Vinblastin - Injection Vinblastine - 10mg/vial 1 Injection(s) / Injection City Overseas Introduction: Vinblastin is an anti-cancer medication used in the treatment of breast cancer, kidney cancer, Hodgkin’s disease, and Non-Hodgkin's lymphoma. Vinblastin is given as an injection into the vein under the supervision of a doctor. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months... Uses of Vinblastin: Breast cancerKidney cancerHodgkin’s diseaseNon-Hodgkin's lymphoma Side effects of Vinblastin: NauseaVomitingDecreased appetiteDecreased white blood cell countDiarrhea How to use Vinblastin: Your doctor or nurse will give you this medicine. Kindly do not self administer. How Vinblastin works: Vinblastin blocks replication of genetic material (DNA) in the cancer cells. Thus it stops the growth and multiplication of cancer cells. Indication: Histiocytic lymphoma, Hodgkin's disease, Kaposi's sarcoma, Letterer-Siwe disease, Lymphocytic lymphoma, Mycosis fungoides, Testicular cancer Administration: IV Preparation IV push 1 mg/mL (dose/syringe); max syringe size for IVP is a 30 mL syringe & syringe should be <75% full Powder: reconstitute w/ 10 mL NS or bacteriostatic NS to obtain 1 mg/mL soln Continuous infusion: 250-1000 mL D5W or NS (dose) Adult Dose: Intravenous Cancers Testicular CA, Squamous cell CA of head & neck, Hodgkin's Dz, Kaposi's sarcoma; histiocytic lymphoma, mycosis fungoides, & Letterer-Siwe disease (histiocytosis X) General Dosing Ranges 3.7-18 mg/sq.meter/day IV q7-10d 1st dose 3.7 mg/sq.meter/day IV Incr by 1.85 mg/sq.meter qweek until WBC equal 3000/cu.mm NMT 18.5 mg/sq.meter Hepatic impairment Decrease dose by half if bilirubin >3 mg/dL [>51 umol/L] Child Dose: Intravenous Cancers Testicular CA, Squamous cell carcinoma CA of head & neck, Hodgkin's Dz, Kaposi's sarcoma; histiocytic lymphoma, mycosis fungoides, & Letterer-Siwe disease (histiocytosis X) General dosing ranges 2.5- 12.5 mg/sq meter IV q7-10d 1st dose 2.5 mg/sq.meter IV Incr by 1.25 mg/sq.meter qWeek until WBC = 3000/cu.mm No more than 12.5 mg/sq.meter Contraindication: Severe bone marrow suppression; presence of bacterial infection; maglignant cell infiltration of bone marrow; Inj into extremity with poor circulation; porphyria; granulocytopenia. Elderly with cachexia or extreme skin ulcerations. Pregnancy; lactation. Intrathecal use may result in death. Mode of Action: 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. It may also interfere with nucleic acid and protein synthesis. Precaution: Hepatic impairment; neurotoxicity; ischemic heart disease; preexisting pulmonary dysfunction; extravasation may cause tissue damage and pain. Discontinue immediately if extravasation occurs, with local Inj of hyaluronidase and local heat application to decrease discomfort and risk of cellulitis; remaining Inj to be injected into another vein. Routine prophylaxis against constipation recommended especially in high doses. Nadir in leukocyte count occur 4-10 days after vinblastine admin; recovery observed 7-14 days after treatment. Lactation: not known if excreted in breast milk, do not nurse Side Effect: 1-10% Anemia,Leukopenia,Myelosuppression,Alopecia Frequency Not Defined Peripheral neuropathy,Hypertension,Bronchospasm,Nausea,Vomiting,Anorexia,Diarrhea,Constipation,Paralytic ileus,Jaw pain,Aspermia,Amenorrhea Interaction: Possible increase in vinblastine levels with aprepitant. Reduced vinblastine metabolism with miconazole. Variable interactions with phenytoin, monitor serum phenytoin levels. Reduced immune response with vaccines. Additive myelotoxicity with zidovudine. Concurrent admin of vinblastine with CYP3A inhibitors may cause an earlier onset and/or an increased severity of side effects. Potentially Fatal: Increased toxicity of vinblastine with erythromycin. Increased neurotoxicity and myelotoxicity with azole antifungals e.g. itraconazole and posaconazole. Increased risk of severe neutropenia with ritonavir. Increased risk of acute pulmonary toxicity with mitomycin. Increased toxicity when ganciclovir is given with, immediately before or after vinblastine.