Details of the Drug

General Information of Drug (ID: DMINOX3)

• Drug Name: Vincristine
• Synonyms: LCR; Leurocristine; Marqibo; Oncovine; Tecnocris; VCR; VIN; Vincasar; Vincristina; Vincristinum; Vincrstine; Vincrystine; Vinkristin; Indole alkaloid; Liposomal Vincristine; Onco TCS; Vincristina [DCIT]; Oncovin (TN); Tecnocris (TN); Vincristine (INN); Vincristine [INN:BAN]; Vincristinum [INN-Latin]; Lilly37231 (1:1 sulfate salt); Oncovin (1:1 sulfate salt); Vincasar (1:1 sulfate salt); Vincrex (1:1 sulfate salt); Vincaleukoblastine, 22-oxo-22-Oxovincaleukoblastine; Z-D-Val-Lys(Z)-OH; 22-Oxovincaleukoblastine

Indication

Disease Entry	ICD 11	Status	REF
Acute lymphoblastic leukaemia	2A85	Approved	[1]
Adult kidney Wilms tumor	N.A.	Approved	[2]
Beckwith-Wiedemann syndrome	N.A.	Approved	[2]
Burkitt lymphoma	N.A.	Approved	[2]
Central nervous system neoplasm	N.A.	Approved	[2]
Childhood acute lymphoblastic leukemia	N.A.	Approved	[2]
Childhood kidney Wilms tumor	N.A.	Approved	[2]
Hamartoma	N.A.	Approved	[2]
Kidney neoplasm	N.A.	Approved	[2]
Leukemia	N.A.	Approved	[2]
MALT lymphoma	N.A.	Approved	[2]
Nodal marginal zone lymphoma	2A85.0	Approved	[2]
Plasma cell myeloma	2A83.1	Approved	[2]
Primitive neuroectodermal tumor	N.A.	Approved	[2]
Splenic marginal zone lymphoma	N.A.	Approved	[2]
Testicular lymphoma	N.A.	Approved	[2]
Wilms tumor	N.A.	Approved	[2]
Classic Hodgkin lymphoma	N.A.	Investigative	[2]
Follicular lymphoma	2A80	Investigative	[2]
Neuroblastoma	2D11.2	Investigative	[2]

• Therapeutic Class: Anticancer Agents
• Affected Organisms: Humans and other mammals
• ATC Code:
  L01CA02: Vincristine
  L01CA: Vinca alkaloids and analogues
  L01C: PLANT ALKALOIDS AND OTHER NATURAL PRODUCTS
  L01: ANTINEOPLASTIC AGENTS
  L: ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS
• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 2:
  Molecular Weight (mw); 825
  Logarithm of the Partition Coefficient (xlogp); 2.8
  Rotatable Bond Count (rotbonds); 10
  Hydrogen Bond Donor Count (hbonddonor); 3
  Hydrogen Bond Acceptor Count (hbondacc); 12
• ADMET Property:
  BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 1: high solubility and high permeability [3]
  Clearance: The drug present in the plasma can be removed from the body at the rate of 2 mL/min/kg [4]
  Elimination: 15% of drug is excreted from urine in the unchanged form [3]
  Half-life: The concentration or amount of drug in body reduced by one-half in 5 minutes (alpha), 2.3 hours (beta), and 85 hours (gamma) [4]
  Metabolism: The drug is metabolized via the hepatic []
  Unbound Fraction: The unbound fraction of drug in plasma is 0.4% [4]
  Vd: Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 2.4 L/kg [4]
  Water Solubility: The ability of drug to dissolve in water is measured as 10 mg/mL [3]
• Chemical Identifiers:
  Formula: C46H56N4O10
  IUPAC Name: methyl (1R,9R,10S,11R,12R,19R)-11-acetyloxy-12-ethyl-4-[(13S,15S,17S)-17-ethyl-17-hydroxy-13-methoxycarbonyl-1,11-diazatetracyclo[13.3.1.04,12.05,10]nonadeca-4(12),5,7,9-tetraen-13-yl]-8-formyl-10-hydroxy-5-methoxy-8,16-diazapentacyclo[10.6.1.01,9.02,7.016,19]nonadeca-2,4,6,13-tetraene-10-carboxylate
  Canonical SMILES: CC[C@@]1(C[C@@H]2C[C@@](C3=C(CCN(C2)C1)C4=CC=CC=C4N3)(C5=C(C=C6C(=C5)[C@]78CCN9[C@H]7[C@@](C=CC9)([C@H]([C@@]([C@@H]8N6C=O)(C(=O)OC)O)OC(=O)C)CC)OC)C(=O)OC)O
  InChI: InChI=1S/C46H56N4O10/c1-7-42(55)22-28-23-45(40(53)58-5,36-30(14-18-48(24-28)25-42)29-12-9-10-13-33(29)47-36)32-20-31-34(21-35(32)57-4)50(26-51)38-44(31)16-19-49-17-11-15-43(8-2,37(44)49)39(60-27(3)52)46(38,56)41(54)59-6/h9-13,15,20-21,26,28,37-39,47,55-56H,7-8,14,16-19,22-25H2,1-6H3/t28-,37+,38-,39-,42+,43-,44-,45+,46+/m1/s1
  InChIKey: OGWKCGZFUXNPDA-XQKSVPLYSA-N
