Vincristina
Vincristina Uses, Dosage, Side Effects, Food Interaction and all others data.
Vincristina arrests cell division at the metaphase stage by inhibiting microtubule formation in the mitotic spindle.
Vincristina is a vinca alkaloid antineoplastic agent used as a treatment for various cancers including breast cancer, Hodgkin's disease, Kaposi's sarcoma, and testicular cancer. The vinca alkaloids are structurally similar compounds comprised of 2 multiringed units, vindoline and catharanthine. The vinca alkaloids have become clinically useful since the discovery of their antitumour properties in 1959. Initially, extracts of the periwinkle plant (Catharanthus roseus) were investigated because of putative hypoglycemic properties, but were noted to cause marrow suppression in rats and antileukemic effects in vitro. Vincristina binds to the microtubular proteins of the mitotic spindle, leading to crystallization of the microtubule and mitotic arrest or cell death. Vincristina has some immunosuppressant effect. The vinca alkaloids are considered to be cell cycle phase-specific.
| Trade Name | Vincristina |
| Availability | Prescription only |
| Generic | Vincristine |
| Vincristine Other Names | 22-Oxovincaleukoblastin, 22-Oxovincaleukoblastine, Leurocristine, Vincristin, Vincristina, Vincristine, Vincristinum |
| Related Drugs | Venclexta, prednisone, methotrexate, Keytruda, rituximab, carboplatin, pembrolizumab, fluorouracil, Rituxan, doxorubicin |
| Type | |
| Formula | C46H56N4O10 |
| Weight | Average: 824.972 Monoisotopic: 824.399644019 |
| Protein binding | ~75% |
| Groups | Approved, Investigational |
| Therapeutic Class | Cytotoxic Chemotherapy |
| Manufacturer | |
| Available Country | |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Vincristina sulfate injection is used for acute leukemia. Vincristina sulfate injection has also been shown to be useful in combination with other oncolytic agents in Hodgkin's disease, non-Hodgkin's malignant lymphomas (lymphocytic, mixed cell, histiocytic, undifferentiated, nodular and diffuse types), rhabdomyosarcoma, neuroblastoma, and Wilms' tumor.
Vincristina is also used to associated treatment for these conditions: Acute Lymphoblastic Leukaemia Recurrent, Acute Lymphocytic Leukemia (ALL), Choriocarcinoma, Chronic Lymphocytic Leukaemia (CLL), Ewing's Sarcoma, Gestational Trophoblastic Disease, Hepatoblastomas, Immune Thrombocytopenic Purpura ( ITP ), Kaposi’s sarcoma, Lymphoma, Hodgkins, Multiple Myeloma (MM), Neuroblastomas, Non-Hodgkin's Lymphoma (NHL), Ovarian germ cell tumour, Pheochromocytomas, Retinoblastoma, Rhabdomyosarcomas, Small Cell Lung Cancer (SCLC), Wilms' tumor, Advanced Thymoma
How Vincristina works
The antitumor activity of Vincristina is thought to be due primarily to inhibition of mitosis at metaphase through its interaction with tubulin. Like other vinca alkaloids, Vincristina may also interfere with: 1) amino acid, cyclic AMP, and glutathione metabolism, 2) calmodulin-dependent Ca2+-transport ATPase activity, 3) cellular respiration, and 4) nucleic acid and lipid biosynthesis.
Dosage
Vincristina dosage
Adult (Intravenous): Usual recommended dosage: 1.4-1.5 mg/m2 once wkly. Max: 2 mg wkly. Subsequent doses may be modified based on clinical and haematological responses and tolerance of the patient. May be used in combination with other drugs. Prescribers should consult published protocols for the dosage, method and sequence of admin.
Child (Intravenous): Usual recommended dosage: 1.5-2 mg/m2 once wkly; for patients ≤10 kg: Initiate at 0.05 mg/kg once wkly. Subsequent doses may be modified based on clinical and haematological responses and tolerance of the patient. May be used in combination with other drugs. Prescribers should consult published protocols for the dosage, method and sequence of admin.
