Products Affected - Description
Vincasar PFS 1 mg/mL – Teva2
1 mL vial (NDC 00703-4402-11)
2 mL vial (NDC 00703-4412-11)
Reason for the Shortage
- Hospira states the shortage was due to manufacturing delays.1
- Teva states vincristine injection is 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)
Estimated Resupply Dates
Teva has Vincasar 1 mL and 2 mL vials available on allocation. Additional supplies are expected to be available in early- to mid-August 2014.2
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, and July 21, 2014.
- Teva (personal communications). February 12, March 3, May 8, and July 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 July 21, 2014 by Leslie Jensen, 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.
This information is provided through the support of Novation to ASHP solely as a service to its members, which shall not use this information for their further commercial use. The content was prepared by the Drug Information Center of University of Utah. Novation, ASHP, and the University of Utah make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, which respect to such information, and specifically disclaim all such warranties. Users of this information are advised that decisions regarding the use of drugs and drug therapies are complex medical decisions and that in using this information, each user must exercise his or her own independent professional judgment. Neither Novation, ASHP nor the University of Utah assumes any liability for persons administering or receiving drugs or other medical care in reliance upon this information, or otherwise in connection with this bulletin. Neither Novation, ASHP nor University of Utah endorses or recommends the use of any drug.
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