Parenteral Manual

VinCRIStine

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
ONCOVIN®, VCR
Classification: 
Antineoplastic, vinca alkaloid - CYTOTOXIC
Original Date: 
August 2005
Revised Date: 
March 2019
Indications: 
  • Acute leukemia
  • Hodgkin's disease and other non-Hodgkin's lymphomas
  • Solid tumors (ie. rhabdomyosarcoma, Ewing's sarcoma, etc.)
  • Central nervous system tumors
  • Wilm's tumor

THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.

Reconstitution and Stability: 
  • Available as a 1 mg/mL solution
  • Refrigerate unopened vial.
  • Punctured vial stable 6 hours* room temperature
  • Diluted solutions (D5W, NS) stable 12 hours* room temperature
  •    * for NAPRA sterility compliance
Compatibility: 

- Solutions Compatible: D5W, NS

- Additive/buretrol Compatible: doxorubicin

- Y-site Compatible: ondansetron

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO, Not approved at CHEO
IV Intermittent Infusion YES
Usual dilution: in 25 mL of compatible solution

Infusion time: 15 minutes via central line
                          30 minutes via peripheral line

IV Continuous Infusion YES
Usual dilution: in 250-500 mL of compatible solution
Infusion time: 24 hours x 4 days
Intrathecal Injection ABSOLUTELY CONTRAINDICATED- WILL RESULT IN FATALITY
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • 1-2 mg/mweekly.  Usual maximum dose is 2 mg; some protocols have a higher maximum dose.
  • Dosage for children <3 years or <0.6 m2 should be dosed on a mg/kg basis (to calculate mg/kg dose, divide mg/m2 dose by 30)

 

 

Potential hazards of parenteral administration: 
  • Neurotoxicity: within a few weeks to months - may be dose related (partially or completely reversible):

Cranial:

  • Jaw pain (trigeminal neuralgia)- may start within a day of first dose, usually less severe with subsequent doses
  • Vocal cord paresis (hoarseness, weak voice)
  • Ocular nerve dysfunction (ptosis, strabismus)

Peripheral:   Parasthesias, foot drop

Autonomic:  Constipation, paralytic ileus, abdominal cramps, urinary retention

Other:

  • Weight loss, fever, mouth ulcers, headaches, alopecia, dizziness
  • Syndrome of inappropriate ADH secretion (SIADH) - may be delayed
  • VESICANT:  tissue irritation and necrosis if extravasated - extreme caution must be observed during administration - refer to Treatment of Infiltration, Section H, Infusion Therapy Manual. If extravasation occurs, click HERE for treatment guidelines.   

- Treatment for unusual side effects are available through the study chair identified on the front page of the protocol and/or pharmacy

Notes: 
  • Monitor serum sodium, intake and urine output, weight (SIADH effect)
  • Assess bowel sounds, bowel movements, encourage fluids, prescribe stool softener (to prevent constipation)
  • Contraindicated in patients with the demyelinating form of Charcot-Marie-Tooth syndrome
  • Intrathecal administration is FATAL

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