Side Effects
Dose limiting neurotoxicity (e.g. motor function impairment, gait abnormalities), hyperuricaemia, bronchospasm, azospermia, amenorrhoea, alopoecia, leucopenia, urinary dysfunction, abdominal cramps, vomiting, diarrhoea, severe constipation, paralytic ileus, convulsions, hypertension, orthostatic hypotension, ptosis, hoarseness, optic neuropathies, hallucinations, blindness, neurological deafness, difficulty in walking, syndrome of inappropriate ADH secretion.
Toxicity
IVN-RAT LD50 1300 mg/kg; IPR-MUS LD50 5.2 mg/kg. Marqibo® must only be administered IV because it is fatal if administered by other routes. Marqibo® also has different dosing than vincristine sulphate injection, so attention is needed to prevent overdoses. The most clinically significant adverse effect of vincristine is neurotoxicity.
Precaution
Elderly. Preexisting pulmonary dysfunction or neuromuscular disease; leucopenia or a complicating infection; impaired liver function; obstructive jaundice. Routine prophylactic laxative needed to ensure regular bowel movement. Discontinue immediately if extravasation occurs, and inj any remaining drug into another vein, followed by local Inj of hyaluronidase and topical heat application to the affected area to aid in drug removal and reduce discomfort. Discontinue in patients who develop progressive dyspnea. CBC to be checked before each dose admin. Frequent monitoring of uric acid during first 3-4 wk of treatment and watch out for uric acid nephropathy.
Interaction
Decreased digoxin (tablets) and verapamil absorption with antineoplastic regimens. Increased etoposide serum levels with vincristine. Increased toxicity when ganciclovir given with, immediately before or after vincristine. Reduced vincristine metabolism with miconazole. Increased neurotoxicity with isoniazid, itraconazole, voriconazole, posaconazole and nifedipine. Decreased immune response when used concurrently with vaccines. Increased myelotoxicity with zidovudine. Increased risk of thromboembolic complications with tamoxifen. Increased risk of ototoxicity with ototoxic drugs (e.g. platinum-containing antineoplastic agents). Possible risk of earlier onset and/or increased severity of adverse effects with macrolides. Possible increase in vincristine levels with aprepitant. Possible decrease in antiepileptic levels with vincristine, monitor serum antiepileptic levels and effectiveness of chemotherapy.
Food Interaction
- Exercise caution with grapefruit products. Grapefruit inhibits CYP3A4 metabolism, which may increase the serum concentration of vincristine.
- Exercise caution with St. John's Wort. This herb induces CYP3A4 metabolism, which may reduce serum levels of vincristine.
Vincristina Drug Interaction
Moderate: pegfilgrastimMinor: doxorubicinUnknown: lorazepam, sulfamethoxazole / trimethoprim, diphenhydramine, sulfamethoxazole / trimethoprim, prochlorperazine, cyclophosphamide, meperidine, arginine, levocarnitine, cysteine, lithium, rituximab, acetaminophen, cyanocobalamin, cholecalciferol, phytonadione, menaquinone, ondansetron
Vincristina Disease Interaction
Major: pulmonary dysfunction, neurologic dysfunctionModerate: constipation, hepatic dysfunction, infections, myelosuppression, renal impairment, SIADH
Volume of Distribution
Within 15 to 30 minutes after injection, over 90% of the drug is distributed from the blood into tissue, where it remains tightly, but not irreversibly, bound.
Half Life
When intravenously injected into cancer patients, a triphasic serum decay patten was observed. The initial, middle, and terminal half-lives are 5 minutes, 2.3 hours, 85 hours respectively. The range of the terminal half-life is humans is 19 - 155 hours.
Elimination Route
The liver is the major excretory organ in humans and animals. 80% of an injected dose of vincristine sulfate is excreted via feces. 10 - 20% is excreted via urine.
Pregnancy & Breastfeeding use
Pregnancy Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Contraindication
Patients with demyelinating form of Charcot-Marie-Tooth syndrome. Pregnancy and lactation. Intrathecal admin (may be fatal). Patients receiving radiation therapy through ports which include liver.
