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vinblastine

Generic Name: vinblastine (vin BLAS teen)
Brand Name: Velban

What is vinblastine?

Vinblastine is cancer medication that interferes with the growth of cancer cells and slows their spread in the body.

Vinblastine is used to treat Hodgkin's disease, certain types of lymphoma, testicular cancer, breast cancer, choriocarcinoma (a type of uterine cancer), Kaposi's sarcoma, and Letterer-Siwe disease.

Vinblastine is often used in combination with other cancer medications.

Vinblastine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about vinblastine?

You should not use this medication if you are allergic to it, or if you have severely low white blood cell counts, or an untreated or uncontrolled bacterial infection.

Do not use vinblastine if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment.

Before you receive vinblastine, tell your doctor if you have liver disease, wasting syndrome, skin ulcers, coronary artery disease, a history of blood clot or stroke, or cancer that has spread to your bone marrow.

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Vinblastine is often used in combination with other cancer medications.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when vinblastine is injected.

Vinblastine can lower blood cells that help your body fight infections. Avoid being near people who have colds, the flu, or other contagious illnesses. Your blood will need to be tested on a regular basis. Do not miss any scheduled appointments. Contact your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while you are being treated with vinblastine, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.

What should I discuss with my healthcare provider before receiving vinblastine?

You should not use this medication if you are allergic to it, or if you have:

  • severely low white blood cell counts; or

  • an untreated or uncontrolled bacterial infection.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

  • liver disease;

  • wasting syndrome (decreased weight with loss of muscle tissue);

  • skin ulcers, bed sores;

  • coronary artery disease, a history of blood clot or stroke (including "mini-stroke"); or

  • cancer than has spread to your bone marrow.

FDA pregnancy category D. Vinblastine can cause harm to an unborn baby or cause birth defects. Before you receive vinblastine, tell your doctor if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

It is not known whether vinblastine passes into breast milk or if it could harm a nursing baby. Before you receive this medication, tell your doctor if you are breast-feeding a baby.

How is vinblastine given?

Vinblastine is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion.

Vinblastine is usually given once every 7 days. Follow your doctor's instructions.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when the medicine is injected.

Vinblastine can lower the blood cells that help your body fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your cancer treatments may be delayed based on the results of these tests. Do not miss any scheduled visits to your doctor.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your vinblastine injection.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

Overdose symptoms may include severe forms of the serious side effects listed in this medication guide.

What should I avoid while receiving vinblastine?

Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.

Do not receive a "live" vaccine while you are being treated with vinblastine, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. Live vaccines include measles, mumps, rubella (MMR), oral polio, chickenpox (varicella), BCG (Bacillus Calmette and Guérin), and nasal flu vaccine.

Talk to your doctor about ways to avoid constipation while being treated with vinblastine.

Vinblastine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • signs of infection such as fever, chills, sore throat, mouth pain, white patches or sores inside your mouth or on your lips;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • numbness, burning, pain, or tingly feeling;

  • bronchospasm (wheezing, chest tightness, trouble breathing);

  • severe constipation;

  • problems with vision, hearing, speech, balance, or daily activities;

  • sudden numbness or weakness on one side of the body, sudden headache or confusion;

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling; or

  • pain, burning, redness, swelling, or skin changes where the IV needle was placed.

Less serious side effects may include:

  • temporary hair loss;

  • jaw pain;

  • tumor pain, bone pain;

  • missed menstrual periods;

  • nausea, vomiting, loss of appetite; or

  • feeling weak or tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Vinblastine Dosing Information

Usual Adult Dose for Breast Cancer:

Initial Dose: 3.7 mg/m2 intravenously over approximately one minute, once.

Because of the variation in the depth of the leukopenic response following therapy, the manufacturer recommends that vinblastine not be given more frequently than once every 7 days. However, there are several multiple day regimens where the dose is split into several consecutive days.

