Adult Extravasation Management
Adult Extravasation Mgt.
NAV Top 5 A B C D E F G H I J K L M N O P R S T V X Y Z
Adult Extravasation Management last updated:
06/18/2025
 PROCEDURE
A. Routinely assess the cannulation site and the surrounding tissue for any signs and symptoms of possible extravasation.
1. Signs and symptoms may include changes in sensation, pain, local burning or tingling at infusion site, swelling, erythema,
 pruritus, or inflammation.
2. Within 2-3 days increased erythema, pain, brawny discoloration, induration, dry desquamation, and/or blistering may occur.
3. Signs and symptoms for central venous catheter (CVC) devices may include accumulation of the extravasated solution in the
 mediastinum, pleura, or in the subcutaneous tissues of the chest or neck. The primary symptom is thoracic pain.
**If extravasation is suspected, treatment should begin as soon as possible. Early detection and treatment can significantly reduce tissue damage. **
B. Management of Peripheral IV Extravasation
1. Stop infusion immediately if extravasation suspected; leave the IV and cannula tubing in place and immobilize the extremity.
2. Gently aspirate any residual drug and/or blood from the IV tubing, cannula, and suspected extravasation site.
 Note: If unable to aspirate residual drug from intravenous cannula, remove the cannula.
3. Elevate site.
4. Notify provider.
5. Apply cold or warm compress per guideline (Refer to Appendix A).
 a. Cold compress: Apply cold compress for 20 minutes, 3 or 4 times per day for up to 3 days to reduce swelling and localize
  the agent.
 b. Warm compress: Apply warm compress for 20 minutes, 3 or 4 times per day for up to 3 days to vasodilate and disperse
  the agent. Warm compress should be used with caution.
6. Administer antidote if ordered by provider (Refer to Appendix A).
7. Disconnect the IV tubing and syringe from the cannula.
8. Mark area of extravasation and monitor site at 24 hours and weekly, as necessary.
9. Document extravasation and management in the patient’s electronic health record as well as in the electronic reporting
 system.
C. Management of CVC IV extravasation
1. Stop infusion if extravasation suspected, if patient complains of changes in CVC site or flow rate discontinue infusion.
2. Aspirate any remaining drug from the device and infiltrated site.
3. Notify provider.
4. Apply cold or warm compress to site per guideline (Refer to Appendix A).  a. Cold compress: Apply cold compress for 20 minutes, 3 or 4 times per day for up to 3 days to reduce swelling and localize
  the agent.
 b. Warm compress: Apply warm compress for 20 minutes, 3 or 4 times per day for up to 3 days to vasodilate and disperse
  the agent. Warm compress should be used with caution.
5. Administer antidote if ordered by provider (Refer to Appendix A).
6. Mark area of extravasation and monitor site at 24 hours and weekly, as necessary.
7. Document extravasation and management in the patient’s electronic health record as well as in the electronic reporting
 system.
Appendix A – Management of Extravasation
  5 generic (Brand) Qualifier
 5-FU - see fluorouracil
  A generic (Brand) Qualifier
 aclambicin (Aclacinomycin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: Dexrazoxane
Antidote link(s):
 acyclovir (Zovirax)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Irritant (at conc > 7mg/mL)
Local Care: Dry warm compresses
Antidote: Hyaluronidase (may consider for refractory cases in addition to supportive measures)
Antidote link(s):
Comments: • Irritant with vesicant-like properties
 Adrenalin - see EPINEPHrine
 Adriamycin - see DOXOrubicin
 Adrucil - see fluorouracil
 Alkeran - see melphalan
 amascrine (Amsidine)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: None
 amino acids
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: Hyaluronidase (200 units/mL) or nitroglycerin topical 2%
Antidote link(s):
 aminophylline
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 amiodarone (Cordarone)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (may consider for refractory cases in addition to supportive measures)
Antidote link(s):
 Amsidine - see amascrine
 Ara-C - see cytarabine
 arginine (R-Gene 10)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm or cold compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 Arranon - see nelarabine
 arsenic trioxide (Trisenox)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold Compress
Antidote: None
 asparaginase (Elspar)
Agent type: Chemotherapeutic
Vesicant/Irritant: Does not typically have vesicant or irritant properties
Local Care: None required
Antidote:  
  B generic (Brand) Qualifier
 bendamustine (Treanda)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant with vesicant-like properties
Local Care: Cold compress
Antidote: Sodium thiosulfate 1/6 M (4%)
Antidote link(s):
Comments: • Irritant with vesicant-like properties
 BiCNU - see carmustine
 bleomycin (Blenoxane)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
 bortezomib (Velcade)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: None
Antidote: None
 Brevibloc - see esmolol
 busulfan (Busulfex, Myleran)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
  C generic (Brand) Qualifier
 calcium salts
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: warm compress
Antidote: Early/Acute extravasation: Hyaluronidase (200 units/mL)
Delayed extravasation: Sodium thiosulfate
Antidote link(s):
 Camptosar - see irinotecan
 CARBOplatin (Paraplatin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
 carmustine (BiCNU)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant/Irritant
Local Care: Cold compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 Cerubidine - see DAUNOrubicin
 CISplatin (Platinol)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant at concentration > 0.4 mg/mL
Local Care: Cold compress
Antidote: Sodium thiosulfate 1/6 M (4%)
Antidote link(s):
Comments: • CISplatin extravasation treatment is ONLY for large volumes (> 20 mL) of a concentration solution (> 0.4 mg/mL).
