In the U.S.—

In Canada—

• Antineoplastic

Vincristine ( vin-KRIS-teen) belongs to the group of medicines known as antineoplastic agents. It is used to treat some kinds of cancer as well as some noncancerous conditions.

Vincristine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by vincristine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, such as hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.

Before you begin treatment with vincristine, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Vincristine is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For vincristine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to vincristine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Tell your doctor if you are pregnant or if you intend to have children. There is a chance that this medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. Vincristine causes birth defects and death of the fetus in animals. In addition, many cancer medicines may cause sterility, which could be permanent. Although sterility has not been reported with this medicine, the possibility should be kept in mind.

Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving vincristine. Tell your doctor right away if you think you have become pregnant while receiving vincristine.

Breast-feeding—Tell your doctor if you are breast-feeding or if you intend to breast-feed during treatment with this medicine. Because vincristine may cause serious side effects, breast-feeding is generally not recommended while you are receiving it.

Children—This medicine has been tested in children and has not been shown to cause different side effects or problems than it does in adults.

Older adults—Nervous system effects may be more likely to occur in the elderly, who are usually more sensitive to the effects of vincristine.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving vincristine, it is especially important that your health care professional know if you are taking any of the following:

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane)—Vincristine may increase the concentration of uric acid in the blood, which these medicines are used to lower

• If you have ever been treated with x-rays or cancer medicines—Vincristine may increase the effects of these medicines or radiation therapy on the blood

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Gout (history of) or
• Kidney stones (history of)—Vincristine may increase levels of uric acid in the body, which can cause gout or kidney stones

• Infection—Vincristine can reduce immunity to infection

• Liver disease—Effects may be increased because of slower removal of vincristine from the body

• Nerve or muscle disease—May be worsened

Vincristine is often given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

While you are using this medicine, it may be necessary to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well. Ask your doctor if this is necessary for you.

This medicine sometimes causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Vincristine frequently causes constipation and stomach cramps. Your doctor may want you to take a laxative. However, do not decide to take these medicines on your own without first checking with your doctor.

Dosing—

The dose of vincristine will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's weight or size, and whether or not other medicines are also being taken. If you are receiving vincristine at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of vincristine, ask your doctor.

It is very important that your doctor check your progress at regular visits to make sure that vincristine is working properly and to check for unwanted effects.

While you are being treated with vincristine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Vincristine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. Other people living in your household should not take or should not have recently taken oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid other persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

If vincristine accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

Along with their needed effects, medicines like vincristine can sometimes cause unwanted effects such as blood problems, nervous system problems, loss of hair, and other side effects. These and others are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. Discuss these possible effects with your doctor.

Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor or nurse immediately if any of the following side effects occur:

• Less common
  • Pain or redness at place of injection 
  
  

• Rare
  • Black, tarry stools;  blood in urine or stools;  cough or hoarseness;  fever or chills;  pinpoint red spots on skin;  unusual bleeding or bruising 
  
  

Check with your health care professional as soon as possible if any of the following side effects occur:

• More common
  • Blurred or double vision;  constipation ;  difficulty in walking;  drooping eyelids;  headache;  jaw pain;  joint pain;  lower back or side pain;  numbness or tingling in fingers and toes;  pain in fingers and toes;  pain in testicles;  stomach cramps;  swelling of feet or lower legs;  weakness  
  
  

• Less common
  • Agitation;  bed-wetting;  confusion;  convulsions (seizures);  decrease or increase in urination;  dizziness or lightheadedness when getting up from a lying or sitting position ;  hallucinations (seeing, hearing, or feeling things that are not there);  lack of sweating;  loss of appetite;  mental depression ;  painful or difficult urination;  trouble in sleeping;  unconsciousness 
  
  

• Rare
  • Sores in mouth and on lips 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Less common
  • Bloating;  diarrhea;  loss of weight;  nausea and vomiting;  skin rash 
  
  

Other side effects may occur that usually do not need medical attention. This medicine often causes a temporary loss of hair. After treatment with vincristine has ended, or sometimes even during treatment, normal hair growth should return.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.