Oncovin (Intravenous)

Vincristine is part of a group of medicines called antineoplastic agents. It is used to treat certain types of cancer and some noncancerous conditions.

Vincristine works by stopping the growth of cancer cells, which are then destroyed. It can also affect the growth of normal body cells, leading to other effects. Some of these effects can be serious and should be reported to your doctor. Other effects, like hair loss, may not be serious but can still be concerning. Some effects may not appear for months or even years after you use the medicine.

Before starting treatment with vincristine, you and your doctor should discuss the benefits of this medicine as well as the risks involved.

Vincristine must be given only by or under the close supervision of your doctor.

It is very important that your doctor check your progress at regular visits to make sure that vincristine is working properly and to check for unwanted effects.

While you are being treated with vincristine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Vincristine may lower your body's resistance, and there is a chance you might get the infection the immunization is meant to prevent. Other people living in your household should not take or should not have recently taken oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid other persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

If vincristine accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

In deciding to use a medicine, you and your doctor need to consider the risks and benefits. For this medicine, keep the following in mind:

Allergies

Inform your doctor if you have had any unusual or allergic reactions to this medicine or any other medicines. Also, tell your healthcare professional about any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

This medicine has been tested in children and has not been shown to cause different side effects or problems compared to adults.

Geriatric

Elderly patients may be more likely to experience nervous system effects, as they are usually more sensitive to the effects of vincristine.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits against the potential risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should never be used together, while others may be used together with caution. If you are taking this medicine, it is especially important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are significant and not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may choose to not treat you with this medication or adjust some of the other medicines you take.

• Boceprevir

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you take one or both medicines.

• Abametapir
• Amiodarone
• Apalutamide
• Aprepitant
• Asparaginase
• Atazanavir
• Carbamazepine
• Carvedilol
• Ceritinib
• Clarithromycin
• Cobicistat
• Conivaptan
• Cyclosporine
• Darunavir
• Dronedarone
• Enzalutamide
• Erythromycin
• Fedratinib
• Fexinidazole
• Filgrastim
• Flibanserin
• Fluconazole
• Fosaprepitant
• Fosnetupitant
• Fosphenytoin
• Idelalisib
• Indinavir
• Itraconazole
• Ketoconazole
• Lapatinib
• Levoketoconazole
• Lopinavir
• Lumacaftor
• Mavacamten
• Methotrexate
• Mitotane
• Nefazodone
• Nelfinavir
• Netupitant
• Nilotinib
• Nirmatrelvir
• Omaveloxolone
• Phenobarbital
• Phenytoin
• Posaconazole
• Primidone
• 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 increase the 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 take one or both medicines.

• Nifedipine

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around meal times or with certain foods due to potential interactions. Using alcohol or tobacco with certain medicines may also cause interactions. The following interactions are significant and not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may adjust the dose or frequency of this medicine or provide specific instructions regarding food, alcohol, or tobacco use.

• Grapefruit Juice

Other Medical Problems

Having other medical problems may affect the use of this medicine. Make sure to inform your doctor if you have any of the following:

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Gout (history of) or
• Kidney stones (history of)—Vincristine may increase uric acid levels in the body, which can lead to gout or kidney stones

• Infection—Vincristine can lower immunity to infections

• Liver disease—Effects may be heightened due to slower elimination of vincristine from the body

• Nerve or muscle disease—May be aggravated

Along with their needed effects, medicines like vincristine can sometimes cause unwanted effects such as blood problems, nervous system issues, hair loss, and other side effects. These and others are described below. Also, because of how these medicines work in the body, there is a chance they might cause other unwanted effects that may not appear 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 the injection site

Rare

• Black, tarry stools
• Blood in urine or stools
• Cough or hoarseness
• Fever or chills
• Pinpoint red spots on skin
• Unusual bleeding or bruising

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Blurred or double vision
• Constipation
• Difficulty 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 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 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:

Less common

• Bloating
• Diarrhea
• Loss of weight
• Nausea and vomiting
• Skin rash

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.

In the U.S.

• Oncovin
• Vincasar PFS

Available Dosage Forms:

• Solution

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Mitotic Inhibitor

Vincristine is often given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

While you are using this medicine, it may be necessary to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well. Ask your doctor if this is necessary for you.

This medicine sometimes causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Vincristine frequently causes constipation and stomach cramps. Your doctor may want you to take a laxative. However, do not decide to take these medicines on your own without first checking with your doctor.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

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