Vincristine – Uses, Dosage, Side Effects, Interaction

Vincristine Sulfate Liposome is a sphingomyelin/cholesterol liposomal formulation of vincristine sulfate with potential antineoplastic activity. Vincristine, a vinca alkaloid isolated from the plant Vinca rosea, irreversibly binds to and stabilizes tubulin, thereby interrupting microtubule assembly/disassembly dynamics, thereby preventing the formation of the mitotic spindle and leading to cell cycle arrest in metaphase. Liposomal encapsulation prolongs the bioavailability of vincristine, increases its delivery to tumor tissues, and reduces its toxicity profile. Compared to standard liposomal delivery, schistosomal drug delivery further increases the circulation time of serum drug and enhances drug accumulation at tumor sites, thereby leading to a further increase in efficacy.

Vincristine is a vinca alkaloid antineoplastic agent used as a treatment for various cancers including breast cancer, Hodgkin’s disease, Kaposi’s sarcoma, and testicular cancer. The vinca alkaloids are structurally similar compounds comprised of 2 multi ringed units, vindoline, and catharanthine. The vinca alkaloids have become clinically useful since the discovery of their antitumor properties in 1959. Initially, extracts of the periwinkle plant (Catharanthus roseus) were investigated because of putative hypoglycemic properties but were noted to cause marrow suppression in rats and antileukemic effects in vitro. Vincristine binds to the microtubular proteins of the mitotic spindle, leading to crystallization of the microtubule and mitotic arrest or cell death. Vincristine has some immunosuppressant effects. The vinca alkaloids are considered to be cell cycle phase-specific.

Use in Cancer

Etoposide phosphate is approved to be used with other drugs to treat:

• Small cell lung cancer. It is used with cisplatin as first-line therapy.
• Testicular cancer. It is used in patients who have already been treated with surgery, radiation therapy, or other chemotherapy and have not gotten better.

Etoposide phosphate is also available in a different form called etoposide. For more information, see the Drug Information Summary for Etoposide.

Etoposide phosphate is also being studied in the treatment of other types of cancer.

Contraindications

Vincristine use is contraindicated in patients with demyelinating Charcot-Marie-Tooth syndrome. While documentation of allergenic cross-reactivity for drugs within this class is limited, cross-sensitivity cannot be ruled out due to the similarities in chemical structures and pharmacological actions.[rx]

• anemia
• decreased blood platelets
• low levels of a type of white blood cell called neutrophils
• Charcot-Marie-Tooth disease
• generalized disorder of peripheral nerves
• a painful condition that affects the nerves in the legs and arms called peripheral neuropathy
• a disorder of the peripheral nerves that enable movement called peripheral motor neuropathy
• a disease affecting muscles and nerves
• abnormal liver function tests
• pregnancy
• a patient who is producing milk and breastfeeding

Experienced physician: Administration of vincristine should be by individuals with experience in administering the drug.

Extravasation: An Intravenous (IV) needle or catheter must be in proper position before infusion or injection of any of the medication. Improper positioning may lead to leakage into the surrounding tissue during IV administration. Leakage may cause considerable irritation. Therefore, injection or infusion must be discontinued immediately if extravasation occurs.

For IV use only: Vincristine is indicated for IV use only. It is fatal if given by any other routes. Vincristine administered by intrathecal routes usually results in death. Therefore, all syringes containing vincristine must be labeled and have the provided auxiliary sticker attached. The auxiliary label must state, ” For intravenous use only. Fatal if given by other routes.”

Dosage

Strengths: 1 mg/mL

Malignant Disease

• Manufacturer suggested dose: 1.4 mg/m2 IV over one minute once a week
• This dose is the manufacturer’s recommendation. It is only a guideline. The institutional protocol should be consulted.
• The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient. Solid Tumors
• Manufacturer suggested dose: 1.4 mg/m2 IV over one minute once a week

Pediatric Dose for Malignant Disease

Less than 18 years and less than or equal to 10 kg:

• Initial dose: 0.05 mg/kg IV over one minute once a week
• Maximum dose: 2 mg/m2 IV over one minute once a week
• Less than 18 years and greater than 10 kg: 1 to 2 mg/m2 IV over one minute once a week
• This dose is the manufacturer’s recommendation. It is only a guideline. The institutional protocol should be consulted.
• The dose of this drug may depend upon the specific indication for its use, and whether other cytotoxic agents are coadministered. Subsequent doses may be determined by the clinical and hematologic response of the patient.

Pediatric Dose for Solid Tumors

Less than 18 years and less than or equal to 10 kg:

• Initial dose: 0.05 mg/kg IV over one minute once a week
• Maximum dose: 2 mg/m2 IV over one minute once a week
• Less than 18 years and greater than 10 kg: 1 to 2 mg/m2 IV over one minute once a week

Side Effects

The Most Common

• nausea
• vomiting
• sores in the mouth and throat
• loss of appetite or weight
• stomach pain
• diarrhea
• headache
• hair loss

More common

• hives
• rash
• itching
• difficulty breathing or swallowing
• constipation
• increased or decreased urination
• swelling of the face, arms, hands, feet, ankles, or lower legs
• unusual bleeding or bruising
• unusual tiredness or weakness
• pain, numbness, burning, or tingling in the hands or feet
• difficulty walking or unsteady walking
• muscle or joint pain
• sudden changes in vision, including loss of vision
• hearing loss
• dizziness
• loss of the ability to move muscles and to feel a part of the body
• hoarseness or loss of ability to speak loudly
• seizures
• jaw pain
• fever, sore throat, chills, or other signs of infection

Rare

• blurred or double vision
• confusion
• constipation
• decrease or increase in urination
• depression
• dizziness or lightheadedness when getting up from a sitting or lying position
• drooping eyelids
• hallucinations
• headache
• hearing loss
• jaw pain
• joint pain
• lack of perspiration
• loss of appetite
• lower back or side pain
• numbness or tingling in fingers and toes
• pain in fingers and toes
• pain in testicles
• painful or difficult urination
• sleeping problems
• sores in mouth and on lips
• stomach cramps
• swelling of feet or lower legs
• weakness
• unconsciousness

