Vincristine

DEA Class; Rx

Common Brand Names; Velban

• Antineoplastics, Vinca Alkaloid

Hypersensitivity

Charcot-Marie-Tooth syndrome (demyelinating form), intrathecal (IT) administration

• Alopecia (20-70%)
• Peripheral neuropathy
• Paresthesia
• Sensory loss
• Acute uric acid nephropathy
• Loss of deep-tendon reflexes
• Hypertension
• Hypotension
• Nausea
• Vomiting
• Constipation
• Paralytic ileus
• Myelosuppression
• Leukopenia
• Gait changes
• Jaw pain
• Aspermia
• Amenorrhea

Use caution in bone marrow depression, neuromuscular disease, neurotoxic agents, ototoxic agents, pulmonary disease, hepatic impairment, potential CYP3A4 interactions

Potential for jaw/parotid pain, hoarseness and dysphagia due to cranial neuropathy

Vincristine sulfate injection has a different dosage recommendation than vincristine sulfate liposome injection; verify drug name and dose prior to preparation and administration to avoid administering incorrect dose

Extravasation can occur and can cause tissue injury; only administer through secure and free-flowing venous access line; if extravasation suspected, discontinue infusion immediately and consider local treatment measures

Neutropenia, thrombocytopenia, or anemia may occur; monitor complete blood counts prior to each dose; for Grade 3 or 4 neutropenia, thrombocytopenia, or anemia, consider dose delay or reduction, as well as supportive care measures

Tumor lysis syndrome (TLS) may occur in patients with ALL receiving therapy; anticipate, monitor for, and manage as appropriate

Ileus, bowel obstruction, and colonic pseudo-obstruction reported; can cause constipation; institute a prophylactic bowel regimen to mitigate potential constipation, bowel obstruction, and paralytic ileus; consider adequate dietary fiber intake, hydration, and stool softeners; use additional laxative products as needed

Therapy can cause severe fatigue; consider dose delay, reduction, or discontinuation of therapy as appropriate

Fatal hepatic toxicity and increased aspartate aminotransferase (AST) occurred; grade ≥3 increased AST reported; monitor hepatic function tests; interrupt or reduce dose as appropriate

Based on findings from nonclinical studies and mechanism of action, therapy can cause fetal harm when administered to a pregnant woman; there are insufficient data on use of vincristine sulfate in pregnant women to evaluate for a drug-associated risk

There are no data on presence of vincristine sulfate or metabolites in human milk, effects on breastfed child, or on milk production