Paclitaxel and Vinca Alkaloids extravasation - Hyaluronidase

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Tue, 08/13/2024 - 14:01

Scott Murray

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Joined: 06/11/2015 - 13:37

Paclitaxel and Vinca Alkaloids extravasation - Hyaluronidase

Has anyone adopted: 1 to 6ml of Hyaluronidase for each 1ml of extravasated drug into practice (Paclitaxel and Vinca Alkaloids), per "Management of Drug Extravasations" (Lexi-Drugs)?

Would you be willing to share the dosing your institution utilizes or policy?

We are not sure when it changed but prior to this it was, "Hyalurondidase 1 mL (15 units/mL) as five separate 0.2 mL injections (using a tuberculin syringe) around the site of extravasation". May have changed around December 2023?

See current excerpt:
"Hyaluronidase: If needle/cannula still in place: Administer 1 to 6 mL (150 units/mL) into existing IV line; usual dose is 1 mL for each 1 mL of extravasated drug; if needle/cannula has been removed, inject subcutaneously in a clockwise manner around area of extravasation; may repeat several times over the next 3 to 4 hours (Ener 2004)"

When you follow the references for this dosing, it is difficult to discern the evidence-based medicine behind this.

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