Drug Interaction

Cyclosporine	Vincristine may increase the immunosuppressive activities of Cyclosporine.
Cyproterone acetate	The metabolism of Vincristine can be decreased when combined with Cyproterone acetate.
Cytarabine	The risk or severity of adverse effects can be increased when Vincristine is combined with Cytarabine.
Dabigatran etexilate	The serum concentration of Vincristine can be increased when it is combined with Dabigatran etexilate.
Dabrafenib	The serum concentration of Vincristine can be decreased when it is combined with Dabrafenib.
Dacarbazine	The risk or severity of adverse effects can be increased when Vincristine is combined with Dacarbazine.
Daclatasvir	The excretion of Vincristine can be decreased when combined with Daclatasvir.
Dacomitinib	The excretion of Vincristine can be decreased when combined with Dacomitinib.
Dactinomycin	The risk or severity of adverse effects can be increased when Vincristine is combined with Dactinomycin.
Dalfopristin	The metabolism of Vincristine can be decreased when combined with Dalfopristin.
Danazol	The metabolism of Vincristine can be decreased when combined with Danazol.
Dapsone	The metabolism of Vincristine can be decreased when combined with Dapsone.
Daptomycin	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Daptomycin is combined with Vincristine.
Darbepoetin alfa	The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Vincristine.
Darolutamide	Darolutamide may decrease the excretion rate of Vincristine which could result in a higher serum level.
Darunavir	The serum concentration of Vincristine can be increased when it is combined with Darunavir.
Dasabuvir	Dasabuvir may decrease the excretion rate of Vincristine which could result in a higher serum level.
Dasatinib	The metabolism of Vincristine can be decreased when combined with Dasatinib.
Daunorubicin	The metabolism of Vincristine can be decreased when combined with Daunorubicin.
Decamethonium	Vincristine may increase the neurotoxic activities of Decamethonium.
Decitabine	The risk or severity of adverse effects can be increased when Vincristine is combined with Decitabine.
Deferasirox	The metabolism of Vincristine can be increased when combined with Deferasirox.
Deflazacort	The metabolism of Vincristine can be increased when combined with Deflazacort.
Delavirdine	The metabolism of Vincristine can be decreased when combined with Delavirdine.
Denosumab	The risk or severity of adverse effects can be increased when Denosumab is combined with Vincristine.
Deoxycholic acid	Deoxycholic acid may increase the excretion rate of Vincristine which could result in a lower serum level and potentially a reduction in efficacy.
Desipramine	The metabolism of Vincristine can be decreased when combined with Desipramine.
Deslanoside	Deslanoside may decrease the cardiotoxic activities of Vincristine.
Desoximetasone	The risk or severity of adverse effects can be increased when Vincristine is combined with Desoximetasone.
Desvenlafaxine	The metabolism of Vincristine can be decreased when combined with Desvenlafaxine.
Deucravacitinib	The risk or severity of adverse effects can be increased when Vincristine is combined with Deucravacitinib.
Deutetrabenazine	The metabolism of Vincristine can be decreased when combined with Deutetrabenazine.
Dexamethasone	The metabolism of Vincristine can be increased when combined with Dexamethasone.
Dexamethasone acetate	The serum concentration of Vincristine can be decreased when it is combined with Dexamethasone acetate.
Dexrazoxane	The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Vincristine.
Dextromethorphan	The metabolism of Vincristine can be decreased when combined with Dextromethorphan.
Dextropropoxyphene	The metabolism of Vincristine can be decreased when combined with Dextropropoxyphene.
Diazepam	The metabolism of Vincristine can be decreased when combined with Diazepam.
Dibenzepin	Vincristine may increase the neurotoxic activities of Dibenzepin.
Diclofenac	Vincristine may decrease the excretion rate of Diclofenac which could result in a higher serum level.
Dicloxacillin	The metabolism of Vincristine can be increased when combined with Dicloxacillin.
Didanosine	Vincristine may increase the neurotoxic activities of Didanosine.
Diethylstilbestrol	The metabolism of Vincristine can be decreased when combined with Diethylstilbestrol.
Difluocortolone	The metabolism of Vincristine can be increased when combined with Difluocortolone.
Digitoxin	The serum concentration of Digitoxin can be increased when it is combined with Vincristine.
Digoxin	Digoxin may decrease the excretion rate of Vincristine which could result in a higher serum level.
Dihydroergocornine	The metabolism of Vincristine can be decreased when combined with Dihydroergocornine.
Dihydroergocristine	The metabolism of Vincristine can be decreased when combined with Dihydroergocristine.
Dihydroergotamine	The metabolism of Vincristine can be decreased when combined with Dihydroergotamine.
Diltiazem	The metabolism of Vincristine can be decreased when combined with Diltiazem.
Dimethyl fumarate	The risk or severity of adverse effects can be increased when Vincristine is combined with Dimethyl fumarate.
Dimethyl sulfoxide	The metabolism of Vincristine can be decreased when combined with Dimethyl sulfoxide.
Dinoprostone	The excretion of Dinoprostone can be decreased when combined with Vincristine.
Dinutuximab	The risk or severity of adverse effects can be increased when Vincristine is combined with Dinutuximab.
Diosmin	The excretion of Vincristine can be decreased when combined with Diosmin.
Diphenhydramine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Diphenhydramine.
Dipyridamole	Vincristine may decrease the excretion rate of Dipyridamole which could result in a higher serum level.
Diroximel fumarate	The risk or severity of adverse effects can be increased when Vincristine is combined with Diroximel fumarate.
Disulfiram	The metabolism of Vincristine can be decreased when combined with Disulfiram.
Docetaxel	The metabolism of Vincristine can be decreased when combined with Docetaxel.
Dolutegravir	The serum concentration of Vincristine can be increased when it is combined with Dolutegravir.
Domperidone	The metabolism of Vincristine can be decreased when combined with Domperidone.
Doravirine	The metabolism of Vincristine can be decreased when combined with Doravirine.
Dosulepin	Vincristine may increase the neurotoxic activities of Dosulepin.
Doxazosin	The metabolism of Vincristine can be decreased when combined with Doxazosin.
Doxepin	Vincristine may increase the neurotoxic activities of Doxepin.
Doxorubicin	The metabolism of Vincristine can be decreased when combined with Doxorubicin.
Dronedarone	The excretion of Vincristine can be decreased when combined with Dronedarone.
Droperidol	Droperidol may increase the neurotoxic activities of Vincristine.
Drospirenone	The metabolism of Vincristine can be decreased when combined with Drospirenone.
Dutasteride	The metabolism of Vincristine can be decreased when combined with Dutasteride.
Duvelisib	The metabolism of Vincristine can be decreased when combined with Duvelisib.
Dyclonine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Dyclonine.
Ebastine	The metabolism of Vincristine can be decreased when combined with Ebastine.
Ebola Zaire	The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Vincristine.
Echinacea	The metabolism of Vincristine can be increased when combined with Echinacea.
Eculizumab	The risk or severity of adverse effects can be increased when Vincristine is combined with Eculizumab.
Edoxaban	The serum concentration of Vincristine can be increased when it is combined with Edoxaban.
Efalizumab	The risk or severity of adverse effects can be increased when Efalizumab is combined with Vincristine.
Efavirenz	The metabolism of Vincristine can be decreased when combined with Efavirenz.
Eflapegrastim	The risk or severity of peripheral neuropathy can be increased when Eflapegrastim is combined with Vincristine.
Elagolix	The excretion of Vincristine can be decreased when combined with Elagolix.
Elbasvir	The metabolism of Vincristine can be decreased when combined with Elbasvir.
Elexacaftor	The metabolism of Vincristine can be decreased when combined with Elexacaftor.
Eliglustat	The serum concentration of Vincristine can be increased when it is combined with Eliglustat.
Eltrombopag	Eltrombopag may decrease the excretion rate of Vincristine which could result in a higher serum level.
Eluxadoline	The serum concentration of Eluxadoline can be increased when it is combined with Vincristine.
Elvitegravir	The metabolism of Vincristine can be decreased when combined with Elvitegravir.
Emapalumab	The metabolism of Vincristine can be increased when combined with Emapalumab.
Enalapril	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Enalapril.

