Trade Names:Oncovin- Solution for Injection 1 mg/mL
Mode of action is unknown. In vitro, vincristine arrests mitotic division at metaphase. It reversibly binds to microtubule and spindle proteins in the S phase.
Very rapidly absorbed via IV (15 to 30 min).
More than 90% of drug is distributed from blood to tissue, where it remains tightly but not irreversibly. Penetration across the blood brain barrier is poor.
Triphasic serum decay following rapid IV injection.
Terminal t ½ is 85 h (19 to 155 h). Liver is the major excretory organ. 80% of the dose appears in the feces, 10% to 20% in the urine.
15 to 30 min.
A 50% reduction in dose is recommended for patients having a direct serum bilirubin more than 3 mg/dL.
Acute lymphocytic leukemia, lymphomas, rhabdomyosarcoma, neuroblastoma, Wilms tumor.
Small-cell lung carcinoma, brain tumors, multiple myeloma, Kaposi sarcoma, chronic lymphocytic and myelocytic leukemias, autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura.
Patients with demyelinating form of Charcot-Marie-Tooth syndrome.
IV 1.4 mg/m 2 weekly (typical dose, 2 mg).Children weighing more than 10 kg (or body surface area at least 1 m 2 )
IV 1.4 to 2 mg/m 2 weekly for 3 to 8 wk. Do not exceed a max of 2 mg/dose.Children weighing up to 10 kg (or body surface area less than 1 m 2 )
IV 0.05 mg/kg weekly initially. Titrate dose as tolerated, up to a max of 2 mg/dose. Continue therapy for 3 to 8 wk.Adjustment in Hepatic InsufficiencyAdult
IV A 50% reduction in dose is recommended for patients having a direct serum bilirubin value more than 3 mg/dL.Neuroblastoma, Combination TherapyChildren weighing more than 10 kg (or body surface area at least 1 m 2 )
IV Vincristine 1 mg/m 2 /day by continuous infusion over 24 h for 3 days (total dose of 3 mg/m 2 over a 3-day period).
Refrigerate. Protect from light.
Vincristine elimination may be reduced by CYP-450 enzyme inhibitors.Digoxin
May decrease digoxin plasma concentration.Itraconazole
Vincristine neurotoxicity has occurred during coadministration.L-asparaginase
Vincristine clearance may decrease when L-asparaginase is given prior to vincristine. Give vincristine 12 to 24 hr prior to L-asparaginase.Mitomycin
Acute shortness of breath and severe bronchospasm have occurred following concomitant or previous use of mitomycin.Phenytoin
May reduce phenytoin plasma concentration.Quinolone antibiotics
Vincristine may decrease oral absorption of quinolone antibiotics.
None well documented.
Hypertension; hypotension; MI.
Autonomic and peripheral neuropathy; headache.
Mucositis; abdominal cramps; diarrhea; anorexia; intestinal necrosis or perforation; constipation that can lead to upper colon impaction; paralytic ileus; weight loss.
Amenorrhea; polyuria; dysuria; urinary retention because of bladder atony; azoospermia.
Bone marrow suppression; nadir less than 7 days.
Acute bone or jaw pain.
Acute shortness of breath; severe bronchospasm.
Optic atrophy with blindness; transient cortical blindness; ptosis; diplopia; photophobia.
WarningsIV use only
Intrathecal use of other vinca alkaloids has been fatal. Label syringe “Warning - For IV Use Only; fatal if given intrathecally.”Granulocytopenia
May be severe and predispose to infection. Do not administer to patients with granulocyte counts less than 1,000 cells/mm 3 .Avoid extravasation
Proper placement of needle/catheter prior to administration. Local irritation or phlebitis may occur. Refer to your institution specific protocol.
Category D . Can cause fetal harm when administered to pregnant women.
Hypersensitivity temporally related to vincristine therapy has occurred.
Follow dosage adjustment guidelines recommended for adults.
CNS leukemia has occurred. Additional agents may be required.
Acute shortness of breath and severe bronchospasm have occurred, most frequently when the drug was used with mitomycin-C.
Side effects are dose-related. Expect exaggerated side effects.
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