What are the main uses of vincristine in cancer treatment. How does vincristine work to stop cancer cell growth. What are the most common side effects of vincristine chemotherapy. How is vincristine typically administered to patients.

What is Vincristine and How Does it Work?

Vincristine is a powerful chemotherapy drug belonging to a class of medications known as vinca alkaloids. It plays a crucial role in the treatment of various types of cancer by interfering with cell division. But how exactly does vincristine work to combat cancer cells?

The primary mechanism of action for vincristine involves preventing cancer cells from separating into two new cells during the process of cell division. By binding to tubulin proteins and inhibiting the formation of microtubules, vincristine effectively halts the growth and spread of cancer cells. This targeted approach makes vincristine an essential component in many cancer treatment regimens.

Types of Cancer Treated with Vincristine

Vincristine has shown efficacy in treating a wide range of cancer types, including:

• Leukemias (particularly acute lymphoblastic leukemia)
• Lymphomas (Hodgkin’s and non-Hodgkin’s lymphoma)
• Neuroblastoma
• Wilms’ tumor
• Rhabdomyosarcoma
• Brain tumors

It’s important to note that vincristine is typically used in combination with other chemotherapy drugs to maximize its effectiveness and target cancer cells through multiple pathways.

How is Vincristine Administered to Patients?

Vincristine is administered intravenously, meaning it is delivered directly into the bloodstream. There are two primary methods of administration:

1. Through a cannula: A small tube is inserted into a vein in the patient’s arm or hand, and the drug is delivered via a drip.
2. Via a central line: A long plastic tube is inserted into a large vein in the chest or arm, allowing for repeated administration over an extended period.

The choice between these methods often depends on the specific treatment plan and the duration of therapy. Central lines are particularly useful for patients requiring multiple cycles of chemotherapy over several months.

Treatment Cycles and Frequency

Vincristine is typically administered in cycles, alternating between periods of treatment and rest. The specific schedule depends on various factors, including the type and stage of cancer, as well as the patient’s overall health. Doctors and nurses work closely with patients to explain the treatment plan and what to expect throughout the course of therapy.

What Are the Most Common Side Effects of Vincristine?

As with any powerful chemotherapy drug, vincristine can cause a range of side effects. It’s crucial for patients and caregivers to be aware of these potential effects and to communicate any concerns with their healthcare team. Some of the most common side effects include:

• Increased risk of infection
• Hair loss
• Numbness or tingling in fingers and toes (peripheral neuropathy)
• Fatigue and weakness
• Nausea and vomiting
• Constipation
• Abdominal pain
• Changes in eyesight
• Bladder problems
• Muscle or bone pain

It’s important to note that the severity and occurrence of these side effects can vary greatly from person to person. Additionally, many side effects can be managed effectively with proper medical intervention and supportive care.

Managing the Side Effects of Vincristine

While side effects can be challenging, there are numerous strategies to help patients cope with and minimize their impact. Here are some approaches to managing common side effects:

Reducing Infection Risk

Due to the increased risk of infection caused by a drop in white blood cell count, patients should take extra precautions to avoid exposure to potential pathogens. This includes:

• Practicing good hand hygiene
• Avoiding crowds and people who are ill
• Maintaining a clean living environment
• Monitoring for signs of infection, such as fever or chills

Patients should contact their healthcare team immediately if they suspect an infection, as prompt treatment is crucial.

Coping with Hair Loss

Hair loss can be a distressing side effect of chemotherapy. Some strategies to help patients cope include:

• Cutting hair short before treatment begins to reduce the shock of hair loss
• Exploring options for wigs, scarves, or hats
• Using gentle hair care products and avoiding heat styling
• Joining support groups to connect with others experiencing similar challenges

It’s important to remember that hair loss is typically temporary, and regrowth usually begins once treatment is completed.

Managing Peripheral Neuropathy

Numbness or tingling in fingers and toes, known as peripheral neuropathy, can be a challenging side effect. To help manage this:

• Report any symptoms to the healthcare team promptly
• Engage in gentle exercise to improve circulation
• Use caution when handling hot or sharp objects
• Consider physical therapy or occupational therapy for severe cases

In some cases, medication adjustments may be necessary to alleviate symptoms.

Monitoring and Testing During Vincristine Treatment

Regular monitoring is essential during vincristine treatment to ensure patient safety and optimize therapeutic outcomes. What types of tests are typically performed, and why are they important?