• Inject 2 mL intravenously into existing IV line for each 100 mg of CISplatin extravasated; consider also injecting 1 mL subcutaneously as 0.1-mL injections clockwise into the area around the extravasation, may repeat subcutaneous injections several times over the next 3-4 hours.
 cladribine (Leustatin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant/Neutral
Local Care: Cold compress
Antidote: None
 clofarabine (Clolar)
Agent type: Chemotherapeutic
Vesicant/Irritant: Does not typically have vesicant or irritant properties
Local Care: None required
Antidote:  
 contrast media
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Warm or cold compress
Antidote: Treatment is often unnecessary.
May consider Hyaluronidase (200 units/mL) for inoperable cases with compartment syndrome
Antidote link(s):
Comments: • < 50 ml, low-osmolarity contrast media extravasation: Careful monitoring recommended; pharmacologic treatment often unnecessary
• > 50 ml low-osmolarity contrast media, any high-osmolarity contrast media, precursors of severe tissue injury: Consider use of hyaluronidase; dose may vary depending on the size of the infiltration
 Cordarone - see amiodarone
 Cosmegen - see DACTINomycin
 cyclophosphamide (Cytoxan)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: Sodium thiosulfate 1/6 M (4%)
Antidote link(s):
Comments: • Administer 5 mL subcutaneously into the extravasation site.
 cytarabine (Ara-C)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant/Neutral
Local Care: Cold compress
Antidote: None
 cytarabine (Cytosar)
Agent type: Chemotherapeutic
Vesicant/Irritant: Does not typically have vesicant or irritant properties
Local Care: None required
Antidote:  
 cytarabine liposomal (DepoCyt)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
  D generic (Brand) Qualifier
 dacarbazine (DTIC-Dome)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant with vesicant-like properties
Local Care: Cold compress
Antidote: Sodium thiosulfate 1/6 M (4%) - only recommended when concentrated dacarbazine is extravasated
Antidote link(s):
Comments: • Protect site from sunlight
 DACTINomycin (Cosmegen)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: None
Comments: • Do not apply heat, it may worsen injury
• Protect site from heat/sunlight
 dantrolene (Dantrium, Revonto, Ryanodex)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant:  
Local Care: None
Antidote: No known antidote
 DAUNOrubicin (Cerubidine)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: Dexrazoxane or topical DMSO. Do not use in combination with each other due to decreased efficacy of dexrazoxane.
Antidote link(s):
Comments: • Do not apply heat, it may worsen injury
• Protect site from heat and sunlight
• Corticosteroids worsen toxicity
 DepoCyt - see cytarabine liposomal
 dextrose ≥ 10%
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 diazePAM (Diastat AcuDial, Valium)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold or warm compress
Antidote: No known antidote
 digoxin (Digitek, Digox, Lanoxin)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: None
Antidote: None
 Dilantin - see phenytoin
 DOBUTamine (Dobutrex)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Phentolamine injection, nitroglycerin topical 2% ointment, or terbutaline
Antidote link(s):
Comments: • Phentolamine preferred 1st line
 DOCEtaxel (Taxotere)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant with vesicant-like Properties
Local Care: Warm or cold compress
Antidote: No known antidote
Comments: • Excess cold can cause further tissue damage
 DOPamine
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Phentolamine injection, nitroglycerin topical 2% ointment, or terbutaline
Antidote link(s):
Comments: • Phentolamine preferred 1st line
 DOXOrubicin (Adriamycin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: Dexrazoxane or topical DMSO. Do not use in combination with each other due to decreased efficacy of dexrazoxane.
Antidote link(s):
Comments: • Do not apply heat, it may worsen injury
• Protect site from heat and sunlight
• Corticosteroids worsen toxicity
 DTIC-Dome - see dacarbazine
  E generic (Brand) Qualifier
 Eldisine - see vindesine
 Ellence - see epiRUBicin
 Eloxatin - see OXALIplatin
 Elspar - see asparaginase
 EPINEPHrine (Adrenalin)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Phentolamine injection, nitroglycerin topical 2% ointment, or terbutaline
Antidote link(s):
Comments: • Phentolamine preferred 1st line
 epiRUBicin (Ellence)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: Dexrazoxane or topical DMSO. Do not use in combination with each other due to decreased efficacy of dexrazoxane.
