Vindesine: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Myanmar prescribing information.

Generic Medicine Info

Indications and Dosage

Intravenous
Acute lymphoblastic leukaemia

Adult: Resistant to other drugs: Initially, 3 mg/m². Dose may be increased in increments of 0.5 mg/m² at weekly intervals if granulocyte count is >1,500 cells/mm³, platelet count is >100,000 cells/mm³, and if there is no abdominal pain. Usual dose: 3-4 mg/m² weekly. Max: 4 mg/m² weekly. Doses to be given via freely running infusion or directly into a vein over 1-3 minutes.
Child: Resistant to other drugs: Initially, 4 mg/m². Dose may be increased in increments of 0.5 mg/m² at weekly intervals if granulocyte count is >1,500 cells/mm³, platelet count is >100,000 cells/mm³, and if there is no abdominal pain. Usual dose: 4-5 mg/m² weekly.

Intravenous
Blastic phase chronic myeloid leukaemia

Adult: Initially, 3 mg/m². Dose may be increased in increments of 0.5 mg/m² at weekly intervals if granulocyte count is >1,500 cells/mm³, platelet count is >100,000 cells/mm³, and if there is no abdominal pain. Usual dose: 3-4 mg/m² weekly. Max: 4 mg/m² weekly. Doses to be given via freely running infusion or directly into a vein over 1-3 minutes.

Intravenous
Breast carcinoma

Adult: Advanced and unresponsive to appropriate endocrine surgery and/or hormonal therapy: Initially, 3 mg/m². Dose may be increased in increments of 0.5 mg/m² at weekly intervals if granulocyte count is >1,500 cells/mm³, platelet count is >100,000 cells/mm³, and if there is no abdominal pain. Usual dose: 3-4 mg/m² weekly. Max: 4 mg/m² weekly. Doses to be given via freely running infusion or directly into a vein over 1-3 minutes.

Intravenous
Malignant melanoma

Adult: Unresponsive to other forms of therapy: Initially, 3 mg/m². Dose may be increased in increments of 0.5 mg/m² at weekly intervals if granulocyte count is >1,500 cells/mm³, platelet count is >100,000 cells/mm³, and if there is no abdominal pain. Usual dose: 3-4 mg/m² weekly. Max: 4 mg/m² weekly. Doses to be given via freely running infusion or directly into a vein over 1-3 minutes.

Hepatic Impairment

Dose reduction may be needed.

Reconstitution

Dissolve 5 mg of vindesine with 5 mL sterile 0.9% NaCl to prepare a solution with a concentration of 1 mg/mL.

Contraindications

Intrathecal administration. Demyelinating form of Charcot-Marie-Tooth syndrome; severe granulocytopenia (<1,500/mm³), thrombocytopenia and bacterial infection.

Special Precautions

Patient with neuromuscular disease. Hepatic impairment. Pregnancy and lactation.

Adverse Reactions

Significant: Bone marrow suppression (e.g. granulocytopenia, thrombocytopenia), extravasation, gastrointestinal effects (e.g. nausea, vomiting, constipation, ileus, stomatitis, diarrhoea, abdominal pain), neurotoxicity (e.g. paraesthesias, jaw pain, loss of deep tendon reflexes, foot drop, headache, convulsions), respiratory effects (e.g. acute shortness of breath, severe bronchospasm, progressive dyspnoea). Rarely, mild anaemia.
Gastrointestinal disorders: Vesiculation of the mouth, anorexia, dysphagia, dyspepsia, perforated duodenal ulcer.
General disorders and administration site conditions: Inj site reaction, malaise, chills, fever, asthenia.
Musculoskeletal and connective tissue disorders: Musculoskeletal pain.
Nervous system disorders: Peripheral neuritis.
Psychiatric disorders: Mental depression.
Vascular disorders: Alopecia, maculopapular rashes.
Potentially Fatal: Paralysis.

Monitoring Parameters

Monitor CBC with differential and LFTs. Monitor for infection, neuro- and pulmonary toxicity. Monitor for signs of paralytic ileus (e.g. acute abdominal pain).

Drug Interactions

May increase risk of pulmonary toxicity with mitomycin. May decrease serum concentrations of phenytoin. May increase serum concentrations with CYP3A4 inhibitors.

Action

Description: Vindesine, a semisynthetic alkaloid derivative of vinblastine, binds to microtubular protein which causes mitotic arrest in metaphase.
Pharmacokinetics:
Distribution: Rapidly distributed to body tissues.
Metabolism: Metabolised mainly in the liver.
Excretion: Via bile and urine. Terminal elimination half-life: Approx 20 hours.

Chemical Structure

Storage

Store unopened vials between 2-8°C. Reconstituted solution in 0.9% NaCl may be stored for up to 24 hours refrigerated.

MIMS Class

Cytotoxic Chemotherapy

ATC Classification

L01CA03 - vindesine ; Belongs to the class of plant alkaloids and other natural products, vinca alkaloids and analogues. Used in the treatment of cancer.

References

Anon. Vindesine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/07/2020.

Buckingham R (ed). Vindesine Sulfate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/07/2020.

Eldisine Powder for Solution for Injection 5.0 mg (Genus Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk/. Accessed 02/07/2020.

Joint Formulary Committee. Vindesine Sulfate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/07/2020.

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