vindesine sulfate: clinical use

Prescribing considerations

• Restrict preparation and administration to appropriately trained cytotoxic-treatment services.
• Assess hepatic and biliary function because metabolism and elimination are principally hepatic.
• Review baseline neuromuscular disease, constipation, infection and previous marrow suppression.
• Prevent wrong-route administration through compliant preparation, packaging, labelling and administration systems.
• Provide reliable contraception counselling and discuss possible fertility effects where appropriate.

Contraindications and cautions

• Hypersensitivity to vindesine sulfate or an excipient
• Drug-induced severe granulocytopenia or severe thrombocytopenia
• Uncontrolled bacterial infection
• Demyelinating Charcot–Marie–Tooth syndrome
• Administration by any route other than intravenous

Monitoring

• Full blood count, particularly granulocytes and platelets, before treatment administrations
• Clinical evidence of infection
• Peripheral and autonomic neurotoxicity, reflexes and neuromuscular symptoms
• Bowel function and signs of ileus
• Liver and biliary function
• Injection site during and after administration
• Respiratory symptoms when mitomycin-C has been used
• Hearing and balance when combined with ototoxic treatment

Clinical pharmacology

Vindesine is a semisynthetic vinca alkaloid derived from vinblastine. Tubulin binding prevents normal microtubule assembly and arrests mitosis in metaphase. Distribution is rapid after intravenous administration; metabolism is mainly hepatic, with biliary and urinary excretion.

Formulation and product differences

• The selected UK product is a white crystalline powder for solution for intravenous injection.
• Mannitol is the listed excipient.
• The vial requires reconstitution and refrigerated storage.
• The product must not be mixed with another medicine.

Injection

Route: Parenteral

Strengths: 5 mg