Blood Tests

Patients receiving vincristine undergo frequent blood tests to assess:

• Complete blood count (CBC) to monitor levels of red blood cells, white blood cells, and platelets
• Liver function tests to ensure the liver is processing the medication effectively
• Kidney function tests to assess how well the body is eliminating the drug

These tests help healthcare providers adjust dosages if necessary and identify any potential complications early on.

Physical Examinations

Regular check-ups allow doctors to assess the patient’s overall health and monitor for any side effects or signs of disease progression. These examinations may include:

• Neurological assessments to check for signs of peripheral neuropathy
• Cardiovascular evaluations to ensure heart health
• General health assessments to monitor weight, hydration, and overall well-being

When to Seek Immediate Medical Attention

While regular monitoring is crucial, there are certain situations where patients should seek immediate medical attention. These include:

• Fever above 37.5째C (99.5째F) or below 36째C (96.8째F), which could indicate an infection
• Severe or worsening side effects that are not responding to prescribed management strategies
• Signs of an allergic reaction, such as difficulty breathing or severe skin reactions
• Unusual bleeding or bruising
• Severe abdominal pain or changes in bowel habits

Prompt communication with the healthcare team can help prevent complications and ensure the best possible outcomes during vincristine treatment.

Combining Vincristine with Other Cancer Treatments

Vincristine is often used as part of a multi-drug chemotherapy regimen. How does combining vincristine with other treatments enhance its effectiveness in fighting cancer?

Synergistic Effects

When combined with other chemotherapy drugs, vincristine can produce synergistic effects, meaning the drugs work together to enhance their overall impact on cancer cells. Common combinations include:

• CHOP regimen (Cyclophosphamide, Hydroxydaunorubicin, Oncovin (vincristine), and Prednisone) for non-Hodgkin’s lymphoma
• ABVD regimen (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine) for Hodgkin’s lymphoma
• Various protocols for acute lymphoblastic leukemia, often including vincristine, asparaginase, and corticosteroids

These combinations target cancer cells through multiple mechanisms, increasing the likelihood of treatment success.

Radiation Therapy

In some cases, vincristine may be used in conjunction with radiation therapy. This approach can be particularly effective for certain types of brain tumors or localized lymphomas. The combination of chemotherapy and radiation can help:

• Shrink tumors more effectively
• Reduce the risk of cancer recurrence
• Target both systemic and localized disease

Immunotherapy

As cancer treatment continues to evolve, researchers are exploring ways to combine traditional chemotherapy drugs like vincristine with newer immunotherapy approaches. This combination strategy aims to:

• Enhance the body’s natural immune response against cancer cells
• Potentially reduce the doses of chemotherapy needed, thereby minimizing side effects
• Improve long-term outcomes and reduce the risk of relapse

While research in this area is ongoing, early results show promise for certain cancer types.

Long-Term Considerations for Patients Receiving Vincristine

While vincristine is an effective treatment for many cancers, patients and healthcare providers must also consider long-term effects and follow-up care. What are some important long-term considerations for patients who have undergone vincristine treatment?

Fertility and Reproductive Health

Vincristine and other chemotherapy drugs can impact fertility in both men and women. Patients should discuss fertility preservation options with their healthcare team before starting treatment. These may include:

• Sperm banking for men
• Egg or embryo freezing for women
• Ovarian tissue preservation in certain cases

After treatment, patients should consult with their doctors about the timing of pregnancy attempts and any potential risks.

Cardiac Health

While vincristine itself is not known to cause significant cardiac toxicity, some chemotherapy combinations that include vincristine may affect heart health. Long-term monitoring may include:

• Regular echocardiograms to assess heart function
• Blood tests to check for markers of cardiac stress
• Lifestyle recommendations to promote heart health

Neurological Follow-up

Given the potential for peripheral neuropathy, long-term neurological follow-up may be necessary. This can involve:

• Regular assessments of nerve function
• Physical therapy or occupational therapy as needed
• Monitoring for any delayed onset of neurological symptoms

Secondary Cancer Risk

While chemotherapy is essential for treating cancer, it can also slightly increase the risk of developing secondary cancers later in life. Patients who have received vincristine should:

• Attend all recommended follow-up appointments
• Stay vigilant for any new or unusual symptoms
• Maintain a healthy lifestyle to reduce overall cancer risk

Regular screenings and open communication with healthcare providers are crucial for early detection and management of any potential long-term effects.

