vinblastine sulphate

CLINICAL USE

Antineoplastic agent

DOSE IN NORMAL RENAL FUNCTION

5.5–7.4 mg/m2 (maximum of once a week) Or consult relevant local protocol

PHARMACOKINETICS

Molecular weight : 909.1

%Protein binding : 99

%Excreted unchanged in urine : 14

Volume of distribution (L/kg) : 13–40

half-life – normal/ESRD (hrs) : 25/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unlikely to be dialysed. Dose as in normal renal function

HD : Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux : Unknown dialysability. Dose as in normal renal function

CAV/VVHD : Unlikely to be dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antibacterials: toxicity increased by erythromycin – avoid concomitant use

Anti-epileptics: phenytoin levels may be reduced

Antifungals: metabolism possibly inhibited by posaconazole (increased risk of neurotoxicity)

Antipsychotics: avoid concomitant use with clozapine (increased risk of agranulocytosis)

ADMINISTRATION

Reconstition

Add 10 mL of diluent to 10 mg vial. May be administered into fast-running drip of sodium chloride 0.9%

Route

Rate of Administration

1 minute

Comments

Do not dilute with large volumes (e.g. 100–250 mL) or give over long periods (30–60 minutes) as thrombophlebitis and extravasation may occur

OTHER INFORMATION

Vinblastine is extensively metabolised (primarily in the liver) to desacetylvinblastine, which is more active than the parent compound. 33% of the drug is slowly excreted in the urine and 21% in the faeces within 72 hours

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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