Vincristine Dosage

Usual Adult Dose for Neuroblastoma

Standard Dose: 1.4 mg/m2 IV over one minute, once. The drug is generally administered once a week.

However, doses from 0.4 to 1.4 mg/m2 IV have been used. Dosages of vincristine 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.

Maximum Dose = 2 mg

Usual Adult Dose for non-Hodgkin's Lymphoma

Standard Dose: 1.4 mg/m2 IV over one minute, once. The drug is generally administered once a week.

However, doses from 0.4 to 1.4 mg/m2 IV have been used. Dosages of vincristine 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.

Maximum Dose = 2 mg

Usual Adult Dose for Hodgkin's Disease

Standard Dose: 1.4 mg/m2 IV over one minute, once. The drug is generally administered once a week.

However, doses from 0.4 to 1.4 mg/m2 IV have been used. Dosages of vincristine 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.

Maximum Dose = 2 mg

Usual Adult Dose for Acute Myeloid Leukemia

Standard Dose: 1.4 mg/m2 IV over one minute, once. The drug is generally administered once a week.

However, doses from 0.4 to 1.4 mg/m2 IV have been used. Dosages of vincristine 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.

Maximum Dose = 2 mg

Usual Adult Dose for Wilms' Tumor

Standard Dose: 1.4 mg/m2 IV over one minute, once. The drug is generally administered once a week.

However, doses from 0.4 to 1.4 mg/m2 IV have been used. Dosages of vincristine 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.

Maximum Dose = 2 mg

Usual Adult Dose for Acute Lymphocytic Leukemia

Standard Dose: 1.4 mg/m2 IV over one minute, once. The drug is generally administered once a week.

However, doses from 0.4 to 1.4 mg/m2 IV have been used. Dosages of vincristine 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.

Maximum Dose = 2 mg

Usual Adult Dose for Rhabdomyosarcoma

Standard Dose: 1.4 mg/m2 IV over one minute, once. The drug is generally administered once a week.

However, doses from 0.4 to 1.4 mg/m2 IV have been used. Dosages of vincristine 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.

Maximum Dose = 2 mg

Usual Adult Dose for Multiple Myeloma

(In combination with other chemotherapeutic agents as a part of the VAD regimen)
0.4 mg/day IV continuous infusion on days 1 through 4

(In combination with other chemotherapeutic agents as a part of the M2 protocol)
0.03 mg/day IV on day 1

Usual Pediatric Dose for Malignant Disease

less than 18 years and less than or equal to 10 kg or BSA less than 1 m2: 0.05 mg/kg once a week

less than 18 years and greater than 10 kg or BSA greater than or equal to 1 m2: 1 to 2 mg/m2 once a week

Subsequent doses may be determined by the clinical and hematologic response of the patient.

Maximum Dose = 2 mg.

Usual Pediatric Dose for Neuroblastoma

1 mg/m2/day by continuous infusion for 72 hours with doxorubicin

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

The manufacturer recommends a 50% dose reduction for patients having a serum bilirubin value above 3 mg/100 mL. However, some clinicians recommend a 50% dose reduction for serum bilirubin values ranging from 1.5 to 3 mg/100 mL.

Dialysis

Data not available

Other Comments

Because the dose-limiting side effect is neurotoxicity, clinical evaluation is necessary to detect the need for dosage reduction or discontinuation. Although vincristine is only mildly myelosuppressive, the manufacturer recommends a complete blood count before the administration of each dose. Serum uric acid levels should be determined frequently during the first three to four weeks, or appropriate measures should be taken to avoid uric acid nephropathy.

A routine prophylactic regimen against constipation may be considered. Other medications known to cause urinary retention (particularly in the elderly) should, if possible, be discontinued for the first few days following the administration of vincristine.

The drug should not be administered to patients while they are receiving radiation therapy through ports that include the liver.

If the drug is to be used in combination with L-asparaginase, vincristine should be administered 12 to 24 hours before L-asparaginase in order to minimize toxicity. The administration of L-asparaginase before vincristine may reduce the hepatic clearance of vincristine.

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