Extravasation GuideTissue injury risk of antineoplastic extravasation

Mechlorethamine

Clormetina

Risk class

Vesicant

If it extravasates

Antidote

Sodium thiosulfate

Compress

Cold

References

Risk class: VesicantESMO-EONS 2012 (Table 1, p. vii167)

Antidote: sodium thiosulfateESMO-EONS 2012 (Table 5, p. vii173)

Compress: coldESMO-EONS 2012 (Fig. 1, p. vii170)

Not classified in: ONS/ASCO 2025, JSCN/JSMO/JASPO 2024

Details by guideline

Risk class in extravasation

ESMO-EONS 2012Vesicant
Vesicants › DNA-binding compounds › Alkylating agents
Table 1, p. vii167

Not classified in: ONS/ASCO 2025, JSCN/JSMO/JASPO 2024

Specific antidote

ESMO-EONS 2012Sodium thiosulfate
Strength/level: V-CMechlorethamine
Table 5, p. vii173

Compress

ESMO-EONS 2012Cold compress
"Localize and neutralize"Anthracyclines; Antibiotics (Mitomycin / Dactinomycin); Alkylating agents
Figure 1, p. vii170

Brand names (ANVISA, Brazil) · DCB (Brazil)

DCB (Brazil)clormetina (nº 2469)

General recommendations of the guidelines

ONS/ASCO 2025Recommendation 1 · Strong; very low
Use antidotes, when one exists, for vesicants and irritants with vesicant properties, rather than no antidote.
Table 3, p. 388
ONS/ASCO 2025Recommendation 3 · Conditional; very low
Thermal compress (cold or warm depending on the agent) rather than no compress.
Table 3, p. 388
ONS/ASCO 2025Recommendation 4 · Conditional; very low
Compress for more than 24 hours rather than 24 hours or less.
Table 3, p. 388
ONS/ASCO 2025Recommendation 5 · Conditional; very low
Central line extravasation: surgical referral or escalation of care in addition to conservative management.
Table 3, p. 388
JSCN/JSMO/JASPO 2024CQ10a · Recommend (weak)
Cold compression (weak recommendation).
Table 1, CQ10a
JSCN/JSMO/JASPO 2024CQ10b · Not recommend (weak); D
Non-use of warm compresses (weak recommendation).
Table 1, CQ10b

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