Vinblastine

Vinblastine is a chemotherapy drug used most often for bladder cancer. You may also have it for lymphoma, or Kaposi's sarcoma.

Vinblastine belongs to the group of drugs called vinca alkaloids. These are often called plant alkaloids because the first of these drugs was developed from the periwinkle plant (vinca). These drugs are sometimes called microtubule inhibitors. This describes the way they work in damaging cancer cells. Vinblastine works by stopping the cancer cells from separating into two new cells. So it blocks the growth of the cancer.

Vinblastine is a clear fluid you have into your bloodstream (intravenously). You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drug directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.

You usually have vinblastine chemotherapy as a course of several cycles of treatment. The treatment plan for vinblastine depends on which cancer you have. There is detailed information about how doctors plan chemotherapy in CancerHelp UK.

Vinblastine side effects are listed below. You can use the links to find out more about each side effect. Or go to the cancer drug side effects section for general information.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
• Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)

Some of these side effects can be life threatening, particularly infections. You should contact your hospital if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Fatigue during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• Hair loss or hair thinning is common and may start about 3 to 4 weeks after your treatment – it grows back when the treatment ends
• Feeling or being sick is usually mild to moderate and happens within 24 hours of having treatment – it is usually easily controlled with anti sickness injections and tablets. Tell your doctor or nurse if yours is not controlled as there are other anti sickness medicines you can try
• A sore mouth or mouth ulcers
• Women may stop having periods (amenorrhoea) but this may only be temporary
• Loss of fertility – you may not be able to get pregnant or father a child after treatment with vinblastine, so it is important to talk to your doctor about your fertility before starting treatment if having a baby is important to you
• Vinblastine may harm a developing baby so it is not advisable to become pregnant or father a child if you are having this drug – talk about contraception with your doctor before having the treatment if there is any chance you or your partner could become pregnant
• You should not breastfeed while having this drug as it may come through in the breast milk

Between 1 and 10 in every 100 people have one or more of these.

• Numbness or tingling in fingers and toes can cause difficulty with fiddly things such as doing up buttons – this starts within a few days or weeks and usually goes within a few months of finishing treatment
• Inflammation around the drip site – if you notice any signs of redness, pain, swelling or leaking at your drip site, tell your chemotherapy nurse immediately
• Constipation can be a problem but is generally prevented with regular laxatives – if you are constipated for more than 3 days, tell your doctor or nurse
• Diarrhoea – drink plenty of fluids and tell your doctor or nurse if it is severe or lasts more than a couple of days

Fewer than 1 in 100 people have these.

• Depression
• Headaches
• Jaw pain
• Increased heart rate
• Dizziness and changes in vision
• Difficulty emptying your bladder
• High blood pressure
• An allergic reaction – tell your doctor or nurse straight away if you have a sudden cough, wheezing or difficulty breathing

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.