Order of Chemotherapy Administration

Last Modified: April 26, 2009

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Dear OncoLink "Ask The Experts,"

I am a 4th-year pharmacy student working on a project for a chemotherapy pharmacist. We are looking for a chart that shows [in] what order chemotherapy agents should be administered. Do you have any advice/resources for us?


Michael Vozniak, PharmD, BCOP, Hematology/Oncology Clinical Pharmacy Specialist, responds:

I think the best or correct order for drug administration is very regimen-specific (if it’s even important at all). So, it is tough to say for given chemo x and chemo y to always give them in a certain order. However, there are certain principles one can follow. For example, when giving a taxane in combination with a platinum, the taxane should always be given first. This is because it has been observed that if you give the platinum and then taxane, patients experience increased myelosuppression.

For some chemotherapy regimens, the original research articles will state the order in which they were administered, but this is rare.

See this related question about R-CHOP administration.

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