Dangerous Drug: Vinblastine Sulfate(VLB)
(vin blas’ teen)
PREGNANCY CATEGORY D
Drug Classes
Antineoplastic
Mitotic inhibitor
Therapeutic Actions
Inhibits microtubule formation in the mitotic spindle, leading to cell-cycle arrest in dividing cells in metaphase.
Indications
Palliative treatment for lymphocytic lymphoma, histiocytic lymphoma, generalized Hodgkin lymphoma (stages III and IV), mycosis fungoides, advanced testicular carcinoma, Kaposi sarcoma, Letterer-Siwe disease
Treatment of choriocarcinoma, breast cancer unresponsive to other therapies
Hodgkin lymphoma (advanced) alone or in combination therapies
Advanced testicular germinal-cell cancers alone or in combination therapy
Contraindications and Cautions
Contraindicated with allergy to vinblastine, leukopenia (unless leukopenia is the result of the disease being treated); acute infection; pregnancy, lactation.
Use cautiously with liver disease.
Available Forms
Powder for injection—10 mg; injection—1 mg/mL
Dosages
Warning Do not administer more than once a wk because of leukopenic response.Adults
Initial dose, 3.7 mg/m2 as a single IV dose, followed at weekly intervals by increasing doses at 1.8 mg/m2 increments; a conservative regimen follows:
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Use these increments until a maximum dose of 18.5 mg/m2 is reached; do not increase dose after WBC count is reduced to 3,000/mm3.
Maintenance therapy: When dose produces WBC count of 3,000/mm3, use a dose one increment smaller for weekly maintenance. Do not give another dose until WBC count is 4,000/mm3 even if 7 days have passed. Duration of therapy depends on disease and response; up to 2 yr may be needed.
Pediatric patients
Initial dose, 2.5 mg/m2 as a single IV dose, followed at weekly intervals by increasing doses at 1.25 mg/m2 increments; a conservative regimen follows:
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