Vincristine instructions for use
- Vincristine instructions for use
- Release form and composition of the drug
- Pharmacological properties of the drug
- Indications for use
- Dosing and Administration
- Use of the drug during pregnancy and breastfeeding
- Side effects
- Drug overdose
- The interaction of the drug with other drugs
- special instructions
- Vincristine analogues
- Conditions of storage and release of the drug
- Vincristine price
The drug Vincristine is a herbal medicine, which is prescribed to patients for the treatment of malignant tumors.
Release form and composition of the drug
The drug Vincristine is available in the form of a lyophysiate for the preparation of a solution with a view to its further introduction. The drug is available in 1 mg brown glass bottles complete with a 10 ml solvent in a separate ampoule. Vincristine is packed in a cardboard box containing 10 pallets with an ampoule of solvent and a vial of lyophysiate.
The bottle with lyophysiatics contains the main active ingredient - vincristine sulfate 1 mg and lactose. The solvent is an isotonic solution of sodium chloride, water for injection and benzyl alcohol.
Pharmacological properties of the drug
The drug Vincristine is a drug with antitumor activity and is a pink periwinkle alkaloid. When it enters the bloodstream, it binds to tubulin protein, which leads to the suppression of cell mitosis.
The active substance of the drug acts on the cells of the body very selectively - it blocks the DNA of tumor nidus cells. In most parts, the drug is excreted in the bile and only 1/10 of it is naturally excreted through the kidneys. The active ingredient of the drug has the ability to accumulate in the tissues of the liver, lungs, spleen, pancreas, kidneys. The drug does not penetrate through the meninges.
Indications for use
This drug is prescribed to patients for intravenous administration in the presence of such conditions:
- Acute leukemia;
- Wilms tumor;
- Hodgkin's disease;
- Mammary cancer;
- Non-Hodgkin lymphomas;
- Kaposi's sarcoma;
Vincristine solution is not prescribed for the treatment of patients with cancer tumors in the presence of such conditions:
- Individual intolerance to the components of the drug;
- As part of combination therapy with radiation, when liver therapy is exposed to liver tissue;
- Period of pregnancy and lactation;
- Neurodystrophic pathology.
The drug with special caution prescribed to patients with a history of diseases and impaired liver function, as well as elderly patients. The drug is also not prescribed or used cautiously in patients with oppression of hematopoietic function, in acute infectious diseases, as well as during chemotherapy or radiotherapy with other drugs.
Dosing and Administration
The drug Vincristine is intended for intravenous administration. The duration of the injection should be at least a minute, the drug is administered very slowly with an interval of 1 week. No other way of introducing the drug is unacceptable!
The dosage of the drug is determined in a strictly individual manner, depending on many factors: the characteristics of the patient's body, tolerance, general health, the severity of the pathological process. According to the instructions, adult patients are prescribed 1-1.4 mg per 1 square meter body surface. The single dose should not be higher than 2 g.
In pediatric practice, the drug is administered at the rate of 1.5-2 mg per square meter of the child's body. For children whose body weight is less than 10 kg, the initial therapeutic dose of the drug is not more than 0.05 mg / kg per week. On average, the duration of the course of therapy is at least 1-1.5 months, after which they take a break.
When changing the concentration of direct bilirubin in the blood, the dose of vincristine must be reduced by half.
Before the introduction of the drug intravenously prepare a fresh solution. The dry contents of the vial are dissolved with the included solvent. The resulting solution can also be diluted, if necessary, with an isotonic solution of sodium chloride and injected into a vein slowly over 1 minute.
Use of the drug during pregnancy and breastfeeding
This drug is contraindicated for use in women during pregnancy.
The use of the drug during breastfeeding is also prohibited. If necessary, therapy, the woman will have to abandon breastfeeding of the child and transfer it to an adapted milk formula.
As a rule, the majority of patients during treatment with anticancer drugs have side effects that can be reduced by adjusting the dose of the medicine. In most cases, children tolerate Vincristine treatment better than adult patients. Elderly patients are most susceptible to the development of intoxication and damage to internal organs during therapy with the drug.
