Adult Dosing
Acute Lymphocytic Leukemia
- 2.25 mg/m² IV infusion over 1 hr q7 days
- For intravenous use only. Do not administer by any other route
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Indicated For IV administration only; Administration through other routes may result in fatalities [US Black Box Warning]
- Death has been reported with intrathecal use [US Black Box Warning]
- Do not confuse liposomal injection with vincristine injection. Vincristine sulphate liposomal injection has different dosage recommendations; verify drug name and dose prior to preparation and administration to avoid overdosage. [US Black Box Warning]
- Only administer through secure and free-flowing venous access line; discontinue infusion immediately if extravasation is suspected consider local treatment measures
- Sensory and motor neuropathies may occur commonly; monitor before and after treatment for symptoms of neuropathy such as hypoesthesia, hyperesthesia, paresthesia, hyporeflexia, areflexia, neuralgia, jaw pain, decreased vibratory sense, cranial neuropathy, ileus, burning sensation, arthralgia, myalgia, muscle spasm, or weakness; risk greater with history of preexisting neuromuscular disorders or concomitant drugs with risk of neurological toxicity
- Therapy may lead to orthostatic hypotension
- Monitor patients for myelosuppression; consider dose modification/reduction if Grade 3/4 neutropenia, thrombocytopenia, or anemia develops. Monitor complete blood counts prior to each dose.
- Therapy may lead to Tumor lysis syndrome (TLS). Closely monitor patients throughout the therapy
- Ileus, bowel obstruction, and colonic pseudo-obstruction have been associated with use of vincristine sulphate liposome; institute prophylactic bowel regimen, consider adequate dietary fiber intake, hydration, and routine use of stool softeners, such as docusate. Additional treatments, such as senna, bisacodyl, milk of magnesia, magnesium citrate, and lactulose may be considered.
- Therapy may lead to severe fatigue; dose delay, reduction, or discontinuation may be necessary
- Fatal liver toxicity and elevated levels of aspartate aminotransferase; monitor hepatic function tests; reduce or interrupt therapy if necessary
- Teratogenic; women of childbearing potential should avoid becoming pregnant while on therapy
Cautions: Use cautiously in:
- Pregnancy
- Breastfeeding
- Renal impairment
- Hepatic impairment
Pregnancy Category:D
Breastfeeding: It is unknown whether the drug is excreted in human milk, a decision should be made whether to discontinue nursing or discontinue the drug taking into account the importance of the drug to the mother; caution advised.
