Products Affected - Description
Vincristine 1 mg/mL
Vincasar PFS 1 mg/mL – Teva
Reason for the Shortage
- Hospira states the shortage was due to manufacturing delays.1
- Teva states vincristine injection was on shortage due to manufacturing delays.2
Vincristine 1 mg/mL - Hospira1
1 mL vial (NDC 61703-0309-06)
2 mL vial (NDC 61703-0309-16)
Vincasar PFS 1 mg/mL – Teva2
1 mL vial (NDC 00703-4402-11)
2 mL vial (NDC 00703-4412-11)
Estimated Resupply Dates
All presentations are currently available.
Implications for Patient Care
- Vincristine is an antineoplastic vinca alkaloid agent. It is labeled for the treatment of acute leukemia. It is labeled in combination with other antineoplastic agents for the treatment of Hodgkin disease, non-Hodgkin lymphomas, rhabdomyosarcoma, neuroblastoma, and Wilms’ tumor.3-5
- Vincristine is used off-label for a variety of neoplastic diseases including Kaposi’s sarcoma, breast cancer, bladder cancer, small cell lung carcinoma, brain tumors, multiple myeloma, and chronic lymphocytic and myelocytic leukemias. It has also been used in the treatment of postherpetic neuralgia, idiopathic thrombocytopenic purpura, and autoimmune hemolytic anemia.3-5
- Vincristine is typically used in combination with other antineoplastic agents.3-5
- Chemotherapy agents, such as vincristine, pose additional safety risks both for patients and for healthcare workers handling these agents.3,4
- Use additional caution when processing orders for chemotherapy drugs, especially when switching between chemotherapy agents or when processing orders for chemotherapy agents with which staff may be unfamiliar (eg, those not normally prescribed at a specific institution).3,4
Alternative Agents & Management
- The choice of an alternative agent must be patient-specific and based on renal function, liver function, and the neoplasm type and location. No single agent can be substituted for vincristine.3-5
- Consider evaluating the health-care system’s total supply of vincristine before beginning patients on combination chemotherapy regimens containing vincristine. If adequate supplies are not available, select an alternative regimen.
- Consult a Hematology/Oncology specialist for patient- and neoplasm-specific recommendations.
- Refer to the ASHP Guidelines on Managing Drug Product Shortages for more guidance on developing a multidisciplinary plan when the supply must be allocated.
- Hospira (personal communications and website). February 12, March 3, April 3, May 8, June 2 and 25, July 21, and August 22, 2014.
- Teva (personal communications). February 12, March 3, May 8, July 21, and August 21, 2014.
- Beckwith MC, Tyler LS, eds. Cancer Chemotherapy Manual. St. Louis, MO: Wolters Kluwer Health Inc. 2010.
- Antineoplastic agents. In: McEvoy GK, ed. AHFS 2010 Drug Information. Bethesda, MD: American Society of Health-Systems Pharmacists; 2010: 902-1260.
- Drug Facts and Comparisons Online. St. Louis, MO: Wolters Kluwer Health Inc. September 2010.
Updated August 26, 2014 by Megan Dryer, PharmD, Drug Information Specialist. Created September 8, 2010, by Leslie Jensen, PharmD and M. Christina Beckwith, PharmD, Drug Information Specialists. Copyright 2014, Drug Information Service, University of Utah, Salt Lake City, UT.
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