vincristine
Vincristine is a chemotherapy medication that helps treat many different kinds of cancer. This includes acute leukemia, Hodgkin’s lymphoma, non-Hodgkin’s lymphomas, and other cancers. The medication works as a microtubule inhibitor, or “vinca alkaloid.” It stops the cancer from growing by destroying cancer cells in the body. Vincristine is given as an infusion through the vein at a medical center. It's common to have constipation as a side effect. You can also feel numbness, pain, and tingling in the fingers and toes. Vincristine is usually given with other cancer treatments.
What is Vincristine?
What is Vincristine used for?
- Acute leukemia
- Hodgkin’s lymphoma
- Non-Hodgkin’s lymphomas
- Rhabdomyosarcoma
- Neuroblastoma
- Wilms’ tumor (a type of kidney cancer)
How Vincristine works
Vincristine is a type of chemotherapy medication called a microtubule inhibitor. People also call it a “vinca alkaloid.” It works by blocking microtubules. These are parts of cells that help them grow and divide.
By blocking microtubules, vincristine stops fast-growing cells, like cancer cells, from dividing. This helps stop the cancer from growing and spreading.
Drug facts
Side effects of Vincristine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nerve pain
- Numbness or tingling in the fingers or toes (peripheral neuropathy)
- Feeling very weak
- Constipation
- Nausea
- Vomiting
- Diarrhea
- Stomach pain or cramps
- Hair loss
- Trouble walking or moving
- Problems with urination
Less Common Side Effects
- Pain or redness at the infusion site
- Feeling dizzy
- Lower appetite
- Mouth sores
- Jaw or throat pain
- Bone or muscle pain
- Headache
- Trouble balancing
- Rash
- Changes in blood pressure
- Low red blood cell counts (anemia)
- Low white blood cell counts
- Low platelets
Vincristine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Problems with the digestive system: severe constipation, stomach pain, can’t pass gas, bloating, fever, chills
- Problems with the nervous system: numbness, tingling, or pain in the fingers or toes; vision, movement, balance, or hearing problems; confusion
- Lung problems: sudden or worsening cough, having trouble catching your breath, fast breathing
- Liver problems: pain in the upper right side of your stomach, yellow skin or eyes
The following Vincristine side effects have also been reported
Along with their needed effects, medicines like vincristine can sometimes cause unwanted effects such as blood problems, nervous system problems, loss of hair, and other side effects. These and others are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. Discuss these possible effects with your doctor.
Check with your doctor immediately if any of the following side effects occur:
Less common
Pain or redness at place of injection
Check with your doctor as soon as possible if any of the following side effects occur:
More common
Blurred or double vision
difficulty in walking
drooping eyelids
headache
jaw pain
joint pain
lower back or side pain
numbness or tingling in fingers and toes
pain in fingers and toes
pain in testicles
stomach cramps
swelling of feet or lower legs
weakness
Less common
Agitation
bed-wetting
confusion
convulsions (seizures)
decrease or increase in urination
dizziness or lightheadedness when getting up from a lying or sitting position
hallucinations (seeing, hearing, or feeling things that are not there)
lack of sweating
loss of appetite
mental depression
painful or difficult urination
trouble in sleeping
unconsciousness
Rare
Sores in mouth and on lips
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects may occur that usually do not need medical attention. This medicine often causes a temporary loss of hair. After treatment with vincristine has ended, or sometimes even during treatment, normal hair growth should return.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Vincristine
Pros
- Typically given once a week
- A part of recommended treatment plans for acute lymphoblastic leukemia, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma
Cons
- Given as an infusion through the vein
- Can cause nerve problems and hair loss
Pharmacist tips for Vincristine
- If you feel pain, burning, or warmth where the IV is during the infusion, tell the nurse right away. These could be signs that vincristine has leaked out from the vein and is irritating the area around it. The nurse can pause your infusion to stop this from happening. They might also put a warm pack on the area to help you feel better.
- Let your oncology care team know if you feel numbness, tingling, or pain in your fingers or toes. This problem is called peripheral neuropathy, and it often bothers people who take vincristine. Your oncologist might adjust your treatment plan to help with this problem.
- Vincristine can cause constipation. It’s a good idea to keep track of your bowel movements while taking this medication. Your oncology care team can work with you to come up with a plan to help prevent constipation.
- Drink plenty of water and eat fiber-rich foods. Your care team might also suggest over-the-counter medications for constipation. These things can help prevent constipation while you’re taking vincristine.
- If you haven’t had a bowel movement for a longer time than usual while taking vincristine, call your care team right away. Also reach out to them if you have stomach pain, can’t pass gas, or have a fever. These can be signs of more serious problems with your gut.
- Give your care team a list of all medications, supplements, and herbal products you take and plan to take. Vincristine can interact with some medications, which can be harmful. For example, the antifungal fluconazole (Diflucan) can raise your risk of nerve problems from vincristine. It’s important your care team checks vincristine is safe for you to take.
- If you can become pregnant, use reliable birth control while taking vincristine. This medication can harm an unborn baby, so it’s important not to get pregnant during treatment. Talk to your oncologist if you’re thinking about getting pregnant. And let them know right away if you do become pregnant while taking this medication.
Common questions about Vincristine
Yes, vincristine is a high-risk or high-alert medication. This means it has a high risk of causing serious harm if it’s not used the right way. Vincristine should only be given as an infusion through the vein (an IV infusion). It can be fatal if it’s given with a lumbar puncture (into the spinal fluid). To keep you safe, your care team will take steps to make sure you receive vincristine in the right way. For example, they’ll put the medication in an infusion bag instead of a syringe. Most traditional chemotherapy medications are high risk because they can also harm normal, healthy cells in the body. Talk to your oncologist if you’re worried about taking this medication.
Nerve problems are a very common side effect of vincristine. Usually, this can feel like numbness, tingling, or pain in the fingers or toes. But vincristine can also affect the nerves in the digestive system, causing constipation. Tell your oncology team if you have numbness, tingling, pain, or constipation that bother you a lot. They can help you with these side effects.
Yes, vincristine is a kind of traditional chemotherapy. More specifically, it’s called a microtubule inhibitor or vinca alkaloid. It works by interfering with the microtubules in your cells. Microtubules are parts of your body’s cells that help them grow and divide. When vincristine interferes with this process, fast-growing cells like cancer cells can’t grow and spread as well.
Yes, vincristine can cause hair loss (alopecia). This can happen from your head and from other parts of the body. Note that it’s possible you might not lose all your hair during treatment. If you do lose your hair though, it’ll likely grow back within a few months after you stop taking vincristine. But it might grow back in a different color or texture. Talk to your care team if you’re worried about hair loss with chemotherapy. They can give you tips and resources to help manage this side effect.
Vincristine was first found in a type of periwinkle plant (Catharanthus roseus, or Vinca rosea). Today, vincristine is made in a lab from chemicals instead of plants. That’s because each periwinkle plant has a very small amount of vincristine. It would take a lot of plants and be too expensive to get enough medication that way.
Vincristine and vinblastine are chemotherapy medications that work in the same way to fight cancer. But they’re used for different kinds of cancer. The main side effects they cause are also different. Vincristine is known for causing nerve problems, like making your fingers and toes feel numb and tingly. This can also happen with vinblastine, but it’s usually less common and not as severe. On the other hand, vinblastine is more likely to lower your white blood cell count. This can put you at risk of a serious infection. Talk to your oncologist to compare the two medications.
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Risks and warnings for Vincristine
Vincristine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Pain and tissue damage around the infusion site
Vincristine can sometimes leak into the tissues around the IV line. This can cause pain and damage to the skin and area around it. That’s why a trained healthcare professional will help with the infusion. They’ll help to make sure the IV line is placed properly.
Let your nurse know right away if you feel any pain, burning, or warmth during your infusion. They’ll stop the infusion and check the infusion site. They might give hyaluronidase injections around the area or put a warm pack over it to help.
For IV use only
Vincristine is only given as an infusion through the vein. It should never be given as an injection into the spine, or intrathecally. It’s dangerous and it can damage the central nervous system, causing paralysis or other problems that can be fatal.
Nerve problems
- Risk factors: History of problems affecting the nervous system | Taking other medications that can cause nerve damage
Vincristine can cause damage to the nerves. It can affect the nerves in your fingers and toes, leading to numbness, tingling, or pain. You might start noticing this side effect within 1 week of starting vincristine.
Let your care team know if you feel any numbness, tingling, or pain in your fingers or toes. They can help you manage these nerve problems. Depending on how much it affects your daily life, your oncologist can help you decide what to do next. They might suggest taking a break from vincristine or stopping it altogether. This can help prevent nerve problems from getting worse.
Other nerve problems can include trouble with vision, movement, balance, thinking, or hearing. But these aren’t usually common. Still, tell your care team if this happens so they can help you.