Etoricoxib	The metabolism of Vincristine can be decreased when combined with Etoricoxib.
Etravirine	The metabolism of Vincristine can be increased when combined with Etravirine.
Everolimus	The excretion of Vincristine can be decreased when combined with Everolimus.
Ezetimibe	Vincristine may decrease the excretion rate of Ezetimibe which could result in a higher serum level.
Favipiravir	The excretion of Vincristine can be decreased when combined with Favipiravir.
Febuxostat	The excretion of Vincristine can be decreased when combined with Febuxostat.
Fedratinib	The excretion of Vincristine can be decreased when combined with Fedratinib.
Felbamate	The metabolism of Vincristine can be increased when combined with Felbamate.
Felodipine	The metabolism of Vincristine can be decreased when combined with Felodipine.
Fenofibrate	The metabolism of Vincristine can be decreased when combined with Fenofibrate.
Fenofibric acid	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Fenofibric acid.
Fentanyl	The metabolism of Vincristine can be decreased when combined with Fentanyl.
Fexinidazole	The metabolism of Vincristine can be decreased when combined with Fexinidazole.
Fexofenadine	The serum concentration of Vincristine can be increased when it is combined with Fexofenadine.
Filgotinib	The serum concentration of Vincristine can be increased when it is combined with Filgotinib.
Filgrastim	The risk or severity of peripheral neuropathy can be increased when Filgrastim is combined with Vincristine.
Finasteride	The metabolism of Vincristine can be decreased when combined with Finasteride.
Fingolimod	Vincristine may increase the immunosuppressive activities of Fingolimod.
Flibanserin	The excretion of Vincristine can be decreased when combined with Flibanserin.
Floxuridine	The risk or severity of adverse effects can be increased when Floxuridine is combined with Vincristine.
Flucloxacillin	The metabolism of Vincristine can be increased when combined with Flucloxacillin.
Fluconazole	The excretion of Vincristine can be decreased when combined with Fluconazole.
Flucytosine	The risk or severity of adverse effects can be increased when Vincristine is combined with Flucytosine.
Fludarabine	The risk or severity of adverse effects can be increased when Vincristine is combined with Fludarabine.
Fludrocortisone	The risk or severity of adverse effects can be increased when Vincristine is combined with Fludrocortisone.
Flunisolide	The metabolism of Vincristine can be increased when combined with Flunisolide.
Fluocinolone	The metabolism of Vincristine can be increased when combined with Fluocinolone acetonide.
Fluocinonide	The metabolism of Vincristine can be increased when combined with Fluocinonide.
Fluocortolone	The metabolism of Vincristine can be increased when combined with Fluocortolone.
Fluorescein	Vincristine may decrease the excretion rate of Fluorescein which could result in a higher serum level.
Fluorometholone	The risk or severity of adverse effects can be increased when Fluorometholone is combined with Vincristine.
Fluorouracil	The risk or severity of adverse effects can be increased when Vincristine is combined with Fluorouracil.
Fluoxetine	The metabolism of Vincristine can be decreased when combined with Fluoxetine.
Flupentixol	Vincristine may increase the neurotoxic activities of Flupentixol.
Fluphenazine	Vincristine may increase the neurotoxic activities of Fluphenazine.
Fluprednisolone	The risk or severity of adverse effects can be increased when Vincristine is combined with Fluprednisolone.
Fluspirilene	Vincristine may increase the neurotoxic activities of Fluspirilene.
Flutamide	The metabolism of Vincristine can be decreased when combined with Flutamide.
Fluticasone	The metabolism of Vincristine can be increased when combined with Fluticasone.
Fluticasone furoate	The metabolism of Vincristine can be increased when combined with Fluticasone furoate.
Fluticasone propionate	The metabolism of Vincristine can be decreased when combined with Fluticasone propionate.
Fluvastatin	The metabolism of Vincristine can be decreased when combined with Fluvastatin.
Fluvoxamine	The metabolism of Vincristine can be decreased when combined with Fluvoxamine.
Formestane	The metabolism of Vincristine can be increased when combined with Formestane.
Fosamprenavir	The metabolism of Vincristine can be decreased when combined with Fosamprenavir.
Fosaprepitant	The metabolism of Vincristine can be increased when combined with Fosaprepitant.
Fosnetupitant	The metabolism of Vincristine can be decreased when combined with Fosnetupitant.
Fosphenytoin	The serum concentration of Vincristine can be decreased when it is combined with Fosphenytoin.
Fostamatinib	The metabolism of Vincristine can be decreased when combined with Fostamatinib.
Fostemsavir	Fostemsavir may decrease the excretion rate of Vincristine which could result in a higher serum level.
Fusidic acid	The metabolism of Vincristine can be decreased when combined with Fusidic acid.
Futibatinib	The serum concentration of Vincristine can be increased when it is combined with Futibatinib.
Gadoxetic acid	The excretion of Gadoxetic acid can be decreased when combined with Vincristine.
Gallium nitrate	The risk or severity of adverse effects can be increased when Vincristine is combined with Gallium nitrate.
Ganciclovir	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Ganciclovir.
Gefitinib	The metabolism of Vincristine can be decreased when combined with Gefitinib.
Gemcitabine	The risk or severity of adverse effects can be increased when Gemcitabine is combined with Vincristine.
Gemfibrozil	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Gemfibrozil.
Gemtuzumab ozogamicin	The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Vincristine.
Gilteritinib	The metabolism of Vincristine can be decreased when combined with Gilteritinib.
Ginkgo biloba	The metabolism of Vincristine can be decreased when combined with Ginkgo biloba.
Glasdegib	The excretion of Vincristine can be decreased when combined with Glasdegib.
Glatiramer	The risk or severity of adverse effects can be increased when Vincristine is combined with Glatiramer.
Glecaprevir	The excretion of Vincristine can be decreased when combined with Glecaprevir.
Glimepiride	Glimepiride may decrease the excretion rate of Vincristine which could result in a higher serum level.
Glipizide	Vincristine may decrease the excretion rate of Glipizide which could result in a higher serum level.

