Adult Extravasation Management
Adult Extravasation Mgt.
NAV Top A B C D E F G H I K L M N O P R S T V Y Z

Adult Extravasation Management
A Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 aclambicin (Aclacinomycin) CHEMO Irritant Cold Compress
 
 acyclovir (Zovirax) Irritant  
 Adrenalin - see EPINEPHrine
 Adriamycin - see DOXOrubicin
 Adrucil - see fluorouracil
 Alkeran - see melphalan
 amascrine (Amsidine) CHEMO Vesicant Cold Compress
 aminophylline (Norphyl) Vesicant Cold compress
 
 amiodarone (Cordarone) Vesicant Warm compress
 
 Amsidine - see amascrine
 Ara-C - see cytarabine
 arginine (R-Gene 10) Vesicant Warm or cold compress
 
 Arranon - see nelarabine
 arsenic trioxide (Trisenox) CHEMO Irritant Cold Compress
 asparaginase (Elspar) CHEMO Typically does not have vesicant or irritant properties None
B Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 bendamustine (Treanda) CHEMO Irritant with vesicant-like properties Cold compress
 
 BiCNU - see carmustine
 bleomycin (Blenoxane) CHEMO Irritant Cold compress
 bortezomib (Velcade) CHEMO Irritant None
 Brevibloc - see esmolol
 busulfan (Busulfex, Myleran) CHEMO Irritant Cold compress
C Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 calcium salts Vesicant Cold compress
 
 Camptosar - see irinotecan
 CARBOplatin (Paraplatin) CHEMO Irritant Cold compress
 carmustine (BiCNU) CHEMO Vesicant/Irritant Cold compress
 
 Cerubidine - see DAUNOrubicin
 CISplatin (Platinol) CHEMO Vesicant at concentration > 0.4 mg/mL Cold compress
  • 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) CHEMO Irritant/Neutral Cold compress
 clofarabine (Clolar) CHEMO Typically does not have vesicant or irritant properties None
 contrast media Irritant Warm or cold Compress
  • < 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) CHEMO Irritant Cold compress
  • Administer 5 mL subcutaneously into the extravasation site.
 cytarabine (Ara-C, Cytosar) CHEMO Irritant/Neutral Cold compress
 cytarabine liposomal (DepoCyt) CHEMO Irritant Cold compress
 Cytoxan - see cyclophosphamide
D Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 dacarbazine (DTIC- Dome) CHEMO Irritant with vesicant-like properties Cold compress
  • Protect site from sunlight.
• sodium thiosulfate recommended only when concentrated dacarbazine is extravasated
 DACTINomycin (Cosmegen) CHEMO Vesicant Cold compress
  • Do not apply heat, it may worsen injury.
• Protect site from heat/sunlight.
 DAUNOrubicin (Cerubidine) CHEMO Vesicant Cold compress
  • Do not apply heat, it may worsen injury.
• Protect site from heat and sunlight.
• Corticosteroids worsen toxicity.
• Do not use dexrazoxane and topical DMSO in combination with each other due to decreased efficacy of dexrazoxane.
 DepoCyt - see cytarabine liposomal
 dextrose > 10% Vesicant Cold compress
 
 diazePAM (Diastat AcuDial, Valium) Vesicant Cold compress
 
 digoxin (Lanoxin, Digitek, Digox) Vesicant None
 Dilantin - see phenytoin
 DOBUTamine (Dobutrex) Vesicant Warm compress
  • phentolamine preferred 1st line.
 DOCEtaxel (Taxotere) CHEMO Irritant with vesicant-like properties Warm or cold compress
  • Excess cold can cause further tissue damage.
 DOPamine (Intropin) Vesicant Warm compress
  • phentolamine preferred 1st line.
 DOXOrubicin (Adriamycin) CHEMO Vesicant Cold compress
  • Do not apply heat, it may worsen injury.
• Protect site from heat and sunlight.
• Corticosteroids worsen toxicity.
• Do not use dexrazoxane and topical DMSO in combination with each other due to decreased efficacy of dexrazoxane.
 DTIC- Dome - see dacarbazine
E Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Eldisine - see vindesine
 Ellence - see epiRUBicin
 Eloxatin - see OXALIplatin
 Elspar - see asparaginase
 EPINEPHrine (Adrenalin) Vesicant Warm compress
  • phentolamine preferred 1st line.
 epiRUBicin (Ellence) CHEMO Vesicant Cold compress
  • Do not apply heat, it may worsen injury.
• Protect site from heat and sunlight.
• Corticosteroids worsen toxicity.
• Do not use dexrazoxane and topical DMSO in combination with each other due to decreased efficacy of dexrazoxane.
 esmolol (Brevibloc) Vesicant Cold compress
 etoposide (Toposar, VePesid) CHEMO Irritant Warm compress
 
 etoposide phosphate (Etopophos) CHEMO Irritant Warm compress
 
F Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 floxuridine (FUDR) CHEMO Irritant Cold compress
 fludarabine (Fludara) CHEMO Not applicable Warm compress
 fluorouracil (Adrucil) CHEMO Irritant Cold compress
G Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 gemcitabine (Gemzar) CHEMO Irritant Cold compress
 gemtuzumab (Mylotarg) CHEMO Irritant Cold compress
H Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Hycamtin - see topotecan
I Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 IDArubicin (Idamycin) CHEMO Vesicant Cold compress
  • Do not apply heat, it may worsen injury.
• Protect from heat/sunlight.
• Corticosteroids worsen toxicity.
 ifosfamide (Ifex) CHEMO Irritant Cold compress
 Intropin - see DOPamine
 irinotecan (Camptosar) CHEMO Irritant Ice pack and flush external site with sterile water
 ixabepilone (Ixempra Kit) CHEMO Irritant Cold compress
K Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Kadcyla - see trastuzumab emtasine
L Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Lanoxin - see digoxin
 Leustatin - see cladribine
 Levophed - see norEPINEPHrine
M Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 mannitol (>5%) Vesicant Warm or cold compress
 
