Drug | Treatment | Route | Frequency | Duration |
Vinca alkaloids (vinblastine, vincristine, vinorelbine) | Heat | Topical | 15 to 20 minutes at least 4 times daily. | 24 to 48 hours |
Hyaluronidase | Subcutaneously | One-time dose: 1 mL (150 units) as 5 separate injections of 0.2 mL each, each injected subcutaneously into the extravasated site using a separate 25 gauge or smaller needle. | ||
Etoposide | Heat | Topical | 15 to 20 minutes at least 4 times daily. | 24 to 48 hours |
Anthracyclines (daunorubicin, doxorubicin, epirubicin, idarubicin) | Cold | Topical | 30 to 60 minutes, then every 15 minutes; discontinue at least 15 minutes prior to dexrazoxane therapy. | Day 1 only |
Dexrazoxane | Over 1 to 2 hours IV in a large vein away from the extravasation area[1,2] | 1000 mg/m2 within 6 hours, 1000 mg/m2 after 24 hours, and 500 mg/m2 after 48 hours. | ||
DMSO | Topical | For peripheral-line extravasations if dexrazoxane is unavailable or cannot be started within 6 hours: apply a few drops of 50% DMSO to the site using a sterile gauze pad every 8 hours. Allow to air dry; do not cover site. | 7 days | |
Liposomal anthracyclines (daunorubicin, doxorubicin) | Cold | Topical | 15 to 20 minutes at least 4 times daily. | 24 hours |
Mitomycin | Cold | Topical | 15 to 20 minutes at least 4 times daily. | 24 hours |
DMSO | Topical | Apply a few drops of 50% DMSO to the site using a sterile gauze pad every 8 hours. Allow to air dry; do not cover site. | 7 days | |
Taxanes (docetaxel, paclitaxel) | Heat | Topical | 15 to 20 minutes at least 4 times daily. | 24 hours |
Hyaluronidase* | Subcutaneously | One-time dose: 1 mL (150 units) as 5 separate injections of 0.2 mL each, each injected subcutaneously into the extravasated site using a separate 25 gauge or smaller needle. | ||
Mechlorethamine Bendamustine Carboplatin Cisplatin Dacarbazine | Cold | Topical | For 6 to 12 hours following sodium thiosulfate antidote injection.¶ | 6 to 12 hours |
Sodium thiosulfateΔ | Subcutaneously | One-time dose: inject 2 mL of the 1/6 Molar solution for each mg of mechlorethamine suspected to have extravasated.¶ Inject solution subcutaneously into the extravasation site using a 25 gauge or smaller needle. | ||
Oxaliplatin | Corticosteroids | Oral | ||
Heat | Topical | 15 to 20 minutes at least 4 times per day. | 1 to 2 days. Exposure to cold may precipitate or worsen the acute neuropathy associated with oxaliplatin. | |
Other agents | Cold | Topical | 15 to 20 minutes at least 4 times per day. | 24 hours |
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