Injection Site Reactions

What is an injection site reaction?

Some medications are given in a vein (intravenous, IV) or into your skin with a needle (subcutaneous, or SubQ and intramuscular, or IM). Some medications that are given IV can cause reactions in the tissues around the IV or central line. There are two types of reactions that can happen:

• Irritation reactions happen when you are sensitive or allergic reaction to the medication. These can be called “flare reactions” and happen during or right after the medication is given.
• Extravasation reactions happen when the chemotherapy drug leaks from the blood vessels into the nearby tissues. This happens in the area where the IV catheter or central line is. Extravasation reactions may happen right away or may happen hours later.

Extravasation reactions can be harmful to the area of the body where the reaction happens. Some medications are known to cause extravasation and special actions may be taken to prevent it. The risk of extravasation with a central line is less than if a peripheral IV (an IV placed in your hand or arm) is used. PICC lines, port-a-caths, and tunneled catheters are all central lines.

How do I manage an injection site reaction?

The way a reaction is treated depends on the type of reaction that has happened. Extravasation reactions can cause serious and lasting tissue damage if not treated right away. Your healthcare team will remove as much of the drug as possible from the tissues. They may use antidote medications (medications that counteract or reverse the medication that is causing the problem) to lessen the damage. Plastic surgery may be needed if there is severe tissue damage or a delay in treatment. Hot or cold packs may be used. The treatment depends on which medication caused the reaction.

Sensitivity or flare reactions are treated with ice or heat, depending on the drug causing the reaction. Do not try to treat injection site reactions yourself unless you have been told to do so by your care provider. If you show signs of an injection site reaction, tell your care team right away.

When should I contact my care team?

If you have pain, redness, blistering, or itching on the skin around or near the injection site during or after a treatment, let your nurse know or call your care provider right away.