Usual Adult Dose for Malignant Disease

Manufacturer suggested dose: 1.4 mg/m2 IV over one minute once a week

Comments:

• This dose is the manufacturer recommendation. It is only a guideline. Institutional protocol should be consulted.
• The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Use: Acute leukemia (this drug 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)

Usual Adult Dose for Solid Tumors

Manufacturer suggested dose: 1.4 mg/m2 IV over one minute once a week

Comments:

• This dose is the manufacturer recommendation. It is only a guideline. Institutional protocol should be consulted.
• The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Use: Acute leukemia (this drug 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)

Usual Pediatric Dose for Malignant Disease

Less than 18 years and less than or equal to 10 kg:

• Initial dose: 0.05 mg/kg IV over one minute once a week
• Maximum dose: 2 mg/m2 IV over one minute once a week

Less than 18 years and greater than 10 kg: 1 to 2 mg/m2 IV over one minute once a week

Comments:

• This dose is the manufacturer recommendation. It is only a guideline. Institutional protocol should be consulted.
• The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Use: Acute leukemia (this drug 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)

Usual Pediatric Dose for Solid Tumors

Less than 18 years and less than or equal to 10 kg:

• Initial dose: 0.05 mg/kg IV over one minute once a week
• Maximum dose: 2 mg/m2 IV over one minute once a week

Less than 18 years and greater than 10 kg: 1 to 2 mg/m2 IV over one minute once a week

Comments:

• This dose is the manufacturer recommendation. It is only a guideline. Institutional protocol should be consulted.
• The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Use: Acute leukemia (this drug 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)

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Serum bilirubin 3 mg/100 mL (51 mcmol/L) or more: Reduce dose by 50%

Precautions

US BOXED WARNINGS:

• FOR INTRAVENOUS USE ONLY - FATAL IF GIVEN BY OTHER ROUTES. Intrathecal administration usually results in death.
• This drug should only be administered by individuals who have experience with it.
• It is extremely important that the IV needle or catheter be properly positioned before any drug is injected. Leakage into surrounding tissue during IV administration 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 help disperse the drug and are thought to minimize discomfort and the possibility of cellulitis.
• To reduce the potential for fatal medication errors due to incorrect route of administration, this drug should be diluted in a flexible plastic container and prominently labeled as indicated for IV use only.
• Syringes containing this product must be labeled, using the auxiliary sticker provided, to state "FOR INTRAVENOUS USE ONLY - FATAL IF GIVEN BY OTHER ROUTES."
• Extemporaneously prepared syringes containing this drug must be packaged in an overwrap which is labeled "Do not remove covering until moment of injection. For intravenous use only - fatal if given by other routes."

CONTRAINDICATIONS:

• Patients with the demyelinating form of Charcot-Marie-Tooth Syndrome

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For IV use only. Fatal if given by other routes.
• Vincristine sulfate has different dosage recommendations than vincristine liposome injection. Verify drug name and dose prior to preparation and administration to avoid overdosage.
• Attention should be given to dosage and neurologic side effects if this drug is administered to patients with preexisting neuromuscular disease and when other drugs with neurotoxic potential are also being used.

Storage requirements:

• Store this drug in the refrigerator at 2C to 8C. Do not freeze.

Reconstitution/preparation techniques:

• The manufacturer product information should be consulted.
• Discard unused solution.
• Protect from light and retain in carton until time of use.
• Store upright.

IV compatibility:

• This drug is compatible with 0.9% sodium chloride injection.

General:

• To reduce the potential for fatal medication errors due to incorrect route of administration, this drug should be diluted in a flexible plastic container and prominently labeled for IV use only.
• When handling urine or feces from patients receiving this drug, protective clothing should be worn for up to 4 to 7 days after therapy.