Vinblastine (Intravenous)

Belonging to the vinca alkaloids family of chemotherapy medicines, Vinblastine is used to treat specific kinds of cancer such as the breast, testicle and lymphoma types. Administered intravenously, it obstructs the growth of cells, effectively stopping the tumor from growing and spreading and eventually killing the cancerous cells.

Overview

Vinblastine, otherwise known by its brand name Velban, is intravenously administered as a treatment for certain types of cancer. Developed from the Madagascan Periwinkle plant, it belongs to a group of medicines known as vinca alkaloids or antineoplastic agents.

Vinblastine works by interfering with the growth of cells and eventually destroying them, which stops tumors from being able to grow or spread any further. Used to treat cancers such as breast, testicle or lymphoma, it can also be used in treating some noncancerous conditions such as the blood disorder histiocytosis and benign tumors.

During treatment, Vinblastine may affect the growth of normal body cells, so side effects are likely to occur. Some of the side effects can be serious and must be communicated to your doctor, however, other side effects, such as hair loss, are not serious but can cause distress or impact your daily routines.

Available in the dosage forms of either a solution or powder for solution, Vinblastine must always be administered intravenously by a medical professional.

Conditions treated

  • Hodgkin lymphoma
  • Non-Hodgkin's lymphoma
  • Testicular, breast, head, neck and bladder cancers
  • Non-small cell lung cancer
  • Melanoma
  • Choriocarcinoma
  • Soft tissue sarcoma
  • Kaposi's sarcoma
  • Mycosis fungoides (t-cell lymphoma)
  • Fibromatosis and germ cell tumors
  • Certain blood disorders including histiocytosis

Type of medicine

  • Antimicrotubule Agent/Vinca Alkaloid

Side effects

Due to Vinblastine's potential effect on normal cells, as well as those that are cancerous, there are a number of side effects that are likely to be experienced by most users. There are many ways that these side effects can be managed, so it is recommended that you discuss side effects and how they can be lessened or effectively controlled, with your care team.

Serious constipation and abdominal pain are common results of Vinblastine that can potentially lead to a blockage or stoppage of the bowel if the right treatment is not received. It is important to keep your liquids up when in treatment as well as maintain a fibrous diet to ease any constipation.

Neurotoxicity (a toxicity that affects the nerves) is another common side effect and one which can cause numbness or tingling in various parts of the body. Feeling this in the hands and feet is more common with those on Vinblastine, but it can become worse and lead to problems with balance and walking. For many, the symptoms will slowly resolve once the medication has stopped, but for others, it never goes away completely. It's important to alert your healthcare provider if you experience any numbness or tingling, as they may need to alter your Vinblastine dosage.

Other, less common effects of neurotoxicity can include malaise, dizziness, depression, headaches and seizures. It has also been found that Vinblastine can cause toxicity of the cranial nerves which can affect the vocal chords, eyes or facial nerves as well as severe pain in the jaw following the first treatment. If you experience any of these symptoms, please contact your healthcare professional immediately.

Mouth ulcers, fatigue, alopecia, high blood pressure, a decrease in appetite and nausea are all widely reported side effects of Vinblastine and can be managed with support from your healthcare team. You are also likely to experience a drop in your white blood cell count, which can make you more susceptible to getting infections. It is important to make changes to your lifestyle and hygiene to protect against illness and infection. Your immediate family and anyone who lives with you will also have to make changes to their lifestyles to help protect you from infection. If you experience a fever, cold, shortness of breath, burning sensation when urinating or a sore throat that doesn't heal, you must contact your doctor immediately.

Less common side effects that should be reported to your healthcare team include urinary retention and pain in tumorous tissue. If you experience fever or chills, lower back pain, blood in urine or stools, pain or redness at the place of the injection or pinpoint red spots on your skin, it is vital that you contact a doctor immediately. Unusual bleeding, bruising and black tarry stools are also signs of serious side effects that must be urgently communicated to your doctor.

