Vincristina
Vincristine
Vincristine sulfate
También conocido como: Oncovin · Vincasar PFS · leurocristine sulfate · VCR · LCR compound 37231 · NSC-67574 · 22oxovincaleukoblastine sulphate · sulfato de vincristina · vincristini sulfas · Vincristine sulfate
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Neoplastic diseases (usually in combination protocols) | 0.5-0.75 mg/m2 | IV | every 1-2 weeks | — | 🌎 NA |
| Transmissible venereal tumor (TVT) | 0.5 mg/m2 (maximum dose 1 mg) | IV | once weekly | for 4-6 weeks | 🌎 NA |
| Adjunctive treatment of immune-mediated thrombocytopenia (IMT) | 0.5 mg/m2 | IV | once | — | 🌎 NA |
| Adjunctive treatment of immune-mediated thrombocytopenia (IMT) refractory to prednisone | 0.5-0.7 mg/m2 | IV | once | — | 🌎 NA |
| Adjunctive treatment of immune-mediated thrombocytopenia (IMT) | 0.02 mg/kg | IV | once | — | 🌎 NA |
| Neoplastic diseases (particularly lymphoproliferative disorders), immune-mediated thrombocytopenia, transmissible venereal tumour | See Appendix for chemotherapy protocols and conversion of body weight to body surface area. | IV | Not specified | Not specified | 🌍 EU |
- Neoplastic diseases (usually in combination protocols): Dosed in mg/m2, NOT mg/kg. Consultation with an oncologist recommended.
- Transmissible venereal tumor (TVT): Used as sole therapy.
- Adjunctive treatment of immune-mediated thrombocytopenia (IMT): If platelet count <10-20,000 cells/mcL or bleeding; consider bone marrow aspiration to document megakaryocytes.
- Adjunctive treatment of immune-mediated thrombocytopenia (IMT) refractory to prednisone: Given as an IV bolus or as an infusion over 4-6 hours.
- Adjunctive treatment of immune-mediated thrombocytopenia (IMT): Generally single use.
- Neoplastic diseases (particularly lymphoproliferative disorders), immune-mediated thrombocytopenia, transmissible venereal tumour: Must be administered i.v. through a carefully pre-placed catheter.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Neoplastic diseases | 0.5-0.75 mg/m2 | IV | every 1-3 weeks | — | 🌎 NA |
| Neoplastic diseases (particularly lymphoproliferative disorders) | See Appendix for chemotherapy protocols and conversion of body weight to body surface area. | IV | Not specified | Not specified | 🌍 EU |
- Neoplastic diseases: Dosed in mg/m2, NOT mg/kg. Consultation with an oncologist recommended.
- Neoplastic diseases (particularly lymphoproliferative disorders): Must be administered i.v. through a carefully pre-placed catheter.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Neoplastic diseases | 0.5 mg/m2 (usually 2.5-3 mg total dose per horse) | IV | weekly | — | 🌎 NA |
- Neoplastic diseases: Often used in CAP protocol with cytarabine and cyclophosphamide.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La vincristina es un agente antineoplásico específico del ciclo celular (fase M) derivado de la planta vinca (Catharanthus roseus). Es un pilar en la oncología veterinaria, utilizado principalmente en protocolos de quimioterapia combinada (como CHOP) para neoplasias linfoides y hematopoyéticas como el linfoma.
Aspectos clínicos destacados:
- Respeto a la médula ósea: A diferencia de muchos otros quimioterapéuticos (por ejemplo, su análogo la vinblastina), la vincristina destaca por no ser mielosupresora a dosis estándar, lo que la hace altamente valiosa en protocolos combinados.
- Tumor Venéreo Transmisible (TVT): Es altamente eficaz como agente único para el TVT en perros.
- Trombocitopenia Inmunomediada (TIM): La vincristina se utiliza de forma única para tratar la TIM refractaria. Promueve la fragmentación de los megacariocitos, lo que conduce a una liberación rápida de plaquetas en la circulación.
- Vesicante: Es un vesicante tisular severo; es obligatoria la administración intravenosa estricta a través de un catéter perfectamente colocado para prevenir lesiones devastadoras por extravasación.
Mecanismo de acción
Vincristine is a cell-cycle specific agent that acts during the M-phase (mitosis).
- Antineoplastic Action: It binds specifically to tubulin dimers → inhibits microtubule polymerization → prevents the formation of the mitotic spindle → arrests cell division in metaphase, ultimately leading to apoptosis.
- Metabolic Effects: It interferes with amino acid metabolism by inhibiting glutamic acid utilization and preventing purine synthesis, citric acid cycle, and urea formation.
- Thrombocytosis: The exact mechanism is unknown, but it is believed to stimulate megakaryocyte fragmentation, accelerating the release of platelets into the peripheral blood.
- Immunosuppression: Exhibits mild immunosuppressive activity, which may contribute to its efficacy in immune-mediated conditions.
