Vikolin Injection

Indications

Vinblastine Sulfate is an anticancer (chemotherapy) medicine. It is used, usually together with other medicines, to treat Hodgkin lymphoma and some non-Hodgkin lymphomas, testicular cancer, Kaposi sarcoma, Langerhans cell histiocytosis, and some other cancers such as breast cancer and choriocarcinoma, as decided by a cancer specialist.

How It Works

Vinblastine is a vinca alkaloid, originally obtained from the Madagascar periwinkle plant. It binds to tubulin, a protein that forms the spindle fibres a cell needs to divide. This stops cancer cells from dividing and they die. Normal fast-dividing cells, such as those in the bone marrow, can also be affected.

Dosage and Administration

Vinblastine is given only by trained staff in hospital or a cancer centre, as an injection into a vein, as prescribed. The dose is based on body surface area, blood counts and the treatment plan, and is usually repeated at intervals of one or more weeks. It must never be given into the spine (intrathecal), because this is fatal. Care is taken that it does not leak out of the vein.

Interactions

Strong CYP3A4 blockers such as Itraconazole, Ketoconazole, Clarithromycin, Erythromycin and some HIV medicines can raise vinblastine levels and increase toxicity. It can lower Phenytoin levels. Live vaccines should not be given during treatment. Use with other medicines that harm the bone marrow or nerves, or with Mitomycin, increases side effects. Tell the team about all medicines and herbal products.

Contraindications

It is not given to people with very low white blood cell counts or a serious uncontrolled bacterial infection, to anyone allergic to vinca alkaloids, or by the intrathecal route.

Side Effects

Common effects include low white cell counts with risk of infection, low platelets, hair loss, tiredness, nausea, vomiting, constipation, mouth sores, jaw or bone pain, and numbness or tingling in the hands and feet. Severe constipation or blocked bowel, high blood pressure and breathing problems can occur.

Get urgent medical help for fever or chills, unusual bleeding or bruising, severe constipation with stomach pain or no bowel movement, shortness of breath, chest pain, pain, redness or swelling at the injection site, or severe weakness.

Pregnancy and Lactation

Vinblastine can harm an unborn baby. It should not be used in pregnancy unless the specialist decides it is essential. Effective contraception is needed during treatment and for some months after, for both women and men. Breastfeeding should be stopped during treatment.

Precautions and Warnings

Regular blood tests are needed before each dose. Tell the doctor about liver disease, nerve problems, or previous radiotherapy. Use a laxative or stool softener if advised to prevent constipation. Avoid contact with people who have infections and do not receive live vaccines. It is a hazardous drug; only trained staff should handle it.

Overdose

Overdose can cause severe bone marrow suppression, nerve damage, bowel blockage and other serious effects. It is a medical emergency managed in hospital with supportive care and close monitoring.

Therapeutic Class

Antineoplastic, vinca alkaloid

Storage

Hospital medicine: store as directed on the pack, usually in a refrigerator at 2 to 8°C, do not freeze, and protect from light. Keep out of the reach of children.