Special Warning
Hepatic Impairment: Dose adjustment may be needed. Serum bilirubin >3 mg/100ml: Reduce dose by 50%.
Acute Overdose
Symptoms: mainly extensions of its common adverse effects.
Management: Treatment is supportive and includes prevention of side effects from syndrome of inappropriate antidiuretic hormone secretion (SIADH) (e.g. fluid restriction and admin of loop diuretic); admin of anticonvulsants and use of enemas (to prevent ileus). Closely monitor the CV system and determine the blood counts daily to guide transfusion requirements. Folinic acid 100 mg admin IV every 3 hr for 24 hr and then every 6 hr for at least 48 h may be admin. Haemodialysis unlikely to be useful.
Storage Condition
Store at 2-8° C. Protect from light.
Innovators Monograph
You find simplified version here Vincristina
Vincristina contains Vincristine see full prescribing information from innovator Vincristina Monograph, Vincristina MSDS, Vincristina FDA label
FAQ
What Vincristina is used for?
Vincristina is used to treat leukemia, Hodgkin's disease, non-Hodgkin's lymphoma, rhabdomyosarcoma , neuroblastoma (cancer that forms in nerve tissue), and Wilms' tumor.Vincristina is cancer medication that interferes with the growth of cancer cells and slows their spread in the body.
What are the side effects of Vincristina?
Vincristina may cause side effects include:
- nausea.
- vomiting.
- sores in the mouth and throat.
- loss of appetite or weight.
- stomach pain.
- diarrhea.
- headache.
- hair loss.
Can Vincristina cause liver damage?
Vincristina has been suspected to cause liver damage and to enhance radiation-induced hepatic injury.
Is Vincristina safe during pregnancy?
Vincristina 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 Vincristina.
Is Vincristina safe during breastfeeding?
Most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy.It is probably impractical to resume breastfeeding after Vincristina therapy because of the drug’s long half-life. Chemotherapy may adversely affect the normal microbiome and chemical makeup of breastmilk.
Does Vincristina make me tired?
Vincristina may make you dizzy or tired or cause numbness in your hands/feet.
What does Vincristina do to the body?
Numbness and tingling in fingers and toes may become progressively worse with repeated doses of Vincristina.
How long is Vincristina good for?
Stable for 7 days under refrigeration, or 2 days at room temperature. In ambulatory pumps, solution is stable for 7 days at room temperature. After preparation, keep Vincristina in a location away from the separate storage location recommended for intrathecal medications.
Can Vincristina cause eye problems?
Vincristina exposure can potentially lead to transient or permanent blindness by mechanisms including cranial neuropathy, optic nerve atrophy and cortical blindness.
Does Vincristina cause my hair loss?
Vincristina often causes a temporary loss of hair. After treatment with Vincristina has ended, or sometimes even during treatment, normal hair growth should return.
Can Vincristina cause hearing loss?
Sudden hearing loss during Vincristina therapy is a very rare event.
Does Vincristina affect the heart?
Vincristina may causes heart problems, rare events associated with Vincristina include lung damage, stroke, and heart attack.
How does Vincristina work in the body?
Vincristina works by stopping the cancer cells from separating into 2 new cells.
How long does Vincristina jaw pain last?
Onset was usually 3 days after Vincristina administration; mean duration was 2 days.
Can Vincristina cause seizures?
No other cause for the seizures was documented.
Can Vincristina cause abdominal pain?
Vincristina can cause serious constipation, abdominal pain and can even lead to a blockage or stoppage of the bowel (called paralytic ileus) if not treated promptly.
How often do you take Vincristina?
Vincristina may be given by a variety of dosing schedules from weekly to bi-weekly to monthly (every 28 days).
How do you administer Vincristina?
Vincristina should not be given intramuscularly, subcutaneously or intrathecally. The solution may be injected either directly into the vein or into the injection site of a running intravenous infusion.
How often is Vincristina given?
Vincristina is usually given once a week.
Can I drive after taking Vincristina?
You should avoid driving after taking Vincristina.Do not drive, use machinery, or do anything that needs alertness until you can do it safely.
