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| Interactions: | Carbamazepine
Adverse Effect: Increased vincristine elimination Clinical Management: Clinicians should be aware of the possibility of decreased vincristine efficacy.
Digoxin
Adverse Effect: Decreased digoxin effectiveness Clinical Management: Closely monitor serum digoxin trough concentrations when administered concomitantly with Vincristine . Also monitor patients for response to digoxin.
Itraconazole
Adverse Effect: an increased risk of neurotoxicity and paralytic ileus Clinical Management:Monitor for the development of neurotoxicity, including paresthesias, muscle weakness, and paralytic ileus. The dose of the Vincristine should be adjusted accordingly.
L - asparaginase
Adverse Effect: an increased risk of toxicity Clinical Management: Administer asparaginase after vincristine rather than before or concurrently to avoid an increased risk of toxicity.
Nifedipine
Adverse Effect: an increased risk of vincristine toxicity (neuropathy, delirium, seizures) Clinical Management: Monitor for neurotoxicity, cardiac rhythm disturbances, and metabolic effects.
Phenytoin
Adverse Effect: increased vincristine elimination Clinical Management: Clinicians should be aware of the possibility of decreased vincristine efficacy.
Zidovudine
Adverse Effect: hematologic toxicity (neutropenia) Clinical Management: If concomitant use of vincristine and zidovudine is necessary, temporary withdrawal or dose reductions of vincristine is recommended |
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