Pronunciation:

vin-KRIS-teen

Brand Names:

• Oncovin
• Vincasar PFS

Dosage Forms:

• Solution

Warnings:

For intravenous use only; fatal if given by other routes. To reduce the potential for fatal medication errors due to incorrect route of administration proper dilution, product labeling and packaging is necessary. Intravenous needle or catheter must be properly positioned before any vinCRIStine is injected, as leakage into the surrounding tissue 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.

Classifications:

Therapeutic—

Antineoplastic Agent

Pharmacologic—

Mitotic Inhibitor

Uses of This Medicine:

Vincristine belongs to the group of medicines known as antineoplastic agents. It is used to treat some kinds of cancer as well as some noncancerous conditions.

Vincristine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by vincristine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, such as hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with vincristine, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Vincristine is to be administered only by or under the immediate supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

This medicine has been tested in children and has not been shown to cause different side effects or problems than it does in adults.

Older adults—

Nervous system effects may be more likely to occur in the elderly, who are usually more sensitive to the effects of vincristine.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Boceprevir

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Abametapir
• Amiodarone
• Apalutamide
• Aprepitant
• Asparaginase
• Atazanavir
• Carbamazepine
• Carvedilol
• Ceritinib
• Clarithromycin
• Cobicistat
• Conivaptan
• Cyclosporine
• Darunavir
• Dronedarone
• Enzalutamide
• Erythromycin
• Fedratinib
• Fexinidazole
• Filgrastim
• Flibanserin
• Fluconazole
• Fosaprepitant
• Fosnetupitant
• Fosphenytoin
• Idelalisib
• Indinavir
• Isavuconazonium Sulfate
• Itraconazole
• Ketoconazole
• Lapatinib
• Levoketoconazole
• Lopinavir
• Lumacaftor
• Mavacamten
• Methotrexate
• Mitotane
• Nefazodone
• Nelfinavir
• Netupitant
• Nilotinib
• Nirmatrelvir
• Omaveloxolone
• Phenobarbital
• Phenytoin
• Posaconazole
• Primidone
• Quinidine
• Quinupristin
• Ranolazine
• Rifabutin
• Rifampin
• Rifapentine
• Ritonavir
• Saquinavir
• Sargramostim
• Simeprevir
• St John's Wort
• Telaprevir
• Telithromycin
• Tipranavir
• Valspodar
• Vemurafenib
• Verapamil
• Voriconazole
• Warfarin
• Zidovudine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Nifedipine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Gout (history of) or
• Kidney stones (history of)—Vincristine may increase levels of uric acid in the body, which can cause gout or kidney stones

• Infection—Vincristine can reduce immunity to infection

• Liver disease—Effects may be increased because of slower removal of vincristine from the body

• Nerve or muscle disease—May be worsened

Proper Use of This Medicine:

Vincristine is often given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

While you are using this medicine, it may be necessary to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well. Ask your doctor if this is necessary for you.

This medicine sometimes causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Vincristine frequently causes constipation and stomach cramps. Your doctor may want you to take a laxative. However, do not decide to take these medicines on your own without first checking with your doctor.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that vincristine is working properly and to check for unwanted effects.

While you are being treated with vincristine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Vincristine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. Other people living in your household should not take or should not have recently taken oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid other persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

If vincristine accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

Side Effects of This Medicine:

Along with their needed effects, medicines like vincristine can sometimes cause unwanted effects such as blood problems, nervous system problems, loss of hair, and other side effects. These and others are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. Discuss these possible effects with your doctor.

Check with your doctor immediately if any of the following side effects occur:

Less common

Pain or redness at place of injection

Rare

Black, tarry stools

blood in urine or stools

cough or hoarseness

fever or chills

pinpoint red spots on skin

unusual bleeding or bruising

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Blurred or double vision

constipation

difficulty in walking

drooping eyelids

headache

jaw pain

joint pain

lower back or side pain

numbness or tingling in fingers and toes

pain in fingers and toes

pain in testicles

stomach cramps

swelling of feet or lower legs

weakness

Less common

Agitation

bed-wetting

confusion

convulsions (seizures)

decrease or increase in urination

dizziness or lightheadedness when getting up from a lying or sitting position

hallucinations (seeing, hearing, or feeling things that are not there)

lack of sweating

loss of appetite

mental depression

painful or difficult urination

trouble in sleeping

unconsciousness

Rare

Sores in mouth and on lips

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Bloating

diarrhea

loss of weight

nausea and vomiting

skin rash

Other side effects may occur that usually do not need medical attention. This medicine often causes a temporary loss of hair. After treatment with vincristine has ended, or sometimes even during treatment, normal hair growth should return.

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.