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Pronunciation
(VIN de seen)
Generic Available (U.S.)
No
Index Terms
Prescribing and Access Restrictions
Investigational agent in the U.S.
Pharmacologic Category
Use: Unlabeled
Management of acute lymphocytic leukemia, chronic myelogenous leukemia; breast, head, neck, and lung cancers; lymphomas (Hodgkin's and non-Hodgkin's)
Lactation
Breast-feeding is not recommended.
Contraindications
Hypersensitivity to vindesine, vinca alkaloids, or any component of the formulation
Warnings/Precautions
Special handling:
• Hazardous agent: Use appropriate precautions for handling and disposal.
Disease-related concerns:
• Hepatic impairment: Use with caution (if at all) in patients with hepatic impairment.
• Neurologic impairment: Use with caution (if at all) in patients with neurologic problems.
Other warnings/precautions:
• Cross-resistance: Vindesine has been reported to be cross-resistance with vincristine.
• Not for intrathecal administration: Intrathecal administration may be fatal.
Adverse Reactions
>10%:
Central nervous system: Pyrexia, malaise (up to 60%)
Dermatologic: Alopecia (6% to 92%)
Gastrointestinal: Mild nausea and vomiting (7% to 27%), constipation (10% to 17%) - related to the neurotoxicity
Hematologic: Leukopenia (50%) and thrombocytopenia (14% to 26%), may be dose limiting; thrombocytosis (20% to 28%)
Nadir: 6-12 days
Recovery: Days 14-18
Neuromuscular & skeletal: Paresthesia (40% to 70%); loss of deep tendon reflexes (35% to 60%, may be dose limiting); myalgia (up to 60%)
1% to 10%:
Dermatologic: Rashes
Gastrointestinal: Loss of taste
Hematologic: Anemia
Local: Phlebitis
Neuromuscular & skeletal: Facial paralysis
<1%: Acute chest pain, ECG changes, paralytic ileus, jaw pain, photophobia
Storage
Reconstituted solutions are stable for 30 days under refrigeration (2°C to 8°C/36°F to 46°F). Solutions diluted in dextrose or saline for I.V. infusion are stable for 24 hours at room temperature (15°C to 30°C/59°F to 86°F). The drug will precipitate at pH >6.
Reconstitution
The powder is reconstituted to a concentration of 1 mg/mL.
Mechanism of Action
Vindesine is a semisynthetic vinca alkaloid, having a mechanism of action similar to the other vinca derivatives. It arrests cell division in metaphase through inhibition of microtubular formation of the mitotic spindle. The drug is cell-cycle specific for the S phase.
Pharmacodynamics/Kinetics
Distribution: Vd: 8 L/kg; minimal distribution to adipose tissue or CNS
Metabolism: Hepatic
Half-life elimination:
Triphasic; Alpha: 2 minutes; Beta: 1 hour
Terminal: 24 hours
Excretion: Feces; urine (~3% to 25% of dose as unchanged drug)
Dosage
Refer to individual protocols. I.V.: Adults:
3-4 mg/m2/week or
1-2 mg/m2 days 1 and 2 every 2 weeks or
1-2 mg/m2 days 1-5 (continuous infusion) every 2-4 weeks or
1-2 mg/m2 days 1-5 every 3-4 weeks
Dosage adjustment in hepatic impairment: Dosage reductions of 50% to 75% have been suggested for “severe” hepatic dysfunction; however, specific guidelines have not been published.
Administration: I.V.
Usually administered as a rapid I.V. push (2-3 minutes) or short (15-20 minutes) infusion; 24-hour continuous infusions are occasionally used.
Dental Health: Effects on Dental Treatment
Key adverse event(s) related to dental treatment: Loss of taste and facial paralysis.
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
Malaise is common
Mental Health: Effects on Psychiatric Treatment
Hematological side effects are common; use caution with clozapine, carbamazepine, and valproic acid.
Mental Health: Comment
Paresthesias are common.
Oncology: Vesicant
Vesicant
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Injection, powder for reconstitution: 5 mg
References
Dancey J and Steward WP, “The Role of Vindesine in Oncology - Recommendations After 10 Years' Experience,” Anticancer Drugs, 1995, 6(5):625-36.
Joel S, “The Comparative Clinical Pharmacology of Vincristine and Vindesine: Does Vindesine Offer Any Advantage in Clinical Use?” Cancer Treat Rev, 1996, 21(6):513-25.
Rhomberg W, Eiter H, Soltesz E, et al, “Long-Term Application of Vindesine: Toxicity and Tolerance,” J Cancer Res Clin Oncol, 1990, 116(6):651-3.
Sorenson JB and Hansen HH, “Is There a Role for Vindesine in the Treatment of Nonsmall Cell Lung Cancer?” Invest New Drugs, 1993, 11(2-3):103-33.
International Brand Names
Lexi-Comp.com
Last full review/revision February 2012
Content last modified February 2012
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