The manufacturer outlines the following conservative incremental approach to dosage at weekly intervals for adults. Therapy may be continued at 5.5 mg/m2 for the second dose, 7.4 mg/m2 for the third dose, 9.25 mg/m2 for the fourth dose, and 11.1 mg/m2 for the fifth dose. This progression may be followed up to a maximum dosage of 18.5 mg/m2. Dosage regimens may vary in clinical practice according to the disease being treated and the combination of antineoplastic agents being used.

White blood cell counts should be obtained just prior to dosage administration. The nadir in the white blood cell count is generally observed from 5 to 10 days following the dosage. Recovery to pretreatment levels is usually observed from 7 to 14 days after treatment. If a dose reduces the white cell count to approximately 3,000 cells/mm3, the next dose should not be given until the white cell count has returned to at least 4,000/mm3. The previous dosage increment may then be administered at weekly intervals for maintenance. In some cases, oncolytic activity may be encountered before leukopenic effect. When this occurs, there is no need to increase subsequent doses.

The manufacturer states that the use of small amounts of vinblastine daily for long periods of time is not advisable and that strict adherence to the recommended dosage schedule is very important.

The duration of maintenance therapy varies according to the disease being treated and the combination of antineoplastic agents being used. Prolonged chemotherapy for maintaining remissions involves several risks, including life-threatening infectious diseases, sterility and the appearance of other cancers through suppression of immune surveillance. These risks must be balanced with potential benefits of therapy.

Usual Adult Dose for Kaposi's Sarcoma:

Initial Dose: 3.7 mg/m2 intravenously over approximately one minute, once.

Because of the variation in the depth of the leukopenic response following therapy, the manufacturer recommends that vinblastine not be given more frequently than once every 7 days. However, there are several multiple day regimens where the dose is split into several consecutive days.

The manufacturer outlines the following conservative incremental approach to dosage at weekly intervals for adults. Therapy may be continued at 5.5 mg/m2 for the second dose, 7.4 mg/m2 for the third dose, 9.25 mg/m2 for the fourth dose, and 11.1 mg/m2 for the fifth dose. This progression may be followed up to a maximum dosage of 18.5 mg/m2. Dosage regimens may vary in clinical practice according to the disease being treated and the combination of antineoplastic agents being used.

White blood cell counts should be obtained just prior to dosage administration. The nadir in the white blood cell count is generally observed from 5 to 10 days following the dosage. Recovery to pretreatment levels is usually observed from 7 to 14 days after treatment. If a dose reduces the white cell count to approximately 3,000 cells/mm3, the next dose should not be given until the white cell count has returned to at least 4,000/mm3. The previous dosage increment may then be administered at weekly intervals for maintenance. In some cases, oncolytic activity may be encountered before leukopenic effect. When this occurs, there is no need to increase subsequent doses.

The manufacturer states that the use of small amounts of vinblastine daily for long periods of time is not advisable and that strict adherence to the recommended dosage schedule is very important.

The duration of maintenance therapy varies according to the disease being treated and the combination of antineoplastic agents being used. Prolonged chemotherapy for maintaining remissions involves several risks, including life-threatening infectious diseases, sterility and the appearance of other cancers through suppression of immune surveillance. These risks must be balanced with potential benefits of therapy.

Usual Adult Dose for Testicular Cancer:

Initial Dose: 3.7 mg/m2 intravenously over approximately one minute, once.

Because of the variation in the depth of the leukopenic response following therapy, the manufacturer recommends that vinblastine not be given more frequently than once every 7 days. However, there are several multiple day regimens where the dose is split into several consecutive days.

The manufacturer outlines the following conservative incremental approach to dosage at weekly intervals for adults. Therapy may be continued at 5.5 mg/m2 for the second dose, 7.4 mg/m2 for the third dose, 9.25 mg/m2 for the fourth dose, and 11.1 mg/m2 for the fifth dose. This progression may be followed up to a maximum dosage of 18.5 mg/m2. Dosage regimens may vary in clinical practice according to the disease being treated and the combination of antineoplastic agents being used.

