Group 1:

Vesicant drugs

All vesicants except vinca alkaloids & cisplatinum

Apply cold pack instantly. SC dexamethasone 4mg around margins. Elevate limb but encourage movement. Reapply cold pack for 24h.

Actinomycin D

Infiltrate area with 1-3mL 3% sodium thiosulphate.







Topical DMSO painted every 2h followed by hydrocortisone cream and 30 mins cold compression. Repeated for 24h thereafter DMSO and hydrocortisone should be alternated every 3h; if blistering occurs stop DMSO.


Infiltrate area with 1-3mL 3% sodium thiosulphate, aspirate off then administer 1500 units hyaluronidase and apply heat and compression.


Infiltrate area with 1-3mL sodium bicarbonate diluted to plicamycin 2.1%, avoid normal tissue at the margins, leave 2 mins then aspirate off.

Docetaxel Paclitaxel

Infiltrate area with 1-3mL of a mixture of 100mg hydrocortisone and 4mg chlorphenamine (chlorpheniramine) as 0.2mL pin-cushion injections, followed by 1500U of hyaluronidase then warm compression alternated with topical antihistamine cream; hydrocortisone and antihistamine creams should be applied alternately for 3d. In severe cases administer 1g sodium cromoglicate PO as soon as possible.

Chlormethine (mustine)

Infiltrate area with 1-3mL 3% sodium thiosulphate then infiltrate with 100mg hydrocortisone, apply cold compression intermittently for 12h.

Vincristine, vinblastine & vindesine

Infiltrate area with 1500 units of hyaluronidase as 0.2mL SC injections over and around the affected area; apply heat and compression for 24h then apply topical non-steroidal anti-inflammatory cream to the area qds.

Group 2: Irritant drugs

• Aspirate as much as possible.

• Administer 100mg hydrocortisone IV.

• Administer 100mg hydrocortisone SC at multiple sites around margins of extravasation.

• Apply topical hydrocortisone.

• Manage symptoms.

Group 3: Non-vesicant drugs

• Aspirate as much as possible.

• Disperse extravasated drug with SC hyaluronidase injection around the area.

• Apply heat and compression to aid dispersal.

• Manage symptoms.

Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

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