Hydroxyzine	The metabolism of Vincristine can be decreased when combined with Hydroxyzine.
Ibandronate	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Ibandronate.
Ibritumomab tiuxetan	The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Vincristine.
Ibrutinib	The metabolism of Vincristine can be decreased when combined with Ibrutinib.
Idarubicin	The risk or severity of adverse effects can be increased when Vincristine is combined with Idarubicin.
Idelalisib	The risk or severity of adverse effects can be increased when Vincristine is combined with Idelalisib.
Ifosfamide	The metabolism of Vincristine can be increased when combined with Ifosfamide.
Iloperidone	The metabolism of Vincristine can be decreased when combined with Iloperidone.
Iloprost	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Iloprost.
Imatinib	The serum concentration of Vincristine can be increased when it is combined with Imatinib.
Imipenem	Vincristine may increase the neurotoxic activities of Imipenem.
Imipramine	The metabolism of Vincristine can be decreased when combined with Imipramine.
Indacaterol	The serum concentration of Vincristine can be increased when it is combined with Indacaterol.
Indinavir	The metabolism of Vincristine can be decreased when combined with Indinavir.
Indocyanine	Vincristine may decrease the excretion rate of Indocyanine green acid form which could result in a higher serum level.
Indomethacin	The risk or severity of adverse effects can be increased when Indomethacin is combined with Vincristine.
Inebilizumab	The risk or severity of infection can be increased when Vincristine is combined with Inebilizumab.
Infigratinib	The metabolism of Vincristine can be decreased when combined with Infigratinib.
Infliximab	The metabolism of Vincristine can be increased when combined with Infliximab.
Influenza A virus A	The therapeutic efficacy of Influenza A virus A/Brisbane/59/2007(H1N1) antigen (propiolactone inactivated) can be decreased when used in combination with Vincristine.
Influenza A virus A	The therapeutic efficacy of Influenza A virus A/Brisbane/59/2007(H1N1) hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Vincristine.
Influenza A virus A	The therapeutic efficacy of Influenza A virus A/California/7/2009 (H1N1) live (attenuated) antigen can be decreased when used in combination with Vincristine.
Influenza A virus A	The therapeutic efficacy of Influenza A virus A/California/7/2009 X-181 (H1N1) antigen (propiolactone inactivated) can be decreased when used in combination with Vincristine.
Influenza A virus A	The therapeutic efficacy of Influenza A virus A/California/7/2009 X-181 (H1N1) hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Vincristine.
Influenza A virus A	The therapeutic efficacy of Influenza A virus A/Perth/16/2009 (H3N2) live (attenuated) antigen can be decreased when used in combination with Vincristine.
Influenza A virus A/	The therapeutic efficacy of Influenza A virus A/Uruguay/716/2007(H3N2) antigen (propiolactone inactivated) can be decreased when used in combination with Vincristine.
Influenza A virus A	The therapeutic efficacy of Influenza A virus A/Victoria/210/2009 X-187 (H3N2) antigen (formaldehyde inactivated) can be decreased when used in combination with Vincristine.
Influenza A virus A/	The therapeutic efficacy of Influenza A virus A/Victoria/210/2009 X-187 (H3N2) hemagglutinin antigen (formaldehyde inactivated) can be decreased when used in combination with Vincristine.
Influenza B virus B/	The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 antigen (formaldehyde inactivated) can be decreased when used in combination with Vincristine.
Influenza B virus B/	The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 antigen (propiolactone inactivated) can be decreased when used in combination with Vincristine.
Influenza B virus B/	The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 hemagglutinin antigen (formaldehyde inactivated) can be decreased when used in combination with Vincristine.
Influenza B virus B	The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Vincristine.
Inotuzumab ozogamicin	The serum concentration of Inotuzumab ozogamicin can be increased when it is combined with Vincristine.
Interferon alfa-2a	The risk or severity of adverse effects can be increased when Interferon alfa-2a is combined with Vincristine.
Interferon alfa-2b	The risk or severity of adverse effects can be increased when Interferon alfa-2b is combined with Vincristine.
Interferon alfa-n1	The risk or severity of adverse effects can be increased when Interferon alfa-n1 is combined with Vincristine.
Interferon alfa-n3	The risk or severity of adverse effects can be increased when Interferon alfa-n3 is combined with Vincristine.
Interferon alfacon-1	The risk or severity of adverse effects can be increased when Interferon alfacon-1 is combined with Vincristine.
Interferon beta-1b	The risk or severity of adverse effects can be increased when Interferon beta-1b is combined with Vincristine.
Interferon gamma-1b	The risk or severity of adverse effects can be increased when Interferon gamma-1b is combined with Vincristine.
Ipecac	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Ipecac.
Irbesartan	The metabolism of Vincristine can be decreased when combined with Irbesartan.
Irinotecan	The metabolism of Vincristine can be decreased when combined with Irinotecan.
Isavuconazole	The excretion of Vincristine can be decreased when combined with Isavuconazole.
Isavuconazonium	The excretion of Vincristine can be decreased when combined with Isavuconazonium.
Isoniazid	The metabolism of Vincristine can be decreased when combined with Isoniazid.
Isotretinoin	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Isotretinoin.
Isradipine	The metabolism of Vincristine can be decreased when combined with Isradipine.
Istradefylline	The excretion of Vincristine can be decreased when combined with Istradefylline.
Itraconazole	The metabolism of Vincristine can be decreased when combined with Itraconazole.
Ivacaftor	The excretion of Vincristine can be decreased when combined with Ivacaftor.
Ivermectin	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Ivermectin.
Ivosidenib	The metabolism of Vincristine can be increased when combined with Ivosidenib.
Ixabepilone	The excretion of Vincristine can be decreased when combined with Ixabepilone.
Ixekizumab	The risk or severity of adverse effects can be increased when Vincristine is combined with Ixekizumab.
Janssen COVID-19 Vaccine	The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Vincristine.
Japanese encephalitis virus	The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Vincristine.
Ketazolam	The metabolism of Vincristine can be decreased when combined with Ketazolam.
Ketoconazole	The excretion of Vincristine can be decreased when combined with Ketoconazole.
Lacosamide	The metabolism of Vincristine can be decreased when combined with Lacosamide.
Lamivudine	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Lamivudine.
Lanreotide	The metabolism of Vincristine can be decreased when combined with Lanreotide.
Lansoprazole	Lansoprazole may decrease the excretion rate of Vincristine which could result in a higher serum level.
Lapatinib	The excretion of Vincristine can be decreased when combined with Lapatinib.
Larotrectinib	The serum concentration of Vincristine can be increased when it is combined with Larotrectinib.
Lasmiditan	The serum concentration of Vincristine can be increased when it is combined with Lasmiditan.
Ledipasvir	The excretion of Vincristine can be decreased when combined with Ledipasvir.
Lefamulin	The serum concentration of Vincristine can be increased when it is combined with Lefamulin.
Leflunomide	The risk or severity of adverse effects can be increased when Vincristine is combined with Leflunomide.
Lemborexant	The metabolism of Vincristine can be decreased when combined with Lemborexant.
Lenalidomide	The risk or severity of adverse effects can be increased when Lenalidomide is combined with Vincristine.
Lenograstim	The risk or severity of peripheral neuropathy can be increased when Lenograstim is combined with Vincristine.
Lenvatinib	Lenvatinib may decrease the excretion rate of Vincristine which could result in a higher serum level.

