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DRUG

GROUP

ASPIRATE

And instill

steroids⁰⁰¹

'SPREAD' AND DILUTE

LOCALISE AND NEUTRALISE

SPECIFIC MANAGEMENT

ADDITIONAL

INFORMATION

Aclarubicin

4

Y

Y

Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress.1 h

Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice

Aldesleukin (IL-2)

1

Y

Y

Infiltrate the site with hyaluronidase a Apply heat and compression.2 g

Amsacrine

5

Y

Y

Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress.1 h

Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice

Asparaginase

1

Y

Y

Infiltrate the site with hyaluronidase 3 Apply heat and compression.2 g

Re-test for asparaginase hypersensitivity before giving further doses

Bleomycin

1

Y

Y

Infiltrate the site with hyaluronidase.a Apply heat and compression.2 g

Carboplatin

3

Y

Yi

Yi

Infiltrate the site with hyaluronidase.a Followed by topical hydrocortisone and warm compression. 2 g

Possibility of local inflammation or necrosis and/or pain. There are no specific antidotes. Although 3% thiosulphate may be useful

Carmustine

5

Y

Y

Infiltrate with 2.1% sodium bicarbonate,c leave for two minutes and aspirate off again.

Sodium bicarbonate is a Vesicant. Topical contact with carmustine may induce hyperpigmentation

Cisplatin

4

Y

Yi

Yi

Infiltrate the site with 3% thiosulphate,b aspirate back, then give hyualuronidase.a Followed by topical hydrocortisone and warm compression.^{2 g}

Cladribine

1

Y

Y

Infiltrate the site with hyaluronidase.a Apply heat and compression.2 g

Cyclophosphamide

1

Y

Y

Infiltrate the site with hyaluronidase.a Apply heat and compression.2 g

Cytarabine

1

Y

Y

Infiltrate the site with hyaluronidase.^a Apply heat and compression.2 g

Dacarbazine

5

Y

Y

Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress.1 h

Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice. Patients should avoid intense exposure of the effected area to sun light after extravasation. Surgical excision e is sometimes required to prevent serious damage

Dactinomycin

5

Y

Y

Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress.1 h

Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice. Surgical excision e is sometimes required to prevent serious damage

Daunorubicin

5

Y

Y

Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress.1 h

Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice. Surgical excision e is sometimes required to prevent serious damage

Daunorubicin Liposomal

4

Y

Y

Apply topical hydrocortisone and cover the area with an ice pack for up to 12 hours, h then at 8-12 hours post incidence apply DMSO 2 hourly for the next 24 hours.3

Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice

Docetaxel

4

Y

Y

Infiltrate the area with a mixture d of hydrocortisone and chlorpheniramine as 0.2ml 'pin cushion' subcutaneous injections. Follow by hyaluronidase a and then warm compressions g alternated with the application of topical antihistamine cream.4 In severe cases 1g of oral sodium cromoglycate should be administered as soon as possible after the injury.

Doxorubicin

5

Y

Y

Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress.1 h

Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice. Sodium bicarbonate may have a role

Surgical excision e is sometimes required to prevent serious damage