Problems with the digestive system, including constipation
Vincristine often causes constipation. It’s important to prevent this from happening during treatment. Drink lots of water and eat fiber-rich foods to help. Your oncologist might suggest taking certain medications to prevent constipation too. If you’re having fewer bowel movements than normal or straining to have a bowel movement, talk to your care team. They can help with this side effect.
In rare cases, some people have had serious tissue damage in the gut while taking vincristine. Call your care team right away if you have sudden severe stomach pain, fever, chills, or bloating. These can be signs of serious gut issues.
Low blood cell counts
- Risk factors: History of bone marrow damage
Some people might have low blood cell counts after getting their vincristine infusion. This can include a low white blood cell count, low red blood cell count, and low platelets.
Your oncology team will check your blood cell counts while you’re taking vincristine. They’ll probably do a blood draw to check this before each infusion. If your counts are too low, your care team might pause treatment or lower your vincristine dose.
Liver problems
- Risk factors: Children
Although rare, some people taking vincristine with other chemotherapy had liver damage. This can sometimes be life-threatening.
Most people don’t feel any symptoms with mild liver damage. But your oncologist can see signs of liver damage on blood tests. Your oncologist might ask you to do blood tests regularly while taking vincristine. This helps make sure your liver is okay. If your liver labs are abnormal, your oncologist might pause or stop your treatment while they look into it.
Call your oncology care team right away if you do notice signs of liver damage. These include pain in the upper right side of the stomach, yellow skin, or yellow eyes.
Lung problems
- Risk factors: History of lung problems | Taking vincristine together with mitomycin-C
It’s rare, but some people taking medications like vincristine had sudden trouble breathing after their infusion. Some also felt their chest get tight. This usually happens when vincristine is given with another cancer medication called mitomyin-C. It can happen minutes to hours after getting vincristine. It can also happen up to 2 weeks after getting mitomycin-C.
Some people taking vincristine have also had a different lung problem called acute respiratory distress syndrome (ARDS). This happens when not enough oxygen can get into the lungs and then into the blood. It can be very serious.
If you have sudden breathing problems, call your oncology team right away. Watch for sudden coughing, trouble breathing, and fast breathing. Your oncologist might pause or stop treatment while they figure out what’s happening.
Harm to an unborn baby
Animal studies show that vincristine can harm an unborn baby if given during pregnancy. It could even cause a miscarriage, or losing the baby early.
If you can get pregnant, use effective birth control while taking vincristine. Tell your oncologist right away if you become pregnant during treatment.
Vincristine dosage
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2ml of 1mg/ml | 1 vial | $13.50 | $13.50 |
| 1ml of 1mg/ml | 1 vial | $9.00 | $9.00 |
Typical dosage for Vincristine
The vincristine dose and how often you need to get it will be different for everyone. It depends on the cancer and your specific treatment plan.
-
Adults
- Your oncologist will calculate the dose based on your body surface area (BSA, in m2 units). They’ll take into account your height and weight.
- The usual approved dose is 1.4 mg/m2 infused through the vein once a week in each treatment cycle.
-
Children
- The oncologist will calculate the dose based on your child’s weight (in kilograms or kg).
- Weigh 10 kg (22 lbs) or less: The usual approved dose is 0.05 mg/kg infused through the vein once a week.
- Weigh more than 10 kg (22 lbs): The usual approved dose is 1.5 mg/m2 to 2 mg/m2 infused through the vein once a week.
Interactions between Vincristine and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Boceprevir
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Amiodarone
- Apalutamide
- Asparaginase
- Atazanavir
- Carbamazepine
- Carvedilol
- Ceritinib
- Clarithromycin
- Cobicistat
- Conivaptan
- Cyclosporine
- Darunavir
- Dronedarone
- Enzalutamide
- Erythromycin
- Filgrastim
- Flibanserin
- Fluconazole
- Fosnetupitant
- Fosphenytoin
- Idelalisib
- Indinavir
- Itraconazole
- Ketoconazole
- Lapatinib
- Lopinavir
- Lumacaftor
- Mitotane
- Nefazodone
- Nelfinavir
- Netupitant
- Nilotinib
- Phenytoin
- Posaconazole
- Quinidine
- Quinupristin
- Ranolazine
- Rifabutin
- Rifampin
- Rifapentine
- Ritonavir
- Saquinavir
- Sargramostim
- Simeprevir
- St John's Wort
- Telaprevir
- Telithromycin
- Tipranavir
- Valspodar
- Vemurafenib
- Verapamil
- Voriconazole
- Warfarin
- Zidovudine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Vincristine cost?
$9.00
Vincristine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Vincristine will not be safe for you to take.
- Demyelinating form of Charcot-Marie-Tooth syndrome