• Cross-matching ID:
  PubChem CID: 5978
  ChEBI ID: CHEMBL90555
  CAS Number: 57-22-7
  UNII: 5J49Q6B70F
  DrugBank ID: DB00541
  TTD ID: D09QVV
  VARIDT ID: DR00143
  INTEDE ID: DR1692
• Drug-Molecule Activity Atlas (DMA)NEW: Click to Jump to the Detailed DMA Information of This Drug
• Drug Pharmacogenomic Perturbation (DPP)NEW: Click to Jump to the Detailed DPP Information of This Drug
• Drug ADMET Endpoint Profile (DAE)NEW: Click to Jump to the Detailed DAE Information of This Drug
• Repurposed Drugs (RPD): Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Tubulin beta (TUBB)	TTYFKSZ	NOUNIPROTAC	Modulator	[5]

Drug Transporter (DTP)

DTP Name	DTP ID	UniProt ID	MOA	REF
Multidrug resistance-associated protein 2 (ABCC2)	DTFI42L	MRP2_HUMAN	Substrate	[6]
Multidrug resistance-associated protein 1 (ABCC1)	DTSYQGK	MRP1_HUMAN	Substrate	[7]
Breast cancer resistance protein (ABCG2)	DTI7UX6	ABCG2_HUMAN	Substrate	[8]
P-glycoprotein 1 (ABCB1)	DTUGYRD	MDR1_HUMAN	Substrate	[9]

Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 3A4 (CYP3A4)	DE4LYSA	CP3A4_HUMAN	Substrate	[10]
Cytochrome P450 3A5 (CYP3A5)	DEIBDNY	CP3A5_HUMAN	Substrate	[10]
Cytochrome P450 3A7 (CYP3A7)	DERD86B	CP3A7_HUMAN	Substrate	[11]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Vincristine

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Clofarabine	DMCVJ86	Moderate	Increased risk of hepatotoxicity by the combination of Vincristine and Clofarabine.	Mature B-cell lymphoma [2A85]	[12]
Blinatumomab	DMGECIJ	Moderate	Decreased metabolism of Vincristine caused by Blinatumomab mediated inhibition of CYP450 enzyme.	Mature B-cell lymphoma [2A85]	[13]

Coadministration of a Drug Treating the Disease Different from Vincristine (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Remdesivir	DMBFZ6L	Moderate	Increased risk of hepatotoxicity by the combination of Vincristine and Remdesivir.	1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019]	[14]
Ivosidenib	DM8S6T7	Moderate	Increased metabolism of Vincristine caused by Ivosidenib mediated induction of CYP450 enzyme.	Acute myeloid leukaemia [2A60]	[15]
Midostaurin	DMI6E0R	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Midostaurin.	Acute myeloid leukaemia [2A60]	[16]
Arn-509	DMT81LZ	Moderate	Accelerated clearance of Vincristine due to the transporter induction by Arn-509.	Acute myeloid leukaemia [2A60]	[16]
Gilteritinib	DMTI0ZO	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Gilteritinib.	Acute myeloid leukaemia [2A60]	[17]
Siltuximab	DMGEATB	Moderate	Additive immunosuppressive effects by the combination of Vincristine and Siltuximab.	Anemia [3A00-3A9Z]	[16]
Dronedarone	DMA8FS5	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Dronedarone.	Angina pectoris [BA40]	[18]
Bedaquiline	DM3906J	Moderate	Increased risk of hepatotoxicity by the combination of Vincristine and Bedaquiline.	Antimicrobial drug resistance [MG50-MG52]	[19]
Voriconazole	DMAOL2S	Major	Decreased clearance of Vincristine due to the transporter inhibition by Voriconazole.	Aspergillosis [1F20]	[20]
Posaconazole	DMUL5EW	Major	Decreased clearance of Vincristine due to the transporter inhibition by Posaconazole.	Aspergillosis [1F20]	[20]
Roflumilast	DMPGHY8	Moderate	Additive immunosuppressive effects by the combination of Vincristine and Roflumilast.	Asthma [CA23]	[16]
Ofloxacin	DM0VQN3	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Ofloxacin.	Bacterial infection [1A00-1C4Z]	[21]
Dalfopristin	DM4LTKV	Moderate	Decreased metabolism of Vincristine caused by Dalfopristin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[22]
Clarithromycin	DM4M1SG	Major	Decreased clearance of Vincristine due to the transporter inhibition by Clarithromycin.	Bacterial infection [1A00-1C4Z]	[20]