Seguridad y advertencias
Contraindicaciones
- Preexisting neuromuscular disease
- Severe leukopenia
- Uncontrolled infection
- No specific absolute contraindications listed, but requires extreme caution in specific disease states
Efectos adversos
- Peripheral neuropathy (proprioceptive deficits, spinal hyporeflexia)
- Paralytic ileus and severe constipation
- Mild leukopenia
- Tissue necrosis and sloughing (if extravasated)
- Anorexia, vomiting, diarrhea
- Impaired platelet aggregation
- Increased liver enzymes
- Syndrome of inappropriate ADH secretion (SIADH)
- Jaw pain
- Alopecia
- Stomatitis
- Seizures
- Pulmonary edema (rare, reported in cats)
- GI tract toxicity
- Severe local irritation/tissue necrosis (if administered perivascularly)
- Myelosuppression (potential)
Precauciones
Extravasation Warning: Vincristine is a potent vesicant. It must be given strictly IV. Use a different needle for injection than the one used to draw the drug from the vial. If extravasation occurs, stop immediately, apply moderate heat (or ice, depending on protocol), and consider topical DMSO or hyaluronidase injections.
- ABCB1 (MDR1) Mutation: Herding breeds (e.g., Collies, Australian Shepherds) with this mutation are highly susceptible to severe bone marrow suppression and GI toxicity. Reduce dose by 25-30% in mutant/normal or mutant/mutant dogs.
- Hepatic Impairment: Extensively metabolized by the liver. Consider a 50% dose reduction if serum bilirubin is > 2 mg/dL.
- Neurotoxicity: Cats are particularly sensitive to neurotoxicity, which can manifest as paralytic ileus, severe constipation, and reversible axon swelling.
- Handling: Wear gloves and protective clothing. Wash thoroughly with soap and water if skin exposure occurs.
- Pregnancy: Potentially teratogenic and embryotoxic (FDA Category D).
Interacciones farmacológicas
Additive neurotoxicity may occur; less common if asparaginase is administered after vincristine.
Severe bronchospasm has occurred in humans receiving mitomycin-C with Vinca alkaloids.
Inhibits P-glycoprotein; may increase vincristine toxicity, especially in MDR1/ABCB1 mutant dogs.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Inhibits P-glycoprotein; may increase vincristine toxicity.
Decreased metabolism of vincristine and increased toxicity
Reduced clearance of vincristine and increased toxicity if given with or before vincristine (vincristine should be given 12-24 hours before L-asparaginase)
Monitorización
- Efficacy (tumor burden reduction or platelet count)
- Peripheral neuropathic clinical signs (e.g., gait abnormalities, constipation)
- Complete blood counts (CBC) with platelets
- Liver function tests (prior to therapy and repeated as necessary)
- Serum uric acid
- Complete Blood Count (CBC) prior to each dose
- IV catheter site for any signs of extravasation during administration
- Gastrointestinal signs (monitoring for ileus or severe constipation)
- Neurological exams (monitoring for peripheral neuropathy, e.g., dragging paws, loss of reflexes)
Farmacocinética
Vida media
Absorción
Unpredictably absorbed from the GI tract; must be administered IV.
Distribución
Rapidly distributed to tissues after injection. In humans, ~75% is bound to tissue proteins. Does not appreciably enter the CNS.
Metabolismo
Extensively metabolized, presumably by the liver.
Eliminación
Primarily excreted in the bile/feces; lesser amounts are eliminated in the urine.
Sobredosis
Vincristine has a narrow therapeutic index.
- Dogs: The maximally tolerated dose is reported as 0.06 mg/kg every 7 days for 6 weeks. Toxicity signs include slight anemia, leukopenia, increased liver enzymes, and neuronal shrinkage in the peripheral and central nervous systems.
- Cats: The lethal dose is reportedly 0.1 mg/kg. Toxic signs include weight loss, seizures, leukopenia, and general debilitation. A reported 10X overdose (5 mg/m2) resulted in death within 72 hours despite intensive care (including calcium folinate).
- Treatment: Primarily supportive. Includes cardiovascular and hematologic monitoring, anticonvulsants for seizures, and prevention of ileus. Fluid restriction and loop diuretics may be needed to manage SIADH. Leucovorin calcium has been used in humans, but efficacy is unconfirmed.
Productos disponibles
Formulaciones
- Injection
- Injectable: 1 mg, 2 mg, 5 mg vials
Etiquetado para humanos
- Vincristine Sulfate Injection: 1 mg/mL in 1 mL, 2 mL & 5 mL vials and flip-top vials (Vincasar PFS; generic)
- Oncovin
- Vincristine 1 mg, 2 mg, 5 mg vials
Estado regulador
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Protect from light and store in the refrigerator (2-8°C).
Información para el cliente
La vincristina es un fármaco de quimioterapia potente utilizado para tratar el cáncer y ciertos trastornos del sistema inmunológico.
- Riesgos de toxicidad: Aunque generalmente es bien tolerada, pueden ocurrir efectos secundarios graves. Contacte a su veterinario inmediatamente si su mascota muestra depresión profunda, sangrado o hematomas anormales, diarrea con sangre, estreñimiento severo o dificultad para caminar (neuropatía).
- Precauciones de seguridad en el hogar: El fármaco y sus productos de degradación se excretan en los fluidos corporales de su mascota. Evite el contacto directo con la orina, saliva o heces de su mascota hasta 7 días después del tratamiento. Use guantes al limpiar los desechos y lávese bien las manos después.
- Dosis omitidas: Los programas de quimioterapia son muy estrictos. Si pierde una cita, contacte a su veterinario inmediatamente para reprogramar.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.