Vinblastine Sulfate is a cytotoxic agent that inhibits cell division at the metaphase stage. Its effects are more significant on rapidly dividing cells compared to normal cells. Similar to vincristine, it acts by binding to microtubular proteins of the mitotic spindle, thereby preventing their polymerization.

Current evidence suggests that Vinblastine Sulfate may be effective, either as monotherapy or in combination with other anticancer agents, in the treatment of Hodgkin’s disease, non-Hodgkin’s lymphoma, breast carcinoma, methotrexate-resistant choriocarcinoma, renal cell carcinoma, testicular teratoma and seminoma, and histiocytosis X. Other types of tumors may also respond to Vinblastine Sulfate, although less frequently compared to the conditions listed above.

Although the exact mechanism is not fully established, Vinblastine is believed to bind to microtubule proteins of the mitotic spindle, preventing their proper formation and leading to metaphase arrest. At higher concentrations, Vinblastine also affects nucleic acid and protein synthesis. It interferes with amino acid metabolism by blocking the utilization of glutamic acid, which in turn inhibits purine synthesis, the citric acid cycle, and urea formation. Additionally, Vinblastine has some immunosuppressive properties.

The recommended dose for adults, the elderly and children is 6 mg/m2 , usually administered no more frequently than once every seven days. For testicular tumours, the dosage may be increased to 0.2 mg/kg administered on each of two consecutive days every three weeks.

To minimise the possibility of extravascular spillage, it is suggested that the mini-bag infusion and needle be rinsed with venous blood before withdrawal. The dose should not be diluted in large volumes of diluent (ie, 100 to 250 ml) or given intravenously for prolonged periods (ranging from 30 to 60 minutes or more), since this frequently results in irritation of the vein and increases the chance of extravasation.

Because of the enhanced possibility of thrombosis, it is considered inadvisable to inject a solution of VinBLAStine sulphate into an extremity in which the circulation is impaired, or potentially impaired, by such conditions as compressing or invading neoplasm, phlebitis or varicosity.

Common side effects include hair loss, constipation, fatigue, and mouth sores. Dose-limiting toxicity includes bone marrow suppression such as granulocytopenia, thrombocytopenia, and anemia. Other effects may include hypertension, neurotoxicity (central and peripheral), auditory and balance disturbances due to cranial nerve damage, heart-related toxicity, breathing difficulty, and pain in bones, tumors, or jaw.
Additional effects include nausea, vomiting, gastrointestinal bleeding, and inappropriate antidiuretic hormone secretion.
If extravasation occurs, it may cause tissue damage, necrosis, or cellulitis.

Vinblastine Sulfate is contraindicated in patients with hypersensitivity to the drug or its components.
It is strictly for intravenous use only and may be fatal if administered by other routes.
It should not be used in patients with leukopenia.
Treatment should not be started in the presence of uncontrolled bacterial infections; infections must be treated prior to therapy.

Common side effects include hair loss, constipation, fatigue, and mouth sores. Dose-limiting toxicity includes bone marrow suppression such as granulocytopenia, thrombocytopenia, and anemia. Other effects may include hypertension, neurotoxicity (central and peripheral), auditory and balance disturbances due to cranial nerve damage, heart-related toxicity, breathing difficulty, and pain in bones, tumors, or jaw. Additional effects include nausea, vomiting, gastrointestinal bleeding, and inappropriate antidiuretic hormone secretion. If extravasation occurs, it may cause tissue damage, necrosis, or cellulitis.

Pregnancy: Available data on the use of Vinblastine during pregnancy are limited; however, it may cause harm to the fetus if given to pregnant women. Animal studies have shown fetal resorption and significant abnormalities in surviving offspring. There are no well-controlled studies in pregnant women. Therefore, Vinblastine should only be used during pregnancy in life-threatening conditions or in severe disease where safer alternatives are not available or have failed. Women of childbearing potential should be advised to avoid pregnancy while receiving this medication. If the drug is used during pregnancy or if a patient becomes pregnant during treatment, she should be informed about the potential risks to the fetus.

Breast-feeding: It is unknown whether Vinblastine passes into human breast milk. Due to the possibility of serious adverse effects in nursing infants, a decision should be made either to discontinue breastfeeding or to stop the drug, considering the importance of treatment for the mother.

Caution is required in patients with liver impairment, neurotoxicity, ischemic heart disease, or existing lung problems. Extravasation during administration may cause severe tissue injury; treatment should be stopped immediately, and appropriate local management applied. Preventive measures for constipation are recommended, especially at high doses. White blood cell count usually reaches its lowest level within 4–10 days after treatment and recovers within 7–14 days.

Cytotoxic Chemotherapy

Store in a refrigerator at 2°C–8°C. Keep the vial in its outer carton to protect it from light.