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Ifosfamide extravasation

J Mateu1, M Alzamora, M Franco

  • 1Department of Pharmacy, Hospital Joan XXIII, Tarragona, Spain.

The Annals of Pharmacotherapy
|November 1, 1994
PubMed
Summary
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Ifosfamide extravasation can cause local reactions, contrary to previous beliefs. Prompt treatment with chondroitinase or hyaluronidase significantly reduced inflammation and pain, suggesting their efficacy as antidotes.

Area of Science:

  • Oncology
  • Pharmacology
  • Dermatology

Background:

  • Ifosfamide is a chemotherapy agent used for various cancers.
  • Extravasation of ifosfamide was previously considered to cause minimal local tissue damage.
  • This case challenges the notion of ifosfamide being a non-irritant upon extravasation.

Observation:

  • A patient with non-Hodgkin's lymphoma developed a significant local reaction after ifosfamide extravasation.
  • The reaction presented as inflammation and pain in the affected arm.
  • Standard supportive measures were implemented, including limb elevation.

Findings:

  • The local reaction was attributed to the ifosfamide itself, not the infusion solution or vehicle.
  • Subcutaneous administration of chondroitinsulfatase, an enzyme similar to hyaluronidase, was initiated around the extravasation site.

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  • The treatment led to a satisfactory reduction in inflammatory signs and pain.

    • Implications:

    • Extravasated ifosfamide should be considered a potential irritant.
    • Local administration of chondroitinsulfatase or hyaluronidase can effectively manage ifosfamide extravasation.
    • This finding may alter clinical guidelines for managing chemotherapy extravasations.