vincristine (Rx)

Brand and Other Names:Oncovin, Vincasar PFS
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 1mg/mL
more...

Acute Leukemia

1.4 mg/m² IV qWeek 

Combination Therapy

Cancers

  • Hodgkin's Disease, Non Hodgkin's Malignant Lymphomas, Rhabdomyosarcoma, Neuroblastoma, and Wilm's Tumor
  • Consult dose modifications in multi-drug regimens

Uveal Melanoma (Orphan)

Indicated for metastatic uveal melanoma

Orphan indication sponsor

  • Hana Biosciences, Inc; 7000 Shoreline Court; Suite 370; South San Francisco, CA 94080

Renal Impairment

Dose adjustment not necessary

Hepatic Impairment

Decrease dose 50% if direct bilirubin >3 mg/dL [51 umol/L]

Monitor: CBC

Other Indications & Uses

ALL, AML, CML, Hodgkin's disease, NHL, neuroblastoma, sarcomas, small cell lung cancer, Wilms' tumor, brain tumors

Off-label: breast cancer, idiopathic thrombocytopenic purpura, Kaposi's sarcoma, bladder cancer

Dosage Forms & Strengths

injectable solution

  • 1mg/mL
more...

Acute Leukemia

2 mg/m² IV qWeek 

<10 kg: 0.05 mg/kg/dose IV qWeek

>10 kg: 1.5-2 mg/m²/dose

Combination Therapy

Cancers

  • Hodgkin's Disease, Non Hodgkin's Malignant Lymphomas, Rhabdomyosarcoma, Neuroblastoma, and Wilm's Tumor
  • Consult dose modifications in multi-drug regimens

Administration

Stool softeners or stimulant laxatives may ease severe constipation

APAP or opioid may ease jaw pain

Other Information

Hepatic Impairment

  • Decr. dose 50% if direct bilirubin >3 mg/dL [51 umol/L]

Monitor: CBC

Next:

Interactions

Interaction Checker

and vincristine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            >10%

            Alopecia (20-70%)

            Frequency Not Defined

            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

            Previous
            Next:

            Warnings

            Black Box Warnings

            The drug should be administered under the supervision of an experienced cancer chemotherapy physician in a facility equipped to diagnose and manage complications

            Properly position needle in the vein before administration; leakage to surrounding tissue during IV administration 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 may minimize discomfort and the possibility of cellulitis

            Intrathecal use may be fatal

            Contraindications

            Hypersensitivity

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

            Cautions

            Intrathecal administration will result in death

            Bone marrow depression, neuropathy, neuromuscular dz, neurotoxic agents, ototoxic agents, pulmonary dz, hepatic impairment, potential CYP3A4 intxns, avoid extravasation

            Withhold if neurotoxicity develops-usually reversible

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

            Vesicant

            Avoid pregnancy

            Risk of paralytic ileus

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: D

            Lactation: not known if excreted in breast milk, do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Vinca alkaloid; acts in M & S phases by inhibiting microtubule formation, inhibits DNA/RNA synthesis

            Pharmacokinetics

            Half-Life: 10.5-155 hr

            Protein Bound: 44%

            Vd: 8.4 L/kg

            Metabolism: Hepatic (CYP3A4)

            Clearance: 146 mL/min

            Excretion: Feces (80%); urine (20%)

            Previous
            Next:

            Administration

            IV Incompatibilities

            Syringe: furosemide

            Y-site: cefepime, furosemide, idarubicin, sodium bicarbonate

            IV Compatibilities

            Additive: bleomycin, cytarabine, doxorubicin, doxorubicin/ondansetron, fluorouracil, methotrexate

            Syringe: bleomycin, cisplatin, cyclophosphamide, doxapram, doxorubicin, droperidol, fluorouracil, heparin, leucovorin, methotrexate, metoclopramide, mitomycin, vinblastine

            Y-site: allopurinol, amifostine, ampho B cholSO4, aztreonam, bleomycin, cisplatin, cladribin, cyclophosphamide, doxorubicin, doxorubicin liposomal, droperidol, etoposide PO4, fligrastim, fludarabine, fluorouracil, gatifloxacin, gemcitabine, granisetron, heparin, leucovorin, linezolid, melphalan, methotrexate, metoclopramide, mitomycin, ondansetron, paclitaxel, piperacillin-tazobactam, sargramostim, teniposide, thiotepa, topotecan, vinbastine, vinorelbine

            IV Preparation

            IVP: 1 mg/mL (dose/syringe); max syringe size for IVP is a 30 mL syringe & syringe should be <75% full

            IVPB: dose/50 mL D5W

            IV Administration

            Vesicant

            IV use ONLY; fatal if given intrathecally

            Desired route: IVP administered within 1 min

            Has also been administered IVPB over 15 min; central line only for IVPB

            Has also been given as slow infusion (4-8 hr) or cont infusion

            Extravasation Management

            Terminate injection or infusion immediately & aspirate back as much as possible

            Apply warm pack for 15-20 min QID & elevate

            Storage

            Store intact vials under refrigeration at 2-8°C

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous