Vindesine is used to treat several cancers such as leukemias, lymphomas, and some solid tumors such as breast cancer and lung cancer either as a single agent or in combination with other cancer-treating drugs.
Vindesine is a cytotoxic drug that belongs to the group of vinca alkaloids. It works by arresting the multiplication of cancer cells and thereby stopping the growth of cancer cells.
Vindesine should not be used in patients-
If there is an allergy to vindesine
Pregnancy and breastfeeding
History of any active infection
Undergoing treatment for infertility
With severe nerve damage
Vindesine should not be given as an intrathecal (into the spinal cord) injection as it leads to death.
The dose of vindesine is calculated based on the patients individual body surface area (BSA).
The recommended dose of vindesine for adults is 3 mg/m2 at weekly intervals.
The dose can be increased by 0.5 mg/m2 gradually if no toxicities are reported. However, the total adult dose should not exceed 4 mg/m2.
Children are given at a dose of 4 mg/m2 and the total dose should not exceed 5 mg/m2.
Dose reduction can be considered in patients who have a history of liver damage to avoid liver toxicity because vindesine is excreted through the liver.
Vindesine should be given as a single rapid bolus injection into the deep vein within 1 to 3 minutes.
Vindesine can be diluted with 0.9% sodium chloride or 5% dextrose solution and can be injected either into the tubing of running intravenous infusion or directly into the vein.
Vindesine preparation must be handled by a trained healthcare provider by using protective gloves, masks, and clothing to avoid accidental contamination.
Women of reproductive potential living with an active male partner are advised to use effective contraception during the treatment with vindesine and few months after the treatment to avoid unwanted pregnancy.
Breastfeeding women should not breastfeed during vindesine treatment as it may cause harm to the babies.
Men or women who wish to have a baby in the future should be advised to use the services of a sperm or egg bank before vindesine treatment is initiated because vindesine can affect the fertility status.
Vindesine must be injected into the large vein to avoid leakage into the surrounding tissues which may result in local irritation, cellulitis, or swelling of the veins.
Neurotoxicity, low platelet, and granulocyte count are observed during vindesine therapy. So, patients must be carefully watched for any symptoms and signs of nerve damage or infection and must be treated appropriately.
Gastrointestinal: Diarrhea, nausea, vomiting, stomach pain, indigestion, constipation, difficulty in swallowing
Nervous system: Headache, dizziness, mood changes, numbness or tingling sensation in the hands and feet, loss of balance
Respiratory: Sore throat, nosebleeds, tightness of the chest, breathing difficulty
Skin: Rashes, hair loss, pain and swelling at the site of injection
Others: Fever, infertility, muscle pain, abnormal blood cell count, weakness, fluctuations in blood pressure, hearing loss
Patients must be advised not to take immunizations with live vaccines such as BCG, rubella, mumps, measles, and yellow fever vaccine during vindesine treatment and for at least six months after the last dose of vindesine.
Extreme caution is required to avoid the contact of vindesine into the eye or the skin. After such contact flush the eye or wash the affected area thoroughly with water or saline.
The unused diluted solution of vindesine should be returned to the pharmacy for safe and legal disposal to avoid accidental contamination.
Mitomycin-C should not be given along with vindesine as it may cause shortness of breath and severe bronchospasm. Therefore, this combination must be avoided.
Avoid the combination of phenytoin and vindesine as the effectiveness of phenytoin is significantly affected, and the chances of increased risk of seizures are possible.
Other drugs that can interact with vindesine and should not be taken together are-
Live vaccines (MMR, BCG, Varicella, Rotavirus, Shingles)
Quinupristin and Dalfopristin
Store vindesine vials in a refrigerator between 2°C and 8°C.
The diluted solution of vindesine can be used for up to 24 hours if stored in a refrigerator.
Protect from excess heat and moisture.
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