White blood cell counts should be obtained just prior to dosage administration. The nadir in the white blood cell count is generally observed from 5 to 10 days following the dosage. Recovery to pretreatment levels is usually observed from 7 to 14 days after treatment. If a dose reduces the white cell count to approximately 3,000 cells/mm3, the next dose should not be given until the white cell count has returned to at least 4,000/mm3. The previous dosage increment may then be administered at weekly intervals for maintenance. In some cases, oncolytic activity may be encountered before leukopenic effect. When this occurs, there is no need to increase subsequent doses.

The manufacturer states that the use of small amounts of vinblastine daily for long periods of time is not advisable and that strict adherence to the recommended dosage schedule is very important.

The duration of maintenance therapy varies according to the disease being treated and the combination of antineoplastic agents being used. Prolonged chemotherapy for maintaining remissions involves several risks, including life-threatening infectious diseases, sterility and the appearance of other cancers through suppression of immune surveillance. These risks must be balanced with potential benefits of therapy.

Usual Adult Dose for Hodgkin's Disease:

Initial Dose: 3.7 mg/m2 intravenously over approximately one minute, once.

Because of the variation in the depth of the leukopenic response following therapy, the manufacturer recommends that vinblastine not be given more frequently than once every 7 days. However, there are several multiple day regimens where the dose is split into several consecutive days.

The manufacturer outlines the following conservative incremental approach to dosage at weekly intervals for adults. Therapy may be continued at 5.5 mg/m2 for the second dose, 7.4 mg/m2 for the third dose, 9.25 mg/m2 for the fourth dose, and 11.1 mg/m2 for the fifth dose. This progression may be followed up to a maximum dosage of 18.5 mg/m2. Dosage regimens may vary in clinical practice according to the disease being treated and the combination of antineoplastic agents being used.

White blood cell counts should be obtained just prior to dosage administration. The nadir in the white blood cell count is generally observed from 5 to 10 days following the dosage. Recovery to pretreatment levels is usually observed from 7 to 14 days after treatment. If a dose reduces the white cell count to approximately 3,000 cells/mm3, the next dose should not be given until the white cell count has returned to at least 4,000/mm3. The previous dosage increment may then be administered at weekly intervals for maintenance. In some cases, oncolytic activity may be encountered before leukopenic effect. When this occurs, there is no need to increase subsequent doses.

The manufacturer states that the use of small amounts of vinblastine daily for long periods of time is not advisable and that strict adherence to the recommended dosage schedule is very important.

The duration of maintenance therapy varies according to the disease being treated and the combination of antineoplastic agents being used. Prolonged chemotherapy for maintaining remissions involves several risks, including life-threatening infectious diseases, sterility and the appearance of other cancers through suppression of immune surveillance. These risks must be balanced with potential benefits of therapy.

Usual Adult Dose for Mycosis Fungoides:

Initial Dose: 3.7 mg/m2 intravenously over approximately one minute, once.

Because of the variation in the depth of the leukopenic response following therapy, the manufacturer recommends that vinblastine not be given more frequently than once every 7 days. However, there are several multiple day regimens where the dose is split into several consecutive days.

The manufacturer outlines the following conservative incremental approach to dosage at weekly intervals for adults. Therapy may be continued at 5.5 mg/m2 for the second dose, 7.4 mg/m2 for the third dose, 9.25 mg/m2 for the fourth dose, and 11.1 mg/m2 for the fifth dose. This progression may be followed up to a maximum dosage of 18.5 mg/m2. Dosage regimens may vary in clinical practice according to the disease being treated and the combination of antineoplastic agents being used.