 mechlorethamine (Mustargen) CHEMO Vesicant Cold compress
  • Administer 2 mL subcutaneously into the extravasation site for each mg of drug suspected to have extravasated.
 melphalan (Alkeran) CHEMO Irritant/Vesicant Cold compress
 methotrexate CHEMO N/A Warm compress
 methylene blue Vesicant Warm compress
 
 Mithracin - see plicamycin
 mitoMYcin (Mutamycin) CHEMO Vesicant Cold compress
  • 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) CHEMO Irritant with vesicant-like properties Cold compress
  • Do not use dexrazoxane and topical DMSO in combination with each other due to decreased efficacy of dexrazoxane.
 Mustargen - see mechlorethamine
 Mutamycin - see mitoMYcin
 Myleran - see busulfan
 Mylotarg - see gemtuzumab
N Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 nafcillin (Nallpen) Vesicant Cold compress
 
 Navelbine - see vinORELBine
 Nebupent - see pentamidine
 nelarabine (Arranon) CHEMO Typically does not have vesicant or irritant properties None
 NeoSynephrine - see phenylephrine
 norEPINEPHrine (Levophed) Vesicant Warm compress
  • phentolamine preferred 1st line.
 Norphyl - see aminophylline
 Novantrone - see mitoXANTRONE
O Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Oncaspar - see PEG-asparaginase
 Oncovin - see vinCRIStine
 Otrexup - see methotrexate
 OXALIplatin (Eloxatin) CHEMO Irritant with vesicant-like properties Warm compress
  • Do not apply cold, may precipitate acute neurotoxicity.
• Early administration of corticosteroids may be beneficial to decrease inflammation.
P Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 PACLitaxel (Taxol) CHEMO Irritant with vesicant-like properties Cold compress
  • 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
 PEG-asparaginase (Oncaspar) CHEMO Typically does not have vesicant or irritant properties None
 pentamidine (Pentam, Nebupent) Irritant with vesicant-like properties Warm compress
 Phenadoz - see promethazine
 Phenergan - see promethazine
 phenylephrine (NeoSynephrine) Vesicant Warm compress
  • phentolamine preferred 1st line.
 phenytoin (Dilantin, Phenytek) Vesicant Warm compress
 
 Pitressin - see vasopressin
 Platinol - see CISplatin
 plicamycin (Mithracin) CHEMO Vesicant/Irritant Cold compress
 potassium salts Vesicant/Irritant Warm or cold compress
 
 promethazine (Phenergan, Phenadoz) Vesicant Warm or cold compress
  • Refractory cases: Consider nitroglycerin 2% topical or hyaluronidase (200 units/ml).
R Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 raltitrexed (Tomudex) CHEMO Irritant Cold compress
 Rasuvo - see methotrexate
 R-Gene 10 - see arginine
S Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 sodium bicarbonate (≥8.4%) Vesicant Cold compress
 
 sodium chloride (≥ 3% percent) Vesicant Cold compress
 
 streptozocin (Zanosar) CHEMO Irritant Cold compress
T Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Taxol - see PACLitaxel
 Taxotere - see DOCEtaxel
 teniposide (Vumon) CHEMO Irritant Warm or cold compress
 
 Thioplex - see thiotepa
 thiotepa (Thioplex) CHEMO N/A Warm or cold compress
 Tomudex - see raltitrexed
 Toposar - see etoposide
 topotecan (Hycamtin) CHEMO Irritant Cold compress
 TPN Vesicant Cold compress
 
 trabectedin (Yondelis) CHEMO Vesicant Cold compress
 trastuzumab emtasine (Kadcyla) CHEMO Irritant None
 Treanda - see bendamustine
 Trisenox - see arsenic trioxide
V Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Valium - see diazePAM
 vancomycin (Vancocin) Irritant Warm or cold compress
 
 vasopressin (Pitressin) Vesicant Warm Compress
  • nitroglycerin preferred 1st line.
 Velcade - see bortezomib
 VePesid - see etoposide
 VePesid - see etoposide
 vinBLAStine (Velban) CHEMO Vesicant Warm compress
  • Corticosteroids and topical cooling can worsen toxicity.
 vinCRIStine (Oncovin) CHEMO Vesicant Warm compress
  • Corticosteroids and topical cooling can worsen toxicity.
 vindesine (Eldisine) CHEMO Vesicant Warm compress
  • Corticosteroids and topical cooling can worsen toxicity.
 vinORELBine (Navelbine) CHEMO Vesicant  
  • Usual dose is 0.75 mL (150 units) of hyaluronidase for each 1 mL of extravasated drug.
 Vumon - see teniposide
Y Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Yondelis - see trabectedin
Z Generic (Brand) Vesicant / irritant Local Care
Comments / Treatment links
 Zanosar - see streptozocin
 Zovirax - see acyclovir
last updated: 03/25/2022

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