Vincristine (Oncovin)

Vincristine is a chemotherapy drug used to treat various types of cancer including breast cancer, lung cancer, non Hodgkin's lymphoma (NHL), leukaemia and brain tumours. 

Vincristine belongs to the group of drugs called vinca alkaloids. These are often called plant alkaloids because the first of these drugs was developed from the periwinkle plant (vinca). These drugs are sometimes called microtubule inhibitors. This describes the way they work in damaging cancer cells. Vincristine works by stopping the cancer cells from separating into two new cells. So it blocks the growth of the cancer.

Vincristine is a clear liquid. You have it into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drug directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.

You usually have vincristine chemotherapy as a course of several cycles of treatment. The treatment plan depends on which cancer you have. There is more about how doctors plan chemotherapy in the chemotherapy section.

Vincristine side effects are listed below. You can use the links to find out more about each side effect or go to the cancer drug side effects section.

More than 10 in every 100 people have one or more of these.

• Tiredness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• Severe constipation with abdominal pain occurs in 1 in 3 people (30%) but this can generally be prevented with regular laxatives – if you are constipated for more than 3 days, tell your doctor or nurse
• The bowel may stop working temporarily (called paralytic ileus) and may cause sickness, a swollen abdomen and stomach cramps – this is more common in children
• Numbness and tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons – this starts within a few days or weeks and usually goes within a few months of finishing treatment
• Women may stop having periods (amenorrhoea) but this may only be temporary
• Loss of fertility – you may not be able to get pregnant or father a child after treatment with vincristine, so it is important to talk to your doctor about your fertility before starting treatment if having a baby is important to you
• Vincristine may harm a developing baby so it is not advisable to become pregnant or father a child if you are having this drug – talk about contraception with your doctor before having the treatment if there is any chance you or your partner could become pregnant
• Feeling or being sick is usually mild and well controlled with anti sickness injections and tablets
• Hair thinning or complete hair loss (alopecia) occurs in about 1 in 5 people (20%) – if you have this, it will probably start about 3 to 4 weeks after your treatment but is temporary and your hair will grow back when your treatment is finished
• You should not breastfeed while having this drug as it may come through in the breast milk

Between 1 and 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
• Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)

Some of these side effects can be life threatening, particularly infections. You should contact your hospital if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other occasional side effects include

• Inflammation around the drip site – if you notice any signs of redness, pain, swelling or leaking at your drip site, tell your chemotherapy nurse immediately
• Effect on the bladder nerves, causing temporary bladder leakage (incontinence)
• Taste changes
• Loss of appetite
• Mouth ulcers
• Jaw pain, caused by vincristine affecting your nerves
• A high temperature (fever) in children, starting 6 to 24 hours after treatment and lasting for 2 or 3 day – tell the doctor or specialist nurse and don't assume the temperature is caused by the drug

With high doses of vincristine, or after many treatments, effects on the nerves (neuropathy) can be greater. You may have

• Cramps
• Staggering
• Bone pain
• Blurred or double vision
• Hearing loss
• Dizziness

Very rarely you may have

• Confusion
• Depression
• Hallucinations

These side effects are temporary and usually go back to normal within two months of finishing the vincristine treatment. If you have any of these side effects let your doctor or nurse know.

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.