
Z-Cristin
Vincristine Injection
Vincristine Sulfate Injection, USP is the salt of an alkaloid obtained from a common flowering herb, the periwinkle plant (Vinca rosea Linn.).
Originally known as 'leurocristine', it has also been referred to as:
- LCR
- VCR
The molecular formula for Vincristine Sulfate, USP is
C₄₆H₅₆N₄O₁₀ • H₂SO₄
It has a molecular weight of 923.04.
Vincristine sulfate injection has also been shown to be useful in combination with other oncolytic agents in:
- Hodgkin’s disease
- Non-Hodgkin's malignant lymphomas
- Rhabdomyosarcoma
- Neuroblastoma
- Wilms’ tumor
Vincristine is a chemotherapy drug that belongs to a group of drugs called vinca alkaloids.
Vincristine works by stopping the cancer cells from separating into 2 new cells.
So, it stops the growth of the cancer.
The mechanisms of action of vincristine sulfate remain under investigation.
The mechanism of action of vincristine sulfate has been related to the inhibition of microtubule formation in mitotic spindle, resulting in an arrest of dividing cells at the metaphase stage.
This preparation is for intravenous use only.
Syringes containing this product must be labelled, using the auxiliary sticker provided, to state:
“FOR INTRAVENOUS USE ONLY – FATAL IF GIVEN BY OTHER ROUTES.”
Keep out of the reach of children.
This preparation is for intravenous use only.
Neurotoxicity appears to be dose related.
Extreme care must be used in calculating and administering the dose of Vincristine Sulfate Injection, USP since overdosage may have a very serious or fatal outcome.
The usual dose of Vincristine Sulfate Injection, USP for paediatric patients is:
- 1.5–2 mg/m²
For pediatric patients weighing 10 kg or less, the starting dose should be:
- 0.05 mg/kg
administered once a week.
The usual dose of Vincristine Sulfate Injection, USP for adults is:
- 1.4 mg/m²
A 50% reduction in the dose of Vincristine Sulfate Injection, USP is recommended for patients having a direct serum bilirubin value above 3 mg/100 mL.
The drug is administered intravenously at weekly intervals.
TO REDUCE THE POTENTIAL FOR FATAL MEDICATION ERRORS DUE TO INCORRECT ROUTE OF ADMINISTRATION, VINCRISTINE SULFATE INJECTION SHOULD BE DILUTED IN A FLEXIBLE PLASTIC CONTAINER AND PROMINENTLY LABELED FOR INTRAVENOUS USE ONLY.
The concentration of Vincristine Sulfate Injection, USP is 1 mg/mL.
Do not add extra fluid to the vial prior to removal of the dose.
Withdraw the solution of Vincristine Sulfate Injection, USP into an accurate dry syringe, measuring the dose carefully.
Do not add extra fluid to the vial in an attempt to empty it completely.
Preparation For Flexible Plastic Container
Vincristine Sulfate Injection, USP when diluted with 0.9% Sodium Chloride Injection in concentrations from 0.0015 mg/mL to 0.08 mg/mL is stable for up to:
- 24 hours when protected from light
or
- 8 hours under normal light at 25°C
Preparation For Syringe
Special Dispensing Information
When dispensing Vincristine Sulfate Injection, USP in a syringe, it is imperative that it be packaged in the provided overwrap which bears the following statement:
“DO NOT REMOVE COVERING UNTIL MOMENT OF INJECTION. FOR INTRAVENOUS USE ONLY – FATAL IF GIVEN BY OTHER ROUTES”
A syringe containing a specific dose must be labeled, using the auxiliary sticker provided, to state:
“FOR INTRAVENOUS USE ONLY – FATAL IF GIVEN BY OTHER ROUTES.”
Caution
It is extremely important that the intravenous needle or catheter be properly positioned before any vincristine is injected.
Leakage into surrounding tissue during intravenous administration of Vincristine Sulfate Injection, USP may cause considerable irritation.
If extravasation occurs, the injection should be discontinued immediately and any remaining portion of the dose should then be introduced into another vein.
Local injection of hyaluronidase and the application of moderate heat to the area of leakage will help disperse the drug and may minimise discomfort and the possibility of cellulitis.
Vincristine Sulfate Injection, USP must be administered via an intact, free-flowing intravenous needle or catheter.
Care should be taken that there is no leakage or swelling occurring during administration.
The solution may be injected either directly into a vein or into the tubing of a running intravenous infusion.
Injection of Vincristine Sulfate Injection, USP should be accomplished within 1 minute.
Patients Receiving Radiation Therapy
Vincristine Sulfate Injection, USP should not be given to patients while they are receiving radiation therapy through ports that include the liver.
When Vincristine Sulfate Injection, USP is used in combination with L-asparaginase, Vincristine Sulfate Injection, USP should be given 12 to 24 hours before administration of the enzyme in order to minimize toxicity.
Administering L-asparaginase before Vincristine Sulfate Injection, USP may reduce hepatic clearance of vincristine.
Handling And Disposal
Procedures for proper handling and disposal of anticancer drugs should be considered.
There is no general agreement that all of the procedures recommended in the guidelines are necessary or appropriate.




