Which of the following drugs are vesicants?

• A. Doxorubicin and vincristine/vinblastine are vesicants.
• B. Methotrexate is a vesicant.
• C. Paclitaxel is a vesicant.
• D. Cisplatin is a vesicant.

Answer: (A)

Vesicants are drugs that can cause severe tissue necrosis if they leak outside the vein during administration. The combination of doxorubicin and the vinca alkaloids vincristine or vinblastine are classic vesicants. Doxorubicin (an anthracycline) is well known for causing aggressive local injury if extravasation occurs, and vincristine and vinblastine are strongly inhibitory to dividing cells and can similarly damage surrounding tissue if they infiltrate the tissue. Because of this, IV access is chosen carefully and any suspected leakage is treated promptly to minimize injury.

The other drugs listed are not categorized as vesicants in this context, though they can cause other forms of local irritation or systemic toxicity if not given properly.