Oncovin®

Posted on December 3rd, 2008 by

Class: Chemotherapy

Generic Name: Vincristine (vin-KRISS-teen), vincristine sulfate, LCR, VCR
Trade Name: Oncovin®, Vincasar® PFS

How is this drug used? Vincristine is FDA approved for the treatment of acute leukemia, and in combination with other agents for the treatment of Hodgkin's disease, non-Hodgkin's lymphoma (lymphocytic, mixed cell, histiocytic, undifferentiated, nodular and diffuse types), rhabdomyosarcoma, neuroblastoma , and Wilms' tumor. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Vincristine is classified as an antimicrotubule agent or vinca alkaloid. Vincristine produces its anti-cancer effects by causing abnormalities in microtubule formation in cells. Microtubules are components of cells that provide structural framework that enables cells to divide and grow. The abnormal microtubule formation caused by vincristine inhibits cellular replication and ultimately causes cellular death.

How is vinicristine given (administered)? Vincristine is administered into a vein (intravenous) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular treatment regimen being used, and the overall health of the patient. If vincristine escapes from the vein in which it is administered it may cause serious damage to tissue it comes into contact with. Although patients will be monitored for this, they should tell their healthcare provider immediately if they experience pain, redness, or swelling at the site that vinicristine is being administered. Although uncommon, patients sometimes experience an allergic-type reaction to treatment with vincristine. If patients experience difficulty breathing, swelling of the throat or facial features, hives or rash, they should tell their healthcare provider immediately.

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with vincristine. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy. Patients will also have their reflexes monitored, as treatment with vincristine may cause numbness of the hands or feet.

Some patients are also at an increased risk for developing a syndrome called tumor lysis syndrome in which electrolyte and metabolic disturbances occur. Tumor lysis syndrome can be prevented if managed aggressively at the beginning of treatment. Blood tests will measure levels of electrolyte and metabolic products, and patients should contact their healthcare provider if they experience symptoms such as nausea and vomiting, shortness of breath, an irregular heartbeat, clouding of urine, lethargy and/or joint discomfort.

What are the common (occur in 30% or more of patients) side effects of treatment with vinicristine?

• Hair loss

What are the less common (occur in 10% to 29% of patients) side effects of treatment with vinicristine?

• Low white blood cell levels – increases risk of infection
• Low red blood cell levels – increases risk of anemia
• Low platelet levels – increases risk of bleeding
• Nausea and vomiting
• Mouth sores
• Diarrhea
• Taste changes
• Numbness or tingling of feet or hands
• Weight loss
• Loss of appetite
• Abdominal cramps
• Constipation

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Since treatment with vincristine may cause numbness of the feet or hands, patients should use caution when around extreme heat or cold.
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Follow physician’s instructions for preventing constipation, as this is a common and sometimes serious side effect associated with vincristine treatment.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, patients should avoid large crowds or persons who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
• Eat small meals frequently to help alleviate nausea.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.

When should patients notify their physician?

• Difficulty breathing
• Swelling of the throat or face
• Hives, itching or rash
• Seizures
• Vision changes
• Inability to urinate, painful urination
• Severe abdominal cramps, bloating or pain
• Constipation
• Bone or joint pain
• Jaw pain
• Nausea and vomiting
• Irregular heart beat
• Clouding of the urine
• Lethargy
• Mouth sores
• Persistent or extreme diarrhea
• Signs of infection: redness, swelling, pus, tenderness
• Unexplained or excessive bleeding (nosebleeds, bruising, black tarry stools, blood in the urine, etc.)
• Redness, pain or swelling at injection site
• Mental status changes (depression, confusion, insomnia, headache, dizziness
• Numbness or tingling in fingers or toes “stocking-glove sensation”
• Unsteadiness or weakness, difficulty with balance, clumsiness
• Pain in extremities

What is a package insert? A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Copyright © 2016 CancerConnect Last updated 07/10.

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Tags: Chemotherapy, O

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