In Canada—

Other commonly used names are desacetyl vinblastine amide sulfate; vincaleukoblastine.

• Antineoplastic

Vindesine ( VIN-de-seen) belongs to the group of medicines known as antineoplastic agents. It is used to treat some kinds of cancer, including leukemia and lung cancer.

Vindesine interferes with the growth of cancer cells, which are eventually destroyed. Since the growth of normal body cells may also be affected by vindesine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, such as hair loss, may not be serious but may cause concern.

Before you begin treatment with vindesine, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

This medicine is available only with your doctor's prescription, in the following dosage form:

Parenteral
• Injection (Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For vindesine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to vindesine.

Pregnancy—Vindesine has not been studied in pregnant women.

Before receiving vindesine make sure your doctor knows if you are pregnant or if you may become pregnant. It is best to use some kind of birth control while you are receiving vindesine. Tell your doctor right away if you think you have become pregnant while receiving vindesine.

Breast-feeding—It is not known whether vindesine passes into the breast milk. However, vindesine is not recommended during breast-feeding, because it may cause unwanted effects in nursing babies.

Children—Although there is no specific information comparing use of vindesine in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of vindesine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking vindesine, it is especially important that your doctor or pharmacist know if you are taking any of the following:

• Acyclovir (e.g., Zovirax) or
• Anticonvulsants (seizure medicine) or
• Antidiabetics, oral (diabetes medicine taken by mouth) or
• Anti-infectives by mouth or by injection (medicine for infection) or
• Antipsychotics (medicine for mental illness) or
• Captopril (e.g., Capoten) or
• Carbamazepine (e.g., Tegretol)
• Enalapril (e.g., Vasotec) or
• Flecainide (e.g., Tambocor) or
• Gold salts (medicine for arthritis) or
• Imipenem or
• Inflammation or pain medicine, except narcotics or
• Lisinopril (e.g., Prinivil, Zestril) or
• Maprotiline (e.g., Ludiomil) or
• Penicillamine (e.g., Cuprimine) or
• Pimozide (e.g., Orap) or
• Procainamide (e.g., Pronestyl) or
• Promethazine (e.g., Phenergan) or
• Ramipril (e.g., Altace) or
• Sulfasalazine (e.g., Azulfidine) or
• Tiopronin (e.g., Thiola) or
• Tocainide (e.g., Tonocard) or
• Tricyclic antidepressants (medicine for depression) or
• Trimeprazine (e.g., Temaril)—Concurrent use of these agents with vindesine may cause blood disorders

• Alpha interferons (e.g., Intron A, Roferon-A) or
• Amphotericin B by injection (e.g., Fungizone) or
• Antineoplastics, other (cancer medicine) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Chloramphenicol (e.g., Chloromycetin) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan) or
• Flucytosine (e.g., Ancoban) or
• Ganciclovir (e.g., Cytovene) or
• Mercaptopurine (e.g., Purinethol)
• Methotrexate (e.g., Rheumatrex)
• Plicamycin (e.g., Mithracin)
• Zidovudine (e.g., AZT, Retrovir)—Concurrent use of these agents with vindesine increases the risk of infection

• Anti-infectives by mouth or by injection (medicine for infection)
• Carbamazepine (e.g., Tegretol)
• Chloroquine (e.g., Aralen)
• Cisplatin (e.g., Platinol)
• Cytarabine (e.g., Cytosar-U)
• Diphtheria, tetanus, and pertussis (DTP) vaccine (recent, within 30 days of vindesine therapy)
• Disulfiram (e.g., Antabuse)
• Ethotoin (e.g., Peganone)
• Hydroxychloroquine (e.g., Plaquenil)
• Lindane, topical (e.g., Kwell)
• Lithium (e.g., Lithane)
• Mephenytoin (e.g., Mesantoin)
• Mexilitene (e.g., Mexitil)
• Pemoline (e.g., Cylert)
• Pyridoxine (e.g., Hexa-Betalin) (with long-term, high-dose use)
• Quinine (e.g., Quinamm)—Concurrent use of these agents with vindesine increases the risk of neurotoxicity

• Phenytoin (e.g., Dilantin)—Concurrent use of this agent with vindesine increases the risk of seizures

• If you have ever been treated with radiation or cancer medicines—Vindesine may increase the effects of these medicines or radiation therapy on the blood

• Charcot-Marie-Tooth syndrome, demyelinating form—May cause increased neuropathic effects

• Drug-induced blood disorders—May worsen

• Infection—There may be an increased risk of infections or worsening infections because of the body's reduced ability to fight them

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body

• Liver disease—Effects of vindesine may increase because of slower removal from the body

• Nerve or muscle disease—May worsen

This medicine sometimes causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your doctor, nurse, or pharmacist for ways to lessen these effects.

Vindesine frequently causes constipation and stomach cramps. Your doctor may want you to take a laxative. However, do not decide to take these medicines on your own without first checking with your doctor.

Dosing—

The dose of vindesine will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's body size, and whether or not other medicines are also being taken. If you are taking or receiving vindesine at home, follow your doctor's orders or the directions on the label.If you have any questions about the proper dose of vindesine, ask your doctor.

It is very important that your doctor check your progress at regular visits to make sure that vindesine is working properly and to check for unwanted effects.

While you are being treated with vindesine, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Vindesine may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. Other people living in your household should not take or should not have recently taken oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid other persons who have taken oral polio vaccine. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.

Vindesine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

If vindesine accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

• More common
  • Black, tarry stools;  chest pain;  chills;  cough;  fever;  painful or difficult urination;  shortness of breath;  sore throat;  sores, ulcers, or white spots on lips or in mouth;  swollen glands 
  
  

• Less common or rare
  • Blindness;  blurred or double vision ;  convulsions (seizures);  difficulty in walking;  drooping eyelids;  headache;  jaw pain;  numbness or tingling in fingers and toes;  pain in fingers and toes;  pain in testicles;  unusual bleeding or bruising;  unusual tiredness or weakness 
  
  

• Symptoms of overdose

  Get emergency help immediately if any of the following symptoms of overdose occur

  • Abnormal drowsiness;  Agitation;  confusion;  dazed feeling;  decreased urine output;  depression;  dizziness;  headache;  hostility;  irritability;  muscle twitching;  nausea;  rapid weight gain;  seizures;  swelling of face, ankles, or hands 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome.

• Less common or rare
  • Constipation;  general feeling of discomfort or illness;  increase in bowel movements;  loose stools;  loss of appetite;  muscle or bone pain;  nausea and vomiting ;  skin rash;  soft stools ;  weight loss 
  
  

This medicine often causes a temporary loss of hair. After treatment with vindesine has ended, normal hair growth should return.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.