Naxitamab	Vincristine may increase the neurotoxic activities of Naxitamab.
Nefazodone	The metabolism of Vincristine can be decreased when combined with Nefazodone.
Nelarabine	The risk or severity of adverse effects can be increased when Vincristine is combined with Nelarabine.
Nelfinavir	The metabolism of Vincristine can be decreased when combined with Nelfinavir.
Neomycin	Vincristine may increase the neurotoxic activities of Neomycin.
Neratinib	The excretion of Vincristine can be decreased when combined with Neratinib.
Netupitant	The excretion of Vincristine can be decreased when combined with Netupitant.
Nevirapine	The metabolism of Vincristine can be decreased when combined with Nevirapine.
Niacin	The metabolism of Vincristine can be decreased when combined with Niacin.
Nicardipine	The metabolism of Vincristine can be decreased when combined with Nicardipine.
Nifedipine	The metabolism of Vincristine can be decreased when combined with Nifedipine.
Nilotinib	The excretion of Vincristine can be decreased when combined with Nilotinib.
Nilvadipine	The metabolism of Vincristine can be decreased when combined with Nilvadipine.
Nintedanib	The metabolism of Vincristine can be decreased when combined with Nintedanib.
Nisoldipine	The metabolism of Vincristine can be decreased when combined with Nisoldipine.
Nitrendipine	The metabolism of Vincristine can be decreased when combined with Nitrendipine.
Nitrofurantoin	Vincristine may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
Nizatidine	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Nizatidine.
Norethisterone	The metabolism of Vincristine can be decreased when combined with Norethisterone.
Norfloxacin	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Norfloxacin.
Norgestimate	The excretion of Vincristine can be decreased when combined with Norgestimate.
Nortriptyline	The serum concentration of Nortriptyline can be increased when it is combined with Vincristine.
Noscapine	The metabolism of Vincristine can be decreased when combined with Noscapine.
Novobiocin	Novobiocin may decrease the excretion rate of Vincristine which could result in a higher serum level.
Nuvaxovid	The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Vincristine.
Obinutuzumab	The risk or severity of adverse effects can be increased when Vincristine is combined with Obinutuzumab.
Ocrelizumab	Ocrelizumab may increase the immunosuppressive activities of Vincristine.
Octreotide	The serum concentration of Vincristine can be increased when it is combined with Octreotide.
Ofatumumab	The risk or severity of adverse effects can be increased when Vincristine is combined with Ofatumumab.
Ofloxacin	Vincristine may decrease the excretion rate of Ofloxacin which could result in a higher serum level.
Olaparib	The metabolism of Vincristine can be decreased when combined with Olaparib.
Olmesartan	Olmesartan may decrease the excretion rate of Vincristine which could result in a higher serum level.
Omadacycline	The serum concentration of Vincristine can be increased when it is combined with Omadacycline.
Ombitasvir	The serum concentration of Vincristine can be increased when it is combined with Ombitasvir.
Omeprazole	The metabolism of Vincristine can be increased when combined with Omeprazole.
Ondansetron	The metabolism of Vincristine can be decreased when combined with Ondansetron.
Oritavancin	The metabolism of Vincristine can be increased when combined with Oritavancin.
Orphenadrine	The metabolism of Vincristine can be decreased when combined with Orphenadrine.
Osilodrostat	The metabolism of Vincristine can be decreased when combined with Osilodrostat.
Osimertinib	The metabolism of Vincristine can be decreased when combined with Osimertinib.
Oteseconazole	The serum concentration of Vincristine can be increased when it is combined with Oteseconazole.
Ouabain	Ouabain may decrease the cardiotoxic activities of Vincristine.
Oxaliplatin	The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Vincristine.
Oxcarbazepine	The metabolism of Vincristine can be increased when combined with Oxcarbazepine.
Oxetacaine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Oxetacaine.
Oxybuprocaine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Oxybuprocaine.
Oxybutynin	The metabolism of Vincristine can be decreased when combined with Oxybutynin.
Oxycodone	The metabolism of Vincristine can be decreased when combined with Oxycodone.
Ozanimod	The risk or severity of adverse effects can be increased when Vincristine is combined with Ozanimod.
Paclitaxel	The metabolism of Vincristine can be increased when combined with Paclitaxel.
Pacritinib	The serum concentration of Vincristine can be increased when it is combined with Pacritinib.
Palbociclib	The excretion of Vincristine can be decreased when combined with Palbociclib.
Paliperidone	The excretion of Vincristine can be decreased when combined with Paliperidone.
Pamidronic acid	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Pamidronic acid is combined with Vincristine.
Panobinostat	The risk or severity of adverse effects can be increased when Vincristine is combined with Panobinostat.
Pantoprazole	Pantoprazole may decrease the excretion rate of Vincristine which could result in a higher serum level.
Paritaprevir	The metabolism of Vincristine can be decreased when combined with Paritaprevir.
Pasireotide	The metabolism of Vincristine can be decreased when combined with Pasireotide.
Pazopanib	The metabolism of Vincristine can be decreased when combined with Pazopanib.
Pegaspargase	The risk or severity of adverse effects can be increased when Pegaspargase is combined with Vincristine.
Pegcetacoplan	The risk or severity of adverse effects can be increased when Vincristine is combined with Pegcetacoplan.
Pegfilgrastim	The risk or severity of peripheral neuropathy can be increased when Pegfilgrastim is combined with Vincristine.
Peginesatide	The risk or severity of Thrombosis can be increased when Peginesatide is combined with Vincristine.
Peginterferon alfa-2a	The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Vincristine.
Peginterferon alfa-2b	The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Vincristine.
Peginterferon beta-1a	The risk or severity of adverse effects can be increased when Vincristine is combined with Peginterferon beta-1a.
Pemetrexed	The risk or severity of adverse effects can be increased when Vincristine is combined with Pemetrexed.
Penicillamine	The risk or severity of adverse effects can be increased when Vincristine is combined with Penicillamine.
Pentamidine	The metabolism of Vincristine can be decreased when combined with Pentamidine.
Pentobarbital	The metabolism of Vincristine can be increased when combined with Pentobarbital.
Pentostatin	The risk or severity of adverse effects can be increased when Vincristine is combined with Pentostatin.
Perampanel	The metabolism of Vincristine can be increased when combined with Perampanel.
Perazine	Vincristine may increase the neurotoxic activities of Perazine.
Periciazine	Vincristine may increase the neurotoxic activities of Periciazine.
Perphenazine	Vincristine may increase the neurotoxic activities of Perphenazine.
Pertussis vaccine	The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Vincristine.
Pertuzumab	The risk or severity of cardiotoxicity can be increased when Vincristine is combined with Pertuzumab.
Phenobarbital	The metabolism of Vincristine can be increased when combined with Phenobarbital.
Phenol	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Phenol.
Phenylalanine	The risk or severity of adverse effects can be increased when Phenylalanine is combined with Vincristine.
Phenylbutazone	The metabolism of Vincristine can be increased when combined with Phenylbutazone.
Phenytoin	The serum concentration of Vincristine can be decreased when it is combined with Phenytoin.
Pibrentasvir	The excretion of Vincristine can be decreased when combined with Pibrentasvir.
Pimavanserin	The metabolism of Vincristine can be decreased when combined with Pimavanserin.
Pimecrolimus	The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Vincristine.
Pimozide	The metabolism of Pimozide can be decreased when combined with Vincristine.
Piperaquine	The metabolism of Vincristine can be decreased when combined with Piperaquine.
Pipotiazine	Vincristine may increase the neurotoxic activities of Pipotiazine.
Pirfenidone	The risk or severity of adverse effects can be increased when Vincristine is combined with Pirfenidone.
Pitavastatin	Vincristine may decrease the excretion rate of Pitavastatin which could result in a higher serum level.
Pitolisant	The serum concentration of Vincristine can be decreased when it is combined with Pitolisant.
Polymyxin B	Vincristine may increase the neurotoxic activities of Polymyxin B.
Pomalidomide	The risk or severity of adverse effects can be increased when Vincristine is combined with Pomalidomide.
Ponatinib	The excretion of Vincristine can be decreased when combined with Ponatinib.
Ponesimod	The metabolism of Vincristine can be decreased when combined with Ponesimod.
Posaconazole	The metabolism of Vincristine can be decreased when combined with Posaconazole.
Pralatrexate	The risk or severity of adverse effects can be increased when Vincristine is combined with Pralatrexate.
Pralsetinib	The excretion of Vincristine can be decreased when combined with Pralsetinib.
Pramocaine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Pramocaine.
Pravastatin	Pravastatin may decrease the excretion rate of Vincristine which could result in a higher serum level.

