Infusion reaction

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: acute infusion reaction; infusion-related reaction


Infusion reactions is defined as a reaction to the infusion of pharmacological or biological substances. Symptoms may appear within minutes to hours following the infusion and may include pruritus, flushing, swelling, dyspnea, bronchospasm, and hypotension.[1]


Common Terminology Criteria for Adverse Events (CTCAE) Grade

CTCAE Grade 1 Cytokine Release Syndrome or Acute Infusion Reaction

Mild reaction; infusion interruption not indicated; intervention not indicated.

CTCAE Grade 2 Cytokine Release Syndrome or Acute Infusion Reaction

Requires therapy or infusion interruption but responds promptly to symptomatic treatment (e.g., antihistamines, NSAIDS, narcotics, IV fluids); prophylactic medications indicated for ≤24 hrs.

CTCAE Grade 3 Cytokine Release Syndrome or Acute Infusion Reaction

Prolonged (i.e., not rapidly responsive to symptomatic medication and/or brief interruption of infusion); recurrence of symptoms following initial improvement; hospitalization indicated for other clinical sequelae (e.g., renal impairment, pulmonary infiltrates).

CTCAE Grade 4 Cytokine Release Syndrome or Acute Infusion Reaction

Life-threatening; pressor or ventilatory support indicated.

CTCAE Grade 5 Cytokine Release Syndrome or Acute Infusion Reaction



Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect

Denileukin diftitox, galsulfase, Ibritumomab tiuxetan, laronidase, Pegloticase

Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

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Signs and Symptoms

  • Flushing
  • Itching
  • Alterations in heart rate and blood pressure
  • Dyspnea or chest discomfort
  • Back or abdominal pain
  • Fever and/or shaking chills
  • Nausea, vomiting, and/or diarrhea
  • Various types of skin rashes
  • Throat tightening
  • Hypoxia
  • Seizures
  • Dizziness and/or syncope
  • Signs and symptoms of anaphylaxis


  1. "NCI Thesaurus".