Guidelines for the administration of Vinca Alkaloids to adults and adolescents within Leeds Cancer Centre

In response to the NPSA rapid response alert RRR04, the Organisation was required to alter the presentation of vinca alkaloids supplied to all the Systemic Anti-Cancer areas (SACT) within the Leeds Cancer Centre

The following rules now apply for adults and adolescents on the TYA unit:

• All vinca alkaloids are supplied in a 50ml minibag. It is impossible to prescribe a vinca alkaloid as an intravenous bolus for adults on the SACT prescribing system.
• All vinca alkaloids are supplied from pharmacy bearing the warning “For intravenous use only - FATAL if administered by any other route”. This statement prints on the product label and there is an additional luminous sticker that is attached to the minibag prior to release from pharmacy.
• All  vinca  alkaloids  are  transported  in  a  separate  and  distinct  container  from  other SACT items. In addition this transport pouch is also labelled with the warning “For intravenous use only - FATAL if administered by any other route”.
• The vinca minibag should be infused intravenously over 5-10 minutes by gravity infusion
• All extravasations involving vinca alkaloids are reviewed at the SACT Steering Group
• Children will not be treated with vinca alkaloids on the adult or adolescent clinical areas.

The LTHT pharmacy also supplies SACT to the paediatric oncology service from the LGI site. For children, intravenous bolus doses of vincristine are permitted under RRR04 at a maximum concentration of 0.1mg/ml. However, LTHT does not sanction the use of more concentrated solutions and as such requires no waiver for this practice.

• As part of the intrathecal competency process it is required, and must be documented, that staff have read the NPSA alert and attended specific intrathecal training before becoming competent for inclusion on any part of the intrathecal register for LTHT.