Medication overfill—i.e., the intentional excess volume present in vials and ampoules—is a common practice in the pharmaceutical industry, but it requires careful attention and controls in the hospital routine. When there is no proper control of the administered milligrams, this excess can generate waste, affect operating costs, and even compromise patient safety. Therefore, understanding what medication overfill is and how to apply effective control strategies is essential for supplies management. In this article, learn about the impacts of medication overfill on the day-to-day work of the hospital pharmacy and the best practices for milligram control. Check it out!
What is medication overfill?
Medication overfill is the practice of including a slightly larger volume than what is stated on the labels of vials or ampoules, with the aim of compensating for inevitable losses during withdrawal and ensuring that the prescribed dose is fully administered. This extra margin is defined by the manufacturer and varies according to the type of medication and the route of administration. Although it is a technical strategy that is necessary for treatment effectiveness, medication overfill must be closely monitored by pharmacy and clinical care teams, because improper use of this excess leads to waste, increases costs, and compromises dose standardization.
Medication overfill: impacts on the day-to-day work of the hospital pharmacy
Medication overfill directly affects the routine of the hospital pharmacy, demanding heightened attention to dose management and waste control. Because the excess volume can vary across manufacturers and product presentations, the lack of standardized processes makes accurate administration more difficult and can result in financial losses.
To minimize these impacts and maintain patient safety, it is important to adopt best practices such as rigorous checking of vials before dispensing, periodic calibration of measuring equipment, and training professionals on the correct use of the available volume. These measures prevent dosing errors, promote the rational use of supplies, and strengthen agility in pharmacy operations.
Medication overfill in oncology
Medication overfill control is even more critical in oncology due to the high cost of chemotherapy drugs and the individualized preparation of doses for each patient. Even small variations in volume may lead to waste when management is not rigorous. For this reason, institutions adopt best practices such as rational dose-splitting, shared use of vials among patients with compatible prescriptions, and cross-check verification among professionals during preparation. Without this control, financial impacts are significant and there are additional risks of medication loss and administration errors, compromising both the sustainability of the oncology pharmacy and the safety of treatments.
Best practices for milligram control
Milligram control ensures precision in medication administration. In the hospital pharmacy, even minimal errors can compromise treatment effectiveness or patient safety. Therefore, adopting best practices is indispensable for safe performance. Below are a few we have selected:
1. Use calibrated scales with a defined calibration frequency
Periodic calibration ensures that equipment maintains accuracy, preventing variations that compromise the exact milligram dose of medications. This measure is especially important when handling high-potency drugs, where small deviations can pose a risk to the patient. Ensuring weighing accuracy also contributes to treatment protection and excellence.
2. Double-checking in measurement and dose-splitting processes
Requiring validation by two professionals reduces the likelihood of failures in critical stages of medication handling, maintaining greater patient safety, improving dose-preparation reliability, and strengthening a culture of shared responsibility within pharmacy teams.
3. Integrating milligram control into the Electronic Health Record (EHR)
Integrating milligram control into the EHR is a best practice that strengthens safety and traceability in medication preparation. By recording data in digital systems, information is automatically cross-checked against medical prescriptions. As a result, human errors decrease, compliance with the indicated doses is ensured, and audits are streamlined. Another advantage is optimizing professionals’ time by centralizing records within a single platform.
About Pixeon
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Our solutions serve hospitals, clinics, laboratories, and diagnostic imaging centers, covering both management (HIS, CIS, RIS, and LIS) and diagnostic processes (PACS and Laboratory Interface), ensuring high performance and top-tier management in healthcare institutions.
The HIS/CIS software for hospitals and clinics, Pixeon Smart, is a complete solution that integrates the entire institution into a single system. It is also certified with the highest level of digital maturity by SBIS (Brazilian Society of Health Informatics).
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