Which antidote is used for extravasation of anthracycline chemotherapy?

• A. Ice Pack
• B. Warm Compress
• C. Totect
• D. Hyaluronidase

Answer: (C)

Anthracyclines (like doxorubicin and daunorubicin) are vesicants, meaning if they leak into surrounding tissue during IV administration they can cause significant tissue injury and necrosis. The antidote specifically used to counteract this type of injury is dexrazoxane, sold under the brand name Totect. It works by chelating iron, which reduces the formation of free radicals and protects the cells from the drug’s damaging effects. Starting Totect promptly after an extravasation is suspected can markedly lessen tissue damage, with a typical three-dose course over the next two days.

Ice packs or warm compresses are general measures to manage extravasation symptoms but do not reverse the drug’s cytotoxic injury. Hyaluronidase is used for extravasations of other drugs (such as some alkaloids) to aid dispersion, not to treat anthracycline injury. Totect is the targeted antidote for anthracycline extravasation.