Vincristine

ONCOVIN

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Pronunciation: vin-KRIS-teen

Vincristine ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Vincristine ballicule

Vincristine ONCOVIN mascot mnemonic cartoon — Visual mnemonic: Vincristine mascot
**“On-call Vin crystal”**

What it isVinca alkaloid preventing microtubule assembly; leukemia and lymphoma.

Why this oneIt causes almost no myelosuppression, so it combines freely with agents that do.

What limits it⚑ Intrathecal administration is uniformly fatal; dispense it in a minibag, never a syringe. Peripheral neuropathy is dose-limiting.

Vincristine molecular structure (skeletal formula) — Molecular structure: Vincristine

FDA-approved for

cancer (~1963)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING For intravenous use only — fatal if given by other routes (e.g., intrathecal); administer only by experienced personnel

FDA dosing	Population	Start	Target	Max
Antineoplastic (per protocol)	adult	1.4 mg/m2 IV weekly	1.4 mg/m2 IV weekly	1.4 mg/m2 IV weekly
Antineoplastic (per protocol)	pediatric >10 kg	1.5-2 mg/m2 IV weekly	1.5-2 mg/m2 IV weekly	1.5-2 mg/m2 IV weekly
Antineoplastic (per protocol)	pediatric ≤10 kg	0.05 mg/kg IV weekly	0.05 mg/kg IV weekly	0.05 mg/kg IV weekly

Renal Undefined

Hepatic Reduce dose 50% if direct serum bilirubin >3 mg/100 mL

Neurotoxicity is dose-related; extreme care in dose calculation and administration

Instructions

Intravenous use only — fatal if given by other routes
Dilute in flexible plastic container and label 'for intravenous use only'
Administer at weekly intervals

Available strengths

inj 1 mg

Contraindications

Demyelinating form of Charcot-Marie-Tooth syndrome

Cautions

Neurotoxicity (dose-related)
Fatal if given by non-IV route
Leukopenia
Constipation / paralytic ileus

Adverse reactions

Alopecia (hair loss)
Neuromuscular effects (neuritic pain, sensory loss, paresthesia, difficulty walking)
Leukopenia
Constipation

Pregnancy See Warnings (usage in pregnancy)

Lactation Undefined

Cost

Vincristine (ONCOVIN)

Strength		#/mo	generic $/unit	CostPlus
1 mg	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Vincristine is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry1986

⚠ BOXED WARNINGS

Fatal if given intrathecally
For intravenous use only

Classes and tags

Clinical profile

Therapeutic safety burden4 / 4

Overdose danger3 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk3 / 4

Legacy pregnancy categoryD

Defining liabilityPotentially severe peripheral/autonomic neurotoxicity; intrathecal administration is fatal.

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Memory aids: interaction avatars

CYP3A4 substrate

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