Extra safety measures must be in place for administration of chemotherapy drugs because of their high risk of toxicity and other adverse drug events (ADEs) that can be fatal. Dose limits and other restrictions are examples of parameters that health care organizations should place upon these medications. However, in some unusual situations, the patient’s clinical condition may require a variation outside the limits that an organization has set. In such situations, the health care organization should require consultation and review of the request by an approved clinical peer who is another prescriber certified to order chemotherapy. This will ensure that the request is warranted by the patient’s condition and will verify that the order is within a safe range.