Vincristine user's manual
- Vincristine user's manual
- Form of formulation and composition of the preparation
- Pharmacological properties of the preparation
- Indications for use
- Contraindications for use
- Dosing and Administration
- Use of the drug during pregnancy and breastfeeding
- Side effects
- An overdose of the drug
- Interaction of the drug with other drugs
- special instructions
- Vincristine analogues
- Storage and dispensing conditions
- Vincristine price
The drug Vincristine is a herbal medicinal product, which is prescribed to patients for the treatment of malignant neoplasms.
Form of formulation and composition of the preparation
The preparation Vincristine is available in the form of lyophysiata for the preparation of a solution for the purpose of its further administration. The medication is available in 1-mg brown glass vials, complete with a 10 ml solvent in a separate ampoule. Vincristine is packed in a cardboard box containing 10 pallets with a solvent ampoule and a lyophysiate bottle.
The bottle with lyophysiate contains the main active substance - vincristine sulfate 1 mg and lactose. In the composition of the solvent - isotonic sodium chloride solution, water for injection and benzyl alcohol.
Pharmacological properties of the preparation
Vincristine is a drug with an antitumor effect and is an alkaloid of rose vinca. Upon entering the bloodstream, it binds to the protein-tubulin, which leads to suppression of cellular mitosis.
The active substance of the drug acts on the body cells very selectively - it blocks the DNA of the cells of the tumor focus. In most cases, the drug is excreted with bile and only 1/10 part - through the kidneys in a natural way. The active substance of the drug has the ability to accumulate in the tissues of the liver, lungs, spleen, pancreas, kidneys. The drug does not penetrate well through the meninges.
Indications for use
This drug is administered to patients for intravenous administration in the presence of such conditions:
- Acute leukemia;
- Wilms tumor;
- Hodgkin's disease;
- Mammary cancer;
- Non-Hodgkin's lymphomas;
- Kaposi's sarcoma;
Contraindications for use
The solution of Vincristine is not prescribed for the treatment of patients with oncological neoplasms in the presence of such conditions:
- Individual intolerance of the constituent components of the drug;
- As part of complex therapy with irradiation, when radiation therapy is exposed to liver tissue;
- Pregnancy and lactation period;
- Neurodystrophic pathology.
The drug with particular caution is prescribed to patients with history of the disease and violations of the liver, as well as patients of advanced age. The drug is also not prescribed or used cautiously in patients with oppression of hematopoiesis, in acute infectious diseases, as well as against 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 at intervals of 1 week. There are no other ways to administer the drug!
The dosage of the drug is determined in a strictly individual order, depending on many factors: the characteristics of the patient's body, tolerance, general health, severity of the pathological process. According to the instructions, adult patients are prescribed 1-1.4 mg per 1 meter square of the body surface. Single dose should not be more than 2 g.
In pediatric practice, the drug is administered at a rate of 1.5-2 mg per square meter of the child's body. For children weighing 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 therapy is at least 1-1.5 months, after which they take a break.
With a change in the concentration of direct bilirubin in terms of blood, the dose of vincristine should be reduced to half.
Before the introduction of the drug, a fresh solution is prepared intravenously. Dry contents of the vial are dissolved with the supplied solvent. The resulting solution can also be diluted if necessary with an isotonic sodium chloride solution and injected into the vein slowly for 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 in the period of breastfeeding is also prohibited. If the therapy is necessary, the woman will have to give up breast feeding of the baby and transfer it to an adapted milk formula.
As a rule, in most patients during the treatment with antitumor drugs, there are side effects that can be reduced by correcting the dose of the drug. In most cases, children better tolerate Vincristine treatment than adults. Patients of the elderly are most susceptible to developing intoxication and lesions of internal organs against the background of drug therapy.
