DBL Vincristine Sulfate

Acute leukaemia. In combination w/ other oncolytic agents in Hodgkin's disease, non-Hodgkin's malignant lymphomas (lymphocytic, mixed-cell, histiocytic, undifferentiated, nodular & diffuse types), rhabdomyosarcoma, neuroblastoma, Wilm's tumour, osteogenic & Ewing's sarcoma, mycosis fungoides, uterine cervix & oat-cell lung carcinoma, breast cancer, malignant melanoma & gynaecological childhood tumours.

Adult 0.4-1.4 mg/m² at wkly intervals. Childn >10 kg or >1 m² 1.5-2 mg/m² at wkly intervals, ≤10 kg or <1 m² 0.05 mg/kg once wkly. Serum bilirubin >3 mg/100 mL 50% dose reduction.

Hypersensitivity to vincristine, vinca alkaloids. Intrathecal administration. Demyelinating form of Charcot-Marie-Tooth syndrome. Concurrent RT through liver ports. Not to be used during lactation.

Not to be given IM, SC or intrathecally. Severe local reaction on extravasation. Granulocytopenia &/or complicating infection; history of gout or urate renal stones; CNS leukaemia; spinal cord irradiation, neurological disease; pre-existing neuromuscular disease & pulmonary dysfunction; secondary malignancies; herpes zoster, existing or recent chicken pox. Avoid eye contamination. Perform CBC prior to each dose; frequently determine uric acid levels during 1st 3-4 wk of treatment; monitor LFTs during initiation & at periodic intervals. Postpone immunisation w/ oral polio vaccines. Previous cytotoxic drug therapy or irradiation. Concomitant use w/ L-asparaginase, neurotoxic agents, mitomycin, anticancer drugs. May affect ability to drive & use machines. Hepatic impairment, jaundice. May affect fertility. Women of childbearing potential should use effective contraception during & at least 7 mth after last dose. Male partners should use effective contraception during & at least 4 mth after last dose. Pregnancy. Elderly.

Alopecia; neurotoxicity; leucopenia, neuritic pain, constipation; sensory loss, paraesthesia, walking difficulty, slapping gait, loss of deep-tendon reflexes, muscle wasting; nausea, vomiting, diarrhoea, anorexia, stomatitis, oral ulceration, intestinal necrosis &/or perforation, abdominal cramps & distension; renal & urinary disorders; HTN, hypotension; neurological, endocrinal & haematological effects; depression, agitation, insomnia, hallucinations, altered consciousness state; transient cortical blindness, optic atrophy w/ blindness; oropharyngeal pain, acute resp distress syndrome, bronchospasm; fever, headache.

Increased cytotoxic induced bone marrow depression w/ allopurinol. Raised blood uric acid conc. Additive neurotoxicity w/ asparaginase, INH, other peripheral nervous system medicines. Increased myelosuppression w/ doxorubicin & prednisone. Increased cellular uptake of MTX. Potentiated vaccine virus replication w/ live vaccines. Decreased antimicrobial effect of oral quinolones. Reduced blood levels & increased seizure activity of phenytoin. Decreased clearance by nifedipine. Increased metabolism w/ CYP450 inducers. Decreased metabolism w/ CYP450 inhibitors. Increased severity of neuromuscular side effects w/ itraconazole, fluconazole. Decreased digitalis glycoside absorption. Increased plasma conc by voriconazole. Increased incidence of acute breath shortness & severe bronchospasm w/ mitomycin. Temporary or permanent hearing impairment w/ potentially ototoxic drugs eg, platinum-containing antineoplastics. Thromboembolism or Raynaud's syndrome w/ bleomycin & other agents eg, cisplatin, etoposide. Delay inj if given in conjunction w/ RT. Administer granulocyte-colony stimulating factors at least 24 hr after cytotoxic chemotherapy.

Cytotoxic Chemotherapy

L01CA02 - vincristine ; Belongs to the class of plant alkaloids and other natural products, vinca alkaloids and analogues. Used in the treatment of cancer.

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