# Infusion reactions, hypersensitivity and extravasation

Source: https://onco.cc/terms/extravasation-infusion-reaction/  
OnCo record `extravasation-infusion-reaction` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Reactions around the moment a drug is given: chills, fever or breathlessness from antibodies (infusion reactions), true allergy (hypersensitivity, rarely anaphylaxis), and leakage of a damaging drug into tissue around the vein (extravasation).

## Summary

Infusion reactions are common with first doses of rituximab, cetuximab, daratumumab and other antibodies (cytokine release from target cells) and with taxanes and platinum (hypersensitivity, rising with cumulative carboplatin exposure); premedication with antihistamines, steroids and paracetamol, slow initial rates and subcutaneous formulations (rituximab, daratumumab, atezolizumab, pembrolizumab) reduce them. Anaphylaxis to asparaginase or platinum leads to switching agents or desensitisation. Extravasation of vesicants (anthracyclines, vinca alkaloids) causes tissue necrosis and is why central venous access is used; dexrazoxane treats anthracycline extravasation. These are distinct from cytokine release syndrome after T-cell engagers, though mechanistically related.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: infusion reaction; infusion reactions; infusion-related reaction; infusion-related reactions; IRR; IRRs; hypersensitivity; hypersensitivity reaction; allergic reaction; anaphylaxis; anaphylactic; premedication; premedicated; pre-medication; antihistamine premedication; extravasation; vesicant; vesicants; infusion site reaction; injection site reaction; subcutaneous formulation; flu-like symptoms; hypersensitivity reactions; subcutaneous formulations

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Infusion-related_reaction
- Wikipedia: https://en.wikipedia.org/wiki/Infusion-related_reaction

## Connected records

- terms: [Anthracyclines (doxorubicin, epirubicin)](https://onco.cc/terms/anthracycline/), [Central venous access (port, PICC line)](https://onco.cc/terms/central-venous-access/), [Cytokine release syndrome (CRS)](https://onco.cc/terms/crs/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Cetuximab](https://onco.cc/drugs/cetuximab/), [Daratumumab](https://onco.cc/drugs/daratumumab/), [Rituximab](https://onco.cc/drugs/rituximab/)

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