Antidote link(s):
Comments: • Do not apply heat, it may worsen injury
• Protect site from heat and sunligh
• Corticosteroids worsen toxicity
 esmolol (Brevibloc)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: Hyaluronidase (may consider for refractory peripheral cases in addition to supportive measures)
Antidote link(s):
 etoposide (VePesid, Toposar)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Warm compress
Antidote: Hyaluronidase
Antidote link(s):
 etoposide phosphate (Etopophos)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Warm compress
Antidote: Hyaluronidase
Antidote link(s):
  F generic (Brand) Qualifier
 floxuridine (FUDR)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
 fludarabine (Fludara)
Agent type: Chemotherapeutic
Vesicant/Irritant: Not applicable
Local Care: Warm compress
Antidote: None
 fluorouracil (Adrucil)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
 FUDR - see floxuridine
  G generic (Brand) Qualifier
 gemcitabine (Gemzar)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
 gemtuzumab (Mylotarg)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
  H generic (Brand) Qualifier
 Hycamtin - see topotecan
  I generic (Brand) Qualifier
 IDArubicin (Idamycin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: Dexrazoxane
Antidote link(s):
Comments: • Do not apply heat, it may worsen injury
• Protect from heat/sunlight
• Corticosteroids worsen toxicity
 ifosfamide (Ifex)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
 irinotecan (Camptosar)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Ice pack and flush external site with sterile water
Antidote: None
 ixabepilone (Ixempra Kit)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
  J generic (Brand) Qualifier
 Jylamvo - see methotrexate
  K generic (Brand) Qualifier
 Kadcyla - see trastuzumab emtasine
  L generic (Brand) Qualifier
 Lanoxin - see digoxin
 Leustatin - see cladribine
 Levophed - see norEPINEPHrine
 Luminal - see PHENobarbital
  M generic (Brand) Qualifier
 mannitol > 5%
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 mechlorethamine (Mustargen)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: Sodium thiosulfate 1/6 M (4%)
Antidote link(s):
Comments: • Administer 2 mL subcutaneously into the extravasation site for each mg of drug suspected to have extravasated.
 melphalan (Alkeran)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant/Vesicant
Local Care: Cold compress
Antidote: None
 methotrexate (Jylamvo, Otrexup, Rasuvo, Trexall, Xatmep)
Agent type: Chemotherapeutic
Vesicant/Irritant: N/A
Local Care: Warm compress
Antidote: None
 methylene blue
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Nitroglycerin 2% topical ointment or phentolamine injection
Antidote link(s):
 Mithracin - see plicamycin
 mitoMYcin (Mutamycin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: DMSO 50% or Sodium thiosulfate 1/6 M (4%)
Antidote link(s):
Comments: • Do not apply heat, it may worsen injury
• Protect extravasation site from heat and sunlight
• Delayed injuries from mitoMYcin have been documented at sites distant from the site of extravasation
 mitoXANTRONE (Novantrone)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant with vesicant-like properties
Local Care: Cold compress
Antidote: Dexrazoxane or topical DMSO. Do not use in combination with each other due to decreased efficacy of dexrazoxane.
Antidote link(s):
 Mustargen - see mechlorethamine
 Mutamycin - see mitoMYcin
 Myleran - see busulfan
 Mylotarg - see gemtuzumab
  N generic (Brand) Qualifier
 nafcillin (Nallpen)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 Navelbine - see vinORELBine
 nelarabine (Arranon)
Agent type: Chemotherapeutic
Vesicant/Irritant: Does not typically have vesicant or irritant properties
Local Care: None required
Antidote:  
 Neo-Synephrine - see phenylephrine
 norEPINEPHrine (Levophed)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Phentolamine injection, nitroglycerin topical 2% ointment, or terbutaline
Antidote link(s):
Comments: • Phentolamine preferred 1st line
 Novantrone - see mitoXANTRONE
  O generic (Brand) Qualifier
 Oncaspar - see PEG-asparaginase
 Oncovin - see vinCRIStine
 Otrexup - see methotrexate
 OXALIplatin (Eloxatin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant with vesicant-like properties
Local Care: Warm compress
Antidote: Oral dexamethasone 8 mg twice daily for up to 14 days or Sodium thiosulfate 1/6 M (4%)
Antidote link(s):
Comments: • Do not apply cold, may precipitate acute neurotoxicity
• Early administration of corticosteroids may be beneficial to decrease inflammation
  P generic (Brand) Qualifier
 PACLitaxel (Taxol)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant with vesicant-like properties
Local Care: Cold compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
Comments: • Usual dose is 0.75 mL (150 units) of hyaluronidase for each 1 mL of extravasated drug. May repeat several times over the next 3-4 hours.
