Dear Colleagues:

As you know ISMP has long promoted that intravenous vincristine should only be given after dilution in a minibag and never by syringe. We recently called upon FDA to eliminate syringe administration in product labeling. Syringe administration remains in certain protocols around the world. In particular, syringes are used in infants and children in some locations, which continues to put patients at risk of injection into spinal fluid when mixed up with a drug intended for administration by that route. We are aware of 4 child deaths outside the US since January.