Vincristine

⚠️ Important: Vincristine is for intravenous use only. Administration by other routes (e.g. intrathecal) is almost always fatal. It should only be given by experienced chemotherapy staff.

💊 About

• A vinca alkaloid chemotherapy agent.
• Always check the BNF entry here for up-to-date prescribing advice.

⚙️ Mode of Action

• Binds to tubulin → prevents microtubule formation.
• Arrests cell growth in metaphase → halts mitosis.
• Cytotoxic, targeting rapidly dividing cells.

🎯 Indications / Uses

• Hodgkin’s & non-Hodgkin’s lymphoma.
• Breast carcinoma.
• Methotrexate-resistant choriocarcinoma.
• Renal cell carcinoma.
• Testicular teratoma & seminoma.
• Histiocytosis X.

💉 Administration / Dosing

• Given via IV infusion only, usually weekly.
• Must be diluted and infused carefully to avoid extravasation injury.

🤝 Interactions

• Check BNF for full details - many interactions with other cytotoxics and CYP3A4 substrates.

⚠️ Cautions

• Give only under expert supervision.
• Monitor for neurotoxicity and myelosuppression.
• Constipation is common - prescribe prophylactic laxatives.

🚫 Contraindications

• See BNF for complete list.

❗ Side Effects

• 🚫 Fatal if given intrathecally.
• Peripheral neuropathy (tingling, numbness, foot drop).
• Myelosuppression (↓WCC, anaemia, thrombocytopenia).
• Headache, malaise, SIADH.
• GI: Constipation, abdominal pain, cholestasis.
• Musculoskeletal: Arthralgia, myalgias.
• Neuropsychiatric: Seizures, psychosis, depression.
• Alopecia.

📚 References

• BNF for Vincristine