Trovafloxacin	DM6AN32	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Trovafloxacin.	Bacterial infection [1A00-1C4Z]	[21]
Sparfloxacin	DMB4HCT	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Sparfloxacin.	Bacterial infection [1A00-1C4Z]	[21]
Gemifloxacin	DMHT34O	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Gemifloxacin.	Bacterial infection [1A00-1C4Z]	[21]
Norfloxacin	DMIZ6W2	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Norfloxacin.	Bacterial infection [1A00-1C4Z]	[21]
ABT-492	DMJFD2I	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by ABT-492.	Bacterial infection [1A00-1C4Z]	[21]
Levofloxacin	DMS60RB	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Levofloxacin.	Bacterial infection [1A00-1C4Z]	[21]
Troleandomycin	DMUZNIG	Major	Decreased clearance of Vincristine due to the transporter inhibition by Troleandomycin.	Bacterial infection [1A00-1C4Z]	[20]
Lomefloxacin	DMVRH9C	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Lomefloxacin.	Bacterial infection [1A00-1C4Z]	[21]
Telithromycin	DMZ4P3A	Major	Decreased clearance of Vincristine due to the transporter inhibition by Telithromycin.	Bacterial infection [1A00-1C4Z]	[20]
Erdafitinib	DMI782S	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Erdafitinib.	Bladder cancer [2C94]	[23]
Pexidartinib	DMS2J0Z	Major	Increased risk of hepatotoxicity by the combination of Vincristine and Pexidartinib.	Bone/articular cartilage neoplasm [2F7B]	[24]
Lomustine	DMMWSUL	Minor	Decreased metabolism of Vincristine caused by Lomustine mediated inhibition of CYP450 enzyme.	Brain cancer [2A00]	[25]
Lapatinib	DM3BH1Y	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Lapatinib.	Breast cancer [2C60-2C6Y]	[26]
Tucatinib	DMBESUA	Major	Decreased clearance of Vincristine due to the transporter inhibition by Tucatinib.	Breast cancer [2C60-2C6Y]	[20]
Palbociclib	DMD7L94	Moderate	Decreased metabolism of Vincristine caused by Palbociclib mediated inhibition of CYP450 enzyme.	Breast cancer [2C60-2C6Y]	[27]
Capecitabine	DMTS85L	Minor	Increased plasma concentrations of Vincristine and Capecitabine due to competitive inhibition of the same metabolic pathway.	Colorectal cancer [2B91]	[25]
Mifepristone	DMGZQEF	Moderate	Decreased metabolism of Vincristine caused by Mifepristone mediated inhibition of CYP450 enzyme.	Cushing syndrome [5A70]	[16]
Ivacaftor	DMZC1HS	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Ivacaftor.	Cystic fibrosis [CA25]	[28]
MK-8228	DMOB58Q	Moderate	Decreased metabolism of Vincristine caused by MK-8228 mediated inhibition of CYP450 enzyme.	Cytomegaloviral disease [1D82]	[29]
Aprepitant	DM053KT	Moderate	Decreased metabolism of Vincristine caused by Aprepitant mediated inhibition of CYP450 enzyme.	Depression [6A70-6A7Z]	[30]
Nefazodone	DM4ZS8M	Major	Decreased metabolism of Vincristine caused by Nefazodone mediated inhibition of CYP450 enzyme.	Depression [6A70-6A7Z]	[20]
Primidone	DM0WX6I	Moderate	Increased metabolism of Vincristine caused by Primidone mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[31]
Oxcarbazepine	DM5PU6O	Moderate	Increased metabolism of Vincristine caused by Oxcarbazepine mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[32]
Cenobamate	DM8KLU9	Moderate	Increased metabolism of Vincristine caused by Cenobamate mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[33]
Fosphenytoin	DMOX3LB	Moderate	Accelerated clearance of Vincristine due to the transporter induction by Fosphenytoin.	Epilepsy/seizure [8A61-8A6Z]	[34]
Rufinamide	DMWE60C	Moderate	Increased metabolism of Vincristine caused by Rufinamide mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[16]