Ongoing Research and Future Directions in Vincristine Treatment

The field of cancer treatment is constantly evolving, with researchers continually seeking ways to improve outcomes and reduce side effects. What are some exciting areas of research related to vincristine and similar treatments?

Targeted Delivery Systems

One promising area of research involves developing more targeted delivery systems for vincristine and other chemotherapy drugs. These approaches aim to:

• Increase the concentration of the drug in cancer cells while minimizing exposure to healthy tissues
• Reduce systemic side effects
• Improve overall treatment efficacy

Nanoparticle-based delivery systems and antibody-drug conjugates are two examples of technologies being explored in this field.

Combination Therapies

Researchers continue to investigate novel combination therapies that include vincristine. Some areas of focus include:

• Combining vincristine with newer targeted therapies
• Exploring synergies between vincristine and immunotherapy agents
• Optimizing dosing schedules to maximize efficacy while minimizing toxicity

Personalized Medicine Approaches

As our understanding of cancer genetics and individual patient characteristics grows, there is increasing interest in personalizing vincristine treatment. This may involve:

• Using genetic markers to predict treatment response and potential side effects
• Tailoring dosing regimens based on individual patient metabolism
• Developing companion diagnostics to guide treatment decisions

These personalized approaches hold the potential to significantly improve treatment outcomes and quality of life for patients receiving vincristine therapy.

Alternative Formulations

Researchers are also exploring alternative formulations of vincristine to enhance its effectiveness and reduce side effects. Some areas of investigation include:

• Liposomal formulations that may improve drug distribution and reduce toxicity
• Oral formulations that could potentially offer more convenient administration for certain patient populations
• Modified versions of the drug with improved pharmacological properties

These ongoing research efforts underscore the continued importance of vincristine in cancer treatment and the potential for future advancements in its use.

Vincristine | Cancer information | Cancer Research UK

Vincristine is a type of chemotherapy. It is a treatment for a number of different cancer types. You usually have vincristine with other cancer drugs.

How does vincristine work?

Vincristine is a chemotherapy drug that belongs to a group of drugs called vinca alkaloids. 

Vincristine works by stopping the cancer cells from separating into 2 new cells. So, it stops the growth of the cancer.

How you have vincristine?

You have vincristine into your bloodstream (intravenously). 

You might have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

Or you might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

How often do you have vincristine?

You have chemotherapy as cycles of treatment. This means you have the cancer drug or drugs and then a rest to allow your body to recover. Your treatment plan depends on which cancer you have. Your doctor or nurse will talk to you about this, so you know what to expect.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of vincristine?

How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you’re having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 
• your side effects aren’t getting any better
• your side effects are getting worse

Early treatment can help manage side effects better.  

Contact your advice line immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

We haven’t listed all the side effects here. Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

You might have one or more of these side effects. They include:

Increased risk of getting an infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Hair loss

You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer.

Numbness or tingling in fingers or toes

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your healthcare team if you’re finding it difficult to walk or complete fiddly tasks such as doing up buttons. 

Tiredness and weakness (fatigue) during and after treatment 

Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don’t push yourself, rest when you start to feel tired and ask others for help.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Constipation

Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor, nurse or pharmacist if you are constipated for more than 3 days. They can prescribe a laxative.

Also tell your doctor about any changes to your bowel habits.

Tummy (abdominal) pain

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Changes to your eyesight

Tell the team looking after you if you notice any changes or have pain. This is usually rare and temporary. 

Problems with your bladder

Let your doctor know if you are having this. Let your treatment team know if you are having problems passing urine or have pain.

Muscle or bone pain

You might feel some pain from your muscles and bones, including pain in your jaw or back. Speak to your doctor or nurse about what painkillers you can take to help with this.

Sore mouth

You might get a sore mouth and mouth ulcers.  It may be painful to swallow drinks or food. You will have mouth washes to keep your mouth healthy.

You can have painkillers to reduce the soreness. Take them half an hour before meals to make eating easier.

Swelling and pain at the drip site

Tell your nurse straight away if you have any pain, redness, swelling or leaking around your drip site.

Allergic reaction

A small number of people have an allergic reaction while having this treatment. Symptoms can include a rash, shortness of breath, redness or swelling of the face, feeling hot, dizziness, and a sudden need to pass urine.

Tell your doctor or nurse immediately if you have any of these symptoms or feel unwell at all while you are having the treatment or shortly afterwards.

Hearing changes

You might have some hearing loss, especially with high pitched sounds. Tell your doctor or nurse if you notice any changes.