White blood cell counts should be obtained just prior to dosage administration. The nadir in the white blood cell count is generally observed from 5 to 10 days following the dosage. Recovery to pretreatment levels is usually observed from 7 to 14 days after treatment. If a dose reduces the white cell count to approximately 3,000 cells/mm3, the next dose should not be given until the white cell count has returned to at least 4,000/mm3. The previous dosage increment may then be administered at weekly intervals for maintenance. In some cases, oncolytic activity may be encountered before leukopenic effect. When this occurs, there is no need to increase subsequent doses.

The manufacturer states that the use of small amounts of vinblastine daily for long periods of time is not advisable and that strict adherence to the recommended dosage schedule is very important.

The duration of maintenance therapy varies according to the disease being treated and the combination of antineoplastic agents being used. Prolonged chemotherapy for maintaining remissions involves several risks, including life-threatening infectious diseases, sterility and the appearance of other cancers through suppression of immune surveillance. These risks must be balanced with potential benefits of therapy.

Usual Adult Dose for Choriocarcinoma:

Initial Dose: 3.7 mg/m2 intravenously over approximately one minute, once.

Because of the variation in the depth of the leukopenic response following therapy, the manufacturer recommends that vinblastine not be given more frequently than once every 7 days. However, there are several multiple day regimens where the dose is split into several consecutive days.

The manufacturer outlines the following conservative incremental approach to dosage at weekly intervals for adults. Therapy may be continued at 5.5 mg/m2 for the second dose, 7.4 mg/m2 for the third dose, 9.25 mg/m2 for the fourth dose, and 11.1 mg/m2 for the fifth dose. This progression may be followed up to a maximum dosage of 18.5 mg/m2. Dosage regimens may vary in clinical practice according to the disease being treated and the combination of antineoplastic agents being used.

White blood cell counts should be obtained just prior to dosage administration. The nadir in the white blood cell count is generally observed from 5 to 10 days following the dosage. Recovery to pretreatment levels is usually observed from 7 to 14 days after treatment. If a dose reduces the white cell count to approximately 3,000 cells/mm3, the next dose should not be given until the white cell count has returned to at least 4,000/mm3. The previous dosage increment may then be administered at weekly intervals for maintenance. In some cases, oncolytic activity may be encountered before leukopenic effect. When this occurs, there is no need to increase subsequent doses.

The manufacturer states that the use of small amounts of vinblastine daily for long periods of time is not advisable and that strict adherence to the recommended dosage schedule is very important.

The duration of maintenance therapy varies according to the disease being treated and the combination of antineoplastic agents being used. Prolonged chemotherapy for maintaining remissions involves several risks, including life-threatening infectious diseases, sterility and the appearance of other cancers through suppression of immune surveillance. These risks must be balanced with potential benefits of therapy.

Usual Adult Dose for Lymphoma:

Initial Dose: 3.7 mg/m2 intravenously over approximately one minute, once.

Because of the variation in the depth of the leukopenic response following therapy, the manufacturer recommends that vinblastine not be given more frequently than once every 7 days. However, there are several multiple day regimens where the dose is split into several consecutive days.

The manufacturer outlines the following conservative incremental approach to dosage at weekly intervals for adults. Therapy may be continued at 5.5 mg/m2 for the second dose, 7.4 mg/m2 for the third dose, 9.25 mg/m2 for the fourth dose, and 11.1 mg/m2 for the fifth dose. This progression may be followed up to a maximum dosage of 18.5 mg/m2. Dosage regimens may vary in clinical practice according to the disease being treated and the combination of antineoplastic agents being used.

White blood cell counts should be obtained just prior to dosage administration. The nadir in the white blood cell count is generally observed from 5 to 10 days following the dosage. Recovery to pretreatment levels is usually observed from 7 to 14 days after treatment. If a dose reduces the white cell count to approximately 3,000 cells/mm3, the next dose should not be given until the white cell count has returned to at least 4,000/mm3. The previous dosage increment may then be administered at weekly intervals for maintenance. In some cases, oncolytic activity may be encountered before leukopenic effect. When this occurs, there is no need to increase subsequent doses.