Naxitamab	Vincristine may increase the neurotoxic activities of Naxitamab.
Nefazodone	The metabolism of Vincristine can be decreased when combined with Nefazodone.
Nelarabine	The risk or severity of adverse effects can be increased when Vincristine is combined with Nelarabine.
Nelfinavir	The metabolism of Vincristine can be decreased when combined with Nelfinavir.
Neomycin	Vincristine may increase the neurotoxic activities of Neomycin.
Neratinib	The excretion of Vincristine can be decreased when combined with Neratinib.
Netupitant	The excretion of Vincristine can be decreased when combined with Netupitant.
Nevirapine	The metabolism of Vincristine can be decreased when combined with Nevirapine.
Niacin	The metabolism of Vincristine can be decreased when combined with Niacin.
Nicardipine	The metabolism of Vincristine can be decreased when combined with Nicardipine.
Nifedipine	The metabolism of Vincristine can be decreased when combined with Nifedipine.
Nilotinib	The excretion of Vincristine can be decreased when combined with Nilotinib.
Nilvadipine	The metabolism of Vincristine can be decreased when combined with Nilvadipine.
Nintedanib	The metabolism of Vincristine can be decreased when combined with Nintedanib.
Nisoldipine	The metabolism of Vincristine can be decreased when combined with Nisoldipine.
Nitrendipine	The metabolism of Vincristine can be decreased when combined with Nitrendipine.
Nitrofurantoin	Vincristine may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
Nizatidine	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Nizatidine.
Norethisterone	The metabolism of Vincristine can be decreased when combined with Norethisterone.
Norfloxacin	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Norfloxacin.
Norgestimate	The excretion of Vincristine can be decreased when combined with Norgestimate.
Nortriptyline	The serum concentration of Nortriptyline can be increased when it is combined with Vincristine.
Noscapine	The metabolism of Vincristine can be decreased when combined with Noscapine.
Novobiocin	Novobiocin may decrease the excretion rate of Vincristine which could result in a higher serum level.
Nuvaxovid	The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Vincristine.
Obinutuzumab	The risk or severity of adverse effects can be increased when Vincristine is combined with Obinutuzumab.
Ocrelizumab	Ocrelizumab may increase the immunosuppressive activities of Vincristine.
Octreotide	The serum concentration of Vincristine can be increased when it is combined with Octreotide.
Ofatumumab	The risk or severity of adverse effects can be increased when Vincristine is combined with Ofatumumab.
Ofloxacin	Vincristine may decrease the excretion rate of Ofloxacin which could result in a higher serum level.
Olaparib	The metabolism of Vincristine can be decreased when combined with Olaparib.
Olmesartan	Olmesartan may decrease the excretion rate of Vincristine which could result in a higher serum level.
Omadacycline	The serum concentration of Vincristine can be increased when it is combined with Omadacycline.
Ombitasvir	The serum concentration of Vincristine can be increased when it is combined with Ombitasvir.
Omeprazole	The metabolism of Vincristine can be increased when combined with Omeprazole.
Ondansetron	The metabolism of Vincristine can be decreased when combined with Ondansetron.
Oritavancin	The metabolism of Vincristine can be increased when combined with Oritavancin.
Orphenadrine	The metabolism of Vincristine can be decreased when combined with Orphenadrine.
Osilodrostat	The metabolism of Vincristine can be decreased when combined with Osilodrostat.
Osimertinib	The metabolism of Vincristine can be decreased when combined with Osimertinib.
Oteseconazole	The serum concentration of Vincristine can be increased when it is combined with Oteseconazole.
Ouabain	Ouabain may decrease the cardiotoxic activities of Vincristine.
Oxaliplatin	The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Vincristine.
Oxcarbazepine	The metabolism of Vincristine can be increased when combined with Oxcarbazepine.
Oxetacaine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Oxetacaine.
Oxybuprocaine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Oxybuprocaine.
Oxybutynin	The metabolism of Vincristine can be decreased when combined with Oxybutynin.
Oxycodone	The metabolism of Vincristine can be decreased when combined with Oxycodone.
Ozanimod	The risk or severity of adverse effects can be increased when Vincristine is combined with Ozanimod.
Paclitaxel	The metabolism of Vincristine can be increased when combined with Paclitaxel.
Pacritinib	The serum concentration of Vincristine can be increased when it is combined with Pacritinib.
Palbociclib	The excretion of Vincristine can be decreased when combined with Palbociclib.
Paliperidone	The excretion of Vincristine can be decreased when combined with Paliperidone.
Pamidronic acid	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Pamidronic acid is combined with Vincristine.
Panobinostat	The risk or severity of adverse effects can be increased when Vincristine is combined with Panobinostat.
Pantoprazole	Pantoprazole may decrease the excretion rate of Vincristine which could result in a higher serum level.
Paritaprevir	The metabolism of Vincristine can be decreased when combined with Paritaprevir.
Pasireotide	The metabolism of Vincristine can be decreased when combined with Pasireotide.
Pazopanib	The metabolism of Vincristine can be decreased when combined with Pazopanib.
Pegaspargase	The risk or severity of adverse effects can be increased when Pegaspargase is combined with Vincristine.
Pegcetacoplan	The risk or severity of adverse effects can be increased when Vincristine is combined with Pegcetacoplan.
Pegfilgrastim	The risk or severity of peripheral neuropathy can be increased when Pegfilgrastim is combined with Vincristine.
Peginesatide	The risk or severity of Thrombosis can be increased when Peginesatide is combined with Vincristine.
Peginterferon alfa-2a	The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Vincristine.
Peginterferon alfa-2b	The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Vincristine.
Peginterferon beta-1a	The risk or severity of adverse effects can be increased when Vincristine is combined with Peginterferon beta-1a.
Pemetrexed	The risk or severity of adverse effects can be increased when Vincristine is combined with Pemetrexed.
Penicillamine	The risk or severity of adverse effects can be increased when Vincristine is combined with Penicillamine.
Pentamidine	The metabolism of Vincristine can be decreased when combined with Pentamidine.
Pentobarbital	The metabolism of Vincristine can be increased when combined with Pentobarbital.
Pentostatin	The risk or severity of adverse effects can be increased when Vincristine is combined with Pentostatin.
Perampanel	The metabolism of Vincristine can be increased when combined with Perampanel.
Perazine	Vincristine may increase the neurotoxic activities of Perazine.
Periciazine	Vincristine may increase the neurotoxic activities of Periciazine.
Perphenazine	Vincristine may increase the neurotoxic activities of Perphenazine.
Pertussis vaccine	The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Vincristine.
Pertuzumab	The risk or severity of cardiotoxicity can be increased when Vincristine is combined with Pertuzumab.
Phenobarbital	The metabolism of Vincristine can be increased when combined with Phenobarbital.
Phenol	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Phenol.
Phenylalanine	The risk or severity of adverse effects can be increased when Phenylalanine is combined with Vincristine.
Phenylbutazone	The metabolism of Vincristine can be increased when combined with Phenylbutazone.
Phenytoin	The serum concentration of Vincristine can be decreased when it is combined with Phenytoin.
Pibrentasvir	The excretion of Vincristine can be decreased when combined with Pibrentasvir.
Pimavanserin	The metabolism of Vincristine can be decreased when combined with Pimavanserin.
Pimecrolimus	The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Vincristine.
Pimozide	The metabolism of Pimozide can be decreased when combined with Vincristine.
Piperaquine	The metabolism of Vincristine can be decreased when combined with Piperaquine.
Pipotiazine	Vincristine may increase the neurotoxic activities of Pipotiazine.
Pirfenidone	The risk or severity of adverse effects can be increased when Vincristine is combined with Pirfenidone.
Pitavastatin	Vincristine may decrease the excretion rate of Pitavastatin which could result in a higher serum level.
Pitolisant	The serum concentration of Vincristine can be decreased when it is combined with Pitolisant.
Polymyxin B	Vincristine may increase the neurotoxic activities of Polymyxin B.
Pomalidomide	The risk or severity of adverse effects can be increased when Vincristine is combined with Pomalidomide.
Ponatinib	The excretion of Vincristine can be decreased when combined with Ponatinib.
Ponesimod	The metabolism of Vincristine can be decreased when combined with Ponesimod.
Posaconazole	The metabolism of Vincristine can be decreased when combined with Posaconazole.
Pralatrexate	The risk or severity of adverse effects can be increased when Vincristine is combined with Pralatrexate.
Pralsetinib	The excretion of Vincristine can be decreased when combined with Pralsetinib.
Pramocaine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Pramocaine.
Pravastatin	Pravastatin may decrease the excretion rate of Vincristine which could result in a higher serum level.

