Vinblastine Disease Interactions

The use of vinblastine is contraindicated in patients with known infectious diseases. Vinblastine can induce myelosuppression. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with vinblastine. Close clinical monitoring of hematopoietic function is recommended. Vinblastine should not be used in patients with neutrophil counts below 1000/mm3.

The use of vinblastine is contraindicated in patients with significant granulocytopenia. Vinblastine induces dose-dependent leukopenia. Thrombocytopenia and anemia have been reported infrequently during vinblastine therapy. Therapy with vinblastine should be administered cautiously in patients whose bone marrow reserve may be severely depressed by prior chemotherapy or irradiation or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

Acute shortness of breath and bronchospasm, some severe and life-threatening, have been reported with the use of vinca alkaloids. These reactions were observed most often during combination therapy with mitomycin C, occurring within minutes to several hours after administration of the vinca alkaloid or up to 2 weeks following the mitomycin dose. Therapy with vinca alkaloids should be administered cautiously in patients with preexisting pulmonary dysfunction. Aggressive treatment may be necessary, including use of supplemental oxygen, bronchodilators, and/or corticosteroids. In patients who develop progressive dyspnea requiring chronic therapy, vinca alkaloid should not be readministered.

Vinblastine is metabolized by the liver and eliminated primarily via biliary excretion. Patients with hepatic impairment may be at increased risk for toxicity associated with vinblastine therapy. Therapy with vinblastine should be administered cautiously in patients with compromised hepatic function.