Appendix. Medications Requiring a Central Line From: Intravenous Administration of Formulary Medications - Adult - Inpatient/Ambulatory Clinical Practice Guideline; Last revised 05/2023. For content changes or questions contact Drug Policy Program 1. Acyclovir: Central line for concentrations ≥10 mg/mL 2. Adenosine: Central line preferred (or site as proximal to trunk as possible) 3. Amiodarone: Central line preferred. Central line required for 600 mg/250 mL or any infusion concentrations ≥2 mg/mL 4. Angiotensin II 5. Anti-thymocyte globulin RABBIT: Central line required for doses diluted in <500 mL 6. Busulfan 7. Calcium chloride: Central line preferred 8. Carmustine: Central line if undiluted or doses ≥300 mg/m2 9. Copper-selenium-zinc 10. Continuous renal replacement therapy (CRRT): Hemodialysis line required for all bags 11. Dobutamine: Central line preferred, however, midline/peripheral/intraosseous access may be used when benefit outweighs risks 12. Dopamine: Central preferred, however, midline/peripheral/intraosseous access may be used when benefit outweighs risks 13. Doxorubicin conventional: Central line required for continuous infusion 14. Epinephrine: Central line preferred, however, midline/peripheral/intraosseous access may be used when benefit outweighs risks 15. Epoprostenol: Central line required for continuous infusion; may give peripherally on a temporary basis until central line placed 16. Esmolol: Central line preferred for concentrations ≥20 mg/mL 17. Ethyl alcohol: Central line preferred, however, peripheral access may be used when benefit outweighs risks or if needed emergently 18. Etoposide: Central line required if undiluted 19. Foscarnet: Central line required if undiluted 20. Melphalan: Central line required if undiluted; central line preferred when diluted, however midline or peripheral infusion is acceptable 21. Micafungin: Central line required for concentrations >1.5 mg/mL 22. Nicardipine: Central line required for concentrations >0.5 mg/mL 23. Norepinephrine: Central line preferred, however, midline/peripheral/intraosseous access may be used when benefit outweighs risks 24. Parenteral Nutrition 25. Phenylephrine: Central line preferred, however, midline/peripheral/intraosseous access may be used when benefit outweighs risks 26. Posaconazole: Central line preferred, however, if unavailable, may administer one dose through a peripheral catheter (over 30 min) 27. Potassium acetate: Central line for concentrations ≥20 mEq/100 mL 28. Potassium chloride: Central line for concentrations ≥20 mEq/100 mL 29. Potassium phosphate: Central line recommended for concentration >15 mmol/100 mL. Central line required for rate >10 mEq/hr 30. Sodium Bicarbonate: Central line preferred if undiluted, however, midline/peripheral/intraosseous access may be used when benefit outweighs risks 31. Sodium Chloride 3%: Central line preferred, however, midline/peripheral/intraosseous access may be used when benefit outweighs risks 32. Thiotepa 33. Treprostinil: Central line preferred, however, peripheral administration on a temporary basis has been documented; unless ordered subcutaneously with home pump 34. Vancomycin: Central line for concentrations ≥10 mg/mL Effective 6/1/2023. Contact CCKM@uwhealth.org for previous versions Copyright © 2023 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission. Contact: CCKM@uwhealth.org Last Revised: 05/2023 35. Vasopressin: Central line preferred, however, midline/peripheral/intraosseous access may be used when benefit outweighs risks Effective 6/1/2023. Contact CCKM@uwhealth.org for previous versions Copyright © 2023 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission. Contact: CCKM@uwhealth.org Last Revised: 05/2023