vincristine sulfate

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Related to vincristine sulfate: Oncovin

vincristine sulfate (VCR)

Pharmacologic class: Vinca alkaloid

Therapeutic class: Antineoplastic

Pregnancy risk category D

Drug should be administered only by individuals experienced in giving it. Make sure needle is positioned properly in vein before injecting drug. Leakage into surrounding tissue during I.V. administration may cause considerable irritation. If it does, discontinue injection immediately and inject remaining portion of dose into another vein. To treat extravasation, administer local injection of hyaluronidase and apply moderate heat to affected area.


Unknown. Thought to block cell division and interfere with synthesis of nucleic acid. Cell-cycle-phase specific.


Solution for injection: 1 mg/ml in 1-, 2-, and 5-ml vials

Indications and dosages

Acute leukemia

Adults: 0.4 to 1.4 mg/m2 I.V. weekly, not to exceed 2 mg/dose. (Dosages higher than 2 mg may be used depending on patient, physician, protocol, and facility.)

Children weighing more than 10 kg (22 lb): 2 mg/m2 I.V. weekly

Children weighing 10 kg (22 lb) or less: 0.05 mg/kg I.V. weekly

Dosage adjustment

• Hepatic impairment

Off-label uses

• Brain, hepatic, ovarian, testicular, and other cancers

• Neuroblastoma

• Kaposi's sarcoma

• Idiopathic thrombocytopenic purpura


• Hypersensitivity to drug

• Demyelinating form of Charcot-Marie-Tooth disease

• Intrathecal use


Use cautiously in:

• infections, decreased bone marrow reserve, hepatic impairment, acute uric acid nephropathy, neuromuscular disease, pulmonary dysfunction, other chronic debilitating illnesses

• females of childbearing age

• pregnant or breastfeeding patients (use not recommended).


Follow facility protocol for handling and preparing chemotherapeutic drugs. Be especially careful to avoid eye contamination.

• Be aware that patient is usually premedicated with antiemetic.

Give by I.V. route only. (Intrathecal injection is fatal.)

• Inject into tubing of running I.V. line, or inject directly into vein over 1 minute.

• Avoid extravasation (may cause tissue necrosis). If extravasation occurs, stop injection, inject hyaluronidase locally, and apply moderate heat.

• Know that drug may be used with other antineoplastics in some diseases.

Adverse reactions

CNS: agitation, insomnia, depression, mental status changes, ascending peripheral neuropathy, transient cortical blindness, seizures, coma

EENT: diplopia

GI: nausea, vomiting, constipation, abdominal cramps, stomatitis, anorexia, paralytic ileus

GU: nocturia, urinary retention, gonadal suppression, oliguria

Hematologic: anemia, leukopenia, thrombocytopenia (mild and brief)

Metabolic: hyperuricemia, syndrome of inappropriate antidiuretic hormone secretion

Respiratory: bronchospasm

Skin: alopecia

Other: tissue necrosis (with extravasation), phlebitis at I.V. site


Drug-drug. Asparaginase: decreased hepatic metabolism of vincristine

Live-virus vaccines: decreased antibody response to vaccine, increased risk of adverse reactions

Mitomycin: increased risk of bronchospasm and shortness of breath

Drug-diagnostic tests. Platelets: increased or decreased count

Uric acid: increased level

White blood cells: decreased count (slight leukopenia) 4 days after therapy, resolving within 7 days

Patient monitoring

Assess respiratory status. Drug may cause bronchospasm, especially in patients who previously received mitomycin.

• Monitor blood pressure.

• Evaluate neurologic status. Know that neurotoxicity is a dose-limiting adverse reaction.

• Monitor CBC with platelet count. Watch for signs and symptoms of blood dyscrasias.

• Stay alert for signs and symptoms of infection.

Patient teaching

• Explain drug therapy to patient. Emphasize importance of follow-up laboratory tests.

• Advise patient to promptly report signs and symptoms of infection and to take his temperature daily.

• Urge patient to practice good oral hygiene, to help prevent infected mouth sores.

• Instruct female of childbearing age to avoid pregnancy. Caution her not to breastfeed during therapy.

• Tell patient that hair loss is a common side effect but typically reverses once treatment ends.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

vin·cris·tine sul·fate

(vin-kris'tēn sŭl'fāt),
A dimeric alkaloid obtained from Vinca rosea; its antineoplastic activity is similar to that of vinblastine, but no cross-resistance develops between these two agents, so it is more useful than vinblastine in lymphocytic lymphosarcoma and acute leukemia.
Synonym(s): leurocristine
Farlex Partner Medical Dictionary © Farlex 2012

vincristine sulfate

(vin-kris′tēn″) [ Vinca, a genus name + crista + -ine]
A fraction of an extract obtained from the periwinkle plant, Vinca rosea, a species of myrtle. It is a cytotoxic agent used in treating certain types of malignant tumors.


Like other cytotoxic drugs, vinblastine should be handled with barriers to protect the administrator. It must be disposed of in environmentally sound containers.
Medical Dictionary, © 2009 Farlex and Partners
References in periodicals archive ?
Complete regression of transmissible venereal tumor (TVT) in Nigerian mongrel dogs with vincristine sulfate chemotherapy.
In July 2011 the company submitted a new drug application (NDA) to the FDA for accelerated approval of Marqibo (vincristine sulfate liposomes injection) in adult Ph- ALL, in second or greater relapse or that has progressed following two or more prior lines of anti-leukemia therapy.
28 September 2011 - US Talon Therapeutics Inc (OTCBB:TLON) said yesterday that the US Food and Drug Administration (FDA) had accepted for filing its New Drug Application (NDA) for accelerated approval of Marqibo (vincristine sulfate liposomes injection).
The difference was a result of increased activity in preparation for the submission of a New Drug Application (NDA) with the US Food and Drug Administration (FDA) for Talon's Marqibo (vincristine sulfate liposomes injection).
8 December 2009 - US-based biopharmaceutical company Hana Biosciences (OTC:HNAB) announced yesterday data from its pivotal Phase II rALLy clinical trial for Marqibo (vincristine sulfate liposomes injection) for the treatment of adult acute lymphoblastic leukemia (ALL) in second relapse.
2 December 2009 - US-based biopharmaceutical company Hana Biosciences (OTCBB: HNAB) announced today that it has completed enrollment of its pivotal Phase II rALLy clinical trial for Marqibo (vincristine sulfate liposomes injection) for the treatment of adult acute lymphoblastic leukemia (ALL) in second relapse, enrolling a total of 65 patients.