IV Extravasation – Vesicant Medications

The most severe type of IV Infiltration usually occurs when highly caustic medications known as vesicants infiltrate the tissues surrounding the IV site causing burns and tissue necrosis, a process called IV Extravasation. If you or someone you know has suffered IV Extravasation as a result of a hospital mistake, you should contact Burnside Law Firm LLP to learn more about your legal rights. Vesicant medications, irritants and caustic chemo agents include the following: For a comprehensive list of the most common irritant and vesicant IV medications visit: www.IVACCESS.com

List of Vesicants

  • Acyclovir > 7mg/mL (Zovirax®)
  • Aminophylline
  • Calcium salts ( 100 mg/mL concentration)
  • Chlorothiazide (Diuril®)
  • Cisplatin (Platinol®)(in concentrations 0.5 mg/mL)
  • Dactinomycin (Actinomycin-D, Cosmegen®)
  • Daunorubicin (daunomycin, Cerubidine®)
  • Dextrose solutions >10%
  • Dobutamine (Dobutrex®)
  • Dopamine (Intropin®)
  • Doxorubicin (Adriamycin®)
  • Epinephrine
  • Epirubicin (Ellence™)
  • Hydroxyzine (Vistacot™) Do NOT administer IV
  • Idarubicin (Idamycin®)
  • Mannitol (> 5% concentration)
  • Mechlorethamine (nitrogen mustard, Mustargen®)
  • Mitomycin C (Mutamycin®)
  • Mitoxantrone (Novantrone®)
  • Nitroglycerin
  • Norepinephrine (Levophed®)
  • Oxaliplatin (EloxatinTM)
  • Phenylephrine
  • Phenytoin (Dilantin®)
  • Promethazine (Phenergan®)
  • Sodium bicarbonate (>8.4% or > 1 mEq/mL)
  • Thiopental (Pentothal®)
  • Total parenteral nutrition (TPN)*
  • Tromethamine (THAM®)
  • Vasopressin (Pitressin®)
  • Vinblastine (Velban ®)
  • Vincristine (Oncovin ®)
  • Vinorelbine (Navelbine ®)
  • *TPN solutions containing amino acid solutions >5% and/or Dextrose >10% are considered
  • Vesicants
  • Partial List of Other Irritants:
  • Amiodarone (Cordarone®)
  • Arsenic Trioxide (Trisenox®)
  • Bleomycin (Blenoxane®)
  • Bortezomib (VelcadeTM)
  • Busulfan (Busulfex®)
  • Calcium salts (< 100 mg/mL concentration)
  • Conivaptan (Vaprisol®)
  • Carboplatin (Paraplatin®)
  • Carmustine (BiCNU®)
  • Cisplatin (Platinol®) (< 0.5 mg/mL concentration)
  • Cladribine (Leustatin®)
  • Dacarbazine (DTIC-Dome®)
  • Dalfopristin/quinupristin (Synercid®)
  • Dextrose (< 10% concentration)
  • Docetaxel (Taxotere®)
  • Erythromycin
  • Esmolol (Brevibloc®)
  • Etoposide (VePesid®)
  • Etoposide phosphate (Etopophos®)
  • Fluorouracil
  • Gemcitabine (Gemzar®)
  • Gentamicin
  • Ifosfamide (Ifex®)
  • Irinotecan (Camptosar®)
  • Liposomal cytarabine (DepoCyt®)
  • Liposomal daunorubicin (DaunoXome®)
  • Liposomal doxorubicin (Doxil™)
  • Liposomal vincristine (Marqibo™)
  • Melphalan (Alkeran®)
  • Nafcillin (Nallpen®)
  • Paclitaxel (Taxol®)
  • Paclitaxel, nanoparticle albumin-bound (Abraxane®)
  • Plicamycin (Mithracin®)
  • Potassium chloride
  • Sodium chloride ( 1% or 170 mEq/L)
  • Streptozocin (Streptozotocin, Zanosar®)
  • Teniposide (Vumon®)
  • Thiotepa
  • Topotecan (HycamtinTM)
  • Vancomycin

The following chemotherapeutic agents are vesicants:

  • actinomycin-D
  • daunorubicin
  • doxorubicin
  • idarubicin
  • mechlorethamine
  • mitomycin-C
  • paclitaxel
  • streptozocin
  • vinblastine
  • vincristine
  • vinorelbine

Some chemotherapeutic agents can cause pain or burning on administration, even though they may remain in the vasculature:

  • carmustine (BCNU)
  • dacarbazine (DTIC)

Pain or burning can be minimized by infusing these drugs slowly, as dilute solutions (eg. 100-250ml over 30-60 minutes, as opposed to IV push injections)

If you suspect medical negligence, do not hesitate to contact our Augusta, Georgia, lawyer. We offer experienced, strategic advocacy in cases involving IV infiltration and IV injury. Call 800-569-1937 or contact us by e-mail for an initial consultation.