vinblastine

n.
An alkaloid, C₄₆H₅₈N₄O₉, obtained from the Madagascar periwinkle and used as an antineoplastic drug.

[Short for vincaleukoblastine : New Latin Vinca, periwinkle genus; see vinca + English leukoblast, a developing leukocyte (LEUKO- + -BLAST) + -INE².]

Key Terms: Alkaloid, Microtubles.

Definition

Vinblastine is a drug used to treat certain types of cancer. Vinblastine is available under the trade names Velban and Velsar, and may also be referred to as vinblastine sulfate. The drug was previously known as vincaleukoblastine or VLB.

Purpose

Vinblastine is an antineoplastic agent used to treat Hodgkin's disease, non-Hodgkin's lymphomas, mycosis fungoides, cancer of the testis, Kaposi's sarcoma, Letterer-Siwe disease, as well as other cancers.

Description

Vinblastine was approved by the Food and Drug Administration (FDA) in 1961.

Vinblastine is a naturally occurring compound that is extracted from periwinkle plants. It belongs to a group of chemicals called alkaloids. The chemical structure and biological action of vinblastine is similar to vincristine and vinorelbine.

Vinblastine prevents the formation of microtubules in cells. One of the roles of microtubules is to aid in the replication of cells. By disrupting this function, vinblastine inhibits cell replication, including the replication the cancer cells.

Vinblastine is one the most effective treatments for Hodgkin's disease, and is typically used in combination with doxorubicin, bleomycin and dacarbazine. It is also used to treat non-Hodgkin's lymphomas, mycosis fungoides, and Letterer-Siwe disease. Vinblastine is also used to treat cancer of the testis in combination with other cancer drugs, and Kaposi's sarcoma alone, or in combination with other drugs. Vinblastine is also used less frequently to treat other types of cancer.

Recommended Dosage

Vinblastine is administered by intravenous injection at intervals of at least seven days. Blood tests may be necessary every seven days to ensure that enough white blood cells are present to continue treatment. The initial dose of vinblastine may be adjusted upward or downward depending on patient tolerance to the toxic side effects of treatment. The minimum recommended treatment duration is four to six weeks.

Precautions

Vinblastine must only be administered by individuals experienced in the use of this cancer chemotherapeutic agent. Vinblastine must only be administered intravenously, that is, directly into a vein. Accidental administration of vinblastine into the spinal cord fluid is a medical emergency that may result in death. Vinblastine has a low therapeutic index. It is unlikely there will be therapeutic benefit without toxic side effects. Certain complications can only be managed by a physician experienced in the use of cancer chemotherapeutic agents.

Because vinblastine is administered intravenously, the site of infusion and surrounding tissue should be monitored for signs of inflammation and irritation.

Adverse side effects are more likely in patients with malnutrition or skin ulceration.

Blood tests may be necessary to ensure that the number of white blood cells is adequate for treatment to continue. Vinblastine is not recommended for use in patients with low white blood cell levels. Infections should also be controlled before vinblastine treatment.

Patients should inform their physician if they experience sore throat, fever, chills, or sore mouth and any serious medical event.

Vinblastine may cause harm to a fetus when administered to pregnant women. Only in life-threatening situations, should this treatment be used during pregnancy. Women of childbearing age are advised not to become pregnant during treatment. Women should stop nursing before beginning treatment, due to the potential for serious adverse side effects in the nursing infants.

Side Effects

The side effects of vinblastine treatment are usually related to the dose of drug and are generally reversible. Toxic side effects are more common in patients with poor liver function. Studies have also shown that patients with advanced prostate cancer experienced toxic side effects of estramustine phosphage (EMP) plus vinblastine (VBL) and from EMP alone.

A decrease in the number of white blood cells is the principal adverse side effect associated with vinblastine treatment. Blood tests will allow a doctor to determine if there are an adequate number of white blood cells to begin or continue treatment. Nausea and vomiting may occur, for which antiemetic agents are usually effective. Shortness of breath is a potentially severe side effect that patients should report to their doctor.

Additional side effects, including loss of appetite (anorexia), diarrhea, constipation, pain, rectal bleeding, dizziness, hearing impairment, and hair loss (alopecia) may occur.

Interactions

Drugs that may alter the metabolism of vinblastine, particularly itraconazole, should be used with caution due to the potential for interactions. Hearing impairment may be enhanced when vinblastine is used with other drugs that affect the ear. These drugs include platinum-containing antineoplastic agents, such as cisplatin. Seizures have been reported in patients taking vinblastine and phenytoin. The doses of vinblastine and phenytoin may need to be adjusted to decrease the chance of this problem.

Brand names: Velban®

Chemical formula:

Español:
• Sulfato de vinblastina, Solución para inyección

Vinblastine Sulfate Solution for injection

What is this medicine?

VINBLASTINE is a chemotherapy drug. It slows the growth of cancer cells. This medicine is used to treat many types of cancer like breast cancer, testicular cancer, Hodgkin's disease, non-Hodgkin's lymphoma, and sarcoma.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•blood disorders
•dental disease
•gout
•infection (especially a virus infection such as chickenpox, cold sores, or herpes)
•liver disease
•lung disease
•nervous system disease
•recent or ongoing radiation therapy
•an unusual or allergic reaction to vinblastine, other chemotherapy agents, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

This drug is given as an infusion into a vein. It is administered in a hospital or clinic by a specially trained health care professional. If you have pain, swelling, burning or any unusual feeling around the site of your injection, tell your health care professional right away.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
•erythromycin
•itraconazole
•mibefradil
•voriconazole

This medicine may also interact with the following medications:
•cyclosporine
•fluconazole
•ketoconazole
•medicines for seizures like phenytoin
•medicines to increase blood counts like filgrastim, pegfilgrastim, sargramostim
•vaccines
•verapamil

Talk to your doctor or health care professional before taking any of these medicines:
•acetaminophen
•aspirin
•ibuprofen
•ketoprofen
•naproxen

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Your condition will be monitored carefully while you are receiving this medicine. You will need important blood work done while you are taking this medicine.

This drug may make you feel generally unwell. This is not uncommon, as chemotherapy can affect healthy cells as well as cancer cells. Report any side effects. Continue your course of treatment even though you feel ill unless your doctor tells you to stop.

In some cases, you may be given additional medicines to help with side effects. Follow all directions for their use.

Call your doctor or health care professional for advice if you get a fever, chills or sore throat, or other symptoms of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid being around people who are sick.

This medicine may increase your risk to bruise or bleed. Call your doctor or health care professional if you notice any unusual bleeding.

Be careful brushing and flossing your teeth or using a toothpick because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are receiving this medicine.

Avoid taking products that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your doctor. These medicines may hide a fever.

Do not become pregnant while taking this medicine. Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information. Do not breast-feed an infant while taking this medicine.

Men may have a lower sperm count while taking this medicine. Talk to your doctor if you plan to father a child.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•low blood counts - This drug may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.
•signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
•signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, nosebleeds
•signs of decreased red blood cells - unusually weak or tired, fainting spells, lightheadedness
•breathing problems
•changes in hearing
•change in the amount of urine
•chest pain
•high blood pressure
•mouth sores
•nausea and vomiting
•pain, swelling, redness or irritation at the injection site
•pain, tingling, numbness in the hands or feet
•problems with balance, dizziness
•seizures

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•constipation
•hair loss
•jaw pain
•loss of appetite
•sensitivity to light
•stomach pain
•tumor pain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

This drug is given in a hospital or clinic and will not be stored at home.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

A vinca alkaloid; the sulfate is used as an antineoplastic usually in combination with other, similar agents.

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