Information about Vinflunine

Generic Name : Vinflunine
Up-to-date prescription details regarding Vinflunine are provided here.

Understand it's uses, recommended dosages, its indications, how to take, when to take, when not to take, side effects, special precautions, warnings and its and its storage instructions.

You will also find a list of the medication's International and Indian brand or trade names, as well as its pricing information. For verification of the information presented on this page or for additional clarifications, it's advisable to consult your doctor.

Therapeutic Classification : Chemotherapy

Trade Names/Brand Names of Vinflunine

India :

Javlor

Why is Vinflunine Prescribed? (Indications)

Vinflunine is prescribed to treat metastatic (cancer that has spread to other body parts) or advanced bladder cancer and cancer of the urinary tract in adult patients.

Vinflunine is used only in patients who have already been treated with platinum-containing medications but showed a loss of response to vinflunine or treatment failure.

Vinflunine is a vinca alkaloid that works by attacking the cell structure and preventing the cell division, thereby arresting the growth of cancer cells through multiplication.

When should Vinflunine not be taken? (Contraindications)

Vinflunine should not be used in patients-

• If there is an allergy to vinflunine
• Pregnancy and breastfeeding
• Immunization with live viral vaccines (e.g., MMR, Yellow fever)
• History of active infection (e.g., Tuberculosis)
• Undergoing treatment for infertility

What is the dosage of Vinflunine?

The dose of vinflunine is calculated based on the patient’s body surface area (BSA) taking into consideration the height and the weight of the patient before prescribing vinflunine.

The recommended adult dose of vinflunine is 320 mg/m² that should be given every three weeks.

Dose adjustments can be made depending on the occurrence of side effects caused during the treatment with vinflunine.

Similarly, the treatment with vinflunine should be temporarily stopped or permanently discontinued if the toxicity or side effects are severe.

How should Vinflunine be taken?

Vinflunine is available in an injection form which should be given intravenously or deep into the vein slowly over 20 minutes.

Vinflunine intravenous infusion should be given only by a trained health care provider who must use gloves, goggles, and protective clothing while handling the dilution and administration.

Do not push or administer as a rapid intravenous infusion and also never give through the spine as an intrathecal injection as it can cause harm to the patient resulting in neurotoxicity.

The required volume of vinflunine is withdrawn from the vial and diluted with 250 ml of 0.9% sodium chloride or 5% dextrose solution only in a clean and non-contaminated area preferably using aseptic techniques. The diluted solution should be used immediately.

Once the infusion is completed flush the IV line with the remaining 250 ml of 0.9% sodium chloride or 5 % dextrose solution.

What are the warnings and precautions for Vinflunine?

• The complete blood count of patients should be monitored before initiating each cycle of vinflunine as abnormal levels of platelets, neutrophils, and red blood cells (RBC) can occur during treatment.

• Caution is required while giving vinflunine to patients who have a history of moderate to severe kidney or liver damage and dose reduction should be considered.

• Constipation can occur during vinflunine treatment. So, patients must be advised to take laxatives and dietary measures along with oral rehydration from day 1 to day 5 or 7 after each administration of vinflunine.

• Vinflunine can cause an increased risk of abnormal heart rhythms and treatment with vinflunine can be discontinued if the patient experiences cardiac ischemia or a heart attack.

• Patients should be monitored for any neurological signs of Posterior Reversible Encephalopathy Syndrome (PRES) such as a headache, confusion, and vision disturbances and treatment should be stopped if the diagnosis is confirmed with brain imaging.

• Sodium levels should be monitored during vinflunine treatment as vinflunine can result in low levels of sodium in the blood which requires appropriate medical care.

• Men and women should follow an effective contraceptive measure during vinflunine therapy that should continue for at least three months after the last dose of vinflunine.

• Patients who wish to have a baby in the future can be guided about storing the sperm or egg in a sperm or egg bank respectively as vinflunine can affect the fertility status of the patients.

• Breastfeeding mothers should be advised not to breastfeed their babies as it can cause harm to the babies.

• Women of reproductive potential living with active male partners must check their pregnancy status before initiating vinflunine treatment and must start the treatment only if the result is negative.

What are the side effects of Vinflunine?

Gastrointestinal: Constipation, stomach pain, diarrhea, nausea, vomiting, stomatitis or painful swelling and sores inside the mouth, indigestion
Cardiovascular: Heart attack, abnormal heart rhythms, increased heart rate, fluctuations in blood pressure, phlebitis or vein inflammation
Nervous system: Peripheral neuropathy, headache, dizziness, insomnia, fainting, taste disturbances, confusion, stabbing pain in the face or the head
Respiratory: Dyspnea or breathing difficulties, chest congestion, cough
Musculoskeletal: Muscle pain, back pain, bone pain, muscle weakness, pain in the jaw and extremities
Skin: Hair loss, rashes, itching, excessive sweating
Others: Weight gain, chills, weakness, injection site reactions, abnormal lab values of platelets, RBCs, neutrophils, and sodium levels in the blood

What are the other precautions for Vinflunine?

If the vinflunine solution comes in contact with the skin, the contact area should be washed thoroughly with mild soap and water. If vinflunine comes in contact with the eyes or the mucous membrane, flush the affected area thoroughly with clean water and consult the doctor.

Any unused medication should be discarded as per the legal requirements as it is a cytotoxic agent which can affect or modify the living cells.

Vinflunine can cause slight drowsiness. Therefore patients must be advised not to perform skilled tasks such as driving or operating heavy machinery.

What are the Drug Interactions of Vinflunine?

Vinflunine should not be used with certain drugs as they may increase or decrease the concentration of vinflunine leading to vinflunine toxicity or treatment failure.

The drugs that should be avoided with vinflunine are-

Ketoconazole
Itraconazole
Rifampin
Ritonavir

Grapefruit juice and herbal supplements such as St. John’s Wort should not be used concomitantly with vinflunine administration.

Drugs that alter the heart rhythm or drugs that lead to QT interval abnormalities such as quinidine, amiodarone, and sotalol should be avoided with vinflunine.

What are the storage conditions for Vinflunine?

Store the unopened vials of vinflunine in a refrigerator at a temperature of 2°C to 8°C.

Keep the vials in their original carton to protect from light.

The diluted solution that is protected from light and kept in a polyethylene or polyvinylchloride infusion bag-

• Should be used within 24 hours if kept at room temperature (15°C to 25°C).
• Can be used for up to 6 days if stored in a refrigerator between 2°C and 8°C.