Key points
- Taxane and antibody reactions usually occur with the first or second dose and in the first minutes; platinum reactions usually come after several cycles (often from the sixth cycle onwards) [1].
- Anaphylaxis: adrenaline 0.5 mg intramuscularly (1:1000), repeated every 5 to 15 minutes if needed [1].
- Rapid desensitisation allows an essential drug to be continued [2].
Management by severity
| Grade | Symptoms | Action |
|---|---|---|
| 1 (mild) | Flushing, limited rash | Slow down or pause briefly; antihistamine; continue at a lower rate |
| 2 (moderate) | Widespread hives, mild shortness of breath, blood pressure change not needing intensive treatment | Stop; antihistamine, corticosteroid, oxygen; after recovery, continue at a lower rate with premedication |
| 3 to 4 (severe or anaphylaxis) | Bronchospasm, hypotension, angioedema | Stop; intramuscular adrenaline, fluids, oxygen; usually permanent discontinuation or desensitisation |
Desensitisation
In rapid desensitisation, the drug is given in 12 steps using three dilutions at increasing rates; of 413 desensitisations (mostly carboplatin and paclitaxel), 94% had no reaction or only a mild one, and there were no deaths [2]. It must be done in an equipped centre with a trained team. In carboplatin allergy, skin testing helps diagnosis and patient selection [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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