Vinblastine

What is Vinblastine

• Vinblastine (Velban) is an alkaloid extracted from Vinca rosea Linn., a common flowering herb known as the periwinkle (more properly known as Catharanthus roseus G. Don). Previously, the generic name was vincaleukoblastine, abbreviated VLB.
• It is a stathmokinetic oncolytic agent.

Vinblastine

Vinblastine ball-and-stick

What are the uses of this medicine?

Vinblastine (Velban) is used as palliative treatment for: Breast cancer:

• That has not gotten better with other treatment.
• It is used in adults.

Choriocarcinoma (a type of gestational trophoblastic disease):

• That has not gotten better with other chemotherapy.
• It is used in adults.

Hodgkin lymphoma:

• It is used in adults and children with advanced disease.

Kaposi sarcoma:

• It is used in adults.

Mycosis fungoides (a type of cutaneous T-cell lymphoma): It is used in adults.

• Non-Hodgkin lymphoma (NHL) in adults

Testicular germ cell tumors:

• It is used in adults and children with advanced disease.

How does this medicine work?

• The vinca alkaloids are antineoplastic agents that act by binding to intracellular tubulin, the basic protein subunit of microtubules which are important in many intracellular processes including mitosis and cell division.
• The vinca alkaloids inhibit cell division by blocking mitosis; they also inhibit purine and RNA synthesis causing death of rapidly dividing cells.
• Vincristine and vinblastine were initially isolated from periwinkle (vinca rosea), extracts of which were found to have antitumor activity. Subsequently, they have been synthesized, although their structure is quite complex. Vinorelbine is a semisynthetic derivative of extracts of periwinkle.

Who Should Not Use this medicine ?

This medicine cannot be used in patients who:

• have significant granulocytopenia
• with bacterial infections

What drug interactions can this medicine cause?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Be sure to mention any of the following:

• aprepitant (Emend)
• certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• clarithromycin (Biaxin, in Prevpac)
• erythromycin (E.E.S., E-Mycin, others)
• HIV protease inhibitors including indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra)
• phenytoin (Dilantin)
• tolterodine (Detrol, Detrol LA)

Is this medicine FDA approved?

• FDA approved vinblastine (vin blas' teen) in the year of 1965.

How should this medicine be used?

Recommended dosage: In Adult Patients:

• It is wise to initiate therapy for adults by administering a single intravenous dose of 3.7 mg/m 2 of body surface area (bsa).
• First dose:3.7 mg/m 2 bsa
• Second dose:5.5 mg/m 2 bsa
• Third dose:7.4 mg/m 2 bsa
• Fourth dose:9.25 mg/m 2 bsa
• Fifth dose:11.1 mg/m 2 bsa
• The above-mentioned increases may be used until a maximum dose not exceeding 18.5 mg/m 2 bsa for adults is reached.

In Pediatric Patients:

• As a single agent for Letterer-Siwe disease (histiocytosis X), the initial dose of vinblastine sulfate was reported as 6.5 mg/m 2.
• When vinblastine sulfate was used in combination with other chemotherapeutic agents for the treatment of Hodgkin’s disease, the initial dose was reported as 6 mg/m 2.
• For testicular germ cell carcinomas, the initial dose of vinblastine sulfate was reported as 3 mg/m 2 in a combination regimen.

Administration:

• Vinblastine comes as a powder or solution (liquid) to be injected intravenously (into a vein) by a doctor or nurse in a medical facility.
• It is usually given once a week.
• The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Vinblastine Sulfate Injection, 10 mg per 10 mL (1 mg per mL) in a 10 mL flip-top vial

This medicine is available in fallowing brand namesː

• Velban

What side effects can this medication cause?

The most common side effects of this medicine include:

• Leukopenia
• Alopecia
• Constipation
• paresthesia
• Hypertension
• Malaise
• bone pain
• weakness
• pain in tumor-containing tissue
• dizziness
• jaw pain

Vinblastine may cause serious side effects, including:

• fever, sore throat, chills, or other signs of infection
• unusual bleeding or bruising
• sores in the mouth
• unusual tiredness or weakness
• pain, numbness, burning, or tingling in the hands or feet
• difficulty walking or unsteady walking
• difficulty breathing
• hearing loss
• seizures
• chest pain

What special precautions should I follow?

• Vinblastine Sulfate preparation is for intravenous use only. It should be administered by individuals experienced in the administration of vinblastine sulfate. The intrathecal administration of vinblastine sulfate usually results in death.
• The patient should be warned to report immediately the appearance of sore throat, fever, chills or sore mouth.
• Advice should be given to avoid constipation, and the patient should be made aware that alopecia may occur and that jaw pain and pain in the organs containing tumor tissue may occur.
• Nausea and vomiting, although not common, may occur. Any other serious medical event should be reported to the physician.
• Acute shortness of breath and severe bronchospasm have been reported following the administration of vinca alkaloids. The onset may be within minutes or several hours after the vinca is injected and may occur up to two weeks following a dose of mitomycin. Progressive dyspnea requiring chronic therapy may occur. Vinblastine should not be readministered.
• The use of small amounts of vinblastine sulfate daily for long periods is not advised, even though the resulting total weekly dosage may be similar to that recommended.
• Care must be taken to avoid contamination of the eye with concentrations of vinblastine sulfate. The eye should be washed with water immediately and thoroughly.
• Despite their cytotoxic activity against cancer cells, the vinca alkaloids have rarely been implicated in causing clinically apparent acute liver injury.

What to do in case of emergency/overdose?

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.

Can this medicine be used in pregnancy?

• Pregnancy Category D.
• Vinblastine sulfate should be given to a pregnant woman only if clearly needed.

Can this medicine be used in children?

• The safety and effectiveness of Velban have been established in pediatric patients.

What are the active and inactive ingredients in this medicine?

Active Ingredient:

• VINBLASTINE SULFATE

Inactive Ingredients:

• SODIUM CHLORIDE
• BENZYL ALCOHOL

Who manufactures and distributes this medicine?

• Packager: Fresenius Kabi USA, LLC

What should I know about storage and disposal of this medication?

• Store products in refrigerator 2° to 8°C (36° to 46°F) to assure extended stability.
• PROTECT FROM LIGHT.

• Dailymed label info on Vinblastine
• FDA Vinblastine

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