Vindesine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Acute lymphoblastic leukaemia; Blastic phase chronic myeloid leukaemia; Malignant melanoma; Breast carcinoma Initial: 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.
Dosage Details
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.
MonitoringParameters
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

Chemical Structure Image
Vindesine

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 40839, Vindesine. https://pubchem.ncbi.nlm.nih.gov/compound/Vindesine. Accessed Aug. 26, 2020.

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

Disclaimer: This information is independently developed by MIMS based on Vindesine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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