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Not everyone will have an infusion reaction, but some treatments put you at a higher risk for them, including certain chemotherapy and targeted therapy drugs, and many immunotherapy drugs. There are, however, things that your cancer care team can do to help reduce your risk of having an infusion reaction.
It's important to remember that an infusion reaction is your body's immune response to a treatment. Because of this, a reaction can happen even when steps were taken to prevent it.
Before starting your treatment, your cancer care team will tell you if there is a chance for a reaction and what signs to look for. Your nurse and the rest of the cancer care team will closely monitor you during the infusion. If the infusion drug you are receiving has a known risk for causing reactions, your doctor may prescribe drugs for you to take before your infusion (pre-medications). Pre-medications, sometimes referred to as pre-meds, help reduce the chance that you will react to the infusion drug. Sometimes a pre-medication is taken at home before you come to the treatment center. If you get a pre-medication prescription, take it as instructed. But sometimes the pre-meds are given at the treatment center just before your infusion.
Your nurse will monitor you during the infusion. If there are any signs of a reaction, the nurse and doctor will likely stop the infusion to assess you, your vital signs, and your symptoms.
A treatment infusion is usually stopped, at least for a short time, if there is any sign of a reaction. While the treatment is stopped, plain IV fluids might be given while the cancer care team checks you and decides on the best action. Medications can often help stop a reaction. They might be given right into the IV line or as a pill by mouth. Depending on how severe a reaction is, your doctor may decide to restart the infusion at a slower rate, delay the infusion until a later time, or permanently stop the drug.
In certain cases and with certain drugs, your doctor may try to desensitize a patient who has had a reaction in the past. Desensitization means the drug is re-introduced to your body slowly until your body can handle the drug without reacting to it. The drug is given to you in small doses to begin with, and the dose is slowly increased until the dosage goal is reached. This way you still will be able to receive the treatment you need.
Your cancer care team will tell you about the immunotherapy you will be receiving and possible reactions or side effects you might have. Report all side effects you are experiencing to your cancer care team so treatment can begin immediately. If you are having any side effects, your doctor may:
Let your doctor or cancer care team know if you have any symptoms of reactions or side effects of immunotherapy so that treatment for the symptoms can start immediately if needed.
Let your cancer care team know if any of your side effects get worse or do not respond to the prescribed treatment.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
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Bonamichi-Santos R, Castells M. Diagnoses and management of drug hypersensitivity and anaphylaxis in cancer and chronic inflammatory diseases: Reactions to taxanes and monoclonal antibodies. Clinic Rev Allerg Immunol. 2018; 54:375-385.
Kroschinsky F, Stölzel F, Bonin S, et al. New drugs, new toxicities: severe side effects of modern targeted and immunotherapy of cancer and their management. Critical Care. 2017;21: 89.
National Comprehensive Cancer Network (NCCN). Management of immunotherapy-related toxicities. 2019. Version 2.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/immunotherapy.pdf on September 20, 2019.
Vigarios E, Epstein JB, Sibaud V. Oral mucosal changes induced by anticancer targeted therapies and immune checkpoint inhibitors. Support Care Cancer. 2017; 25:1713-1739.
Last Revised: February 1, 2020
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