Applies to vincristine: intravenous solution.
Warning
Intravenous route (Solution)
For intravenous use only; fatal if given by other routes. To reduce the potential for fatal medication errors due to incorrect route of administration proper dilution, product labeling and packaging is necessary. Intravenous needle or catheter must be properly positioned before any vinCRIStine is injected, as leakage into the surrounding tissue 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.
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.
Check with your doctor immediately if any of the following side effects occur while taking vincristine:
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 doctor as soon as possible if any of the following side effects occur while taking vincristine:
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 of Vincristine
Some side effects of vincristine 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.
For Healthcare Professionals
Applies to vincristine: compounding powder, intravenous solution.
Nervous system
Uncommon (0.1% to 1%): Seizures[Ref]
Dermatologic
Very common (10% or more): Alopecia[Ref]
Respiratory
Frequency not reported: Acute shortness of breath, severe bronchospasm, dyspnea[Ref]
Gastrointestinal
Common (1% to 10%): Constipation (may take the form of upper colon impaction), paralytic ileus, abdominal cramps
Uncommon (0.1% to 1%): Nausea, vomiting, diarrhea, anorexia, stomatitis, oral ulceration, intestinal necrosis and/or perforation, abdominal cramps, abdominal distension, weight loss
Frequency not reported: Paralytic ileus (particularly in young children and in the elderly), pancreatitis[Ref]
Hematologic
Frequency not reported: Anemia, leukopenia, thrombocytopenia[Ref]
Cardiovascular
Frequency not reported: Hypertension, hypotension[Ref]
Ocular
Frequency not reported: Transient cortical blindness, optic atrophy with blindness, diplopia, ptosis, photophobia, visual hallucinations[Ref]
Genitourinary
Frequency not reported: Polyuria, oliguria, nocturia, dysuria, urinary retention, testicular pain[Ref]
Oncologic
Frequency not reported: Second malignancies[Ref]
Hypersensitivity
Rare (0.01% to 0.1%): Allergic-type reactions (e.g., anaphylaxis)[Ref]
Hepatic
Frequency not reported: Hepatic veno-occlusive disease, hepatitis[Ref]
Musculoskeletal
Frequency not reported: Neurotoxicity is the most common dose-limiting side effect of this drug. Frequently, there is a sequence to the development of neuromuscular side effects. Initially, only sensory impairment and paresthesia
may develop. With continued treatment, neuritic pain and later, motor difficulties may occur. Loss of deep-tendon reflexes, foot drop, wrist drop, ataxia, and paralysis have been reported with continued administration. Cranial nerve manifestations, including isolated paresis and/or paralysis of muscles controlled by cranial motor nerves, may occur in the absence of motor impairment elsewhere; extra-ocular and laryngeal muscles are those most commonly involved. Numbness of the fingers and toes, atrophy, cramps, slapping gait, and difficulty in walking or inability to walk, may occur. Jaw pain, pharyngeal pain, parotid gland pain, bone pain, back pain, limb pain, and myalgias have been reported; pain in these areas may be severe.[Ref]
Psychiatric
Frequency not reported: Depression, agitation, insomnia, hallucinations[Ref]
General
In general, adverse reactions are reversible and are related to dosage size and cumulative dosage. The use of small amounts of this drug daily for long periods is not advised. The most common adverse reaction is alopecia; the most troublesome adverse reactions are neuromuscular in origin.[Ref]
