vincristine

High Alert

Used alone and in combination with other treatment modalities (antineoplastics, surgery, or radiation therapy) in treatment of:
- Hodgkin disease,
- Leukemias,
- Neuroblastoma,
- Malignant lymphomas,
- Rhabdomyosarcoma,
- Wilms tumor,
- Other tumors.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Infection;
↓bone marrow reserve;
Hepatic impairment (↓ dose if serum bilirubin >3 mg/dL);
Rep: Women of reproductive potential.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: alopecia

EENT: cortical blindness, diplopia

Endo: syndrome of inappropriate antidiuretic hormone (SIADH)

GI: nausea, vomiting, abdominal cramps, anorexia, constipation, ileus, stomatitis

GU: gonadal suppression, nocturia, oliguria, urinary retention

Hemat: anemia, leukopenia, thrombocytopenia(mild and brief)

Local: phlebitis , tissue necrosis (from extravasation)

Metab: hyperuricemia

Neuro: ascending peripheral neuropathy, agitation, depression, insomnia, mental status changes

Resp: bronchospasm

Interactions ⬆ ⬇

Drug-drug:

Bronchospasm may occur in patients who have been previously treated with mitomycin.
l-asparaginase may ↑ levels and risk of toxicity; give vincristine 12–24 hr before asparaginase.
May ↓ antibody response to live-virus vaccines and ↑ risk of adverse reactions.

Availability ⬆ ⬇

(Generic available)

Solution for injection: 1 mg/mL

Route/Dosage ⬆ ⬇

IV (Adults ): 10–30 mcg/kg (0.4–1.4 mg/m²) as a single dose; may repeat weekly (not to exceed 2 mg/dose).
IV (Children >10 kg): 1.5–2 mg/m² as a single dose; may repeat weekly.
IV (Children <10 kg): 50 mcg/kg as a single dose; may repeat weekly.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Binds to proteins of mitotic spindle, causing metaphase arrest.
Cell replication is stopped as a result (cell cycle specific for M phase).
Has little or no effect on bone marrow.

Therapeutic effects:

Death of rapidly replicating cells, particularly malignant ones.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: vinca alkaloids

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Rapidly and widely distributed; extensively bound to tissues.

Metabolism/Excretion: Metabolized by the liver and eliminated in the feces via biliary excretion.

Half-Life: 10.5–37.5 hr.

Time/Action Profile ⬆ ⬇

(effects on blood counts‡)

ROUTE	ONSET	PEAK	DURATION
IV	unknown	4 days	7 days

‡Usually mild.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy.
Emphasize need for periodic lab tests to monitor for side effects.
Instruct patient to notify health care provider immediately if redness, swelling, or pain at injection site occurs.
Instruct patient to report symptoms of neurotoxicity (numbness and tingling, pain, difficulty walking, persistent or severe constipation, abdominal pain). Advise patient to ↑ fluid intake, dietary fiber, and exercise to minimize constipation; stool softeners or laxatives may be used.
Advise patient to notify health care provider of signs and symptoms of urinary retention (difficulty urinating, weak stream, abdominal pain).
Advise patient to notify health care provider of fever; chills; sore throat; signs of infection; bleeding gums; bruising; petechiae; blood in urine, stool, or emesis; or mouth sores. Caution patient to avoid crowds and persons with known infections.
Discuss the possibility of hair loss. Explore coping strategies.
Instruct patient not to receive any vaccinations without advice of health care provider.
Rep: May cause fetal harm. Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected and to avoid breastfeeding during therapy. Contraception should be used during therapy and ≥2 mo after last dose.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

48954- Fine Chemicals Corporation (PTY) Ltd.
- 48954-587-
  - 48954-587-00- 1 BOTTLE in 1 BOX (48954-587-00) / 180 g in 1 BOTTLE

54087- Hospira Australia Pty Ltd
- 54087-329-
  - 54087-329-01- 10 TRAY in 1 BOX (54087-329-01) / 74 VIAL, SINGLE-USE in 1 TRAY / 5 mL in 1 VIAL, SINGLE-USE

61703- Hospira, Inc.
- 61703-309- VinCRIStine Sulfate
  - 61703-309-06- 1 VIAL, SINGLE-DOSE in 1 CARTON (61703-309-06) / 1 mL in 1 VIAL, SINGLE-DOSE

61703- Hospira, Inc.
- 61703-309- VinCRIStine Sulfate
  - 61703-309-16- 1 VIAL, SINGLE-DOSE in 1 CARTON (61703-309-16) / 2 mL in 1 VIAL, SINGLE-DOSE

61703- Hospira, Inc.
- 61703-309- VinCRIStine Sulfate
  - 61703-309-25- 1 VIAL, SINGLE-DOSE in 1 CARTON (61703-309-25) / 2 mL in 1 VIAL, SINGLE-DOSE

61703- Hospira, Inc.
- 61703-309- VinCRIStine Sulfate
  - 61703-309-26- 1 VIAL, SINGLE-DOSE in 1 CARTON (61703-309-26) / 1 mL in 1 VIAL, SINGLE-DOSE

62158- Hubei Honch Pharmaceutical Co., Ltd.
- 62158-0010-
  - 62158-0010-1- 200 g in 1 BAG (62158-0010-1)

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Indications ⬇