Vincristine sulfate

What is Vincristine sulfate?

• Vincristine sulfate (Oncovin) a sulfate salt of a natural alkaloid isolated from the plant Vinca rosea Linn with antimitotic and antineoplastic activities.

Vincristine

Vincristine3Dan

Vincristine Structural Formula V2

What are the uses of this medicine?

Vincristine sulfate is approved to treat adults and children with:

• Acute leukemia

Vincristine sulfate is sometimes used in combination with other oncolytic agents to treat adults and children with other types of cancer, including:

• Hodgkin lymphoma
• Neuroblastoma
• Non-Hodgkin lymphoma (NHL)
• Rhabdomyosarcoma
• Wilms tumor

How does this medicine work?

• Vincristine binds irreversibly to microtubules and spindle proteins in S phase of the cell cycle and interferes with the formation of the mitotic spindle, thereby arresting tumor cells in metaphase.
• This agent also depolymerizes microtubules and may also interfere with amino acid, cyclic AMP, and glutathione metabolism; calmodulin-dependent Ca++ -transport ATPase activity; cellular respiration; and nucleic acid and lipid biosynthesis.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• demyelinating form of Charcot–Marie–Tooth syndrome.

What drug interactions can this medicine cause?

Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following:

• aprepitant (Emend)
• carbamazepine (Tegretol)
• certain antifungals such as itraconazole (Sporanox), ketoconazole (Nizoral), voriconazole (Vfend), and posaconazole (Noxafil)
• clarithromycin (Biaxin, in Prevpac)
• darifenacin (Enablex)
• dexamethasone (Decadron)
• fesoterodine (Toviaz)
• HIV protease inhibitors including atazanavir (Reyataz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase)
• nefazodone
• oxybutynin (Ditropan, Ditropan XL, Oxytrol)
• phenobarbital
• phenytoin (Dilantin)
• rifabutin (Mycobutin)
• rifampin (Rifadin, Rimactane)
• rifapentine (Priftin)
• solifenacin (Vesicare)
• telithromycin (Ketek)
• trospium (Sanctura)
• tolterodine (Detrol, Detrol LA)

• Tell your doctor what herbal products you are taking, especially St. John's wort.

Is this medicine FDA approved?

• It was approved as a therapy of bladder cancer in the United States 1998, was removed in 2002 because of manufacturing issues, but reintroduced in 2009.

How should this medicine be used?

Recommended dosage:

• The usual dose of Vincristine Sulfate Injection, USP for pediatric patients is 1.5–2 mg/m2.
• For pediatric patients weighing 10 kg or less, the starting dose should be 0.05 mg/kg, administered once a week.
• The usual dose of Vincristine Sulfate Injection, USP for adults is 1.4 mg/m2. A 50% reduction in the dose of Vincristine Sulfate Injection, USP is recommended for patients having a direct serum bilirubin value above 3 mg/100 mL.

Administration:

• The drug is administered intravenously at weekly intervals.
• The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.
• Your doctor may tell you to take a stool softener or laxative to help prevent constipation during your treatment with vincristine injection.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Vincristine Sulfate Injection

This medicine is available in fallowing brand namesː

• Oncovin

What side effects can this medication cause?

The most common side effects of this medicine include:

• nausea
• vomiting
• sores in the mouth and throat
• loss of appetite or weight
• stomach pain
• diarrhea
• headache
• hair loss

Vincristine Sulfate may cause some serious side effects which may include:

• muscle or joint pain
• sudden changes in vision, including loss of vision
• hearing loss
• dizziness
• loss of the ability to move muscles and to feel a part of the body
• hoarseness or loss of ability to speak loudly
• hives
• rash
• itching
• difficulty breathing or swallowing
• constipation
• increased or decreased urination
• swelling of the face, arms, hands, feet, ankles, or lower legs
• seizures
• jaw pain
• fever, sore throat, chills, or other signs of infection
• unusual bleeding or bruising
• unusual tiredness or weakness
• pain, numbness, burning, or tingling in the hands or feet
• difficulty walking or unsteady walking

What special precautions should I follow?

• Vincristine Sulfate Injection is for intravenous use only. It should be administered by individuals experienced in the administration of vincristine sulfate injection. The intrathecal administration of vincristine sulfate injection usually results in death.
• Acute uric acid nephropathy, which may occur after the administration of oncolytic agents, has also been reported with vincristine sulfate. In the presence of leukopenia or a complicating infection, administration of the next dose of vincristine sulfate injection warrants careful consideration.
• Acute shortness of breath and severe bronchospasm have been reported following the administration of vinca alkaloids. The onset of these reactions may occur minutes to several hours after the vinca alkaloid is injected and may occur up to 2 weeks following the dose of mitomycin. Progressive dyspnea requiring chronic therapy may occur. Vincristine sulfate should not be readministered.
• Care must be taken to avoid contamination of the eye with concentration of vincristine sulfate injection used clinically. If accidental contamination occurs severe irritation (or, if the drug was delivered under pressure, even corneal ulceration) may result. The eye should be washed immediately and thoroughly.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• seizures
• severe constipation
• stomach pain
• unusual bleeding or bruising

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.

Can this medicine be used in pregnancy?

• Vincristine sulfate can cause fetal harm when administered to a pregnant woman.
• Women of child–bearing potential should be advised to avoid becoming pregnant.

Can this medicine be used in children?

• Safety and effectiveness in pediatric patients have been established.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• VINCRISTINE SULFATE

Inactive ingredients:

• MANNITOL
• SULFURIC ACID
• SODIUM HYDROXIDE
• WATER

Who manufactures and distributes this medicine?

Distributed by

• Hospira, Inc.,
• Lake Forest, IL USA

What should I know about storage and disposal of this medication?

• This product should be refrigerated between 2°–8°C (36°–46°F).
• Discard unused solution.
• Protect from light.
• Store Upright.

• Dailymed label info on Vincristine sulfate
• FDA Vincristine sulfate

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