The manufacturer states that the use of small amounts of vinblastine daily for long periods of time is not advisable and that strict adherence to the recommended dosage schedule is very important.

The duration of maintenance therapy varies according to the disease being treated and the combination of antineoplastic agents being used. Prolonged chemotherapy for maintaining remissions involves several risks, including life-threatening infectious diseases, sterility and the appearance of other cancers through suppression of immune surveillance. These risks must be balanced with potential benefits of therapy.

Usual Adult Dose for Histiocytosis:

Initial Dose: 3.7 mg/m2 intravenously over approximately one minute, once.

Because of the variation in the depth of the leukopenic response following therapy, the manufacturer recommends that vinblastine not be given more frequently than once every 7 days. However, there are several multiple day regimens where the dose is split into several consecutive days.

The manufacturer outlines the following conservative incremental approach to dosage at weekly intervals for adults. Therapy may be continued at 5.5 mg/m2 for the second dose, 7.4 mg/m2 for the third dose, 9.25 mg/m2 for the fourth dose, and 11.1 mg/m2 for the fifth dose. This progression may be followed up to a maximum dosage of 18.5 mg/m2. Dosage regimens may vary in clinical practice according to the disease being treated and the combination of antineoplastic agents being used.

White blood cell counts should be obtained just prior to dosage administration. The nadir in the white blood cell count is generally observed from 5 to 10 days following the dosage. Recovery to pretreatment levels is usually observed from 7 to 14 days after treatment. If a dose reduces the white cell count to approximately 3,000 cells/mm3, the next dose should not be given until the white cell count has returned to at least 4,000/mm3. The previous dosage increment may then be administered at weekly intervals for maintenance. In some cases, oncolytic activity may be encountered before leukopenic effect. When this occurs, there is no need to increase subsequent doses.

The manufacturer states that the use of small amounts of vinblastine daily for long periods of time is not advisable and that strict adherence to the recommended dosage schedule is very important.

The duration of maintenance therapy varies according to the disease being treated and the combination of antineoplastic agents being used. Prolonged chemotherapy for maintaining remissions involves several risks, including life-threatening infectious diseases, sterility and the appearance of other cancers through suppression of immune surveillance. These risks must be balanced with potential benefits of therapy.

Usual Pediatric Dose for Malignant Disease:

Hodgkin's disease: 2.5 to 6 mg/m2/day once every one to two weeks for three to six weeks. The maximum weekly dose is 12.5 mg/m2.

Histiocytosis: 0.4 mg/kg once every seven to ten days.

Germ cell tumor: 0.2 mg/kg on days one and two of the cycle every three weeks for four cycles.

What other drugs will affect vinblastine?

Tell your doctor about all other medications you use, especially:

  • conivaptan (Vaprisol);

  • diclofenac (Arthrotec, Cataflam, Voltaren, Flector Patch, Solareze);

  • imatinib (Gleevec);

  • isoniazid (for treating tuberculosis);

  • phenytoin (Dilantin);

  • an antibiotic such as clarithromycin (Biaxin), dalfopristin/quinupristin (Synercid), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), or telithromycin (Ketek);

  • antifungal medication such as clotrimazole (Mycelex Troche), itraconazole (Sporanox), ketoconazole (Nizoral), or voriconazole (Vfend);

  • an antidepressant such as nefazodone;

  • heart or blood pressure medication such as diltiazem (Cartia, Cardizem), felodipine (Plendil), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others;

  • cancer medicines such as cisplatin (Platinol), carboplatin (Paraplatin), mitomycin (Mutamycin), or oxaliplatin (Elixatin);

  • HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir).

This list is not complete and there may be other drugs that can interact with vinblastine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about vinblastine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02. Revision Date: 2010-12-15, 5:01:39 PM.

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