Vinblastine

Registered South African indications:

• Malignant non-Hodgkin's lymphoma
• Hodgkin's disease 
• Carcinoma of the testes
• Carcinoma of the breast
• Choriocarcinoma

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to any of the other vinca alkaloids
• Depressed bone marrow function caused by tumours, cytostatics or irradiation
• Bacterial infections
• Porphyria
• Bad nutritional state
• Intrathecal use

Cautions

• Pregnancy
• Breastfeeding
• Hepatic impairment
• Men and women of childbearing potential
• Cachexia
• Ulcerated areas of the skin 
• Malignant cell infiltration of the bone marrow
• Contamination of the eye

Forms avail. in SA and covered in this monograph: inj

Used for the treatment of

Malignant non-Hodgkin's lymphoma
Hodgkin's disease 
Carcinoma of the testes
Carcinoma of the breast
Choriocarcinoma

Consult specialist for dosages and regimens

Paed. forms avail. in SA and covered in this monograph: inj 

Used for the treatment of

Malignant non-Hodgkin's lymphoma
Hodgkin's disease 
Carcinoma of the testes
Carcinoma of the breast
Choriocarcinoma

Consult specialist for dosages and regimens

Pregnancy

• Caution; not recommended

Breastfeeding

• Caution; not recommended
• It is not known whether vinblastine is excreted in human milk
• Because of the potential for serious adverse reactions due to vinblastine in nursing infants, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother

Fertility

• The effect of vinblastine on fertility in humans is not fully known. Aspermia has occurred in some individuals during vinblastine therapy

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• Caution; dose adjustment recommended

Elderly            

• No dose adjustment recommended

Porphyria Information

• Contraindicated

Central Nervous System Disorders

• Numbness
• Paraesthesias
• Peripheral neuritis
• Mental depression
• Loss of deep tendon reflexes
• Headache
• Convulsions
• Vestibular and auditory damage to the eighth cranial nerve
• Dizziness
• Nystagmus
• Malaise

Cardiovascular Disorders

• Myocardial infarction
• Cerebrovascular accident 
• Hypertension

Respiratory Disorders

• Acute respiratory distress

Gastrointestinal Disorders

• Nausea and vomiting
• Constipation
• Oral mucosal blistering
• Diarrhoea
• Anorexia
• Abdominal pain
• Rectal bleeding
• Pharyngitis
• Haemorrhagic enterocolitis
• Bleeding from an old peptic ulcer
• Ileus 
• Stomatitis

Endocrine and Metabolic Disorders

• Syndrome of inappropriate antidiuretic hormone secretion

Musculoskeletal Disorders

• Myalgia
• Bone pain
• Jaw pain
• Tumour pain

Skin and Subcutaneous Tissue Disorders

• Blister
• Alopecia
• Injection site reaction 
• Extravasation 
• Cellulitis 
• Phlebitis
• Sloughing 
• Raynaud's phenomenon 

Immune, Blood and Lymphatic System Disorders

• Leucopenia
• Thrombocytopaenia
• Anaemia

Sensory Disorders

• Partial or total deafness
• Vertigo

• Radiation 
• Mitomycin 
• Cisplatin 
• Bleomycin
• Erythromycin 
• Anticonvulsants 
• CYP3A4 inhibitors

• Full blood count with differential
• Serum uric acid
• Hepatic function

Because of the enhanced possibility of thrombosis, it is considered inadvisable to inject a solution of vinblastine sulfate into an extremity in which the circulation is impaired, or potentially impaired, by such conditions as compressing or invading neoplasm

Although the mechanism of action has not been definitely established, vinblastine appears to bind to or crystallise critical microtubular proteins of the mitotic spindle, thus preventing their proper polymerisation and causing metaphase arrest. Vinblastine may also interfere with nucleic acid and protein synthesis by blocking glutamic acid utilization.

Injection (per ml) 1mg

• Vinblastine Faulding (Pharmaplan)
• Vinblastine Teva (Teva)