TM Owner Eli Lilly
Velban 10mg Vial
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Indications & Clinical Uses
- The Velban brand of vinblastine sulfate has been discontinued in the US according to Drugs.com (a manufacturer discontinuation; no formal FDA withdrawal notice was found), and generic vinblastine sulfate injection, for example from Fresenius Kabi, is the version described here, taken from that generic label.
- Velban 10 mg (vinblastine sulfate) is a vinca alkaloid chemotherapy medicine given only by intravenous injection by experienced clinicians, at intervals of no less than seven days.
- The label lists it for palliative treatment of Hodgkin's disease (stages III and IV), lymphomas, mycosis fungoides, advanced testicular carcinoma, Kaposi's sarcoma and Letterer-Siwe disease, and, less frequently, choriocarcinoma resistant to other agents and breast carcinoma unresponsive to endocrine therapy.
- The generic product is a 1 mg/mL solution in a 10 mL multiple-dose vial (10 mg in total).
Side Effects
- BOXED WARNING: FOR INTRAVENOUS USE ONLY - FATAL IF GIVEN BY OTHER ROUTES.
- Intrathecal injection usually results in death and needs immediate neurosurgical intervention.
- The most common and dose-limiting side effect is leukopenia (low white blood cell count); anaemia and thrombocytopenia (low platelets) also occur.
- Other effects include hair loss (alopecia), nausea, vomiting, constipation, and nerve effects such as pins and needles, loss of reflexes and convulsions.
- If the injection leaks outside the vein it can cause severe tissue irritation and cellulitis.
- Aspermia (absence of semen) has been reported in men.
- Tell your care team at once about fever, sore throat, unusual bleeding or bruising, or pain, redness or swelling at the injection site.
Precautions & Warnings
- BOXED WARNING: Velban must be given into a vein only, by experienced personnel, and is fatal if given by other routes.
- It is diluted in a flexible plastic container labelled 'FOR INTRAVENOUS USE ONLY - FATAL IF GIVEN BY OTHER ROUTES', not in volumes over 100 mL, and not infused longer than 30 minutes.
- It is contraindicated with significant granulocytopenia (unless caused by the disease) and with active bacterial infection.
- White blood cell counts guide each dose, which starts at 3.7 mg/m2 and is raised in steps according to response.
- Vinblastine is classified as pregnancy Category D: teratogenic effects were seen in animals and fetal harm is possible, so effective contraception is advised.
- Live vaccines should be avoided during treatment.
- Unopened vials are stored in a refrigerator at 2°C to 8°C, protected from light, and kept in the carton until use.
Avoid Interactions
- Drugs that increase toxicity: erythromycin and other CYP3A inhibitors can increase the severity of vinblastine toxicity.
- Live vaccines (such as measles, mumps, rubella, varicella, rotavirus, zoster and yellow fever) should be avoided during treatment, per Drugs.com consumer information.
- Drugs that reduce efficacy or levels: vinblastine may lower phenytoin levels, which can increase seizure activity, so phenytoin levels need monitoring.
- Tell your oncology team about all prescription and non-prescription medicines, vitamins and herbal products you use.
- Pharmacy point: vinblastine is diluted only in a flexible plastic container labelled for intravenous use only.
References
Frequently Asked Questions
Velban (vinblastine sulfate) is a chemotherapy medicine used to treat Hodgkin's disease, lymphomas, mycosis fungoides, advanced testicular cancer, Kaposi's sarcoma and Letterer-Siwe disease. The Velban brand is discontinued in the US, and generic vinblastine sulfate injection is used instead. Velban is given only by experienced clinicians.
Velban (vinblastine sulfate) is given by intravenous injection or infusion by an experienced healthcare provider, usually once a week, and never more often than every seven days. The dose is raised step by step based on your white blood cell count. It is not for home use.
Velban side effects include low white blood cells, anaemia, low platelets, hair loss, nausea, vomiting, constipation and nerve effects such as tingling. Leakage from the vein can damage tissue. Report fever, bleeding or bruising. Boxed warning: Velban is fatal if given by any route other than into a vein.
Avoid live vaccines, and tell your team about phenytoin, erythromycin and other CYP3A-inhibiting medicines while receiving Velban (vinblastine sulfate). Avoid pregnancy, because vinblastine may harm an unborn baby. Do not receive Velban if you have a serious bacterial infection or very low neutrophil counts not caused by your cancer.
Blood counts are checked regularly during Velban (vinblastine sulfate) treatment because low white blood cells are the main dose-limiting effect. Your dose is increased in steps according to your white cell count, with the label aiming for about 3,000 cells/mm3. Your team may delay treatment if counts are too low.
Velban (vinblastine sulfate) carries a boxed warning: for intravenous use only, fatal if given by other routes. If it is given into the spinal fluid it usually causes death and needs immediate neurosurgery. It is therefore prepared in a labelled plastic bag and given only by experienced staff.
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