Policy for the Safe Administration of Vinca Alkaloid Drugs

The policy set out below has been written in response to the National Medication Safety Alert issued in December 2005^[1] regarding the fatal risks of “wrong route” administration of vincristine (a vinca alkaloid drug).  The aim is to minimise the risk of inadvertent administration of vincristine by the intrathecal route.  Vincristine must never be administered intrathecally.  These policy guidelines were developed by an expert working group of the WA Medication Safety Group (WAMSG) and have been endorsed by the WA Therapeutics Advisory Group (WATAG).  They shall apply at all Western Australian public hospitals.

This guideline should be used in conjunction with existing cytotoxic chemotherapy policies and, where applicable, the “Policy for the safe administration of intrathecal chemotherapy”.  Standardisation across the health sector is considered one of the principles of medication safety.  Therefore this policy mandates standard packaging and labelling for vinca alkaloids irrespective of whether intrathecal chemotherapy is administered within a given institution.

The guidelines contain provisions for training and education of staff qualified in the preparation, handling or administration of cytotoxic vinca alkaloid chemotherapy.  These provisions are strongly recommended to minimise the risk of errors in the administration of vinca alkaloids.

Health Service Managers and Clinical Directors are requested to:

• bring this Circular to the attention of all medical, pharmacy and nursing staff;
• ensure that local policies and procedures comply with the requirements of this policy; and
• implement the provisions of this circular promptly.

Dr Simon Towler
ACTING DIRECTOR GENERAL
DEPARTMENT OF HEALTH