Vinblastine sulfate (Specialist drug)

How it works

It binds tubulin and inhibits microtubule assembly, arresting cells in metaphase and preventing cell division.

Prescribing in practice

• It is for intravenous use only and is fatal if given by the intrathecal route; administration must follow strict spinal-injection safety procedures.
• It is a potent vesicant, so extravasation must be avoided and managed promptly if it occurs.
• Myelosuppression, particularly neutropenia, is dose-limiting and requires count-guided dosing.

Monitoring

Monitor full blood count before each dose, together with hepatic function and clinical assessment for neuropathy and infection.

Counselling the patient

• Report fever, sore throat or other signs of infection urgently as the white cell count may be low.
• Tell the team at once about pain, swelling or leakage at the injection site.
• Report numbness, tingling or constipation, which may indicate nerve effects.

Evidence & guidelines

Its role is established within long-standing combination chemotherapy regimens supported by clinical guidelines.