Vincristine

Vincristine has been use in combination with other medicines to treat certain types of cancer. Types of cancer include non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, acute lymphoblastic leukemia (ALL), Wilms’ tumor (a form of pediatric kidney cancer), rhabdomyosarcoma, and neuroblastoma. It has also been used in the treatment of blood disorders.

Vincristine belongs to a group of drugs called vinca alkaloids. It works by slowing or stopping the growth of cancer cells in your body.

This medication comes in a liposome injection as well as an injection to be given directly into a vein (IV) by a healthcare provider. It is usually given once a week.

Common side effects of vincristine include hair loss, nausea, constipation, fatigue (feeling tired), and peripheral neuropathy (weakness, numbness, and pain, usually in the hands and feet).

Vincristine has been use in combination with other medicines to treat the following cancers: non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, acute lymphoblastic leukemia (ALL), Wilms’ tumor (a form of pediatric kidney cancer), rhabdomyosarcoma, and neuroblastoma.

It has also been used in the treatment of the following blood disorders: thrombotic thrombocytopenic purpura (TTP) and idiopathic thrombocytopenic purpura (ITP).

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Vincristine may be found in some form under the following brand names:

• Marqibo

• Oncovin

• Vincasar

Common side effects of vincristine include:

• hair loss
• nausea
• vomiting
• diarrhea
• a decrease in white blood cells and platelet counts.
• constipation
• fatigue (feeling tired)
• peripheral neuropathy (weakness, numbness, and pain, usually in the hands and feet)
• cramping
• weight loss
• changes in taste and appetite
• mouth sores
• anemia

The side effects listed below are serious and need to be told to your doctor about within 24 hours of noticing them:

• vomiting more than four to five times in a day
• diarrhea more than four to five times in a day
• constipation
• strange bleeding or bruising
• bone pain
• severe stomach pain
• sores on the lips or mouth
• blood in the urine or stool (this can look like black or tarry stools) 

This medicine may interfere with the normal menstrual cycle (period) in women. It may also stop sperm production in men. You should not assum that you cannot get pregnant (or you cannot get someone else pregnant) while taking this medicine. Use a reliable method of birth control while receiving vincristine treatments.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• aspirin
• aprepitant (Emend)

• certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• certain antibiotics such as clarithromycin (Biaxin, in Prevpac), erythromycin (E.E.S., E-Mycin, others)
• HIV protease inhibitors including indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra)
• phenytoin (Dilantin)
• tolterodine (Detrol, Detrol LA)

This is not a complete list of vincristine drug interactions. Ask your doctor or pharmacist for more information.

Do not receive vaccinations without talking to your doctor first.

It is extremely important that the intravenous needle delivering vincristine be properly positioned in the vein. If it is not, the drug can cause serious blistering and damage to the surrounding tissue. If you notice irritation, swelling, or redness at the IV site, notify your doctor or nurse immediately.

With repeated doses of vincristine, you may feel symptoms of peripheral neuropathy (tingling sensation and numbness in the fingers and toes). This needs to be reported to your doctor immediately.

Notify your doctor if you experience fever, productive cough, or decreased appetite.

Report immediately any burning or local irritation during or after the infusion.

People with Charcot-Marie-Tooth syndrome should not be given vincristine.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of vincristine there are no specific foods that you must exclude from your diet.

Before receiving this medication, tell your doctor about all of your medical conditions. Especially tell your doctor if:

• you are allergic to vincristine or to any of its ingredient 
• you have heart, liver, nerve or muscle disease
• you are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category D. Vincristine can cause birth defects for the baby if you are already pregnant. Both men and women should not plan on conceiving a child while on vincristine. Your doctor can tell you when it will be safe to do so after treatment.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if vincristine is excreted in human breast milk or if it will harm your nursing baby.

Vincristine is for intravenous (into the vein) use only. Your doctor will choose the correct dosage for your situation and in most cases will give the injection in his or her office or clinic.

Vincasar PFS (vincristine injection)

• The usual dose for children is 1.5 to 2 mg/m2. For children weighing 10 kg or less, the starting dose should be 0.05 mg/kg, administered once a week. The usual dose for adults is 1.4 mg/m2. A dose reduction may be necessary for patients with other medical conditions or receiving other medications.

Marquibo (liposomal vincristine)

• The recommended dose of Marqibo is 2.25 mg/m2 intravenously over 1 hour once every 7 days.

Since this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Keep all scheduled appointments with your doctor as well as all laboratory appointments. This medicine may cause a decrease of blood cells. Your doctor may order tests before, during and after your treatment to monitor this side effect.

Drink lots of water while receiving vincristine treatments, unless you are told not to, to help prevent constipation and dehydration.

Good diet and nutrition will be helpful, as well as eating foods that will help reduce the effects of diarrhea.

People on vincristine may be at risk of infections, so avoiding crowds or other people with contagious illnesses may help. Always maintain good hygiene and wash hands often.

WARNINGS

Caution–This preparation should be administered by individuals experienced in the administration of Vincristine Sulfate Injection, USP. It is extremely important that the intravenous needle or catheter be properly positioned before any vincristine is injected. Leakage into surrounding tissue during intravenous administration of Vincristine Sulfate Injection, USP may cause considerable irritation. If extravasation occurs, the injection should be discontinued immediately, and any remaining portion of the dose should then be introduced into another vein. Local injection of hyaluronidase and the application of moderate heat to the area of leakage help disperse the drug and are thought to minimize discomfort and the possibility of cellulitis.

FOR INTRAVENOUS USE ONLY – FATAL IF GIVEN BY OTHER ROUTES.