Chemotherapy (e.g. vincristine and other vinca alkaloids) to be administered by injection or infusion can only be prescribed by a consultant oncologist / haematologist, or an advanced trainee.

The ARIA system only allows prescribing of vinca alkaloids in a volume of 50mL.

All cytotoxic doses are prepared externally by a third-party provider.

• Vincristine and other vinca alkaloids must be supplied in an infusion bag (e.g. in small-volume intravenous bag) and NOT in a syringe. The use of infusion bag for the vinca alkaloids will reduce risk of inadvertent/accidental intrathecal administration.
• For specific drug administration advice associated with the administration of vinca alkaloids, refer to the most recent edition of the Australian Injectable Drugs Handbook. In adults, vincristine is prepared in a small-volume intravenous bag containing 50mL of sodium chloride 0.9%. This is administered as a short intravenous bolus over 5 to 10 minutes. For paediatric patients, the same approach is used but with a smaller volume of fluid in the infusion bag and a slower rate of administration.
• Care should be taken to avoid extravasation which can occur with the vinca alkaloids. If extravasation is suspected, stop infusion immediately, attempt to aspirate residual drug and start extravasation treatment.
• Prepared doses will be labelled “FOR INTRAVENOUS USE ONLY- Fatal if given by other routes’.