Somatostatin	The metabolism of Vincristine can be decreased when combined with Somatostatin.
Somatotropin	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Somatotropin is combined with Vincristine.
Somatrogon	The metabolism of Vincristine can be increased when combined with Somatrogon.
Sorafenib	The excretion of Vincristine can be decreased when combined with Sorafenib.
Sotagliflozin	The excretion of Vincristine can be decreased when combined with Sotagliflozin.
Sotorasib	The serum concentration of Vincristine can be decreased when it is combined with Sotorasib.
Spesolimab	The risk or severity of adverse effects can be increased when Vincristine is combined with Spesolimab.
Spironolactone	Spironolactone may decrease the excretion rate of Vincristine which could result in a higher serum level.
St. John’s Wort	The serum concentration of Vincristine can be decreased when it is combined with St. John’s Wort.
Stavudine	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Stavudine.
Stiripentol	The metabolism of Vincristine can be decreased when combined with Stiripentol.
Streptozocin	The risk or severity of adverse effects can be increased when Streptozocin is combined with Vincristine.
Succinylcholine	Succinylcholine may increase the neurotoxic activities of Vincristine.
Sulfamethoxazole	The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Vincristine.
Sulfasalazine	The risk or severity of adverse effects can be increased when Vincristine is combined with Sulfasalazine.
Sulfinpyrazone	The metabolism of Vincristine can be increased when combined with Sulfinpyrazone.
Sulpiride	Sulpiride may increase the neurotoxic activities of Vincristine.
Sultopride	Vincristine may increase the neurotoxic activities of Sultopride.
Sumatriptan	The excretion of Sumatriptan can be decreased when combined with Vincristine.
Sunitinib	The metabolism of Sunitinib can be decreased when combined with Vincristine.
Suvorexant	The excretion of Vincristine can be decreased when combined with Suvorexant.
Tacrine	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Tacrine is combined with Vincristine.
Tacrolimus	Tacrolimus may increase the immunosuppressive activities of Vincristine.
Tadalafil	The metabolism of Vincristine can be decreased when combined with Tadalafil.
Tafamidis	The serum concentration of Vincristine can be increased when it is combined with Tafamidis.
Talazoparib	The serum concentration of Talazoparib can be increased when it is combined with Vincristine.
Tamoxifen	The excretion of Vincristine can be decreased when combined with Tamoxifen.
Tasimelteon	The metabolism of Vincristine can be decreased when combined with Tasimelteon.
Taurocholic acid	Taurocholic acid may increase the excretion rate of Vincristine which could result in a lower serum level and potentially a reduction in efficacy.
Tazemetostat	The metabolism of Vincristine can be decreased when combined with Tazemetostat.
Technetium	The excretion of Technetium Tc-99m mebrofenin can be decreased when combined with Vincristine.
Technetium	The serum concentration of Vincristine can be increased when it is combined with Technetium Tc-99m sestamibi.
Tecovirimat	The metabolism of Vincristine can be increased when combined with Tecovirimat.
Tegafur	The metabolism of Tegafur can be decreased when combined with Vincristine.
Tegaserod	The serum concentration of Vincristine can be increased when it is combined with Tegaserod.
Telaprevir	The excretion of Vincristine can be decreased when combined with Telaprevir.
Telithromycin	The metabolism of Vincristine can be decreased when combined with Telithromycin.
Telmisartan	Telmisartan may decrease the excretion rate of Vincristine which could result in a higher serum level.
Telotristat ethyl	The serum concentration of Vincristine can be decreased when it is combined with Telotristat ethyl.
Temozolomide	The risk or severity of adverse effects can be increased when Vincristine is combined with Temozolomide.
Temsirolimus	The excretion of Vincristine can be decreased when combined with Temsirolimus.
Teniposide	Teniposide may increase the neurotoxic activities of Vincristine.
Tenofovir alafenamide	The metabolism of Vincristine can be decreased when combined with Tenofovir alafenamide.
Tenofovir disoproxil	The serum concentration of Vincristine can be increased when it is combined with Tenofovir disoproxil.
Tepotinib	The serum concentration of Vincristine can be increased when it is combined with Tepotinib.
Teprotumumab	The risk or severity of adverse effects can be increased when Vincristine is combined with Teprotumumab.
Terbinafine	The metabolism of Vincristine can be increased when combined with Terbinafine.
Terfenadine	The metabolism of Vincristine can be decreased when combined with Terfenadine.
Teriflunomide	The risk or severity of adverse effects can be increased when Vincristine is combined with Teriflunomide.
Testosterone	The metabolism of Vincristine can be increased when combined with Testosterone.
Testosterone cypionate	The metabolism of Vincristine can be decreased when combined with Testosterone cypionate.
Testosterone enanthate	The metabolism of Vincristine can be decreased when combined with Testosterone enanthate.
Tetracaine	The risk or severity of methemoglobinemia can be increased when Vincristine is combined with Tetracaine.
Tetracycline	The metabolism of Vincristine can be decreased when combined with Tetracycline.
Tezacaftor	The metabolism of Vincristine can be decreased when combined with Tezacaftor.
Thalidomide	The risk or severity of peripheral neuropathy can be increased when Thalidomide is combined with Vincristine.
Thiamylal	The metabolism of Vincristine can be increased when combined with Thiamylal.
Thiethylperazine	Thiethylperazine may increase the neurotoxic activities of Vincristine.
Thioridazine	Vincristine may increase the neurotoxic activities of Thioridazine.
Thiotepa	The risk or severity of adverse effects can be increased when Vincristine is combined with Thiotepa.
Thiothixene	Vincristine may increase the neurotoxic activities of Thiothixene.
Ticagrelor	The excretion of Vincristine can be decreased when combined with Ticagrelor.
Tick-borne	The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Vincristine.
Tinidazole	Vincristine may decrease the excretion rate of Tinidazole which could result in a higher serum level.
Tioguanine	The risk or severity of adverse effects can be increased when Tioguanine is combined with Vincristine.
Tipranavir	The serum concentration of Vincristine can be decreased when it is combined with Tipranavir.
Tivozanib	Tivozanib may decrease the excretion rate of Vincristine which could result in a higher serum level.
Tixocortol	The risk or severity of adverse effects can be increased when Vincristine is combined with Tixocortol.
Tocilizumab	The metabolism of Vincristine can be increased when combined with Tocilizumab.
Tofacitinib	Vincristine may increase the immunosuppressive activities of Tofacitinib.
Tolvaptan	The serum concentration of Tolvaptan can be increased when it is combined with Vincristine.
Topiramate	The metabolism of Vincristine can be increased when combined with Topiramate.
Topotecan	The risk or severity of adverse effects can be increased when Vincristine is combined with Topotecan.
Torasemide	The excretion of Torasemide can be decreased when combined with Vincristine.
Toremifene	The excretion of Vincristine can be decreased when combined with Toremifene.
Tositumomab	The risk or severity of adverse effects can be increased when Tositumomab is combined with Vincristine.
Trabectedin	The risk or severity of adverse effects can be increased when Vincristine is combined with Trabectedin.
Trastuzumab	Trastuzumab may increase the neutropenic activities of Vincristine.
Trastuzumab emtansine	The metabolism of Trastuzumab emtansine can be decreased when combined with Vincristine.
Trazodone	The serum concentration of Vincristine can be decreased when it is combined with Trazodone.
Tretinoin	The metabolism of Vincristine can be decreased when combined with Tretinoin.
Triamcinolone	The metabolism of Vincristine can be increased when combined with Triamcinolone.
Triazolam	The metabolism of Vincristine can be decreased when combined with Triazolam.
Triclabendazole	The metabolism of Vincristine can be decreased when combined with Triclabendazole.
Trifluoperazine	Vincristine may increase the neurotoxic activities of Trifluoperazine.
Triflupromazine	Triflupromazine may increase the neurotoxic activities of Vincristine.
Trifluridine	The risk or severity of adverse effects can be increased when Trifluridine is combined with Vincristine.
Trilaciclib	The serum concentration of Vincristine can be increased when it is combined with Trilaciclib.
Trilostane	The risk or severity of adverse effects can be increased when Vincristine is combined with Trilostane.
Trimethoprim	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Trimethoprim is combined with Vincristine.
Trimipramine	The serum concentration of Trimipramine can be increased when it is combined with Vincristine.
Troglitazone	The metabolism of Vincristine can be increased when combined with Troglitazone.
Troleandomycin	The metabolism of Vincristine can be decreased when combined with Troleandomycin.