Phenobarbital	DMXZOCG	Moderate	Increased metabolism of Vincristine caused by Phenobarbital mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[31]
Carbamazepine	DMZOLBI	Moderate	Accelerated clearance of Vincristine due to the transporter induction by Carbamazepine.	Epilepsy/seizure [8A61-8A6Z]	[31]
Cannabidiol	DM0659E	Moderate	Increased risk of hepatotoxicity by the combination of Vincristine and Cannabidiol.	Epileptic encephalopathy [8A62]	[16]
Tazemetostat	DMWP1BH	Moderate	Increased metabolism of Vincristine caused by Tazemetostat mediated induction of CYP450 enzyme.	Follicular lymphoma [2A80]	[35]
Itraconazole	DMCR1MV	Major	Decreased metabolism of Vincristine caused by Itraconazole mediated inhibition of CYP450 enzyme.	Fungal infection [1F29-1F2F]	[20]
Miconazole	DMPMYE8	Moderate	Decreased metabolism of Vincristine caused by Miconazole mediated inhibition of CYP450 enzyme.	Fungal infection [1F29-1F2F]	[36]
Ketoconazole	DMPZI3Q	Major	Decreased metabolism of Vincristine caused by Ketoconazole mediated inhibition of CYP450 enzyme.	Fungal infection [1F29-1F2F]	[20]
Boceprevir	DMBSHMF	Major	Decreased metabolism of Vincristine caused by Boceprevir mediated inhibition of CYP450 enzyme.	Hepatitis virus infection [1E50-1E51]	[20]
Telaprevir	DMMRV29	Major	Decreased clearance of Vincristine due to the transporter inhibition by Telaprevir.	Hepatitis virus infection [1E50-1E51]	[20]
Rifampin	DMA8J1G	Moderate	Accelerated clearance of Vincristine due to the transporter induction by Rifampin.	HIV-infected patients with tuberculosis [1B10-1B14]	[31]
Rifapentine	DMCHV4I	Moderate	Accelerated clearance of Vincristine due to the transporter induction by Rifapentine.	HIV-infected patients with tuberculosis [1B10-1B14]	[31]
Brentuximab vedotin	DMWLC57	Moderate	Increased risk of hepatotoxicity by the combination of Vincristine and Brentuximab vedotin.	Hodgkin lymphoma [2B30]	[37]
Delavirdine	DM3NF5G	Major	Decreased metabolism of Vincristine caused by Delavirdine mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[20]
Fosamprenavir	DM4W9B3	Major	Decreased metabolism of Vincristine caused by Fosamprenavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[20]
Cobicistat	DM6L4H2	Major	Decreased clearance of Vincristine due to the transporter inhibition by Cobicistat.	Human immunodeficiency virus disease [1C60-1C62]	[20]
Efavirenz	DMC0GSJ	Moderate	Increased metabolism of Vincristine caused by Efavirenz mediated induction of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[38]
Saquinavir	DMG814N	Major	Decreased metabolism of Vincristine caused by Saquinavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[20]
Etravirine	DMGV8QU	Moderate	Increased metabolism of Vincristine caused by Etravirine mediated induction of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[39]
Zalcitabine	DMH7MUV	Moderate	Increased risk of peripheral neuropathy by the combination of Vincristine and Zalcitabine.	Human immunodeficiency virus disease [1C60-1C62]	[40]
Amprenavir	DMLMXE0	Major	Decreased metabolism of Vincristine caused by Amprenavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[20]
Darunavir	DMN3GCH	Moderate	Decreased metabolism of Vincristine caused by Darunavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[41]
Atazanavir	DMSYRBX	Major	Decreased metabolism of Vincristine caused by Atazanavir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[20]
Mipomersen	DMGSRN1	Major	Increased risk of hepatotoxicity by the combination of Vincristine and Mipomersen.	Hyper-lipoproteinaemia [5C80]	[42]
Teriflunomide	DMQ2FKJ	Major	Increased risk of hepatotoxicity by the combination of Vincristine and Teriflunomide.	Hyper-lipoproteinaemia [5C80]	[43]
BMS-201038	DMQTAGO	Major	Increased risk of hepatotoxicity by the combination of Vincristine and BMS-201038.	Hyper-lipoproteinaemia [5C80]	[44]
