Vinblastine Sulfate (vinblastine sulfate)

The effect of renal and/or hepatic impairment on the disposition of vinblastine has not been fully determined. Reduction of vinblastine dosage in patients with renal impairment does not appear to be necessary. Because the drug is extensively metabolized in the liver, doses of vinblastine should be reduced and the drug should be administered with caution in patients with hepatic impairment. A 50% reduction in vinblastine sulfate dose is recommended for patients with a direct serum bilirubin exceeding 3 mg/dL.

Subsequent dosage of vinblastine sulfate must be determined by the clinical and hematologic response and tolerance of the patient in order to obtain optimum therapeutic results with minimum adverse effects. Because of the possible leukopenic response that follows administration of vinblastine, the drug is given at intervals of at least 7 days; however, even if 7 days have elapsed, the next dose of vinblastine should not be given until the leukocyte count has returned to at least 4000/mm3. Doses are usually increased at weekly intervals in increments of about 1.8 mg/m2 in adults until the desired therapeutic response is obtained, the leukocyte count decreases to about 3000/mm3, or a maximum weekly dose of 18.5 mg/m2 is being administered to adults.

For most adult patients, the optimum weekly dose of vinblastine sulfate will be 5.5-7.4 mg/m2; however, leukopenia (leukocyte count of 3000/mm3) may occur in some patients with 3.7 mg/m2 per week, whereas other patients may tolerate 18.5 mg/m2 per week. Dosage is generally reduced in patients with recent exposure to radiation therapy or chemotherapy; single doses in these patients usually do not exceed 5.5 mg/m2.

Dosage modifications in pediatric patients should be guided by hematologic tolerance.

Once the dose required to produce a leukocyte count of 3000/mm3 has been determined, a maintenance dose of one increment (about 1.8 mg/m2 in adults) less than this amount should be administered at weekly intervals. Thus, the patient receives the maximum dose of vinblastine sulfate that does not cause leukopenia (leukocyte count of 3000/mm3 or less).

To ensure an adequate trial, vinblastine therapy must be continued for at least 4-6 weeks. Some experts advocate a trial of at least 12 weeks, particularly in patients with carcinomas.

Strict adherence to the recommended dosage interval is important. The use of small daily doses for prolonged periods (even if equivalent to the total weekly dosage) is not recommended because it has produced severe toxicity with little or no added therapeutic benefit. When doses several times the recommended weekly dosage were administered daily for long periods, seizures, permanent CNS damage, and death occurred. However, some clinicians believe that patients with rapidly progressing tumors with short generation times should receive large divided doses over several days, repeated as often as toxicity permits.

No dosing information is available for this tab.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

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No enhanced messaging available.

Although information on the use of vinblastine during pregnancy is limited, the drug may cause fetal toxicity when administered to pregnant women. The drug causes resorption of fetuses in animals and produces gross fetal abnormalities in surviving offspring. There are no adequate and controlled studies to date using vinblastine in pregnant women, and the drug should be used during pregnancy only in life-threatening situations or severe disease for which safer drugs cannot be used or are ineffective. Women of childbearing potential should be advised to avoid becoming pregnant while receiving the drug. When vinblastine is administered during pregnancy or the patient becomes pregnant while receiving the drug, the patient should be informed of the potential hazard to the fetus.

It is not known whether vinblastine is distributed in milk. Because of the potential for serious adverse reactions to vinblastine in nursing infants, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the woman.

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