Enhanced vincristine neurotoxicity from drug interactions: case report and review of literature

Pediatr Hematol Oncol. 2001 Dec;18(8):543-6. doi: 10.1080/088800101753328529.


This study reports observed toxicity in a child with acute lymphocytic leukemia who had received vincristine (VCR) with nifedipine and itraconazole. A 5-year-old-child with leukemia developed bilateral cranial nerve palsies, severe peripheral neuropathy involving upper and lower extremities, seizures, hypertension, heart failure, and syndrome of inappropriate antidiuretic hormone secretion after being treated with VCR, nifedipine, and itraconazole. Appropriate management of the above problems including discontinuation of VCR resulted in recovery from neurotoxic manifestations. Concurrent administration of VCR with nifedipine and itraconazole may enhance its neurotoxicity.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Child, Preschool
  • Drug Interactions
  • Drug Therapy, Combination
  • Female
  • Humans
  • Itraconazole / administration & dosage
  • Itraconazole / toxicity
  • Neurotoxicity Syndromes / diagnosis
  • Neurotoxicity Syndromes / etiology*
  • Neurotoxicity Syndromes / physiopathology
  • Nifedipine / administration & dosage
  • Nifedipine / toxicity
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Vincristine / administration & dosage
  • Vincristine / toxicity*


  • Itraconazole
  • Vincristine
  • Nifedipine