vinblastine sulfate: clinical use

Prescribing considerations

• Administration must be supervised by clinicians experienced in cytotoxic chemotherapy and comply with local vinca-alkaloid safety systems.
• Assess hepatic and biliary function because impaired elimination can substantially increase toxicity.
• Consider prior chemotherapy, radiotherapy, marrow infiltration, frailty, cachexia, ulcerated skin and impaired limb circulation.
• Discuss reproductive risks and fertility preservation before treatment where relevant.
• Avoid eye exposure and manage cytotoxic contamination according to local procedures.

Contraindications and cautions

• Hypersensitivity to vinblastine sulfate or an excipient
• Leucopenia
• Uncontrolled bacterial infection
• Administration by any route other than intravenous

Monitoring

• Full blood count, particularly neutrophils and platelets
• Clinical evidence of infection
• Liver function and bilirubin
• Peripheral and cranial neuropathy, reflexes and bowel function
• Intravenous site throughout administration for extravasation
• Respiratory symptoms when mitomycin is co-administered
• Hearing, balance and neurological toxicity when combined with potentially ototoxic or neurotoxic agents

Clinical pharmacology

Vinblastine is a vinca alkaloid that disrupts mitotic-spindle microtubules and arrests cells in metaphase. It is extensively metabolised, mainly in the liver, crosses the blood–brain barrier poorly and is eliminated slowly through bile, faeces and urine.

Formulation and product differences

• The selected product is a clear, colourless sterile solution for intravenous injection supplied in glass vials.
• It contains sodium chloride and water for injections and contributes a measurable sodium load.
• Unopened vials require refrigerated, light-protected storage.
• It is incompatible with furosemide when mixed or administered sequentially through a Y-site without flushing.

Injection

Route: Parenteral

Strengths: 1 mg/mL