Generic
Vinblastine
2 brands available in the market
At a glance
Vinblastine is an anti-cancer medication used in the treatment of breast cancer, kidney cancer, Hodgkin's disease, and Non-Hodgkin's lymphoma.
Description
Vinblastine is M phase specific. It binds to microtubular proteins and arrests mitosis at the metaphase by disrupting mitotic spindle formation. It blocks glutamic acid utilization, thus inhibiting purine synthesis, the citric acid cycle, and the formation of urea.
Indications
- Breast cancer
- Kidney cancer
- Hodgkin's disease
- Non-Hodgkin's lymphoma
- Testicular cancer
- Kaposi's sarcoma
Therapeutic class
Cytotoxic Chemotherapy
Pharmacological class
Vinca Alkaloid
Pharmacology
Vinblastine binds to or crystallises critical microtubular proteins of the mitotic spindle, thus preventing their proper polymerisation and causing metaphase arrest. In high concentrations, Vinblastine also exerts complex effects on nucleic acid and protein synthesis.
Mechanism of action
Binds to microtubular proteins, disrupting mitotic spindle formation and arresting mitosis at metaphase.
Dosage
Adult Dose (IV):
- General Dosing Ranges: 3.7-18 mg/m²/day IV every 7-10 days
- First dose: 3.7 mg/m²/day IV; increase by 1.85 mg/m² weekly until WBC equals 3000/cu.mm; max 18.5 mg/m²
- Testicular tumors: 0.2 mg/kg on each of two consecutive days every three weeks
- Hepatic impairment: Decrease dose by half if bilirubin >3 mg/dL
Child Dose (IV):
- General dosing ranges: 2.5-12.5 mg/m² IV every 7-10 days
- First dose: 2.5 mg/m² IV; increase by 1.25 mg/m² weekly until WBC equals 3000/cu.mm; no more than 12.5 mg/m²
Administration
- Administered by a doctor or nurse as IV injection; do not self-administer
- For intravenous use only; fatal if given by other routes
- Discontinue immediately if extravasation occurs
Missed dose
If you miss a dose, consult your doctor.
Side effects
Common Side Effects:
- Nausea
- Vomiting
- Decreased appetite
- Decreased white blood cell count
- Diarrhea
- Alopecia
- Constipation
- Stomatitis
- Neurotoxicity
Precautions & warnings
- May affect ability to drive
- May cause aspermia (infertility) in males; amenorrhea in females
- May cause inflammation of mouth and lips (stomatitis) and neurological toxicity
- Avoid even accidental contamination of eyes
- May cause acute kidney disease related to uric acid level
- Consult doctor if pregnant or breastfeeding
Contraindications
- Severe bone marrow suppression
- Presence of bacterial infection
- Malignant cell infiltration of bone marrow
- Injection into extremity with poor circulation
- Porphyria
- Granulocytopenia
- Pregnancy
- Lactation
- Intrathecal use may result in death
Drug interactions
- Aprepitant: possible increase in vinblastine levels
- Miconazole: reduced vinblastine metabolism
- Phenytoin: variable interactions; monitor serum phenytoin levels
- Vaccines: reduced immune response
- Zidovudine: additive myelotoxicity
- CYP3A inhibitors: earlier onset and/or increased severity of side effects
- Erythromycin: increased toxicity of vinblastine (potentially fatal)
- Azole antifungals (itraconazole, posaconazole): increased neurotoxicity and myelotoxicity (potentially fatal)
- Ritonavir: increased risk of severe neutropenia (potentially fatal)
- Mitomycin: increased risk of acute pulmonary toxicity (potentially fatal)
- Ganciclovir: increased toxicity (potentially fatal)
Food interactions
It is not known whether it is safe to consume alcohol with Vinblastine; consult your doctor.
Use in pregnancy
Use in Pregnancy: Unsafe; definite evidence of risk to the developing baby; consult your doctor.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Unsafe; data suggests the drug may cause toxicity to the baby.
Pediatric use
Pediatric dosage regimen established
Geriatric use
Caution required in elderly with cachexia or extreme skin ulcerations
Renal / hepatic impairment
Renal Impairment: Safe; no dose adjustment recommended
Hepatic Impairment: Caution needed; decrease dose by half if bilirubin >3 mg/dL; may not be advised in severe liver disease
Overdose effects
Symptoms: Bone marrow suppression, neurotoxicity.
Treatment: Supportive care.
Storage conditions
Store in a refrigerator (2°C-8°C). Keep vial in outer carton in order to protect from light.