Vincasar PFS (Intravenous)

Vincristine is a type of medicine called an antineoplastic agent. It is used to treat certain types of cancer and some noncancerous conditions.

Vincristine works by interfering with the growth of cancer cells, which are eventually killed off. However, it may also affect the growth of normal body cells, leading to other effects. Some of these effects can be serious and need to be reported to your doctor. Other effects, like hair loss, might not be serious but can still be concerning. Some effects may not appear for months or even years after using the medicine.

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

Vincristine should only be given 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 injection site.

In deciding to use a medicine, you and your doctor need to think about the risks of taking the medicine compared to the benefits it may provide. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies you may have, such as to foods, dyes, preservatives, or animals. For over-the-counter products, check the label or package ingredients carefully.

Pediatric

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

Geriatric

Older adults may be more likely to experience nervous system effects, as they are typically 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 while breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction could occur. If you are taking this medicine, it is very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change 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 adjust the dose or frequency of 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 lead to a higher risk of certain side effects, but using both could be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Nifedipine

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used around the time of eating food or certain types of food due to possible interactions. Drinking alcohol or using tobacco with certain medicines may also cause interactions. The following interactions have been selected based on their potential significance and are 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 give you specific instructions about using food, alcohol, or tobacco.

• Grapefruit Juice

Other Medical Problems

Having other medical problems may affect the use of this medicine. Be sure to tell your doctor if you have any other medical issues, especially:

• 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 raise uric acid levels in the body, which can lead to gout or kidney stones

• Infection—Vincristine can lower your immunity to infection

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

• Nerve or muscle disease—May worsen

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

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 in 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 in 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 about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, 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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