Alkaban-AQ®

Posted on April 28th, 2009 by

Class: Chemotherapy    

Generic Name: Vinblastine (vin-BLASS-teen), Vinblastine sulfate, vincaleukoblastine, VLB
Trade Name: Velban®, Alkaban-AQ®

How is this drug used? Vinblastine is FDA approved for the treatment of advanced Hodgkin’s disease, lymphocytic lymphoma, histiocytic lymphoma, advanced Mycosis fungoides, advanced testicular cancer, Kaposi’s sarcoma, choriocarcinoma that has stopped responding to previous chemotherapy agents and advanced breast cancer that has stopped responding to surgery and hormonal therapy.  It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Vinblastine belongs to a group of drugs called anti-microtubule agents or vinca alkaloids. Vinblastine produces its anti-cancer effects by causing abnormalities in microtubule formation in cells. Microtubules are components of cells that provide structural framework that enables cells to divide and grow. The abnormal microtubule formation caused by vinblastine inhibits cellular replication and ultimately causes cell death.  Vinblastine may also inhibit DNA, RNA and protein synthesis, all of which can lead to cell death.

How is vinblastine given (administered)? Vinblastine is administered into a vein (intravenous), and the dose depends on several factors, including the condition being treated, the size of the patient, the particular regimen being used, and the overall health of the patient. If vinblastine escapes from the vein in which it is administered it may cause serious damage to the tissue that it comes in contact with.  Although patients will be monitored for this, they should tell their healthcare provider immediately if they experience pain, redness or swelling at the site in which the drug is being administered.  In addition, patients may experience an allergic-type reaction with the administration of vinblastine. Patients experiencing shortness of breath or closing of the throat should tell their healthcare provider immediately.

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with vinblastine.  Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver.  Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.  Patients are also monitored for signs of an allergic reaction (shortness of breath, closing of the throat).

What are the common (occur in 30% or more of patients) side effects of treatment with vinblastine?

• Low white blood cell levels – increases risk of infection
• Low red blood cell levels – increases risk of anemia
• Low platelet levels – increases risk of bleeding
• Fatigue

What are the less common (occur in 10% to 29% of patients) side effects of treatment with vinblastine?

• Nausea and vomiting
• Loss of appetite
• Numbness or tingling of feet or hands
• Diarrhea
• Constipation
• Mouth sores
• Headache
• Jaw pain
• Depression
• High blood pressure
• Shortness of breath
• Changes in taste, metallic taste in mouth
• Hair loss

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What are the possible late side effects of treatment with vinblastine?  Patients treated with vinblastine are at a slightly increased risk of developing a secondary malignancy.  A secondary malignancy is a new and unrelated cancer that occurs in an individual as a result of previous treatment with radiation or chemotherapy.  Patients should ask their physician about the possibility of developing a secondary malignancy as a result of their treatment.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, patients should avoid large crowds or persons who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• Avoid activities that may cause injury or bruising.
• Use a soft toothbrush and an electric razor to prevent cuts on the mouth or skin.
• Eat small meals frequently to help alleviate nausea.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Patients should use caution when driving or completing tasks that require mental alertness until effects of the drug are known, as they may experience fatigue, vision changes, and confusion.

When should patients notify their physician?

• Numbness or tingling in hands, fingers or toes
• Shortness of breath, difficulty breathing
• Closing of throat
• Chest pain, jaw pain
• Severe depression
• Mouth sores
• Dizziness
• Headache
• Blisters, pain, redness or swelling at site of drug administration
• Persistent or severe fatigue
• Unexplained or excessive bleeding (nosebleeds, bruising, black tarry stools, blood in the urine, etc.)
• Flu or cold-like symptoms – fever, chills, sore throat, cough, fatigue, painful urination
• Signs of infection – redness, swelling, pus, tenderness
• Persistent or extreme nausea or vomiting
• Skin rash or itching

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.  A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. 

Copyright © 2005 Cancer Consultants  Last updated 01/05.

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Tags: A, Chemotherapy

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