Your sexual libido may decrease and, for the sexually active, it is important to use effective birth control. Vinblastine can cause birth defects to an unborn child, so it is advised to not become pregnant or father a child when on the medication. Sperm banking or egg harvesting are both methods that should be considered if you are likely to have a child in the future. These options can all be discussed in detail with your oncology team.

Dosage

Vinblastine is available in the form of either a solution or a powder solution dosage. The dosage that you may receive is dependant on the condition that it will treat, with more common cancers such as breast cancer starting at a dose of 3.7 mg IV. The second dose will progress to 5.5 mg IV, the third to 7.4 mg IV while the fourth is 9.25 mg IV. A fifth dose will usually be at 11.1 mg IV.

This can be followed with a dosage of up to 18.5 mg IV. The dose should not be increased following this, as at 18.5 mg, the white cell count will be reduced to 3000 cells/mm3.

In certain adults, 3.7 mg IV has been proven to make this leukopenia (loss of white blood cells); while for others, they may need more than 11.1 mg IV; and, in rare cases, a dose as high as 18.5 mg IV may be needed. The weekly dose will be 5.5 to 7.4 mg IV for the majority of adult patients.

When the dose which produces a loss of 3000 white blood cells/mm3 has been established, a dose of one accretion smaller than this should be given at weekly intervals for maintenance. This will mean that the patient is receiving the maximum dose that does not cause leukopenia. Even though seven days have elapsed, the next dose should not be given until the white cell count has returned to at least 4000/mm3. Oncolytic (cancer cell killing) activity has been known to be encountered before the leukopenic effect takes place. When this happens, there is no need to increase the size of the patient's subsequent doses.

The dosage of Vinblastine follows a similar format to the above for every condition that will be treated, yet the doses will vary depending on your white blood cell. In most cases, your doctor will ensure that your dose will not produce a loss of more than 3000 white blood cells/mm3. It is important to speak to your doctor to find out more about your dosage, and how to manage its effects before you begin your treatment.

Interactions

Vinblastine reacts to a known total of 354 drugs, making it incredibly important to be completely transparent with your doctor about any pharmaceutical, herbal or other supplements and medications that you may be taking. Some medications should never be used together, but in certain cases, different medicines may be used together even if they do cause a reaction. Because of this, your doctor may want to change your dose or implement other precautions. The most important medications that should be communicated to your doctor include live vaccines for measles, mumps, rotavirus and varicella. If you are taking these or any other vaccines, your doctor may decide to change your treatment completely or alter any other medications that you are taking.

It is also not recommended to use Vinblastine with the following medications:

  • Clarithromycin
  • Darunavir
  • Eliglustat
  • Fluconazole
  • Ketoconazole
  • Lopinavir
  • Mitomycin
  • Posaconazole
  • Quinupristin
  • Ritonavir
  • Simeprevir
  • Ulipristal
  • Voriconazole
  • Zidovudine
  • Tolterodine

However, in some scenarios, it will be necessary to take some of the listed medications. In this case, your doctor will change the dose or how often you use Vinblastine.

Aside from the above medications, other factors such as types of food, alcohol, tobacco and other illnesses may affect your Vinblastine treatment. Discussing your lifestyle, diet and health with your healthcare professional will ensure that your treatment is as effective as possible.

Warnings

When taking Vinblastine, it is vital that you have regular check-ups and visits with your doctor to understand whether the medicine is working properly, as well as check for any unwanted side effects.

Keeping track of any changes within your medical, dietary and mental circumstances is vital, and when taking Vinblastine, you must be mindful of introducing any new foods, drinks, therapies and activities into your life. Vinblastine can lower your body's resistance to infection, in turn causing infections, but additional medication such as vaccines should never be taken without your doctor's approval. It is also important to be fully aware of any medications and treatments that people living in your household may be taking, as vaccines such as the oral polio vaccine has a chance of passing the polio virus to you. In these circumstances, wearing a protective face mask that covers the nose and mouth is recommended. Due to your lowered white blood cell count and resistance to infection, it is also important to avoid people with infections, refrain from partaking in sport or situations that could cause bruising or injury, be careful when brushing teeth or using dental floss and avoid touching your eyes or inside your nose at all times unless you have washed your hands. All the mentioned scenarios can lead to infections and viruses entering the body and you must be diligent in avoiding them.

