From the Research
Management of amiodarone extravasation involves immediate cessation of the infusion, elevation of the affected limb, and application of dry heat to the area, as supported by the most recent and highest quality study available 1. The extravasated site should be gently aspirated to remove any residual medication if possible. Local infiltration with normal saline can help dilute the extravasated drug.
- Topical application of DMSO (dimethyl sulfoxide) 50-99% solution four times daily for 14 days may be beneficial as it has anti-inflammatory properties and enhances absorption of the extravasated drug.
- Cold compresses should be avoided as they can worsen tissue damage. Amiodarone is highly alkaline (pH 4.08) and contains polysorbate 80, making it vesicant and potentially causing severe tissue damage if extravasated.
- The damage occurs through direct cellular toxicity and vascular compression from inflammation. Regular monitoring of the site for signs of necrosis, blistering, or persistent pain is essential.
- If severe tissue damage develops, surgical consultation may be necessary. Documentation of the event, including the approximate amount extravasated, site appearance, and interventions performed, is important for continuity of care, although the exact protocol may vary based on the specific clinical context and institutional guidelines, as noted in various studies 2, 3, 4, 5. However, the most recent study 1 provides the most relevant guidance on managing amiodarone extravasation, focusing on the use of chrysin as a potential therapeutic agent to reduce injury area, inflammation, and promote healing.