These changes are due to damage to one of the cranial nerves. You may also have difficulty with balance including dizziness, feeling like the room is spinning (vertigo) and uncontrolled eye movement (nystagmus).

Loss of appetite and weight loss

You might not feel like eating and may lose weight. It is important to eat as much as you can. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss. 

Skin rash

Tell your doctor or nurse if you have a skin rash. They can prescribe medicine to soothe your skin.

Headaches

Let your doctor or nurse know if you have headaches. They can give you painkillers.

Diarrhoea

This is a rare side effect.

Contact your advice line if you have diarrhoea, such as if you’ve had 4 or more loose watery poos (stools) in 24 hours. Or if you can’t drink to replace the lost fluid. Or if it carries on for more than 3 days.

Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.

Heart problems

This includes coronary heart disease and a heart attack. This is a possible side effect if you have had radiotherapy to part of the chest before (the mediastinum), and you have had vincristine with other chemotherapy drugs. It is not clear if this side effect is directly caused by the vincristine.

Tell your doctor or nurse immediately, or call 999, if you have symptoms of a heart attack. These include: chest pain, pain spreading from the chest to your arms, jaw, back or tummy, feeling dizzy, sweaty, short of breath, coughing or wheezing, being sick or an overwhelming feeling of anxiety.

Bruising, bleeding gums or nose bleeds

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Low sodium levels

You may develop low sodium levels in your blood. This is due to your body making too much anti diuretic hormone. This means your body holds on to too much water. As your blood becomes more dilute, your levels of sodium drop. This is rare, but you have regular blood tests to check for this.

Fits (seizures)

Tell your doctor or nurse straight away if this happens.

Muscle weakness

Your muscles may get weaker. This can make it difficult to walk and cause difficulty with your speech.

Changes in blood pressure

During treatment, your blood pressure may be lower or higher than normal. Tell your nurse if you feel dizzy or faint. Or if you have headaches, nosebleeds, blurred or double vision, or shortness of breath.

Your blood pressure usually goes back to normal while you are on treatment or when treatment ends.

Second cancers

There is a small risk that you may get a second cancer some years after this treatment. Your doctor will discuss this with you.

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you’re having treatment and for a few months afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner falls pregnant while having treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment. For example, if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine – talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations – You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn’t possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

• Electronic Medicines Compendium
  Accessed January 2019

• Immunisation against infectious disease: Chapter 6: General contraindications to vaccination
  Public Health England
  First published: March 2013 and regularly updated on the Gov. UK website

Last reviewed: 

12 Aug 2022

Next review due: 

12 Aug 2025

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Vinblastine (Velban®, Alkaban AQ) | OncoLink

Vinblastine is a member of the vinca alkaloids family of chemotherapy agents. These medications work by interfering with cell division, which leaves the tumor unable to grow and spread. Vinblastine was developed from the Madagascar periwinkle plant.

How to Take Vinblastine

This medication is administered intravenously (IV, into a vein), by a trained professional. Specific dosage and dosing schedule depends on the person’s size and the type of cancer being treated.

This medication is a vesicant. Even when carefully and correctly administered by trained personnel, this drug may cause a feeling of burning and pain. There is a risk that this medication may leak out of the vein at the injection site, resulting in tissue damage that can be severe. If the area of injection becomes red, swollen, or painful at any time during or after the injection, notify your doctor or nurse immediately. Do not apply anything to the site unless instructed by your doctor or nurse.

The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. These include: grapefruit, grapefruit juice, ketoconazole, rifampin, phenytoin, St. John’s wort, and many anti-fungal medications. Be sure to tell your healthcare provider about all medications and supplements you take.

Possible Side Effects of Vinblastine

There are a number of things you can do to manage the side effects of vinblastine. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Constipation

Vinblastine can cause serious constipation, abdominal pain and can even lead to a blockage or stoppage of the bowel (called paralytic ileus) if not treated promptly. There are several things you can do to prevent or relieve constipation. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day, and keep active. A stool softener once or twice a day may prevent constipation. If you do not have a bowel movement for 2-3 days, you should contact your healthcare team for suggestions to relieve the constipation.

Neurotoxicity

This is a toxicity that affects the nerves. The most common effect is called peripheral neuropathy, which affects the nerves in the hands and feet, causing causes numbness or tingling, often in the pattern of a stocking or glove. This can get progressively worse with additional doses of the medication and can lead to difficulty with balance or walking. In some people, the symptoms slowly resolve after the medication is stopped, but for some, it never goes away completely. You should let your healthcare provider know if you experience numbness or tingling in the hands and feet, as they may need to adjust the doses of your medication.