The most common side effects are:
- From the side of the nervous system - increased blood pressure, convulsive syndrome, pain along the nerve, sensations of "crawling" on the skin, pain when chewing, swallowing, in the ears, decreased reflexes, depression and apathy to what is happening, headaches and dizziness, Sleep disturbances, sometimes it is possible to develop hallucinations, reduce vision and acuity of hearing, unsteadiness of gait;
- On the part of the organs of the digestive canal - pain in the epigastric region, nausea, vomiting, constipation, diarrhea, inflammation of the oral mucosa, in pediatric practice often develops intestinal atony and its obstruction, necrosis of intestinal tissues, anorexia;
- On the part of the urinary system - dysuric phenomena, acute retention of urine, edema, nephropathy;
- From the heart and blood vessels - increased blood pressure, angina and myocardial infarction, especially in patients who had previously undergone chemotherapy;
- On the part of the respiratory system - dyspnea, impaired respiratory function, bronchospasm;
- With the moans of the endocrine system - the development of hyponatremia as a result of a violation of the production of antidiuretic hormone. With the development of such a condition, the patient has no signs of impaired kidney function, edema and increased blood pressure;
- From the hematopoietic system - a moderate decrease in the number of leukocytes, anemia, thrombocytopenia;
- Phlebitis, inflammation of the subcutaneous fat, tissue necrosis, local hyperthermia - when the drug gets under the skin.
In rare cases, anaphylactic shock or Quincke's edema develops. Against the backdrop of treatment with the drug, the patient may have a persistent increase in body temperature to subfebrile marks, myalgia, joint pain, amenorrhea , impaired spermatogenesis in men.
An overdose of the drug
When an overdose of drugs in the patient, the above side effects are aggravated. In severe cases, it is possible to develop hepatic insufficiency, cirrhosis and coma. Treatment of an overdose Vincristinum symptomatic, a hemodialysis thus is not effective.
Interaction of the drug with other drugs
When treating with Vincristine, patients may experience a decrease in the anticonvulsant effect of phenytoin.
With the simultaneous use of this drug with neurotoxic drugs, the risk of intoxication of the body and the nervous system is significantly increased.
With simultaneous application of Vincristine with Verapamil, the toxicity of the first increases.
With simultaneous use of drugs for the treatment of gout on the background of therapy with antineoplastic agents, the risk of developing nephropathy increases.
If you need to use other medications compatible with Vincristine, you should not mix everything in one syringe to prevent the development of side effects and complications.
The resulting solution vincristine can be diluted only with an isotonic solution of sodium chloride, if necessary!
Treatment with this medication should only be carried out under the supervision of an oncologist who has experience using Vincristine in anticancer therapy.
When the drug is administered intrathecally, the patient may die, so the medicine is administered only through the vein! During the period of Vincristine therapy, the doctor must constantly monitor the clinical picture of the patient's blood and, in the case of liver or kidney dysfunction, the dosage should be adjusted.
Since against the background of the use of this drug in patients often develop constipation, it is advisable to use laxatives or to perform cleansing enemas.
If during the introduction of the drug the health worker accidentally pierced the vein, the further infusion is immediately stopped and the intact vein is used for this purpose. The puncture site of the vein should be urgently chopped with hyaluronidase solution.
Vincristine solution for cancer treatment with special care is prescribed for 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 need to constantly monitor their overall condition and the work of internal organs.
Women who have been treated with this drug and plan to become pregnant in the future should use reliable contraceptives for 3-6 months.
If you accidentally get a solution of the drug on the mucous membrane of the eyes, immediately flush them with copious amounts of running water and consult an ophthalmologist.
Increased neurotoxicity Vincristine can negatively affect the performance of the central nervous system and the speed of psychomotor reactions, which patients should know about driving a car or controlling complex mechanisms.
The analogues of Vincristine are:
- Vincristine liquid-Richter;
Storage and dispensing conditions
The solution is dispensed in pharmacies only on prescription. The shelf life of vials with a dry content is 3 years from the date of production, subject to proper storage. The drug should be kept in the refrigerator at a temperature not exceeding 8 degrees Celsius.
The average cost of Vincristine for preparing solutions in pharmacies in Moscow is from 180 to 2400 rubles, depending on the manufacturer.