 Paraplatin - see CARBOplatin
 parenteral nutrition
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL) or nitroglycerin topical 2%
Antidote link(s):
 PEG-asparaginase (Oncaspar)
Agent type: Chemotherapeutic
Vesicant/Irritant: Does not typically have vesicant or irritant properties
Local Care: None required
Antidote:  
 pentamidine
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Irritant with vesicant-like properties
Local Care: Warm compress
Antidote: None
 Phenergan - see promethazine
 PHENobarbital (Luminal, Sezaby, Solfoton)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm or cold compress
Antidote: None
 phenylephrine (Neo-Synephrine)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Phentolamine injection, nitroglycerin topical 2% ointment, or terbutaline
Antidote link(s):
Comments: • Phentolamine preferred 1st line
 phenytoin (Dilantin,Phenytek)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL),nitroglycerin topical 2%
Antidote link(s):
 Pitressin - see vasopressin
 Platinol - see CISplatin
 plicamycin (Mithracin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant/Irritant
Local Care: Cold compress
Antidote:  
 potassium salts
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant/Irritant
Local Care: Warm or cold compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 promethazine (Phenergan)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm or cold compress
Antidote: None
Comments: • Refractory cases: Consider Nitroglycerin 2% topical or hyaluronidase (200 units/ml)
  R generic (Brand) Qualifier
 raltitrexed (Tomudex)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote:  
 Rasuvo - see methotrexate
 Revonto - see dantrolene
 R-Gene 10 - see arginine
 Ryanodex - see dantrolene
  S generic (Brand) Qualifier
 Sezaby - see PHENobarbital
 sodium bicarbonate > 8.4%
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 sodium chloride > 3%
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 Solfoton - see PHENobarbital
 streptozocin (Zanosar)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
  T generic (Brand) Qualifier
 Taxol - see PACLitaxel
 Taxotere - see DOCEtaxel
 teniposide (Vumon)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Warm or cold compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
 thiotepa (Thioplex)
Agent type: Chemotherapeutic
Vesicant/Irritant: N/A
Local Care: Warm or cold compress
Antidote: None
 Tomudex - see raltitrexed
 Toposar - see etoposide
 topotecan (Hycamtin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Cold compress
Antidote: None
 trabectedin (Yondelis)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Cold compress
Antidote: None
 trastuzumab emtasine (Kadcyla)
Agent type: Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: None
Antidote: None
 Treanda - see bendamustine
 TrexalL - see methotrexate
 Trisenox - see arsenic trioxide
  V generic (Brand) Qualifier
 Valium - see diazePAM
 vancomycin (Vancocin)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Irritant
Local Care: Warm or cold compress
Antidote: Hyaluronidase
Antidote link(s):
 vasopressin (Pitressin, Vasostrict)
Agent type: Non-Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Phentolamine injection,nitroglycerin topical 2% ointment, or terbutaline
Antidote link(s):
Comments: • Nitroglycerin preferred 1st line
 Vasostrict - see vasopressin
 Velban - see vinBLAStine
 Velcade - see bortezomib
 VePesid - see etoposide
 vinBLAStine (Velban)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
Comments: • Corticosteroids and topical cooling can worsen toxicity.
• Usual dose is 0.75 mL (150 units) of hyaluronidase for each 1 mL of extravasated drug.
 vinCRIStine (Oncovin)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
Comments: • Corticosteroids and topical cooling can worsen toxicity.
• Usual dose is 0.75 mL (150 units) of hyaluronidase for each 1 mL of extravasated drug.
 vindesine (Eldisine)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
Comments: • Corticosteroids and topical cooling can worsen toxicity.
• Usual dose is 0.75 mL (150 units) of hyaluronidase for each 1 mL of extravasated drug.
 vinORELBine (Navelbine)
Agent type: Chemotherapeutic
Vesicant/Irritant: Vesicant
Local Care: Warm compress
Antidote: Hyaluronidase (200 units/mL)
Antidote link(s):
Comments: • Corticosteroids and topical cooling can worsen toxicity.
• Usual dose is 0.75 mL (150 units) of hyaluronidase for each 1 mL of extravasated drug.
 Vumon - see teniposide
  X generic (Brand) Qualifier
 Xatmep - see methotrexate
  Y generic (Brand) Qualifier
 Yondelis - see trabectedin
  Z generic (Brand) Qualifier
 Zanosar - see streptozocin
 Zovirax - see acyclovir
   generic (Brand) Qualifier

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556



This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.
Copyright © 2025 Rpharmy, LLC ­ All Rights Reserved