The compatibility of acetyl-l-carnitine with three chemotherapy agents was studied during simulated Y-site administration. Acetyl-l-carnitine 30 mg/mL in 5% dextrose for injection (D5W) was combined with carboplatin 4 mg/mL, paclitaxel 2 mg/mL, and docetaxel 0.74 mg/mL in glass vials. Physical compatibility over the 4-hour storage at room temperature was assessed by visual examinations with unaided eye under fluorescent light and by measuring the percent transmittance at 600 nm. Chemical compatibility was measured by the percent of initial concentration remaining using stability-indicating high-performance liquid chromatographic-ultraviolet and high-performance liquid chromatographic-mass spectrometry methods. No visible particulate matter, haze, or color change was observed, and the percent transmittance was >95% for all admixtures. After a 4-hour incubation, 93.2% of the paclitaxel and 96.5% of docetaxel remained in separate mixtures with acetyl-l-carnitine. Carboplatin 4 mg/mL, paclitaxel 1.2 mg/mL, and docetaxel 0.74 mg/mL are physically and chemically compatible with acetyl-l-carnitine 30 mg/mLin D5W during a simulated 4-hour Y-site administration.