Tubocurarine	Vincristine may increase the neurotoxic activities of Tubocurarine.
Tucatinib	Tucatinib may decrease the excretion rate of Vincristine which could result in a higher serum level.
Typhoid vaccine	The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Vincristine.
Typhoid Vaccine Live	The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Vincristine.
Typhoid	The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Vincristine.
Ubidecarenone	The risk or severity of myopathy, rhabdomyolysis, and myoglobinuria can be increased when Vincristine is combined with Ubidecarenone.
Ubrogepant	The serum concentration of Vincristine can be increased when it is combined with Ubrogepant.
Udenafil	The metabolism of Vincristine can be decreased when combined with Udenafil.
Umbralisib	The excretion of Vincristine can be decreased when combined with Umbralisib.
Umeclidinium	The serum concentration of Vincristine can be increased when it is combined with Umeclidinium.
Upadacitinib	The risk or severity of adverse effects can be increased when Vincristine is combined with Upadacitinib.
Ursodeoxycholic acid	Ursodeoxycholic acid may decrease the excretion rate of Vincristine which could result in a higher serum level.
Valbenazine	The metabolism of Vincristine can be decreased when combined with Valbenazine.
Valproate bismuth	Vincristine may increase the neurotoxic activities of Valproate bismuth.
Valproic acid	The metabolism of Vincristine can be decreased when combined with Valproic acid.
Valsartan	The excretion of Valsartan can be decreased when combined with Vincristine.
Vandetanib	The excretion of Vincristine can be decreased when combined with Vandetanib.
Vardenafil	The excretion of Vincristine can be decreased when combined with Vardenafil.
Varicella zoster	The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Vincristine.
Varicella zoster	The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Vincristine.
Vasopressin	Vincristine may increase the fluid retaining and vasopressor activities of Vasopressin.
Vedolizumab	The risk or severity of adverse effects can be increased when Vincristine is combined with Vedolizumab.
Velpatasvir	The excretion of Vincristine can be decreased when combined with Velpatasvir.
Vemurafenib	The serum concentration of Vincristine can be increased when it is combined with Vemurafenib.
Venetoclax	The excretion of Vincristine can be decreased when combined with Venetoclax.
Venlafaxine	Venlafaxine may increase the excretion rate of Vincristine which could result in a lower serum level and potentially a reduction in efficacy.
Verapamil	The excretion of Vincristine can be decreased when combined with Verapamil.
Vibrio cholerae	The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Vincristine.
Vilanterol	The risk or severity of adverse effects can be increased when Vincristine is combined with Vilanterol.
Viloxazine	The metabolism of Vincristine can be decreased when combined with Viloxazine.
Vinblastine	The metabolism of Vincristine can be increased when combined with Vinblastine.
Vindesine	The risk or severity of adverse effects can be increased when Vindesine is combined with Vincristine.
Vinflunine	The serum concentration of Vinflunine can be increased when it is combined with Vincristine.
Vinorelbine	The risk or severity of adverse effects can be increased when Vinorelbine is combined with Vincristine.
Viomycin	Vincristine may increase the neurotoxic activities of Viomycin.
Vismodegib	Vismodegib may decrease the excretion rate of Vincristine which could result in a higher serum level.
Vitamin E	The metabolism of Vincristine can be increased when combined with Vitamin E.
Voclosporin	The serum concentration of Vincristine can be increased when it is combined with Voclosporin.
Vonoprazan	The metabolism of Vincristine can be decreased when combined with Vonoprazan.
Vorapaxar	The excretion of Vincristine can be decreased when combined with Vorapaxar.
Voriconazole	The metabolism of Vincristine can be decreased when combined with Voriconazole.
Vorinostat	The risk or severity of adverse effects can be increased when Vincristine is combined with Vorinostat.
Vortioxetine	The metabolism of Vincristine can be decreased when combined with Vortioxetine.
Voxelotor	The serum concentration of Vincristine can be increased when it is combined with Voxelotor.
Voxilaprevir	The excretion of Vincristine can be decreased when combined with Voxilaprevir.
Warfarin	The metabolism of Vincristine can be increased when combined with Warfarin.
Yellow fever vaccine	The risk or severity of infection can be increased when the Yellow fever vaccine is combined with Vincristine.
Zafirlukast	The metabolism of Vincristine can be decreased when combined with Zafirlukast.

Pregnancy and Lactation

FDA Pregnancy category D

Pregnancy

There is a possibility of birth defect if either partner is using vincristine at the time of conception, or if it is taken during pregnancy. It may also harm the baby in other ways if used during pregnancy. Use effective birth control while you are taking this medication, and tell the doctor immediately if you become pregnant.

Breast-feeding

It is not known whether vincristine passes into breast milk. Because of the risk of harm to the infant, women should not breastfeed while receiving vincristine.

How should this medicine be used?

Vincristine comes as a solution (liquid) to be injected intravenously (into a vein) by a doctor or nurse in a medical facility. It is usually given once a week. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.

Your doctor may need to delay your treatment or change your dose if you experience certain side effects. It is important for you to tell your doctor how you are feeling during your treatment with a vincristine injection.

Your doctor may tell you to take a stool softener or laxative to help prevent constipation during your treatment with a vincristine injection.

What special precautions should I follow?

Before receiving vincristine,

• tell your doctor and pharmacist if you are allergic to vincristine, any other medications, or any of the ingredients in vincristine injection. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: aprepitant (Emend); carbamazepine (Tegretol); certain antifungals such as itraconazole (Sporanox), ketoconazole (Nizoral), voriconazole (Vfend), and posaconazole (Noxafil); clarithromycin (Biaxin, in Prevpac); darifenacin (Enablex); dexamethasone (Decadron); fesoterodine (Toviaz); HIV protease inhibitors including atazanavir (Reyataz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); nefazodone; oxybutynin (Ditropan, Ditropan XL, Oxytrol); phenobarbital; phenytoin (Dilantin); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane); rifapentine (Priftin); solifenacin (Vesicare); telithromycin (Ketek); trospium (Sanctura); or tolterodine (Detrol, Detrol LA). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor what herbal products you are taking, especially St. John’s wort.
• tell your doctor if you have or have ever had a disorder that affects your nerves. Your doctor may not want you to receive a vincristine injection.
• tell your doctor if you are having or have ever had radiation (x-ray) therapy, if you have an infection, or if you have or have ever had lung or liver disease.
• you should know that vincristine may interfere with the normal menstrual cycle (period) in women and may temporarily or permanently stop sperm production in men. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You should not become pregnant or breastfeed while you are receiving a vincristine injection. If you become pregnant while receiving a vincristine injection, call your doctor. Vincristine may harm the fetus.

References

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