Vincristine - an alkaloid with antitumor action.
Release form and composition
Vincristine is produced in the form of a solution and a lyophilisate for preparing a solution for injection.
The active ingredient of the drug is vincristine sulfate.
One ml of its solution contains 1 mg. Sold in bottles of 1, 2, 3 or 5 ml.
One vial of lyophilisate contains 1 mg of the active ingredient. The composition of the solvent: injectable water, benzyl alcohol and sodium chloride.
Indications for use
According to the instructions to Vincristine, the drug is intended for the treatment of:
- Acute leukemia;
- Non-Hodgkin's malignant lymphomas (lymphocytic, mixed-cell, histiocytic, undifferentiated; diffuse or nodular type);
- Ewing sarcoma;
- Soft tissue sarcoma;
- Osteogenic sarcoma;
- Rhabdomyosarcoma, including embryonic;
- Small cell lung cancer;
- Breast cancer;
- Wilms tumors;
- Kaposi's sarcoma;
- Bladder cancer;
- Cancer of the ureters and renal pelvis;
- Fungal mycosis;
- Uterine sarcoma;
- Cervical cancer;
- Germ cell tumors of the ovaries and testicles;
- Ependymomas (tumors of the central nervous system);
- Chorionepithelioma of the uterus;
- Malignant tumors of the genital organs in girls;
- Pleurisy tumor etiology;
- Idiopathic thrombocytopenic purpura resistant to glucocorticosteroids, and with the ineffectiveness of splenectomy.
The use of Vincristine, according to the instructions, is contraindicated in:
- Neurodystrophic diseases (in particular, with the demyelinated form of Charcot-Marie-Tut syndrome);
- Hypersensitivity to vinkoalkaloidov;
- The need for simultaneous radiotherapy with involvement of the liver;
Prescribe the drug, but with extreme caution:
- To old people;
- When liver failure;
- With a history of indications of neuropathy;
- Patients with acute infectious diseases;
- With the oppression of bone marrow hematopoiesis;
- If the use of Vincristine was preceded by radiation or chemotherapy.
Dosing and Administration
Vincristine solution, including that prepared from lyophilisate, is intended for intravenous administration.
Enter it drip or slowly jet once a week.
In each case, the doctor sets the dosage individually, taking into account the type and stage of the disease, as well as the treatment regimen used.
A single dose for adults ranges from 0.4 to 1.4 mg per m 2 (in some cases it can be increased to 2 mg), the course dose is 10-12 mg / m 2 .
Patients with reduced liver function (in which the concentration of direct bilirubin exceeds 0.3 mg%) reduce the dosage of vincristine by half.
The dose for children weighing more than 10 kg is 1.5-2 mg / m 2 , for babies weighing up to 10 kg - 0.05 mg per kilogram of weight.
Vincristine solution immediately before administration is diluted with 0.9% sodium chloride solution to a concentration of 0.1 mg / ml. The lyophilisate is dissolved with the applied solvent, and then, if necessary, with 0.9% NaCl solution.
The total duration of treatment is determined individually.
Possible side effects when using Vincristine:
- On the part of the nervous system: dysfunction of the cranial nerves (especially VIII pairs: nystagmus, dizziness, deafness), convulsions with increased blood pressure, neuritis of the peripheral nerves, headache, neuralgia, sagging of the feet, isolated paresis, ataxia, paresthesia, impaired motor function , decrease in muscle strength, muscle paralysis, decrease in deep tendon reflexes, neuropathy, ataxia, depression, sleep disturbances, hallucinations, diplopia, transient loss of vision, optic nerve atrophy, ptosis;
- On the part of the digestive system: paralytic intestinal obstruction (mainly in children), nausea, vomiting, abdominal pain, spasm of smooth muscles of the digestive tract, constipation or diarrhea, stomatitis, perforation and / or necrosis of the wall of the small intestine;
- On the part of the urogenital system: urinary retention (as a result of atony of the bladder), azoospermia, dysuria, amenorrhea, acute uric nephropathy;
- Allergic reactions: skin rash, angioedema, anaphylaxis;
- Since the cardiovascular system: the lability of blood pressure; angina and myocardial infarction may develop in patients with previously irradiated mediastinum when using Vincristine;
- On the part of the respiratory system: hoarseness, shortness of breath, acute respiratory failure, bronchospasm (especially with the simultaneous appointment of mitomycin C);
- On the part of the endocrine system: in some cases, hyponatremia, polyuria (with dehydration, signs of damage to the adrenal glands and kidneys are absent);
- On the part of the hemostasis system and the blood-forming organs: rarely - thrombocytopenia, leukopenia, anemia;
- Other: fever, alopecia, loss of appetite, weight loss.
All side effects of Vincristine are dose-dependent.
If the solution gets under the skin, inflammation of the subcutaneous fat can develop, as well as phlebitis and even necrosis.
Intrathecal administration (in the cerebrospinal fluid system) of Vincristine is strictly prohibited, since this can lead to the death of the patient!
During the period of treatment with this drug should monitor the peripheral blood, the level of bilirubin and uric acid, the concentration of sodium in the serum.
Structural analogues: Vero-Vincristine, Vincristine-Richter, Vincristine-Teva, Oncovin, Cytomid.
Analogs on the mechanism of action: Velbin, Vinblastin, Vinelbin, Vincarelbine, Wincatera, Vinorelbine, Gavlor, Mavereks, Navelek, Navelbin, Rozevin, Tsituvin.
Terms and conditions of storage
Vincristine is a prescription drug.
Both dosage forms of the drug should be stored at a temperature of from 2 to 8 ºС. The shelf life of the solution is 2 years, the lyophilisate is 3 years.