Vincristine Injection 1mg/ml

Vincristine, Vincasar
Description: Antineoplastic Agent, Antimicrotubular; Antineoplastic Agent, Vinca Alkaloid

“ALERT: US Boxed Warning

Experienced provider:
Vincristine should be administered by individuals experienced in the administration of vincristine.

​Extravasation:
It is extremely important that the IV needle or catheter be properly positioned before any vincristine is injected. Leakage into surrounding tissue during IV administration may cause considerable irritation. If extravasation occurs, discontinue the injection immediately and then introduce any remaining portion of the dose into another vein. Local injection of hyaluronidase and the application of moderate heat to the area of leakage will help disperse the drug and are thought to minimize discomfort and the possibility of cellulitis.

For IV use only:
For IV use only. Fatal if given by other routes. See “Additional Information/Pharmacotherapy Pearls” for treatment of patients given (inadvertent) intrathecal administration of vincristine.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Vincristine, Vincasar Vincristine binds to tubulin and inhibits microtubule formation which arrests the cell at metaphase by disrupting the formation of the mitotic spindle.  It may also interfere with nucleic acid and protein synthesis by blocking utilization of glutamic acid.

Acute lymphocytic leukemia; Hodgkin lymphoma; Neuroblastoma; Non-Hodgkin lymphomas; Rhabdomyosarcoma; Wilms tumor

Before starting Vincristine, Vincasar make sure your physician is aware of any allergies or medications you currently take, if you have Charcot-Marie-Tooth syndrome, hepatic impairment, are pregnant, or breastfeeding. Vincristine, Vincasar use has been associated with rare but serious adverse events such as severe local irritation with extravasation, gastrointestinal toxicity, hepatitis B exacerbation, neurotoxicity, uric acid nephropathy, shortness of breath, and bronchospasm.

IV: Dosing and frequency may vary by protocol and/or treatment phase but may be capped at a maximum of 2 mg/dose.

How to Take: For IV administration only. Fatal if given by other routes.  Ensure proper needle or catheter placement prior to and during infusion to prevent extravasation.  Dispense vincristine in a minibag or other flexible plastic container (not in a syringe) and should not be delivered to the patient at the same time with any medications intended for CNS administration all to prevent accidental administration by non-IV route. Preferred administration is as a short 5- to 10-minute infusion in a 25 to 50 mL minibag. If extravasation occurs, stop infusion immediately and disconnect leaving the cannula/needle in place then gently aspirate extravasated solution, but do NOT flush the line.  Initiate hyaluronidase antidote then remove needle/cannula and apply dry warm compresses for 20 minutes 4 times a day for 1 to 2 days while keeping the infusion site elevated. Remaining portion of the vincristine dose should be infused through a separate vein.  Store intact vials at 2°C to 8°C (36°F to 46°F). Protect from light.

You Need to Avoid:  Significant drug interactions exist, requiring dose/frequency adjustment or avoidance so avoid starting any new medications without consulting prescriber.

Hypertension, hypotension, alopecia (common), dehydration, hyperuricemia, weight loss, abdominal cramps, anorexia, constipation (may involve upper colon fecal impaction), diarrhea, intestinal necrosis, intestinal perforation, nausea, oral mucosa ulcer, paralytic ileus, vomiting, bladder dysfunction (atony), dysuria, leukopenia, abnormal gait, abnormal sensory symptoms (loss of), cranial nerve disorder (including impairment of extraocular movement, laryngeal muscle impairment, paresis, vocal cord paralysis), decreased deep tendon reflex, headache, neuritic pain, paresthesia, sensorimotor neuropathy (dysfunction), amyotrophy, foot-drop (including slap gait), polyuria, fever, skin rash, uric acid nephropathy (acute), sore throat, anemia, thrombocytopenia, ataxia, paralysis, parotid pain, seizure, back pain, jaw pain, limb pain, myalgia, ostealgia, blepharoptosis, cortical blindness (transient), optic atrophy (with blindness), acute respiratory distress syndrome

Note the frequency of side effects has not been determined in clinical trials

1. What do I do if side effects are intolerable?
   If side effects are causing a lot of distress speak to your physician as soon as possible to discuss options.
2. Why would my physician prescribe a medication with such serious side effects?
   Your physician takes the most recent clinical guidelines to make evidence-based decisions on what medication is appropriate in which situations.  Your current medications, your allergies, age, cost of medication, comorbid conditions and many other factors will further complicate or limit which medications are appropriate.  This medication is used for certain forms of cancer and your physician has determined the benefits outweigh the risks.  Furthermore, they will be monitoring your bloodwork and symptoms closely to avoid many of the serious side effects and will keep you on the lowest effective dosage for the shortest amount of time possible.