Verapamil	DMA7PEW	Minor	Increased plasma concentration of Vincristine and Verapamil due to competitive binding of plasma proteins.	Hypertension [BA00-BA04]	[45]
Conivaptan	DM1V329	Major	Decreased metabolism of Vincristine caused by Conivaptan mediated inhibition of CYP450 enzyme.	Hypo-osmolality/hyponatraemia [5C72]	[20]
Tolvaptan	DMIWFRL	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Tolvaptan.	Hypo-osmolality/hyponatraemia [5C72]	[17]
Berotralstat	DMWA2DZ	Moderate	Decreased metabolism of Vincristine caused by Berotralstat mediated inhibition of CYP450 enzyme.	Innate/adaptive immunodeficiency [4A00]	[46]
Amobarbital	DM0GQ8N	Moderate	Increased metabolism of Vincristine caused by Amobarbital mediated induction of CYP450 enzyme.	Insomnia [7A00-7A0Z]	[31]
Methotrexate	DM2TEOL	Moderate	Increased risk of hepatotoxicity by the combination of Vincristine and Methotrexate.	Leukaemia [2A60-2B33]	[16]
Glycerol phenylbutyrate	DMDGRQO	Moderate	Increased metabolism of Vincristine caused by Glycerol phenylbutyrate mediated induction of CYP450 enzyme.	Liver disease [DB90-DB9Z]	[16]
Denosumab	DMNI0KO	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Denosumab.	Low bone mass disorder [FB83]	[47]
Crizotinib	DM4F29C	Moderate	Decreased metabolism of Vincristine caused by Crizotinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[48]
Brigatinib	DM7W94S	Moderate	Increased metabolism of Vincristine caused by Brigatinib mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[49]
Ceritinib	DMB920Z	Major	Decreased metabolism of Vincristine caused by Ceritinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[20]
PF-06463922	DMKM7EW	Moderate	Increased metabolism of Vincristine caused by PF-06463922 mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[50]
Osimertinib	DMRJLAT	Moderate	Increased metabolism of Vincristine caused by Osimertinib mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[16]
Capmatinib	DMYCXKL	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Capmatinib.	Lung cancer [2C25]	[51]
Selpercatinib	DMZR15V	Moderate	Decreased metabolism of Vincristine caused by Selpercatinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[16]
Calaspargase pegol	DMQZBXI	Moderate	Increased risk of hepatotoxicity by the combination of Vincristine and Calaspargase pegol.	Malignant haematopoietic neoplasm [2B33]	[52]
Idelalisib	DM602WT	Major	Decreased metabolism of Vincristine caused by Idelalisib mediated inhibition of CYP450 enzyme.	Mature B-cell leukaemia [2A82]	[20]
IPI-145	DMWA24P	Moderate	Decreased metabolism of Vincristine caused by IPI-145 mediated inhibition of CYP450 enzyme.	Mature B-cell leukaemia [2A82]	[53]
LGX818	DMNQXV8	Moderate	Increased metabolism of Vincristine caused by LGX818 mediated induction of CYP450 enzyme.	Melanoma [2C30]	[54]
Dabrafenib	DMX6OE3	Moderate	Increased metabolism of Vincristine caused by Dabrafenib mediated induction of CYP450 enzyme.	Melanoma [2C30]	[16]
Lasmiditan	DMXLVDT	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Lasmiditan.	Migraine [8A80]	[55]
Exjade	DMHPRWG	Moderate	Decreased metabolism of Vincristine caused by Exjade mediated inhibition of CYP450 enzyme.	Mineral absorption/transport disorder [5C64]	[56]
Thalidomide	DM70BU5	Major	Additive thrombogenic effects by the combination of Vincristine and Thalidomide.	Multiple myeloma [2A83]	[57]
Tecfidera	DM2OVDT	Moderate	Additive immunosuppressive effects by the combination of Vincristine and Tecfidera.	Multiple sclerosis [8A40]	[58]
Siponimod	DM2R86O	Major	Additive immunosuppressive effects by the combination of Vincristine and Siponimod.	Multiple sclerosis [8A40]	[17]
