Introduction
Vinstin is an anti-cancer medication used in the treatment of breast cancer, non-small cell lung cancer, pancreatic cancer, kidney cancer, blood cancer, multiple myeloma, lymphomas and bone cancer.
Vinstin is given as an injection into the vein under the supervision of a doctor. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
The most common side effects of this medicine include hair loss, peripheral neuropathy (tingling and numbness of feet and hand), and constipation. This medicine may reduce the number of blood cells (white blood cells) in your blood, thereby, increasing the susceptibility to infections and fever. In some cases, it may also cause kidney disease related to uric acid level. Regular blood tests are required to check your blood cells along with heart, liver, and blood uric acid levels.
Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy. you are suggested to avoid direct contact of medicine with eyes, as it may cause eye irritation.
Uses of Vinstin
- Breast cancer
- Non-small cell lung cancer
- Pancreatic cancer
- Kidney cancer
- Blood cancer
- Multiple myeloma
- Lymphomas
- Bone cancer
Side effects of Vinstin
Common
- Hair loss
- Peripheral neuropathy (tingling and numbness of feet and hand)
- Constipation
How to use Vinstin
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Vinstin works
Vinstin blocks replication of genetic material (DNA) in the cancer cells. Thus it stops the growth and multiplication of cancer cells.
Indication
Acute lymphoblastic leukaemia, Acute myeloid leukaemia, AIDS-related Kaposi's sarcoma, Brain tumours, Hodgkin's disease, Neuroblastoma, Non-Hodgkin's lymphoma, Small cell lung cancer, Wilm's tumour
Adult Dose
Intravenous
Acute lymphoblastic leukaemia
Adult: Usual recommended dosage: 1.4-1.5 mg/m2 once wkly. Max: 2 mg wkly. Subsequent doses may be modified based on clinical and haematological responses and tolerance of the patient.
May be used in combination with other drugs. Prescribers should consult published protocols for the dosage, method and sequence of admin.
Hepatic impairment: Dose adjustment may be needed. Serum bilirubin >3 mg/100ml: Reduce dose by 50%.
Child Dose
Intravenous
Acute lymphoblastic leukaemia
Child: Usual recommended dosage: 1.5-2 mg/m2 once wkly; for patients ?10 kg: Initiate at 0.05 mg/kg once wkly. Subsequent doses may be modified based on clinical and haematological responses and tolerance of the patient.
May be used in combination with other drugs. Prescribers should consult published protocols for the dosage, method and sequence of admin.
Renal Dose
Renal Impairment
Dose adjustment not necessary
Contraindication
Patients with demyelinating form of Charcot-Marie-Tooth syndrome. Pregnancy and lactation. Intrathecal admin (may be fatal). Patients receiving radiation therapy through ports which include liver.
Mode of Action
Vincristine arrests cell division at the metaphase stage by inhibiting microtubule formation in the mitotic spindle.
Precaution
Elderly. Preexisting pulmonary dysfunction or neuromuscular disease; leucopenia or a complicating infection; impaired liver function; obstructive jaundice. Routine prophylactic laxative needed to ensure regular bowel movement. Discontinue immediately if extravasation occurs, and inj any remaining drug into another vein, followed by local Inj of hyaluronidase and topical heat application to the affected area to aid in drug removal and reduce discomfort. Discontinue in patients who develop progressive dyspnea. CBC to be checked before each dose admin. Frequent monitoring of uric acid during first 3-4 wk of treatment and watch out for uric acid nephropathy.
Lactation: not known if excreted in breast milk, do not nurse
Side Effect
>10%
Alopecia (20-70%)
Frequency Not Defined
Dose limiting neurotoxicity (e.g. motor function impairment, gait abnormalities), hyperuricaemia, bronchospasm, azospermia, amenorrhoea, alopoecia, leucopenia, urinary dysfunction, abdominal cramps, vomiting, diarrhoea, severe constipation, paralytic ileus, convulsions, hypertension, orthostatic hypotension, ptosis, hoarseness, optic neuropathies, hallucinations, blindness, neurological deafness, difficulty in walking, syndrome of inappropriate ADH secretion.
Potentially Fatal: Myelosuppression.
Interaction
Decreased digoxin (tablets) and verapamil absorption with antineoplastic regimens. Increased etoposide serum levels with vincristine. Increased toxicity when ganciclovir given with, immediately before or after vincristine. Reduced vincristine metabolism with miconazole. Increased neurotoxicity with isoniazid, itraconazole, voriconazole, posaconazole and nifedipine. Decreased immune response when used concurrently with vaccines. Increased myelotoxicity with zidovudine.
Increased risk of thromboembolic complications with tamoxifen. Increased risk of ototoxicity with ototoxic drugs (e.g. platinum-containing antineoplastic agents). Possible risk of earlier onset and/or increased severity of adverse effects with macrolides. Possible increase in vincristine levels with aprepitant. Possible decrease in antiepileptic levels with vincristine, monitor serum antiepileptic levels and effectiveness of chemotherapy.
Potentially Fatal: Increased risk of bronchospasm with mitomycin C. Reduced vincristine clearance and increased toxicity with asparaginase, minimise toxicity by giving vincristine 12-24 hr before L-asparaginase admin.