxList: 3/20/2017
This monograph has been modified to include the generic and brand name in many instances.

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