When receiving intravenous Vinblastine treatment, if the agent accidentally leaks into its injected vein, it may cause painful damage to the skin and scarring. When receiving your treatment it is vital to alert your doctor or nurse immediately if you do notice any redness, pain or swelling at or around the point of injection.

Another important point before taking Vinblastine is its impact on pregnancy, breastfeeding and conceiving. Even though information regarding Vinblastine and its effects during pregnancy is limited, the drug has the potential to cause toxicity to pregnant women when administered. It has been proven to cause the resorption of foetuses in animals, as well as produce severe foetal abnormalities in any surviving offspring. Because of this, it is recommended that Vinblastine should only ever be used during pregnancy in life-threatening circumstances or when safer drugs are ineffective or cannot be used. If a patient does become pregnant during treatment with Vinblastine, it is important to discuss and consider the above problems with their doctor and the best plan of action for both mother and baby.

In regards to Vinblastine's effects on human milk, there is no knowledge of its effects. However, because of the potential for damaging and dangerous reactions to any infant who receives the milk, it is advised that you either discontinue the drug or make alternative arrangements for breastfeeding.

Storage

Vinblastine should always be stored at a temperature of 2 to 8°C and must be protected from light by being kept inside its container at all times. Because it should only ever be administered by or under the supervision of qualified physicians, your doses of Vinblastine will always be kept in a sterile and safe environment. If a spillage should happen, operators must wear gloves and mop up the spilt Vinblastine with a special sponge that is kept in a separate area for the purpose of cleaning hazardous waste. The area should then be twice rinsed with water, and any solutions and sponges need to be put in a sealed plastic bag. On disposal, any tools and fabrics that have come into contact with Vinblastine must be placed in a thick plastic bag and incinerated.

Summary

For cancer, tumor and rare blood disorder sufferers, Vinblastine offers an effective treatment that can extend and save your life, as well as increase its quality. By effectively stopping cancerous cells from growing and spreading, and eventually killing them, Vinblastine proves to be an effective treatment for specific cancers. However, it is an invasive medicine that is highly likely to cause side effects, as well as pose some greater risks. Common side effects including drowsiness, nausea and the inability to eat usual diets make it hard for some people to coordinate normal activities that they may previously have taken part in. Among this, side effects such as a lowered immune system and resistance can have a huge impact on a person's life and the people surrounding them. However, the benefits of a full course of Vinblastine treatment far outweigh the risks in this case. Cancer is a debilitating condition that can affect every aspect of a person and their family's life, and managing it can be incredibly hard. Vinblastine offers a solution that can extend your life and help to remove the cancer, by obstructing and eventually destroying cancerous cells.

The fact that it is mostly controlled by your doctor also reduces any anxiety that many patients have with oral medications or injections. It can offer a peace of mind in patients, and the knowledge that they are in the best place of care. This also means that maintenance of how Vinblastine is administered is much higher than with that of other medications and that the dose can be easily increased or decreased to suit the patient's needs.

With the effective use of Vinblastine, a patient's cancer can be eradicated, enabling them to regain control of their life and take part in everyday activities that they may have been unable to do before. This may involve tasks that are as simple as going to the shops or taking a short walk outside. Most importantly, Vinblastine can offer you and your family a valuable extension of time together.

To achieve the best results from Vinblastine, it is important that you work closely and develop a good relationship with your doctor, maintaining regular visits, check-ups and communication. It can take time to recover from side effects, making Vinblastine an agent that requires lots of mental strength and support from your healthcare professional, as well as your family.

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Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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