Fingolimod	DM5JVAN	Major	Additive immunosuppressive effects by the combination of Vincristine and Fingolimod.	Multiple sclerosis [8A40]	[59]
Ocrelizumab	DMEZ2KH	Moderate	Additive immunosuppressive effects by the combination of Vincristine and Ocrelizumab.	Multiple sclerosis [8A40]	[60]
Ozanimod	DMT6AM2	Major	Additive immunosuppressive effects by the combination of Vincristine and Ozanimod.	Multiple sclerosis [8A40]	[16]
Rifabutin	DM1YBHK	Moderate	Increased metabolism of Vincristine caused by Rifabutin mediated induction of CYP450 enzyme.	Mycobacterium infection [1B10-1B21]	[31]
Fedratinib	DM4ZBK6	Moderate	Decreased metabolism of Vincristine caused by Fedratinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[16]
Nilotinib	DM7HXWT	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Nilotinib.	Myeloproliferative neoplasm [2A20]	[61]
Imatinib	DM7RJXL	Moderate	Decreased metabolism of Vincristine caused by Imatinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[62]
Dasatinib	DMJV2EK	Moderate	Decreased metabolism of Vincristine caused by Dasatinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[63]
Omacetaxine mepesuccinate	DMPU2WX	Moderate	Additive immunosuppressive effects by the combination of Vincristine and Omacetaxine mepesuccinate.	Myeloproliferative neoplasm [2A20]	[64]
Modafinil	DMYILBE	Minor	Increased metabolism of Vincristine caused by Modafinil mediated induction of CYP450 enzyme.	Narcolepsy [7A20]	[65]
Rolapitant	DM8XP26	Moderate	Decreased clearance of Vincristine due to the transporter inhibition by Rolapitant.	Nausea/vomiting [MD90]	[66]
Entrectinib	DMMPTLH	Moderate	Decreased metabolism of Vincristine caused by Entrectinib mediated inhibition of CYP450 enzyme.	Non-small cell lung cancer [2C25]	[67]
Rucaparib	DM9PVX8	Moderate	Decreased metabolism of Vincristine caused by Rucaparib mediated inhibition of CYP450 enzyme.	Ovarian cancer [2C73]	[68]
Abametapir	DM2RX0I	Moderate	Decreased metabolism of Vincristine caused by Abametapir mediated inhibition of CYP450 enzyme.	Pediculosis [1G00]	[69]
Lefamulin	DME6G97	Moderate	Decreased metabolism of Vincristine caused by Lefamulin mediated inhibition of CYP450 enzyme.	Pneumonia [CA40]	[70]
Lonafarnib	DMGM2Z6	Major	Decreased metabolism of Vincristine caused by Lonafarnib mediated inhibition of CYP450 enzyme.	Premature ageing appearance [LD2B]	[20]
Enzalutamide	DMGL19D	Moderate	Accelerated clearance of Vincristine due to the transporter induction by Enzalutamide.	Prostate cancer [2C82]	[71]
Ustekinumab	DMHTYK3	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Ustekinumab.	Psoriasis [EA90]	[16]
Tildrakizumab	DMLW9HG	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Tildrakizumab.	Psoriasis [EA90]	[16]
Risankizumab	DMM32GT	Moderate	Additive immunosuppressive effects by the combination of Vincristine and Risankizumab.	Psoriasis [EA90]	[16]
Ixekizumab	DMXW92T	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Ixekizumab.	Psoriasis [EA90]	[16]
Bosentan	DMIOGBU	Moderate	Increased metabolism of Vincristine caused by Bosentan mediated induction of CYP450 enzyme.	Pulmonary hypertension [BB01]	[72]
Temsirolimus	DMS104F	Moderate	Increased plasma concentrations of Vincristine and Temsirolimus due to competitive inhibition of the same metabolic pathway.	Renal cell carcinoma [2C90]	[73]
Gatifloxacin	DMSL679	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Gatifloxacin.	Respiratory infection [CA07-CA4Z]	[21]
Tocilizumab	DM7J6OR	Moderate	Additive immunosuppressive effects by the combination of Vincristine and Tocilizumab.	Rheumatoid arthritis [FA20]	[16]
Canakinumab	DM8HLO5	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Canakinumab.	Rheumatoid arthritis [FA20]	[16]
