Table 1.

Definition of infusion reactions, in accordance with the Cheifetz criteria14.

Severity of Infusion ReactionSymptomsTreatment
MildHyperemia, malaise, or dizziness. Self-limited courseReduction (to 10 ml/h) or stop infusion. Eventually clemastine IV (0.05 mg/kg). Monitoring of vital signs every few minutes until within normal limits. Restart of infusion after break of at least 30 min with slow infusion rate (10 ml/h), then gradual increase.
ModerateRespiratory symptoms (e.g., dyspnea, chest tightness, stridor). Gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain). UrticariaStop infusion. Clemastine IV (0.05 mg/kg); methylprednisolone IV (2 mg/kg), and inhalation (albuterol, epinephrine) if necessary. Monitoring of vital signs every few minutes until within normal limits. Restart of infusion after break of at least 30 min.
SevereRespiratory, gastrointestinal symptoms, and/or rash and tachycardia and hypotoniaStop infusion. Clemastine IV (0.05 mg/kg); methylprednisolone IV (2 mg/kg), adrenalin (1:1000, 0.1 mg IM) in case of hypotonia. Monitoring of vital signs every few minutes until within normal limits.
  • IV: intravenously.