Vincrist
Generic Name
Vincristine Sulfate
Manufacturer
Various
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vincrist 1 mg injection | ৳ 300.00 | N/A |
Description
Overview of the medicine
Vincristine is a vinca alkaloid antineoplastic agent used in combination chemotherapy for various types of cancer, including leukemias, lymphomas, and certain solid tumors. It works by interfering with cell division.
Uses & Indications
Dosage
Adults
Typically 1.4 mg/m² intravenously (IV) weekly, maximum single dose 2 mg. Dosage should be adjusted based on clinical response and toxicity, especially neurotoxicity.
Elderly
Lower doses or extended intervals may be considered due to potential for increased neurotoxicity and decreased hepatic function.
Renal_impairment
No dosage adjustment needed for renal impairment, as it's primarily excreted hepatically. However, monitor for increased toxicity.
How to Take
Vincristine is administered intravenously (IV) ONLY. IT IS FATAL IF ADMINISTERED INTRATHECALLY. It should be given slowly over 1 minute or infused over a short period (e.g., 5-10 minutes) into a running IV line.
Mechanism of Action
Vincristine selectively binds to tubulin, a protein essential for the formation of microtubules. This binding inhibits microtubule polymerization, leading to disruption of the mitotic spindle and arrest of cells in metaphase, ultimately preventing cell division and inducing apoptosis in cancer cells.
Pharmacokinetics
Onset
Rapid onset after IV administration.
Excretion
Primarily excreted via the feces (80%) after hepatic metabolism, with a small amount (10-20%) excreted in urine.
Half life
Triphasic elimination, terminal half-life typically 19-155 hours (average 85 hours).
Absorption
Administered intravenously, thus 100% bioavailability.
Metabolism
Extensively metabolized in the liver, primarily by CYP3A enzymes.
Side Effects
Contraindications
- Hypersensitivity to vincristine or any component
- Demyelinating Charcot-Marie-Tooth syndrome
- Patients receiving radiation therapy involving the liver
- Significant pre-existing neurotoxicity
Drug Interactions
Phenytoin
Decreased phenytoin levels, potentially leading to loss of seizure control.
L-asparaginase
May increase neurotoxicity if given concurrently; sequence of administration may be important.
Itraconazole/Macrolide antibiotics (e.g., erythromycin, clarithromycin)
Increased vincristine toxicity due to inhibition of CYP3A4-mediated metabolism.
Storage
Store refrigerated at 2°C to 8°C (36°F to 46°F). Protect from light. Do not freeze.
Overdose
Overdose leads to exaggerated adverse effects, particularly severe neurotoxicity (e.g., neuropathy, seizures, coma) and bone marrow suppression. Treatment is symptomatic and supportive, including anticonvulsants, fluid management, and possibly folinic acid (though efficacy is unproven).
Pregnancy & Lactation
Pregnancy Category D. Vincristine can cause fetal harm when administered to a pregnant woman. Avoid during pregnancy. Advise women of childbearing potential to use effective contraception. It is not known whether vincristine is excreted in human milk; due to the potential for serious adverse reactions in nursing infants, breastfeeding should be discontinued during treatment.
Side Effects
Contraindications
- Hypersensitivity to vincristine or any component
- Demyelinating Charcot-Marie-Tooth syndrome
- Patients receiving radiation therapy involving the liver
- Significant pre-existing neurotoxicity
Drug Interactions
Phenytoin
Decreased phenytoin levels, potentially leading to loss of seizure control.
L-asparaginase
May increase neurotoxicity if given concurrently; sequence of administration may be important.
Itraconazole/Macrolide antibiotics (e.g., erythromycin, clarithromycin)
Increased vincristine toxicity due to inhibition of CYP3A4-mediated metabolism.
Storage
Store refrigerated at 2°C to 8°C (36°F to 46°F). Protect from light. Do not freeze.
Overdose
Overdose leads to exaggerated adverse effects, particularly severe neurotoxicity (e.g., neuropathy, seizures, coma) and bone marrow suppression. Treatment is symptomatic and supportive, including anticonvulsants, fluid management, and possibly folinic acid (though efficacy is unproven).
Pregnancy & Lactation
Pregnancy Category D. Vincristine can cause fetal harm when administered to a pregnant woman. Avoid during pregnancy. Advise women of childbearing potential to use effective contraception. It is not known whether vincristine is excreted in human milk; due to the potential for serious adverse reactions in nursing infants, breastfeeding should be discontinued during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when stored correctly, refer to product label for exact expiry date.
Availability
Hospitals, Oncology centers, specialized pharmacies
Approval Status
FDA approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Vincristine has been extensively studied in numerous clinical trials for its efficacy in various hematological and solid malignancies, both as a single agent and in combination chemotherapy regimens. Ongoing research continues to explore its role in new therapeutic strategies and combination therapies.
Lab Monitoring
- Complete Blood Count (CBC) with differential
- Liver function tests (LFTs)
- Neurological examinations and assessment of reflexes
- Serum electrolyte levels (especially sodium for SIADH)
- Bowel function monitoring
Doctor Notes
- Absolutely critical to administer intravenously only; intrathecal administration is fatal. Verify administration route carefully before each dose.
- Close monitoring for neurotoxicity, especially peripheral neuropathy, is essential. Dose reduction or delay may be necessary if neurotoxicity is severe or progressive.
- Assess liver function regularly, as hepatic impairment can significantly increase vincristine toxicity due to its primary hepatic metabolism.
- Monitor CBC for myelosuppression, though vincristine is generally less myelosuppressive than other chemotherapeutic agents. Platelet counts should be particularly monitored.
- Counsel patients on potential side effects, especially neuropathy and constipation, and advise on management strategies.
Patient Guidelines
- Report any numbness, tingling, pain, or weakness in hands or feet immediately to your healthcare provider.
- Inform your doctor about severe constipation or abdominal pain, and discuss bowel management strategies.
- Do not receive any immunizations or vaccinations without your doctor's approval during treatment and for a period afterward.
- Avoid contact with people who have infections, as your immune system may be weakened.
- Drink plenty of fluids to help prevent constipation and support kidney function.
Missed Dose Advice
Contact your oncologist or healthcare provider immediately if a dose is missed. Do not attempt to administer a missed dose yourself or double the next dose.
Driving Precautions
Vincristine can cause neurological side effects such as peripheral neuropathy, vision changes, or dizziness, which may impair your ability to drive or operate machinery safely. Exercise caution and avoid these activities if you experience such effects.
Lifestyle Advice
- Maintain good oral hygiene to prevent mouth sores.
- Ensure adequate hydration by drinking enough water.
- Manage constipation proactively with a high-fiber diet and stool softeners as advised by your doctor.
- Avoid strenuous activities if feeling fatigued or experiencing significant side effects.
- Wear comfortable, supportive shoes to help manage any peripheral neuropathy.
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