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Vincristine

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Vincristine

  • See Also
  1. Vincristine Liposome
  2. Vinblastine
  3. Vinorelbine
  4. Mitotic Inhibitor Chemotherapy
  5. Chemotherapy
  • Indications
  1. FDA Approved (combined with other agents)
    1. Acute Lymphocytic Leukemia
    2. Lymphoma (Hodgkin Lymphoma, Non-Hodgkin Lymphoma)
    3. Multiple Myeloma
    4. Neuroblastoma
    5. Rhabdomyosarcoma
    6. Sarcoma
    7. Wilms Tumor
  2. Off-Label
    1. Breast Cancer
    2. Bladder Cancer
    3. Kaposi Sarcoma
    4. Idiopathic Thrombocytopenic Purpura
  • Mechanism
  1. See Mitotic Inhibitor Chemotherapy
  2. Vincristine, like Vinblastine, is a natural Vinca Alkaloid with antineoplastic activity
    1. Isolated from the periwinkle plant (Vinca rosea Linn)
  3. Vincristine is an antitubular agent
    1. Binds tubulin and inhibits microtubule formation
    2. Disrupts mitotic spindle formation
    3. Arrests Cell Cycle in G2/M phase
  4. Other possible activity
    1. Interferes with metabolism of Amino Acids cAMP, glutathione
    2. Interferes with calmodulin-dependent Calcium transport ATPase activity
    3. Interferes with biosynthesis of Nucleic Acids and lipids
  • Medications
  1. Vincristine intravenous solution: 1 mg/ml in 1 and 2 ml vials
  • Dosing
  1. See other references for disease specific dosing protocols
  • Adverse Effects
  1. Impaired future fertility
  2. Alopecia
  3. Bronchospasm
  4. Central Nervous System Toxicity
  5. Hyperuricemia
  6. Hypersensitivity Reaction
  7. Severe skin and soft tissue necrosis on extravasation
    1. Vincristine is a strong Vesicant (causes Blistering)
  8. Myelosuppression (Bone Marrow suppression)
    1. Minimal compared with other agents (e.g. Vinblastine)
  9. Peripheral Neuropathy
    1. More than Vinblastine
  • Safety
  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
  • Drug Interactions
  1. Decreases other drug levels
    1. Phenytoin
    2. Digoxin
  • Resources
  1. Vincristine Injection Solution (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=49596de6-ab18-49d1-9e5b-30968fc21c36
  2. Vincristine (StatPearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK537122/
  • References
  1. Dhyani (2022) Cancer Cell Int 22(1):206 +PMID: 35655306 [PubMed]
    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9161525/