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CYTOCRISTIN

VINCRISTINE SULFATE · by A. J. MIRZA

Composition

Inj1 mg/2 mg: Vincristine sulphate 1 mg/2 mg; vial.

Indications & Dosage

Variety of cancers including leukaemias, lymphomas, and some solid tumours (e.g. breast and lung cancer): BY IV INF: Adults: 0.4-1.4 mg/m2, may repeat every wk or 0.4-0.5 mg/day continuous INF for 4 days every 4 week or 0.25-0.5 mg/ m2/d continuous INF for 5 days every 4 week. Also refer individual protocols for dosages. Children: <10 kg or BSA<1 m2: Initial therapy: 0.05 mg/kg once weekly then titrate dose; max single dose: 2 mg. 10 kg or BSA>1 m2: 1-2 mg/m2, may repeat once wkly for 3-6 week; max single dose: 2 mg. Neuroblastoma: BY IV INF: Adult: continuous INF with doxorubicin: 1 mg/m2/day for 72 hr.

Administration

Administered as slow (1-2 min) push or short (10-15 min) infusion; 24 hours continuous infusions are occasionally used.Solutions for IV infusion may be mixed in NS or D5W.

Compatibility

Stable in D5W, LR, NS.

Stability

Store refrigerated at 2C-8C (36F-46F). Protect from light.

Contraindications

Patients with demyelinating form of Char-cot- Marie- tooth syndrome.

Precautions

Impaired hepatic function, elderly, pre-existing neuro-muscular disease. Intrathecal administration can cause severe neurotoxicity which may result in death.

Interactions

Digoxin, CYP3A4 enzyme inhibitors, mitomycin C.

Pregnancy

Positive evidence of risk: Avoid

Lactation

Contraindicated. Discontinue breast-feeding

Side Effects

Alopecia, autonomic neuropathy, extravasation, eye disorders, hyperuricaemia, loss of deep tendon reflexes, motor weakness, muscle wasting, myelosuppression, neurotoxicity, oral mucositis, ototoxicity, peripheral neuropathy, peripheral paraesthesia, severe bronchospasm, severe local irritation, thromboembolism, tumourlysis syndrome, vomiting. Rare: Inappropriate secretion of antidiuretic hormone, intestinal necrosis, paralytic ileus, seizures, urinary retention