Injection compatibility: Learning outcomes

Last updated: Thursday, November 18, 2021

After completing this tutorial, you will be able to:
  • Define physical and chemical incompatibility.
  • Know where to look for, and interpret information about the compatibility of injectable medicines.
  • Be able to predict injection incompatibility if data are lacking.
  • Advise ward staff how to avoid compatibility problems with injectable medicines, and be able to recommend safe alternatives.

You can download a PDF of the whole tutorial (without interactive elements such as the Learning exercises) and a one-page summary of key points.

You should allow 60 minutes to complete this tutorial, including the Learning exercises.


This tutorial is aimed at hospital trainee pharmacists, and will help you achieve GPhC learning outcomes such as these:

  • LO 12 Take an all-inclusive approach to ensure the most appropriate course of action based on clinical, legal and professional considerations
  • LO 16 Apply professional judgement in all circumstances taking legal and ethical reasoning into account
  • LO 21 Apply the science behind pharmacy in all activities 
  • LO 30  Appraise the evidence base and apply clinical reasoning and professional judgement to make safe and logical decisions which minimise risk and optimise outcomes for the person

If you are a foundation pharmacist, this tutorial may assist with meeting certain competencies from the RPS framework including:

  • 1.1 Applies evidence-based clinical knowledge to make suitable recommendations or take appropriate actions 
  • 1.6 Uses own pharmaceutical knowledge to positively impact the usage and stewardship of medicines at an individual and population level.
  • 2.1 Keeps the individual at the centre of their approach to care at all times.
  • 3.1 Draws upon own knowledge and up-to-date guidance to effectively make decisions appropriately and with confidence.
  • 3.2 Critically appraises appropriate information to make a decision in an efficient and systematic manner; adopts evidence-informed solutions.
  • 3.3 Demonstrate awareness of where to seek appropriate information to solve problems and make decisions. 
  • 3.5 Manages uncertainty and possible risk appropriately, while ensuring high attention to detail is maintained when making decisions regarding the individual receiving care.
  • 6.5 Uses effective questioning when working with individuals receiving care or other healthcare professionals.

Continuing professional development

Finally, here are some CPD activities you could consider:

★  If you don't work on a ward where you encounter injection compatibility issues, then ask to visit a high care ward with a colleague. Reflect on the differences in pharmacy practice in a high care area. How else do pharmacists in a high care area ensure that injections are safe, other than checking for incompatibility?
★  If you have access to ASHP Injectable Drug Information, then read the introduction to discover how the published data on compatibility are interpreted and presented. Examine a selection of monographs to make sure you can understand how to apply the information in practice.
★  Next time you advise about a compatibility issue then write it up as a CPD exercise, clinical intervention, or case study. Present this case to your tutor, a colleague, or at a journal club and ask for peer feedback. Do you think your original approach was about right or did the feedback give you ideas for improvement?