Key points
- If extravasation is suspected: stop the infusion immediately, do not remove the cannula, and aspirate as much of the drug as possible [1].
- Anthracyclines: cold and IV dexrazoxane within 6 hours [1, 2].
- Vinca alkaloids: warmth and hyaluronidase, not cold [1].
- Give vesicants through a central catheter or a large, healthy forearm vein.
Drug categories
| Group | Examples |
|---|---|
| Vesicant (DNA-binding) | Doxorubicin, epirubicin, daunorubicin, idarubicin, mitomycin, dactinomycin, mechlorethamine |
| Vesicant (non-DNA-binding) | Vincristine, vinblastine, vinorelbine, paclitaxel, docetaxel |
| Irritant | Oxaliplatin, cisplatin, carboplatin, etoposide, bendamustine, irinotecan |
| Non-vesicant | Methotrexate, cytarabine, gemcitabine, fluorouracil, monoclonal antibodies |
Action
- 1
Immediately
Stop the infusion, aspirate the drug through the cannula, then remove it; mark the area and photograph it; elevate the limb [1].
- 2
- 3
Vinca alkaloids and taxanes
Warm compresses and subcutaneous hyaluronidase around the area [1].
- 4
Follow-up
Assess on days 1 and 7 and later; with persistent pain, blistering or necrosis, seek plastic surgery advice [1].
References
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Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
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