Table 1

Hypersensitivity reactions after chemotherapy: classification and management

Classification of reactions

Management of reactions


One or more mild symptoms:

Complete chemotherapy infusion with supervision at bedside. No treatment required.

• mild flushing

• rash

• pruritis


One or more moderate symptoms:

Stop chemotherapy infusion, venous infusion of antihistamine (Clemastine 2 mg IV and Dexamethasone 10 mg IV), → after recovery of symptoms resume paclitaxel infusion at a rate of 20 ml/h for 15 minutes then 50 ml/h for 15 minutes then, if no further symptoms, at full dose rate until infusion is complete.

• moderate rash

• flushing

• mild dyspnea

• chest discomfort

• mild hypotension


One or more severe symptoms:

Stop chemotherapy infusion, give IV antihistamine and steroid as above. Add epinephrine or bronchodilators if indicated, report as an adverse event, the patient will go off protocol therapy.

• respiratory distress requiring treatment

• generalized urticaria

• angioedema

• hypotension requiring therapy


van Heijl et al. BMC Surgery 2008 8:21   doi:10.1186/1471-2482-8-21

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