See Available Brands of Vincristine Sulfate in India
P - Contraindicated in pregnancy
L - Contraindicated in lactation
Vincristine (brand name, Oncovin), also known as leurocristine, is a vinca alkaloid from the Catharanthus roseus (Madagascar periwinkle), formerly Vinca rosea and hence its name. It is a mitotic inhibitor, and is used in cancer chemotherapy.
Pharmacodynamics
Pharmacokinetics
Vincristine arrests cell division at the metaphase stage by inhibiting microtubule formation in the mitotic spindle.
Absorption
Poorly absorbed from the GI tract.
Distribution
Does not cross the blood-brain barrier in significant amounts. Protein-binding: Extensive.
Metabolism
Metabolised in liver.
Excretion
Excreted mainly via bile into faeces (as unchanged drug and metabolites, 70-80%), urine; 85 hours (elimination half-life).
Vincristine Sulfate Indications / Vincristine Sulfate Uses
Information Not Available
Vincristine Sulfate Adverse Reactions / Vincristine Sulfate Side Effects
Dose limiting neurotoxicity (e.g. motor function impairment, gait abnormalities), hyperuricaemia, bronchospasm, azospermia, amenorrhoea, alopoecia, leucopenia, urinary dysfunction, abdominal cramps, vomiting, diarrhoea, severe constipation, paralytic ileus, convulsions, hypertension, orthostatic hypotension, ptosis, hoarseness, optic neuropathies, hallucinations, blindness, neurological deafness, difficulty in walking, syndrome of inappropriate ADH secretion.
Potentially Fatal: Myelosuppression.
Precautions
Information Not Available
Special Precautions
Elderly. Preexisting pulmonary dysfunction or neuromuscular disease; leucopenia or a complicating infection; impaired liver function; obstructive jaundice. Routine prophylactic laxative needed to ensure regular bowel movement. Discontinue immediately if extravasation occurs, and inj any remaining drug into another vein, followed by local Injection of hyaluronidase and topical heat application to the affected area to aid in drug removal and reduce discomfort. Discontinue in patients who develop progressive dyspnea. CBC to be checked before each dose admin. Frequent monitoring of uric acid during first 3-4 weeks of treatment and watch out for uric acid nephropathy.
Other Drug Interactions
Decreased digoxin (tablets) and verapamil absorption with antineoplastic regimens. Increased etoposide serum levels with vincristine. Increased toxicity when ganciclovir given with, immediately before or after vincristine. Reduced vincristine metabolism with miconazole. Increased neurotoxicity with isoniazid, itraconazole, voriconazole, posaconazole and nifedipine. Decreased immune response when used concurrently with vaccines. Increased myelotoxicity with zidovudine. Increased risk of thromboembolic complications with tamoxifen. Increased risk of ototoxicity with ototoxic drugs (e.g. platinum-containing antineoplastic agents). Possible risk of earlier onset and/or increased severity of adverse effects with macrolides. Possible increase in vincristine levels with aprepitant. Possible decrease in antiepileptic levels with vincristine, monitor serum antiepileptic levels and effectiveness of chemotherapy.
Potentially Fatal: Increased risk of bronchospasm with mitomycin C. Reduced vincristine clearance and increased toxicity with asparaginase, minimise toxicity by giving vincristine 12-24 hours before L-asparaginase admin.
Other Interactions
Information Not Available
Dosage
Intravenous
Acute lymphoblastic leukaemia, Wilm's tumour, Brain tumours, Neuroblastoma, Small cell lung cancer, Acute myeloid leukaemia, Non-Hodgkin’s lymphoma, Hodgkin's disease, AIDS-related Kaposi's sarcoma
Adult: Usual recommended dosage: 1.4-1.5 mg/m2 once wkly. Max: 2 mg weekly. Subsequent doses may be modified based on clinical and haematological responses and tolerance of the patient. May be used in combination with other drugs. Prescribers should consult published protocols for the dosage, method and sequence of admin.
Child: Usual recommended dosage: 1.5-2 mg/m2 once weekly; for patients ≤10 kg: Initiate at 0.05 mg/kg once weekly. Subsequent doses may be modified based on clinical and haematological responses and tolerance of the patient. May be used in combination with other drugs. Prescribers should consult published protocols for the dosage, method and sequence of admin.
Hepatic impairment: Dose adjustment may be needed. Serum bilirubin >3 mg/100ml: Reduce dose by 50%.
Incompatibility
Any solution that may change pH of the solution beyond 3.5-5.5.
Food(before/after)
Information Not Available
List of Contraindications
Vincristine Sulfate and Pregnancy
Contraindicated in pregnancy
Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Vincristine Sulfate and Lactation
Contraindicated in lactation
Vincristine Sulfate and Children
Information Not Available
Vincristine Sulfate and Geriatic
Information Not Available
Vincristine Sulfate and Other Contraindications
Patients with demyelinating form of Charcot-Marie-Tooth syndrome. Pregnancy and lactation. Intrathecal admin (may be fatal). Patients receiving radiation therapy through ports which include liver.
Storage
Intravenous
Store at 2-8°C. Protect from light
Lab interference
Information Not Available
