Vincristine Sulphate

• Breast cancer
• Non-small cell lung cancer
• Pancreatic cancer
• Kidney cancer
• Blood cancer
• Multiple myeloma
• Lymphomas
• Bone cancer
• Acute leukemia
• Hodgkin's disease
• Non-Hodgkin's malignant lymphomas
• Rhabdomyosarcoma
• Neuroblastoma
• Wilms' tumor

Adult Dose (IV):

• Acute lymphoblastic leukaemia: 1.4-1.5 mg/m² once weekly; max 2 mg weekly
• Hepatic impairment: If serum bilirubin >3 mg/100ml, reduce dose by 50%

Child Dose (IV):

• Acute lymphoblastic leukaemia: 1.5-2 mg/m² once weekly; for patients ≤10 kg: initiate at 0.05 mg/kg once weekly

Renal Impairment: Dose adjustment not necessary

• Administered by a doctor or nurse as IV injection; do not self-administer
• Fatal if given by other routes
• Discontinue immediately if extravasation occurs
• Local injection of hyaluronidase and application of moderate heat

Common Side Effects:

• Hair loss
• Peripheral neuropathy (tingling and numbness of feet and hand)
• Constipation
• Nausea
• Vomiting
• Diarrhea
• Decreased appetite
• Decreased white blood cell count
• Stomatitis
• Neurotoxicity

• May affect ability to drive
• Avoid being near people suffering from infections; leukopenia possible
• Avoid even accidental contamination of eyes
• May cause acute kidney disease related to uric acid level
• Elderly are more susceptible to neurotoxic effects
• May cause aspermia (infertility) in males; amenorrhea in females
• Consult doctor if pregnant or breastfeeding

• Demyelinating form of Charcot-Marie-Tooth syndrome
• Pregnancy and lactation
• Intrathecal administration (may be fatal)
• Patients receiving radiation therapy through ports which include liver

• Digoxin (tablets) and verapamil absorption decreased with antineoplastic regimens
• Etoposide: increased serum levels
• Ganciclovir: increased toxicity
• Miconazole: reduced vincristine metabolism
• Isoniazid, itraconazole, voriconazole, posaconazole and nifedipine: increased neurotoxicity
• Vaccines: decreased immune response
• Zidovudine: increased myelotoxicity
• Tamoxifen: increased risk of thromboembolic complications
• Ototoxic drugs (platinum-containing antineoplastic agents): increased risk of ototoxicity
• Macrolides: possible risk of earlier onset and/or increased severity of adverse effects
• Aprepitant: possible increase in vincristine levels
• Antiepileptics: possible decrease in levels; monitor serum levels and effectiveness of chemotherapy
• Mitomycin C: increased risk of bronchospasm (potentially fatal)
• Asparaginase: reduced vincristine clearance and increased toxicity; give vincristine 12-24 hr before L-asparaginase (potentially fatal)

Use in Pregnancy: Unsafe; definite evidence of risk to the developing baby; consult your doctor.

Use in Lactation: Unsafe; data suggests the drug may cause toxicity to the baby.

Renal Impairment: Dose adjustment not necessary

Hepatic Impairment: Caution needed; if serum bilirubin >3 mg/100ml, reduce dose by 50%

Symptoms: Neurotoxicity, bone marrow suppression, extravasation.

Treatment: Supportive care.