vincristine sulfate: clinical use

Prescribing considerations

• Intravenous administration only by clinicians experienced in cancer chemotherapy; wrong-route administration can be fatal.
• Use wrong-route safeguards and monitor for extravasation during administration.
• Review hepatic and biliary function, neurological disease, bowel and bladder function, infection, cytopenias and important interactions.
• Discuss reproductive risk and fertility preservation where relevant.

Contraindications and cautions

• Hypersensitivity to vincristine sulfate or an excipient
• Demyelinating Charcot–Marie–Tooth syndrome
• Intrathecal administration

Monitoring

• Full blood count and clinical signs of infection
• Liver and biliary function
• Peripheral and cranial nerve toxicity, reflexes, strength and gait
• Bowel function and symptoms of ileus
• Bladder function and urinary retention
• Infusion site for extravasation

Clinical pharmacology

Vincristine is a tubulin-binding vinca alkaloid that inhibits microtubule assembly and arrests cells in metaphase. It is predominantly eliminated in bile; hepatic or biliary impairment can prolong elimination.

Formulation and product differences

• Sterile, colourless solution for intravenous injection or infusion.
• Vial and graduated syringe presentations may be available; not all pack types are necessarily marketed.
• The selected formulation contains mannitol, water for injections and pH-adjusting agents.
• Do not mix with other medicines; specified compatible diluents are sodium chloride solution or glucose solution.

Injection

Route: Parenteral

Strengths: 1 mg/mL