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  • This clinical procedure outlines the management of an extravasation with the following drugs that are known to be irritants with vesicant properties; docetaxel, liposomal doxorubicin, melphalan, mitozantrone, oxaliplatin, paclitaxel or nab paclitaxel. Cisplatin (greater than 0.5 mg/mL) is also included in this document, as although it is considered a vesicant at doses greater than 0.5 mg/mL, the management of an extravasation is the same as drugs that are known to be irritants with vesicant properties. Only health care professionals who have expertise and the knowledge of cytotoxic drugs and who have attained competency as per institutional guidelines in extravasation management should perform this procedure.
  • Extravasation of a vesicant is a medical emergency; early detection and prompt appropriate action is required to prevent necrosis and functional loss of the tissue or limb involved.
  • There have been some clinical reports of positive outcomes with using hyaluronidase as an antidote for paclitaxel. If hyaluronidase is administered for a paclitaxel extravasation no compress is recommended.

This procedure should be read in conjunction with the  extravasation management document, and the immediate management of an extravasation flow chart.

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20 Jan 2019