(for veterinary information only)
BRAND NAME: ONCOVIN, VINCASAR
HOW THIS MEDICATION IS USED
Vincristine is chiefly used as one drug in multi-drug combination protocols against lymphoid and round cell tumors. Lymphoma, Mast Cell Tumors, and Transmissible Venereal Tumors often include vincristine in their protocols.
Separate from its chemotherapy use, vincristine has the unexplained ability to cause a sudden release of platelets (blood clotting cells) from the bone marrow. For this reason, vincristine is commonly included in treatment of immune-mediated thrombocytopenia or ( “ITP”).
Vincristine is typically utilized as a weekly injection.
Vincristine must absolutely be given intravenously. Vincristine is highly irritating to the soft tissues and if it is not given intravenously, where the bloodstream rapidly carries it away and dilutes it within the body’s blood volume, it will cause what is called a “tissue slough.” This means the soft tissues will die and fall away leaving a large sore. Unlike the tissue sloughs of adriamycin, a vincristine slough will eventually heal but while it is present, it will require bandaging and be a source of discomfort.
Vincristine has some potential for neurologic side effects, especially in cats. A neurologically based constipation may result, particularly in cats. Difficulty coordinating the feet may be seen. Humans report “paresthesias” which include odd sensations such as occur when one’s foot is “asleep.”
Vincristine use will increase blood uric acid levels, rarely a concern in animals, but could be a problem in dogs with a history of uric acid bladder stones.
Dogs with the MDR1 mutation will likely require dose adjustments. This mutation is common in collie-related breeds and affects the way numerous drugs are metabolized. Genetic testing may be indicated to determine a patient's MDR1 status before therapy with this medication. See below for more information on this.
INTERACTIONS WITH OTHER DRUGS
The neurologic toxicities noted above are more likely to occur when vincristine is used in combination with L-Asparaginase, not an uncommon combination in the treatment of lymphoma.
CONCERNS AND CAUTIONS
Vincristine is not able to pass through the blood/brain barrier and thus cannot treat tumors in the nervous system.
Vincristine is removed from the body by the liver. If poor liver function is present, a dose-adjustment may be needed or a different drug selected. A guideline that has been published is to cut the vincristine dose by 50% in patients with a total bilirubin level of higher than 2mg/dl.
Vincristine should not be used in pregnancy and may cause sterility in males.
Page last updated: 10/17/2021