vincristine sulphate

CLINICAL USE

Antineoplastic agent

DOSE IN NORMAL RENAL FUNCTION

IV: 1.4–1.5 mg/m2 weekly; maximum 2 mg Consult relevant local protocol

PHARMACOKINETICS

Molecular weight : 923

%Protein binding : 75

%Excreted unchanged in urine :

10 to 20 :

Volume of distribution (L/kg) : 5–11

half-life – normal/ESRD (hrs) : 15–155/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unlikely to be dialysed. Dose as in normal renal function

HD : Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux : Unknown dialysability. Dose as in normal renal function

CAV/VVHD : Unlikely to be dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anti-epileptics: phenytoin levels may be reduced

Antifungals: metabolism possibly inhibited by itraconazole and posaconazole (increased risk of neurotoxicity)

Antipsychotics: avoid concomitant use with clozapine (increased risk of agranulocytosis)

ADMINISTRATION

Reconstition

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Route

Rate of Administration

Slow bolus

Comments

May be administered into fast running drip of sodium chloride 0.9% or glucose 5%

OTHER INFORMATION

Most of an IV dose is excreted into the bile after rapid tissue binding Metabolised by cytochrome P450 (in the CYP 3A subfamily). Elimination is primarily biliary; excreted into bile and faeces (67% within 72 hours, 40–50% as metabolites), 10% excreted in urine in 24 hrs

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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