Vinblastine

IMPORTANT WARNING:

Vinblastine should be administered only into a vein. However, it may leak into surrounding tissue causing severe irritation or damage. Your doctor or nurse will monitor your administration site for this reaction. If you experience any of the following symptoms, call your doctor immediately: pain, itching, redness, swelling, blisters, or sores in the place where the medication was injected.

Vinblastine should be given only under the supervision of a doctor with experience in the use of chemotherapy medications.

WHY is this medicine prescribed?

Vinblastine is used in combination with other chemotherapy drugs to treat Hodgkin's lymphoma (Hodgkin's disease) and non-Hodgkin's lymphoma (types of cancer that begin in a type of white blood cell that normally fights infection), and cancer of the testicles. It is also used to treat Langerhans cell histiocytosis (histiocytosis X; Letterer-Siwe disease; a condition in which too many of a certain type of white blood cell grows in parts of the body). It may also be used to treat breast cancer that has not improved after treatment with other medications and gestational trophoblastic tumors (a type of tumor that forms inside a woman's uterus while she is pregnant) that has not improved after surgery or treatment with other medications. Vinblastine is in a class of medications called vinca alkaloids. It works by slowing or stopping the growth of cancer cells in your body.

Are there OTHER USES for this medicine?

Vinblastine is also sometimes used to treat bladder cancer, certain types of lung cancer, Kaposi's sarcoma, and certain brain tumors. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Vinblastine comes as a powder or solution (liquid) to be injected intravenously (into a vein) by a doctor or nurse in a medical facility. It is usually given once a week. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.

Your doctor may need to delay your treatment or change your dose if you experience certain side effects. It is important for you to tell your doctor how you are feeling during your treatment with vinblastine injection.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before receiving vinblastine,

• tell your doctor and pharmacist if you are allergic to vinblastine, any other medications, or any of the ingredients in vinblastine injection. Ask your pharmacist for a list of the ingredients.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aprepitant (Emend), certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); clarithromycin (Biaxin, in Prevpac); erythromycin (E.E.S., E-Mycin, others); HIV protease inhibitors including indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra); phenytoin (Dilantin), tolterodine (Detrol, Detrol LA). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Tell your doctor and pharmacist about all the medications you are taking so they can check whether any of your medications may increase the risk that you will develop hearing problems during your treatment with vinblastine.

• tell your doctor if you have an infection. Your doctor will want to treat your infection before you receive vinblastine injection.

• tell your doctor if you have or have ever had heart or blood vessel disease, including varicose veins (swelling, redness, or pain in a vein in your arms or legs), or lung or liver disease.

• you should know that vinblastine may interfere with the normal menstrual cycle (period) in women and may temporarily or permanently stop sperm production in men. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You should not become pregnant or breast-feed while you are receiving vinblastine injection. If you become pregnant while receiving vinblastine injection, call your doctor. Vinblastine may harm the fetus.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Vinblastine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• constipation
• nausea
• vomiting
• loss of appetite or weight
• stomach pain
• diarrhea
• headache
• dizziness
• jaw pain, bone pain, and other aches
• hair loss

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

• fever, sore throat, chills, or other signs of infection
• unusual bleeding or bruising
• sores in the mouth
• unusual tiredness or weakness
• pain, numbness, burning, or tingling in the hands or feet
• difficulty walking or unsteady walking
• difficulty breathing
• hearing loss
• seizures
• chest pain

Vinblastine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• confusion
• seizures
• constipation
• stomach pain
• unusual bleeding or bruising
• fever, sore throat, chills, or other signs of infection

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to vinblastine.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

^¶ This branded product is no longer on the market. Generic alternatives may be available.