When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to vincristine, if you are pregnant, or if you have Charcot-Marie-Tooth syndrome or a similar nerve disorder.

How to Use This Medicine:
Injectable

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• This medicine is usually given every 7 days.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using St John's wort, dexamethasone (Decadron®), nefazodone (Serzone®), medicine to treat seizures (such as carbamazepine, phenobarbital, phenytoin, Dilantin®, Luminal®, Tegretol®), medicine to treat infection (such as clarithromycin, itraconazole, ketoconazole, posaconazole, rifabutin, rifampin, rifapentine, telithromycin, voriconazole, Biaxin®, Nizoral®, Rifadin®), or medicine to treat HIV infection (such as atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, Crixivan®, Norvir®, Reyataz®).

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Make sure your doctor knows if you are breastfeeding or if you have liver problems, bowel problems (blockage, constipation), or nerve or muscle problems (neuropathy).
• This medicine commonly causes nerve problems. Call your doctor if you have any symptoms of nerve damage, such as numbness, pain, burning, tingling, or muscle spasms, or if you feel more sensitive or less sensitive to touch, pain, heat, or cold.
• This medicine may damage the skin and cause scars if it accidentally leaks out of the vein where it is injected. Tell your doctor if you notice redness, pain, or swelling at the injection site.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine may cause a serious reaction called tumor lysis syndrome (TLS). Call your doctor if you have a change in how much or how often you urinate, change in your heartbeat, rapid weight gain, muscle or joint pain, swelling of the feet or lower legs, or tiredness.
• You might have severe constipation, stomach pain, nausea, or vomiting. To prevent constipation, your doctor may tell you to take laxatives, drink fluids, or increase the fiber in your diet. Follow the directions carefully to prevent severe constipation.
• Call your doctor if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.
• This medicine may cause numbness, tiredness, or a tingling sensation. Avoid driving, using machines, or doing anything else that could be dangerous until you know how this medicine affects you.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate
• Dark-colored urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, yellow skin or eyes
• Fever, chills, cough, sore throat, body aches
• Increased or decreased sensitivity to heat, cold, or pain
• Lightheadedness, dizziness, or fainting
• Muscle or joint pain, pain in your jaw or head
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Pain, itching, burning, swelling, or a lump under your skin where the needle is placed
• Rapid weight gain, swelling of your feet or lower legs
• Severe constipation or stomach pain
• Severe tiredness or weakness
• Trouble walking or holding things, slapping or dropping of the front part of your foot when walking
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Mild nausea, diarrhea, constipation, loss of appetite
• Trouble sleeping

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088