Cancer Treatment   /   Chemotherapy

Vincristine (Oncovin®, Vincasar, VCR)

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OncoLink
Last Modified: May 6, 2007

Facts about vincristine

• Vincristine is a member of the vinca alkaloids family of chemotherapy drugs. The drug works by interfering with cell division, which leaves the tumor unable to grow and spread. Vincristine was developed from the Madagascar periwinkle plant.
• Vincristine is used to treat many types of cancer including: various types of leukemias and sarcomas, neuroblastoma, multiple myeloma, Hodgkin's and non-Hodgkin's lymphomas, and lung, breast, cervical and colorectal cancers.

How to take vincristine

This medication is given through an IV (into a vein) by a trained professional. Vincristine is a vesicant, which means that if the medication leaks out of the vein, it can cause serious damage to the tissue. If you notice any swelling, redness or burning during the infusion, notify your nurse or doctor immediately. The actual dose is based on your body size.

How long should you take vincristine?

You can receive vincristine for as long as the cancer cells continue to respond to this therapy and you are able to tolerate any side effects.

Side effects of vincristine

Some of the possible side effects and suggestions for dealing with them include:

Low White Blood Cell Count (leukopenia or neutropenia)

White blood cells are important for fighting infection. While receiving treatment you are at a higher risk of getting infections. You should wash your hands frequently and avoid large crowds or people who are sick (i.e.: those who have a cold, fever or cough) or large crowds. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4 °), sore throat or cold, shortness of breath, cough, or a sore that doesn't heal. Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.

Low Platelet Count (thrombocytopenia)

Platelets help your blood clot, so when the count is low you are at a higher risk of bleeding. You should avoid using a razor (you can use an electric razor with caution), playing contact sports, or taking aspirin or ibuprofen products (these can also increase the risk of bleeding). Let your doctor or nurse know if you have any bleeding, including nose bleeds or bleeding gums. If the count becomes too low, you may receive a transfusion of platelets.

Low Red Blood Cell Count (anemia)

Your red blood cells are responsible for carrying oxygen to the tissues in your body. When the red cell count is low, you may feel tired or weak. You should let your doctor or nurse know if you experience any shortness of breath, difficulty breathing or pain in your chest. If the count gets too low you may receive a blood transfusion.

Loss or thinning of scalp and body hair (alopecia)

Your hair may become thin, brittle, or may fall out. This typically begins two to three weeks after treatment starts. This hair loss can be all body hair, including pubic, underarm, legs/arms, eyelashes, and nose hairs. The use of scarves, wigs, hats and hairpieces may help. Hair generally starts to regrow soon after treatment is completed. Remember your hair helps keep you warm in cold weather, so a hat is particularly important in cold weather or to protect you from the sun.

Mouth ulcers (sores)

Notify your doctor or nurse if your mouth, tongue, or inside of your cheek becomes white, ulcerated or painful. Brush with a soft-bristle toothbrush or cotton swab twice a day. Avoid mouthwashes that contain alcohol. A baking soda and/or salt warm water mouth rinse (2 level teaspoons of baking soda or 1 level teaspoon salt in an eight ounce glass of warm water) is recommended 4 times daily. If your mouth becomes dry, eat moist foods, drink plenty of fluids (at least 6-8 glasses), and suck on sugarless hard candy. Avoid drinking alcoholic beverages and citrus juices, smoking, and chewing tobacco. If mouth sores become painful, your doctor or nurse can recommend a pain reliever.

Fatigue

See OncoLink's section on fatigue for helpful tips on dealing with this side effect.

Constipation

Vincristine can cause serious constipation, abdominal pain and can even lead to a blockage or stoppage of the bowel (called paralytic ileus) if not treated promptly. There are several things you can do to prevent or relieve constipation. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day, and keep active. A stool softener once or twice a day may prevent constipation. If you do not have a bowel movement for 2-3 days, you should contact your healthcare team for suggestions to relieve the constipation.

Neurotoxicity

This is a toxicity that affects the nerves. The most common affect is called peripheral neuropathy, which causes a numbness or tingling of the hands and feet, which can get progressively worse with subsequent doses. You should let your healthcare provider know if you experience numbness or tingling in the hands and feet, as they may need to change the doses of your medication. See OncoLink's section on peripheral neuropathy for tips on dealing with this side effect.

The vinca alkaloid chemotherapies are known to cause neuropathy. In rare cases, vincristine can also cause neurolo gic toxicity that presents as mental depression, headache, malaise, dizziness and seizures. The drug can cause toxicity of the cranial nerves, which affects the vocal cords (changes in voice), eyes (visual changes) or facial nerves (drooping of the face or mouth). If you notice any of these problems, notify your healthcare team right away.

Sexual and reproductive changes

The menstrual cycle or sperm production may become irregular or stop permanently. Women may experience menopausal effects including hot flashes and vaginal dryness. The desire for sex may decrease during treatment. Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment. You may want to consider sperm banking or egg harvesting if you may wish to have a child in the future. See OncoLink's section on sexuality for helpful tips for dealing with these side effects.

Other side effects

Patients can develop severe pain in the jaw soon after the first treatment with vincristine. Your healthcare team can recommend a pain reliever for this problem, which will go away in time. Urinary retention can develop. If you notice you are unable to urinate, you should call your healthcare team right away or go to the emergency room to be evaluated. Some patients will have an allergic reaction to the medication during the infusion. Let your nurse know right away if you have any swelling, rash, lightheadedness, dizziness or difficulty breathing.