Pronunciation:

vin-BLAS-teen

Brand Names:

• Velban

Dosage Forms:

• Solution
• Powder for Solution

Warnings:

Caution - This preparation should be administered by individuals experienced in the administration of vinblastine sulfate. It is extremely important that the needle be properly positioned in the vein before this product is injected. If leakage into surrounding tissue should occur during intravenous administration of vinblastine sulfate, it may cause considerable irritation. The injection should be discontinued immediately, and any remaining portion of the dose should then be introduced into another vein. Local injection of hyaluronidase and the application of moderate heat to the area of leakage help disperse the drug and are thought to minimize discomfort and the possibility of cellulitis.

Fatal if given intrathecally. For intravenous use only .

Intravenous needle or catheter must be properly positioned before any vinblastine is injected as leakage into the surrounding tissue may cause considerable irritation. If extravasation occurs, the injection should be discontinued immediately, and any remaining portion of the dose should then be introduced into another vein. Local injection of hyaluronidase and the application of moderate heat to the area of leakage help disperse the drug and are thought to minimize discomfort and the possibility of cellulitis .

Classifications:

Therapeutic—

Antineoplastic Agent

Pharmacologic—

Mitotic Inhibitor

Uses of This Medicine:

Vinblastine belongs to the group of medicines known as antineoplastic agents. It is used to treat certain kinds of cancer, including lymphoma and cancer of the breast or testicles, as well as some noncancerous conditions.

Vinblastine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by vinblastine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, such as hair loss, may not be serious but may cause concern. Some effects do not occur until months or years after the medicine is used.

Before you begin treatment with vinblastine, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Vinblastine is to be administered only by or under the immediate supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, vinblastine is used in certain patients with the following medical conditions:

• Cancer of the bladder
• Cancer of the kidneys
• Cancer of the lungs
• Cancer of the prostate
• Germ cell ovarian tumors (a certain type of cancer of the ovaries)
• Malignant melanoma

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

This medicine has been tested in children and has not been shown to cause different side effects or problems than it does in adults.

Older adults—

Many medicines have not been tested in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information about the use of vinblastine in the elderly.

Pregnancy—

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Rotavirus Vaccine, Live

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Gout (history of) or
• Kidney stones (history of)—Vinblastine may increase levels of uric acid in the body, which can cause gout or kidney stones

• Infection—Vinblastine may decrease your body's ability to fight infection

• Liver disease—Effects may be increased because of slower removal of vinblastine from the body

Proper Use of This Medicine:

Vinblastine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

While you are using this medicine, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well.

Vinblastine sometimes causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with vinblastine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Vinblastine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. Other people living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the past several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Vinblastine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

If vinblastine accidentally seeps out of the vein into which it is injected, it may damage the skin and cause some scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

Side Effects of This Medicine:

Along with their needed effects, medicines like vinblastine can sometimes cause unwanted effects such as blood problems, loss of hair, and other side effects. These and other effects are described below. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More frequent

Cough or hoarseness accompanied by fever or chills

fever or chills

lower back or side pain accompanied by fever or chills

painful or difficult urination accompanied by fever or chills

Less common

Blood in urine or stools

pain or redness at place of injection

pinpoint red spots on skin

unusual bleeding or bruising

Rare

Black, tarry stools

Check with your doctor as soon as possible if any of the following side effects occur:

Less common

Joint pain

sores in mouth and on lips

swelling of feet or lower legs

Rare

Difficulty in walking

dizziness

double vision

drooping eyelids

headache

jaw pain

mental depression

numbness or tingling in fingers and toes

pain in fingers and toes

pain in testicles

weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Bone or muscle pain

nausea and vomiting

This medicine often causes a temporary loss of hair. After treatment with vinblastine has ended, or sometimes even during treatment, normal hair growth should return.

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.