Alkaban

Trade names: Alkaban-AQ®, Velban®
Other names: Vinblastine Sulfate, Vincaleukoblastine, VLB
Drug type: Vinblastine is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as a "plant alkaloid." (For more detail, see "How this drug works" section below).

 

What this drug is used for:

• This drug is given to treat Hodgkin's disease, non-Hodgkin's lymphoma, testicular, breast, lung, head and neck, and bladder cancers, Kaposi's sarcoma, mycosis fungoides (t-cell lymphoma), and choriocarcinoma.
• It is also used in the treatment of certain blood disorders such as histiocytosis and idiopathic thrombocytopenia purpura (ITP). Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How this drug is given:

• Vinblastine is given through a vein by intravenous injection (IV push) or infusion (IV). There is no pill form.
• Vinblastine is a vesicant. A vesicant is a chemical that causes extensive tissue damage and blistering if it escapes from the vein. The nurse or doctor who gives this drug must be carefully trained. If you notice pain, redness or swelling at the IV site while you are receiving vinblastine, alert your health care professional immediately.
• The amount of vinblastine you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side effects:

Important things to remember about the side effects of vinblastine include:

• Most people do not experience all of the side effects listed.
• Side effects are often predictable in terms of their onset and duration.
• Side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent side effects.
• There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking vinblastine:

• Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
• Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
  
• Onset: 4-7 days
• Nadir: 5-10 days
• Recovery: 17 days

Injection site reactions

• Fatigue, and weakness

The following are less common side effects (occurring in 10-29%) for patients receiving vinblastine:

• Nausea and vomiting - usually moderate and occur within first 24 hours of treatment.
• Poor appetite.
• Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated doses. This should be reported to your healthcare provider.
• Constipation may occur within 1-3 days after your treatment, and is sometimes accompanied by abdominal cramping. It is important to keep your bowels moving regularly.
• Diarrhea
• Hair loss may occur, but your hair will most likely grow back when the treatments are completed. This usually begins 2-3 weeks after each treatment.
• Mouth sores
• Taste changes, metallic taste
• Headache
• Depression
• Jaw pain
• High blood pressure (hypertension)
• Shortness of breath, myalgias (muscle pain) and arthralgias (joint pain) may occur infrequently.

Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

• Fever of 100.5º F (38º C), chills (possible signs of infection)
• Chest pain, shortness of breath
• Severe, persistent headaches, severe abdominal pain
• Urinary retention (inability to urinate)

The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:

• Unusual bleeding or bruising
• Black or tarry stools, or blood in your stools or urine
• Severe constipation, unrelieved by laxative use
• Diarrhea (4-6 episodes in a 24-hour period)
• Nausea (interferes with ability to eat and unrelieved with prescribed medications)
• Vomiting (vomiting more than 4-5 times in a 24-hour period)
• Lip or mouth sores (painful redness, swelling or ulcers)
• Dizziness, or "feeling faint," especially when changing positions (from sitting to standing)
• Extreme fatigue (unable to carry on selfcare activities)

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

• Before starting vinblastine treatment, make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). Do not take aspirin or products containing aspirin unless your healthcare provider permits this.
• Do not receive any kind of immunization or vaccination without your doctor's approval while taking vinblastine.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (vinblastine may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).
• For both men and women: Do not conceive a child (get pregnant) while taking vinblastine. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking this medication.

Self Care Tips:

• Apply warm compress if you have any pain, redness or swelling at the IV site, and notify your doctor.
• Keep your bowels moving. Your health care provider may prescribe a stool softener to help prevent constipation that may be caused by this medicine.
• If you experience diarrhea of greater than 4-6 stools per day, contact your healthcare provider and increase your fluid intake.
• Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. This will decrease your chances of being constipated, and prevent dehydration.
• You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your healthcare provider.
• Wash your hands often.
• Use an electric razor and soft toothbrush to minimize bleeding.
• Avoid contact sports or activities that could cause injury.
• Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• To help treat/prevent mouth sores, use a soft toothbrush, and rinse at least three times a day with 1/2 to 1 teaspoon of baking soda and/or salt in 8 ounces of water.
• In general, drinking alcoholic beverages should be minimized or avoided. You should discuss this with your doctor.
• Use caution when driving or engaging in tasks that require alertness until response to the drug is known.

 

If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

 

Monitoring and testing:

You will be checked regularly by your doctor while you are taking vinblastine, to monitor side effects and check your response to therapy. Periodic blood work will be ordered by your doctor to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver).

How this drug works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division). The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Vinblastine belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May Apple plant. Camptothecan analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division.

• Vinca alkaloids: Vincristine, Vinblastine and Vinorelbine
• Taxanes: Paclitaxel and Docetaxel
• Podophyllotoxins: Etoposide and Tenisopide
• Camptothecan analogs: Irinotecan and Topotecan

Antimicrotubule agents (such as vinblastine), inhibit the microtubule structures within the cell. Microtubules are part of the cell's apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death. Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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