Vincristine
A vinca alkaloid for acute leukemia, lymphomas and childhood solid tumors whose main toxicity is peripheral neuropathy.
Drug card
- Class
- Vinca alkaloid
- How it works
- Blocking tubulin assembly into microtubules so the mitotic spindle fails
- Used for
- Acute leukemia
- Hodgkin and non-Hodgkin lymphoma
- Wilms tumor, neuroblastoma and rhabdomyosarcoma
- Known for
- Peripheral neuropathy: tingling, lost reflexes, foot drop
- Constipation, sometimes high in the colon
- Its name
- vin- means a vinca alkaloid
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does vincristine work?
Binds microtubule proteins and blocks microtubule formation in the mitotic spindle, so dividing cells stop in metaphase. Little reaches the cerebrospinal fluid. CYP3A enzymes and P-glycoprotein clear it, so CYP3A inhibitors heighten its nerve toxicity, and nerve damage rather than marrow suppression limits the dose.
Uses
What is vincristine used for?
- Acute leukemia
- Hodgkin and non-Hodgkin lymphoma
- Wilms tumor, neuroblastoma and rhabdomyosarcoma
Side effects
Side effects of vincristine
- Peripheral neuropathy: tingling, lost reflexes, foot dropKnown forSerious
- Constipation, sometimes high in the colonKnown for
- Paralytic ileus, especially in young childrenSerious
- Hair loss
- Jaw, bone and muscle pain
- Urinary retention from bladder atony
- Low sodium (SIADH)Serious
- Seizures, often with high blood pressureSerious
- Hearing loss and vertigoSerious
- Severe irritation and cellulitis if it leaksSerious
- Hepatic veno-occlusive disease, mainly in childrenSerious
- Low blood counts, mainly in combinationsSerious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- For intravenous use only: given intrathecally it is usually fatal, so doses are diluted in clearly labeled infusion bags.
- Avoid strong CYP3A inhibitors such as itraconazole, and P-gp inhibitors or inducers.
- Give a routine laxative regimen to prevent constipation and ileus.
- Contraindicated in demyelinating Charcot-Marie-Tooth disease; take care with other neurotoxic drugs.
Remember it
A way to remember it
Vincristine crisps the nerves but spares the marrow.
Its dose-limiting toxicity is peripheral neuropathy, while serious marrow suppression is unusual when it is given alone.
Written for biofideX
Its name
vin- means vinca alkaloid
Vincristine, vinblastine and vinorelbine are vinca alkaloids. Vincristine, from the periwinkle plant, stops microtubules forming so dividing cells stall; it is fatal if not given intravenously.
- Every drug name stem
Its class
Vinca alkaloids
Vinca alkaloids come from the periwinkle plant Vinca rosea. They bind tubulin and spindle proteins and stop microtubules from forming, so the mitotic spindle cannot assemble and dividing cells halt in metaphase. For vincristine, nerve damage rather than marrow suppression is what limits the dose.
Easily mixed up with taxanes, colchicine and benzimidazole anthelmintics.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Cancer chemotherapy
Vincristine is one of 9 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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