The vinca alkaloid chemotherapies are known to cause neuropathy, but they can also cause neurologic toxicity that presents as mental depression, headache, malaise, dizziness, and seizures. It can also cause toxicity of the cranial nerves, which affects the vocal cords (changes in voice), eyes (visual changes) or facial nerves (drooping of the face or mouth). Patients can develop severe pain in the jaw soon after the first treatment with vincristine, which is caused by the medication affecting the nerves. If you notice any of these problems, notify your healthcare team right away.

Low White Blood Cell Count (Leukopenia or Neutropenia)

White blood cells (WBC) are important for fighting infection. While receiving treatment, your WBC count can drop, putting you at a higher risk of getting an infection. You should let your doctor or nurse know right away if you have a fever (temperature greater than 100.4°F or 38°C), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn’t heal.

Tips to preventing infection:

• Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.
• Avoid large crowds and people who are sick (i.e.: those who have a cold, fever or cough or live with someone with these symptoms).
• When working in your yard, wear protective clothing including long pants and gloves.
• Do not handle pet waste.
• Keep all cuts or scratches clean.
• Shower or bath daily and perform frequent mouth care.
• Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
• Ask your oncology care team before scheduling dental appointments or procedures.
• Ask your oncology care team before you, or someone you live with, has any vaccinations.

Mouth Ulcers (Sores)

Certain cancer treatments can cause sores or soreness in your mouth and/or throat. Notify your doctor or nurse if your mouth, tongue, inside of your cheek or throat becomes white, ulcerated or painful. Performing regular mouth care can help prevent or manage mouth sores. If mouth sores become painful, your doctor or nurse can recommend a pain reliever.

• Brush with a soft-bristle toothbrush or cotton swab twice a day.
• Avoid mouthwashes that contain alcohol. A baking soda and/or salt warm water mouth rinse (2 level teaspoons of baking soda or 1 level teaspoon salt in an eight-ounce glass of warm water) is recommended 4 times daily.
• If your mouth becomes dry, eat moist foods, drink plenty of fluids (6-8 glasses), and suck on sugarless hard candy.
• Avoid smoking and chewing tobacco, drinking alcoholic beverages, and citrus juices.

Loss or Thinning of Scalp and Body Hair (Alopecia)

Your hair may become thin, brittle, or may fall out. This typically begins two to three weeks after treatment starts. This hair loss can be all body hair, including pubic, underarm, legs/arms, eyelashes, and nose hairs. The use of scarves, wigs, hats, and hairpieces may help. Hair generally starts to regrow soon after treatment is completed. Remember your hair helps keep you warm in cold weather, so a hat is particularly important in cold weather or to protect you from the sun.

High Blood Pressure

This medication can cause high blood pressure (hypertension). Patients should have their blood pressure checked regularly during therapy. Any hypertension should be treated appropriately.

Decrease in Appetite or Taste Changes

Nutrition is an important part of your care. Cancer treatment can affect your appetite and, in some cases, the side effects of treatment can make eating difficult. Ask your oncology care team about nutritional counseling services at your treatment center to help with food choices.

• Try to eat five or six small meals or snacks throughout the day, instead of 3 larger meals.
• If you are not eating enough, nutritional supplements may help.
• You may experience a metallic taste or find that food has no taste at all. You may dislike foods or beverages that you liked before receiving cancer treatment. These symptoms can last for several months or longer after treatment ends.
• Avoid any food that you think smells or tastes bad. If red meat is a problem, eat chicken, turkey, eggs, dairy products, and fish without a strong smell. Sometimes cold food has less of an odor.
• Add extra flavor to meat or fish by marinating it in sweet juices, sweet and sour sauce, or dressings. Use seasonings like basil, oregano, or rosemary to add flavor. Bacon, ham, and onion can add flavor to vegetables.

Fatigue

Fatigue is very common during cancer treatment and is an overwhelming feeling of exhaustion that is not usually relieved by rest. While on cancer treatment, and for a period after, you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team for helpful tips on dealing with this side effect.

Nausea and/or Vomiting

Talk to your doctor or nurse so they can prescribe medications to help you manage nausea and vomiting. In addition, dietary changes may help. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). Try antacids, (e.g. milk of magnesia, calcium tablets such as Tums), saltines, or ginger ale to lessen symptoms.

Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.

Less common, but important side effects can include:

• Urinary retention: Some patients may experience an inability to urinate (even when you feel that you need to). If you notice you are unable to urinate, you should call your healthcare team right away or go to the emergency room to be evaluated.
• Pain in tumor-containing tissue: Some patients may experience pain in tumor-containing tissue. This is thought to occur due to swelling of that area during its response to treatment.
• Radiation Recall: This medication may cause radiation recall. It may present as a skin reaction that looks like a sunburn (redness, swelling, soreness, peeling skin) in areas where radiation was previously given. Notify your oncology care team if you notice this side effect. Treatment can include topical steroid ointments and a delay in your next chemotherapy dose. 

Sexual & Reproductive Concerns

This drug may affect your reproductive system, resulting in the menstrual cycle or sperm production becoming irregular or stopping permanently. In addition, the desire for sex may decrease during treatment.

Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Effective birth control is necessary during treatment, even if your menstrual cycle stops or you believe you are not producing sperm. You may want to consider sperm banking or egg harvesting if you may wish to have a child in the future. Discuss these options with your oncology team. You should consult with your healthcare team before breastfeeding while receiving this medication.

23.2. Vinca alkaloid derivatives

Vinpocetine
(cavinton*) – semi-synthetic derivative
vincamine alkaloid found in
periwinkle plant (Vinca
minor L. and Vinca
erecta), expands
predominantly cerebral vessels. Myotropic
antispasmodic effect of the drug
associated with inhibition of phosphodiesterase,
which contributes to the accumulation
cAMP smooth muscle cells. Vinpocetine
does not cause the phenomenon of “robbing”;
without affecting the blood supply of intact
areas, it enhances the blood supply
ischemic areas of the brain.
Vinpocetine improves cerebral circulation
(microcirculation) not only due to
vasodilation of the brain, but also for
score

raise
the ability of erythrocytes to deform,
which leads to a decrease in
blood viscosity, since aggregation
platelets are reduced. Besides,
vinpocetine increases brain resilience
to hypoxia, increases oxygen utilization,
enhances absorption and metabolism
glucose with switching to energy
more beneficial, aerobic oxidation pathway.

Vinpocetine
indicated for chronic insufficiency
cerebral circulation, conditions
after a stroke, with neurological and
mental disorders in patients with
cerebrovascular insufficiency,
in vascular diseases of the eye and
decreased hearing acuity of vascular or
toxic genesis. Assign inside
During a long time. At
need to be administered intravenously
drip.

Side effects
effects: decreased blood pressure, nausea and
dizziness. With rapid intravenous
the introduction of possible tachycardia, extra-
systole, intraventricular slowdown
conductivity.

23.3. Ergot alkaloid derivatives

Nicergoline
(sermion ^*)
– synthetic derivative of alkaloids
ergot, with attached bromine
residue of nicotinic acid.
The vasodilating effect of the drug
associated with α-adrenergic blocking and direct
myotropic action. Expands arterioles
brain and peripheral vessels.
Improves cerebral, pulmonary, renal
blood flow and blood supply to the extremities.

Apply
with disorders of cerebral circulation
against the background of atherosclerosis and thromboembolism,
in disorders of the peripheral
blood circulation, etc. Introduced inside and
parenterally. When taken orally in
therapeutic doses does not affect blood pressure,
possible after intravenous administration
hypotensive effect. Of the side
effects are also possible dizziness,
itching, dyspeptic disorders.

23.4. Derivatives of nicotinic acid

Nicotine
acid has a pronounced
vasodilating effect as
peripheral vessels, and on the vessels
brain. nicotinic acid is bad
tolerate (see the chapter “Means used
with atherosclerosis”), therefore, with
disorders of cerebral circulation
use its derivatives with less
pronounced side effects.

Xanthinol
nicotinate (Complamin*) in its structure
has elements of nicotinic acid and
theophylline. The drug expands
peripheral vessels and vessels of the brain,
improves both peripheral and
cerebral circulation, reduces
phenomena of cerebral hypoxia, several
reduces platelet aggregation. A drug
used for disorders of the peripheral
and cerebral circulation associated
with cerebral atherosclerosis.

Nicotinoyl-GABA
(Pikamilon*) belongs to the group of derivatives
GABA, combines the structure of GABA and nicotinic
acids, mainly expands
brain vessels.

Cardiotoxic effects of yew tree alkaloids and periwinkle rosea | Mal

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