III. 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

IV. Medications

  1. Vincristine intravenous solution: 1 mg/ml in 1 and 2 ml vials

V. Dosing

  1. See other references for disease specific dosing protocols

VI. 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

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count

VIII. Drug Interactions

  1. Decreases other drug levels
    1. Phenytoin
    2. Digoxin

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