Alemtuzumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Amsacrine |
Vesicant |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hours |
Dimethyl sulfoxide (DMSO 99% solution) |
Arsenic trioxide |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Asparaginase
(L-aspariginase) |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Azacitidine |
Non-irritant (neutral)
(this does not preclude subcutaneous therapy) |
Not indicated |
Not indicated |
Bendamustine |
Irritant |
Cold compress
(initial for comfort measures) |
Not indicated |
Bevacizumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Bleomycin |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Bortezomib |
Irritant
(this does not preclude subcutaneous therapy) |
Cold compress
(initial for comfort measures) |
Not indicated |
Brentuximab |
Non-irritant (neutral) |
Not indicated |
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 |
Carmustine |
Irritant |
Cold compress
(initial for comfort measures) |
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 FOUR times daily for 48 hours |
No recommended antidote |
Cladribine |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Cyclophosphamide |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Cytarabine |
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 |
Vesicant |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Dimethyl sulfoxide (DMSO 99% solution) |
Daunorubicin |
Vesicant |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Dimethyl sulfoxide (DMSO 99% solution) |
Docetaxel |
Irritant with vesicant properties |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
No recommended antidote |
Doxorubicin |
Vesicant |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Dimethyl sulfoxide (DMSO 99% solution) |
Doxorubicin liposomal |
Irritant with vesicant properties* |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
No recommended antidote
Do not use DMSO 99% solution |
Epirubicin |
Vesicant |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Dimethyl sulfoxide (DMSO 99% solution) |
Eribulin mesilate |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Etoposide |
Irritant |
Cold compress
(initial for comfort measures) |
Not indicated |
Etoposide phosphate |
Irritant* |
Cold compress
(initial for comfort measures) |
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 |
Idarubicin |
Vesicant |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Dimethyl sulfoxide (DMSO 99% solution) |
Ifosfamide |
Irritant |
Cold compress
(initial for comfort measures) |
Not indicated |
Ipilimumab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Irinotecan |
Irritant |
Cold compress
(initial for comfort measures) |
Not indicated |
Melphalan |
Irritant with vesicant properties |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
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 FOUR times daily for 48 hour |
Dimethyl sulfoxide (DMSO 99% solution) |
Mitozantrone |
Irritant with vesicant properties |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
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 |
No warm or cold compress recommended |
No recommended antidote |
Paclitaxel |
Irritant with vesicant properties |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
There have been some clinical reports of positive outcomes with using hyaluronidase.
If hyaluronidase is administered no compress is recommended. |
Paclitaxel nab (Abraxane®) |
Irritant with vesicant properties |
Cold compress apply 15 to 20 minutes FOUR times daily for 48 hour |
No recommended antidote |
Panitumumab |
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 |
Raltitrexed |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Rituximab |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Teniposide |
Irritant |
Cold compress
(initial for comfort measures) |
Not indicated |
Thiotepa |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Topotecan |
Irritant |
Cold compress
(initial for comfort measures) |
Not indicated |
Trastuzumab (Herceptin®) |
Non-irritant (neutral) |
Not indicated |
Not indicated |
Trastuzumab emtansine (Kadcyla®) |
Irritant |
Not indicated |
Not indicated |
Vinblastine |
Vesicant |
Warm compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Hyaluronidase |
Vincristine |
Vesicant |
Warm compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Hyaluronidase |
Vindesine |
Vesicant |
Warm compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Hyaluronidase |
Vinflunine |
Vesicant |
Warm compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Hyaluronidase |
Vinorelbine |
Vesicant |
Warm compress apply 15 to 20 minutes FOUR times daily for 48 hour |
Hyaluronidase |