Vincrist
Generic Name
Vincristine Sulfate
Manufacturer
Various generic manufacturers
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vincrist 2 mg injection | ৳ 550.00 | N/A |
Description
Overview of the medicine
Vincristine is a vinca alkaloid used in chemotherapy to treat various types of cancer. It works by interfering with cell division, primarily by inhibiting microtubule formation, which is essential for cell replication.
Uses & Indications
Dosage
Adults
Typically 1.4 mg/m² intravenously once weekly, with a maximum single dose of 2 mg.
Elderly
Similar to adults, but with careful monitoring for increased neurotoxicity and dose adjustments as needed.
Renal_impairment
No significant dose adjustment is usually required for renal impairment, but caution is advised due to potential for increased toxicity in severe cases.
Hepatic_impairment
Significant dose reduction (e.g., 50% or more) is required for moderate to severe hepatic impairment due to hepatic metabolism and biliary excretion.
How to Take
Vincristine is for intravenous use only. It should be administered slowly over 1 minute or more, either directly into a vein or into the tubing of a running intravenous infusion. EXTREMELY IMPORTANT: It must not be given intrathecally; intrathecal administration is fatal.
Mechanism of Action
Vincristine binds to tubulin, disrupting the formation of microtubules and mitotic spindle assembly. This leads to metaphase arrest in the cell cycle, ultimately causing cell death (apoptosis).
Pharmacokinetics
Onset
Clinical effects are typically observed after multiple doses due to its cell cycle-specific action.
Excretion
Primarily excreted via the bile and feces (80%), with a smaller portion excreted renally (12%).
Half life
Triphasic elimination with a terminal half-life of 19-155 hours (mean 85 hours).
Absorption
Rapidly and completely absorbed after intravenous administration.
Metabolism
Extensively metabolized in the liver by cytochrome P450 enzymes, particularly CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to vincristine or any component of the formulation.
- Patients with demyelinating Charcot-Marie-Tooth syndrome.
- Intrathecal administration (fatal).
- Patients with significant hepatic impairment (relative contraindication, requires dose modification).
Drug Interactions
Phenytoin
Vincristine may decrease phenytoin levels.
Live vaccines
Avoid use with live vaccines due to immunosuppression.
Other neurotoxic agents (e.g., taxanes)
Concurrent use may increase the risk and severity of neurotoxicity.
CYP3A4 inhibitors (e.g., azole antifungals, macrolides, protease inhibitors)
May increase vincristine plasma concentrations and enhance toxicity (especially neurotoxicity).
Storage
Store in a refrigerator (2-8°C). Protect from light. Do not freeze. Reconstituted solution should be used within 24 hours.
Overdose
Overdose symptoms include severe neurotoxicity, bone marrow suppression (though less prominent than other vinca alkaloids), paralytic ileus, and inappropriate antidiuretic hormone secretion (SIADH). Treatment is symptomatic and supportive. No specific antidote exists.
Pregnancy & Lactation
Pregnancy Category D: Vincristine can cause fetal harm when administered to a pregnant woman. Avoid during pregnancy. Lactation: It is not known whether vincristine is excreted in human milk. Due to potential serious adverse reactions in breastfed infants, breastfeeding is contraindicated.
Side Effects
Contraindications
- Hypersensitivity to vincristine or any component of the formulation.
- Patients with demyelinating Charcot-Marie-Tooth syndrome.
- Intrathecal administration (fatal).
- Patients with significant hepatic impairment (relative contraindication, requires dose modification).
Drug Interactions
Phenytoin
Vincristine may decrease phenytoin levels.
Live vaccines
Avoid use with live vaccines due to immunosuppression.
Other neurotoxic agents (e.g., taxanes)
Concurrent use may increase the risk and severity of neurotoxicity.
CYP3A4 inhibitors (e.g., azole antifungals, macrolides, protease inhibitors)
May increase vincristine plasma concentrations and enhance toxicity (especially neurotoxicity).
Storage
Store in a refrigerator (2-8°C). Protect from light. Do not freeze. Reconstituted solution should be used within 24 hours.
Overdose
Overdose symptoms include severe neurotoxicity, bone marrow suppression (though less prominent than other vinca alkaloids), paralytic ileus, and inappropriate antidiuretic hormone secretion (SIADH). Treatment is symptomatic and supportive. No specific antidote exists.
Pregnancy & Lactation
Pregnancy Category D: Vincristine can cause fetal harm when administered to a pregnant woman. Avoid during pregnancy. Lactation: It is not known whether vincristine is excreted in human milk. Due to potential serious adverse reactions in breastfed infants, breastfeeding is contraindicated.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 12-24 months for unopened vials, refer to manufacturer's specific instructions.
Availability
Hospitals, oncology centers
Approval Status
Approved (internationally)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Vincristine is a well-established chemotherapy drug, and its efficacy is primarily evaluated in combination with other agents for various cancers. Ongoing trials focus on optimizing regimens and managing toxicity.
Lab Monitoring
- Complete Blood Count (CBC) with differential before each dose
- Liver function tests (ALT, AST, bilirubin) regularly
- Neurological assessment before each dose and throughout treatment
- Serum electrolytes, especially sodium, for SIADH monitoring
Doctor Notes
- Crucial: Administer IV only. Verify correct route prior to administration.
- Monitor for neurotoxicity (paresthesias, motor weakness, constipation) at each visit; dose reduction or temporary discontinuation may be necessary.
- Manage constipation proactively with laxatives and dietary advice.
- Caution in patients with hepatic impairment; significant dose adjustment required.
Patient Guidelines
- Report any tingling, numbness, pain, or weakness in hands or feet immediately.
- Drink plenty of fluids and discuss strategies for managing constipation with your healthcare team.
- Avoid grapefruit and grapefruit juice during treatment.
- Report any signs of infection (fever, chills) or unusual bleeding/bruising.
Missed Dose Advice
If a dose is missed, contact your oncologist or healthcare provider immediately to reschedule the dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Vincristine can cause neurological side effects such as dizziness, motor weakness, and visual disturbances, which may impair your ability to drive or operate machinery. Exercise caution or avoid these activities if affected.
Lifestyle Advice
- Maintain good oral hygiene to prevent stomatitis.
- Engage in gentle physical activity if tolerated to help manage constipation and maintain overall well-being.
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International brand names for this medicine. Click a brand to search for detailed information.
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