The most common side effects are:
- On the part of the nervous system - an increase in blood pressure, convulsive syndrome, pain along the nerve, feeling of “crawling” on the skin, pain during chewing, swallowing, in the ear, reflexes, depression and apathy to what is happening, headaches and dizziness, sleep disturbances, sometimes it may develop hallucinations, decrease vision and hearing acuity, unsteadiness of gait;
- On the part of the digestive canal - pain in the epigastric region, nausea, vomiting, constipation, diarrhea, inflammation of the oral mucosa, intestinal atony and its obstruction, intestinal necrosis, anorexia often develop in pediatric practice;
- On the part of the urinary system - dysuric phenomena, acute urinary retention, edema, nephropathy;
- On the part of the heart and blood vessels - increased blood pressure, angina, and myocardial infarction, especially in patients who have previously undergone chemotherapy;
- On the part of the respiratory system - shortness of breath, impaired respiratory function, bronchospasm;
- From the endocrine system organs - the development of hyponatremia as a result of impaired production of antidiuretic hormone. With the development of a similar condition, the patient has no signs of impairment of the kidneys, edema and increased blood pressure;
- On the part of the hematopoietic system - a moderate decrease in the number of leukocytes, anemia, thrombocytopenia;
- Phlebitis, inflammation of the subcutaneous fat, tissue necrosis, local hyperthermia - if the drug gets under the skin.
In rare cases, anaphylactic shock or angioedema develops. On the background of drug treatment in a patient, a persistent increase in body temperature to subfebrile marks, myalgia, pain in the joints, amenorrhea , impaired spermatogenesis in men is possible.
With an overdose of drugs in a patient, the above side effects increase. In severe cases, liver failure, cirrhosis and coma may develop. Treatment of overdose with symptomatic Vincristine, hemodialysis is not effective.
The interaction of the drug with other drugs
When treating drug Vincristine in patients may experience a decrease in the anticonvulsant effect of phenytoin.
The simultaneous use of this drug with neurotoxic drugs significantly increases the risk of intoxication of the body and nervous system.
With the simultaneous use of Vincristine with Verapamil increases the toxicity of the first.
With the simultaneous use of drugs for the treatment of gout during therapy with anticancer drugs increases the risk of nephropathy.
If you need to use other drugs that are compatible with Vincristine, do not mix everything in one syringe to prevent the development of side effects and complications.
The resulting solution of vincristine can, if necessary, be diluted only with isotonic sodium chloride solution!
Treatment with this drug should be carried out only under the supervision of an oncologist who has experience using Vincristine in anticancer therapy.
With intrathecal administration of the drug in a patient, death can occur, so the drug is injected only through a vein! During the period of treatment with Vincristine, the doctor must constantly monitor the clinical picture of the patient's blood, and with the development of disorders of the liver or kidneys, the dosage must be adjusted.
Since patients often develop constipation while using this drug, it is advisable to use laxatives or carry out cleansing enemas.
If during the administration of the drug, the health worker accidentally punctured the vein, further infusion is immediately stopped and a non-damaged vein is used for this purpose by a friend. The puncture site of a vein should be immediately cleaved with hyaluronidase solution.
Vincristine solution for the treatment of cancer with special care is prescribed to elderly patients, as the risk of developing severe side effects from the nervous system is much higher than in other patients. Against the background of therapy, physicians must constantly monitor their overall condition and the functioning of the internal organs.
Women who have been treated with this drug and are planning to become pregnant in the future should use reliable contraceptive methods for 3-6 months.
In case of accidental ingestion of a solution of the drug on the mucous membrane of the eyes, you should immediately wash them with copious amounts of running water and contact an ophthalmologist.
Increased neurotoxicity of Vincristine can negatively affect the work of the central nervous system and the speed of psychomotor reactions, as patients, who drive or control complex mechanisms, should be aware of.
Analogues of the drug Vincristine are:
- Vincristine Liquid-Richter;
- Vincristine LENS.
Conditions of storage and release of the drug
The solution is released in pharmacies only by prescription. The shelf life of vials with dry contents is 3 years from the date of production, subject to proper storage. The drug should be kept in the refrigerator at a temperature not higher than 8 degrees Celsius.
The average cost of Vincristine for preparing a solution in pharmacies in Moscow ranges from 180 to 2400 rubles, depending on the manufacturer.