Rilonacept	DMGLUQS	Moderate	Additive immunosuppressive effects by the combination of Vincristine and Rilonacept.	Rheumatoid arthritis [FA20]	[16]
Golimumab	DMHZV7X	Major	Additive immunosuppressive effects by the combination of Vincristine and Golimumab.	Rheumatoid arthritis [FA20]	[74]
Dexamethasone	DMMWZET	Moderate	Increased metabolism of Vincristine caused by Dexamethasone mediated induction of CYP450 enzyme.	Rheumatoid arthritis [FA20]	[31]
Sarilumab	DMOGNXY	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Sarilumab.	Rheumatoid arthritis [FA20]	[16]
Leflunomide	DMR8ONJ	Major	Additive myelosuppressive effects by the combination of Vincristine and Leflunomide.	Rheumatoid arthritis [FA20]	[43]
Anthrax vaccine	DM9GSWY	Moderate	Antagonize the effect of Vincristine when combined with Anthrax vaccine.	Sepsis [1G40-1G41]	[75]
Voxelotor	DMCS6M5	Moderate	Decreased metabolism of Vincristine caused by Voxelotor mediated inhibition of CYP450 enzyme.	Sickle-cell disorder [3A51]	[76]
Telotristat ethyl	DMDIYFZ	Moderate	Increased metabolism of Vincristine caused by Telotristat ethyl mediated induction of CYP450 enzyme.	Small intestine developmental anomaly [DA90]	[16]
Larotrectinib	DM26CQR	Moderate	Decreased metabolism of Vincristine caused by Larotrectinib mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[17]
Armodafinil	DMGB035	Minor	Increased metabolism of Vincristine caused by Armodafinil mediated induction of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[65]
LEE011	DMMX75K	Moderate	Decreased metabolism of Vincristine caused by LEE011 mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[77]
Etoposide	DMNH3PG	Minor	Decreased metabolism of Vincristine caused by Etoposide mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[25]
Fluorouracil	DMUM7HZ	Minor	Increased plasma concentrations of Vincristine and Fluorouracil due to competitive inhibition of the same metabolic pathway.	Solid tumour/cancer [2A00-2F9Z]	[25]
Doxorubicin	DMVP5YE	Minor	Decreased metabolism of Vincristine caused by Doxorubicin mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[25]
Pitolisant	DM8RFNJ	Moderate	Increased metabolism of Vincristine caused by Pitolisant mediated induction of CYP450 enzyme.	Somnolence [MG42]	[16]
Naltrexone	DMUL45H	Moderate	Increased risk of hepatotoxicity by the combination of Vincristine and Naltrexone.	Substance abuse [6C40]	[78]
Fostamatinib	DM6AUHV	Moderate	Decreased metabolism of Vincristine caused by Fostamatinib mediated inhibition of CYP450 enzyme.	Thrombocytopenia [3B64]	[79]
Brilinta	DMBR01X	Moderate	Decreased metabolism of Vincristine caused by Brilinta mediated inhibition of CYP450 enzyme.	Thrombosis [DB61-GB90]	[16]
Sirolimus	DMGW1ID	Moderate	Increased plasma concentrations of Vincristine and Sirolimus due to competitive inhibition of the same metabolic pathway.	Transplant rejection [NE84]	[73]
Azathioprine	DMMZSXQ	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Azathioprine.	Transplant rejection [NE84]	[17]
Tacrolimus	DMZ7XNQ	Moderate	Increased plasma concentrations of Vincristine and Tacrolimus due to competitive inhibition of the same metabolic pathway.	Transplant rejection [NE84]	[73]
Cinoxacin	DM4EWNS	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Cinoxacin.	Urinary tract infection [GC08]	[21]
Nalidixic acid	DMRM0JV	Minor	Decreased absorption of Vincristine due to intestinal mucosa variation caused by Nalidixic acid.	Urinary tract infection [GC08]	[21]
Ganciclovir	DM1MBYQ	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Ganciclovir.	Virus infection [1A24-1D9Z]	[17]
Valganciclovir	DMS2IUH	Moderate	Additive myelosuppressive effects by the combination of Vincristine and Valganciclovir.	Virus infection [1A24-1D9Z]	[17]

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