Aflibercept |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Alemtuzumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Amifostine |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Amsacrine |
Vesicant |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Dimethyl sulfoxide (DMSO 99% solution) |
Antithymocyte globulin (horse) (ATGAM®) |
Non-irritant (neutral)* |
Not indicated |
Not indicated |
Antithymocyte globulin (rabbit) (Thymoglobulin®) |
Non-irritant (neutral)* |
Not indicated |
Not indicated |
Arsenic trioxide |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Asparaginase
(L-asparaginase) |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Atezolizumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Avelumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Azacitidine |
Non-irritant (neutral)
(this does not preclude subcutaneous therapy) |
Not indicated |
Not indicated |
Bendamustine |
Irritant with vesicant properties* |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Not indicated |
Bevacizumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Bleomycin |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Blinatumomab |
Non-irritant (neutral)* |
Not indicated |
Not indicated |
Bortezomib |
Irritant
(this does not preclude subcutaneous therapy) |
COLD compress
(initial for comfort measures) |
Not indicated |
Brentuximab vedotin |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Busulfan |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Cabazitaxel |
Irritant* |
COLD compress
(initial for comfort measures) |
Not indicated |
Calcium leucovorin |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Carboplatin |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Carfilzomib |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Carmustine |
Vesicant (treated as an irritant with vesicant properties) |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Not indicated |
Cemiplimab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Cetuximab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Cisplatin ≤ 0.5 mg/mL |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Cisplatin > 0.5 mg/mL |
Vesicant (treated as an irritant with vesicant properties) |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
No recommended antidote |
Cladribine |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Contrast media** |
Vesicant |
WARM or COLD compress |
Not indicated |
Cyclophosphamide |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Cytarabine |
Non-irritant (neutral)
(this does not preclude subcutaneous therapy) |
Not indicated |
Not indicated |
Cytarabine liposomal |
Non-irritant (neutral)* |
Not indicated |
Not indicated |
Dacarbazine |
Irritant |
COLD compress
(initial for comfort measures)
(Phlebitis and pain not to be confused with extravasation) |
Not indicated |
Dactinomycin (Actinomycin D) |
Vesicant |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Dimethyl sulfoxide (DMSO 99% solution) |
Daratumumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Daunorubicin |
Vesicant |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Dimethyl sulfoxide (DMSO 99% solution) |
Denosumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Docetaxel |
Irritant with vesicant properties* |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Some clinical reports of positive outcomes with using hyaluronidase.
If hyaluronidase is administered no compress is recommended. |
Doxorubicin |
Vesicant |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Dimethyl sulfoxide (DMSO 99% solution) |
Doxorubicin liposomal |
Irritant with vesicant properties* |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
No recommended antidote
Do not use DMSO 99% solution |
Durvalumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Enfortumab vedotin |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Epirubicin |
Vesicant |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Dimethyl sulfoxide (DMSO 99% solution) |
Eribulin mesilate |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Etoposide |
Irritant |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
Not indicated |
Etoposide phosphate |
Irritant* |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
Not indicated |
Fludarabine |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Fluorouracil |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Fotemustine |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Ganciclovir |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Gemcitabine |
Irritant |
COLD compress
(initial for comfort measures)
(phlebitis and pain not to be confused with extravasation) |
Not indicated |
Gemtuzumab ozogamicin |
Non-irritant (neutral)* |
Not indicated |
Not indicated |
Idarubicin |
Vesicant |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Dimethyl sulfoxide (DMSO 99% solution) |
Ifosfamide |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Inotuzumab ozogamcin |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Interferon |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Ipilimumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Irinotecan |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Irinotecan nanoliposomal |
Irritant |
COLD compress
(initial for comfort measures) |
No recommended antidote |
Melphalan |
Irritant with vesicant properties |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
No recommended antidote |
Mesna |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Methotrexate |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Mitomycin |
Vesicant |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Dimethyl sulfoxide (DMSO 99% solution) |
Mitozantrone |
Irritant with vesicant properties |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
No recommended antidote |
Nivolumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Obinutuzumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Ofatumumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Oxaliplatin |
Irritant with vesicant properties |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
No recommended antidote |
Paclitaxel |
Irritant with vesicant properties |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
Some clinical reports of positive outcomes with using hyaluronidase.
If hyaluronidase is administered no compress is recommended. |
Nab-paclitaxel |
Irritant with vesicant properties |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
No recommended antidote |
Pamidronate |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Panitumumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Pegaspargase |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Pembrolizumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Pemetrexed |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Pertuzumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Polatuzumab vedotin |
Irritant* |
COLD compress
(initial for comfort measures) |
No recommended antidote |
Pralatrexate |
Non-irritant (neutral)* |
Not indicated |
Not indicated |
Raltitrexed |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Ramucirumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Rituximab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Romidepsin |
Irritant |
COLD compress
(initial for comfort measures) |
No recommended antidote |
Sacituzumab govitecan |
Irritant |
COLD compress
(initial for comfort measures) |
No recommended antidote |
Temsirolimus |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Teniposide |
Irritant* |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
Not indicated |
Thiotepa |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Topotecan |
Irritant |
COLD compress
(initial for comfort measures) |
Not indicated |
Trabectedin |
Vesicant (treated as an irritant with vesicant properties) |
COLD compress apply 15 to 20 minutes every 6 hours for 48 hours |
No recommended antidote |
Trastuzumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Trastuzumab emtansine |
Irritant |
Not indicated |
Not indicated |
Vinblastine |
Vesicant |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
Hyaluronidase |
Vincristine |
Vesicant |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
Hyaluronidase |
Vindesine |
Vesicant |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
Hyaluronidase |
Vinflunine |
Vesicant |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
Hyaluronidase |
Vinorelbine |
Vesicant |
WARM compress apply 15 to 20 minutes every 6 hours for 48 hours |
Hyaluronidase |
Zoledronic acid |
Irritant* |
COLD compress
(initial for comfort measures) |
Not indicated |