MONOFER 100 mg/mL Price

Overview

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This medicine contains an important and useful components, as it consists of
Ferric derisomaltoseis available in the market in concentration

Name

Vinblastine

Precaution

Before using **Vinblastine**, it is crucial to consult with a healthcare provider, as there are several important precautions: - **Hematologic Toxicity**: Vinblastine can cause significant bone marrow suppression, leading to **neutropenia**, **thrombocytopenia**, and **anemia**. Regular blood tests are necessary to monitor white blood cell, platelet, and red blood cell counts before and during treatment. - **Liver Dysfunction**: Vinblastine is metabolized by the liver, so patients with **liver impairment** (e.g., cirrhosis, hepatitis) may require dosage adjustments. Liver function tests should be monitored periodically. - **Pregnancy and Lactation**: Vinblastine is classified as **Category D** for pregnancy, meaning it may harm a developing fetus. It is contraindicated during pregnancy and should only be used if absolutely necessary, with careful consideration of the risks and benefits. It is also excreted in breast milk, so nursing mothers should avoid breastfeeding while undergoing treatment. - **Peripheral Neuropathy**: Vinblastine can cause peripheral neuropathy, including symptoms like **numbness**, **tingling**, or **weakness** in the hands or feet. Patients should report any such symptoms to their healthcare provider immediately. - **Infection Risk**: Due to its effects on the immune system, Vinblastine can increase the risk of **infections**, including severe or opportunistic infections. Patients should be closely monitored for signs of infection. - **Gastrointestinal Toxicity**: Vinblastine can cause nausea, vomiting, and other gastrointestinal disturbances, which can lead to dehydration and weight loss. Anti-nausea medications may be given to mitigate these effects.

Indication

Vinblastine is primarily used for its **antineoplastic** (cancer-fighting) properties and is typically prescribed for the following conditions: - **Hodgkin’s Lymphoma**: Vinblastine is part of the **ABVD chemotherapy regimen**, used to treat **Hodgkin's lymphoma**, a type of cancer that affects the lymphatic system. - **Non-Hodgkin’s Lymphoma**: It is also used in the treatment of various forms of **non-Hodgkin's lymphoma**, often in combination with other chemotherapy drugs. - **Testicular Cancer**: Vinblastine is used as part of chemotherapy for **testicular cancer**, especially when it has spread beyond the testicle. - **Breast Cancer**: In some cases, Vinblastine is used to treat advanced **breast cancer**. - **Bladder Cancer**: Vinblastine may be used as part of combination therapy for **bladder cancer**, particularly when it is in an advanced stage. - **Kaposi’s Sarcoma**: In patients with **Kaposi’s sarcoma**, a cancer associated with **HIV**, Vinblastine can be utilized as part of the treatment regimen.

Contra indication

Vinblastine should be avoided in the following conditions: - **Hypersensitivity to Vinblastine**: Any patient with a known allergy or hypersensitivity to **Vinblastine sulfate** or any of its components should not receive this medication. - **Severe Bone Marrow Suppression**: In patients who already have significant **bone marrow suppression**, such as those with pre-existing low blood cell counts (e.g., neutropenia or thrombocytopenia), Vinblastine is contraindicated due to its potential to exacerbate these conditions. - **Pregnancy**: Vinblastine is contraindicated during pregnancy due to its teratogenic potential, as it can cause fetal harm, including birth defects and miscarriage. - **Severe Liver Disease**: Given that Vinblastine is metabolized in the liver, its use is contraindicated in patients with **severe liver dysfunction** or **hepatic failure** because of the potential for increased toxicity and accumulation of the drug in the body. - **Neuropathy**: Vinblastine should not be used in patients with pre-existing severe **peripheral neuropathy**, as it can worsen these symptoms.

Side Effect

Common and severe side effects associated with **Vinblastine** include: - **Hematologic Toxicity**: Vinblastine commonly causes **myelosuppression**, leading to **neutropenia**, **thrombocytopenia**, and **anemia**. Regular blood counts are required to monitor these effects. In severe cases, this can lead to increased susceptibility to infections, bleeding, and fatigue. - **Nausea and Vomiting**: Gastrointestinal upset is common, with **nausea**, **vomiting**, and **loss of appetite** being frequent side effects. Anti-nausea medications are often prescribed alongside Vinblastine to help manage these symptoms. - **Alopecia**: Hair loss, or **alopecia**, is a common side effect during treatment with Vinblastine, which may be temporary. - **Peripheral Neuropathy**: Symptoms such as **numbness**, **tingling**, or **weakness** in the hands and feet can occur. This can be bothersome and, in some cases, may become persistent. - **Constipation**: Due to its effects on the digestive system, Vinblastine can cause **constipation**. Laxatives or stool softeners may be prescribed to alleviate this. - **Hepatotoxicity**: Liver toxicity, such as elevated liver enzymes, can occur, requiring dose adjustments and close monitoring of liver function. - **Extravasation**: Vinblastine should be administered through an intravenous (IV) line with proper technique, as extravasation (leakage of the drug into surrounding tissue) can cause significant tissue damage. - **Fatigue**: Many patients experience general **fatigue** and **weakness** during treatment, which may persist for some time after the drug is discontinued.

Pregnancy Category ID

4

Mode of Action

Vinblastine works by disrupting the ability of cells to divide, specifically targeting **mitosis** (the phase of cell division): - **Inhibition of Microtubule Formation**: Vinblastine binds to **tubulin**, a protein that is essential for the formation of **microtubules**, structures that help segregate chromosomes during cell division. By preventing the polymerization of tubulin into microtubules, Vinblastine disrupts the **spindle formation**, which is crucial for the proper alignment and separation of chromosomes. - **Cell Cycle Arrest**: This disruption causes the cancer cell to undergo **mitotic arrest**, preventing it from completing cell division. This leads to **cell death** (apoptosis) of rapidly dividing cancer cells, thereby reducing tumor size. - **Selective Action**: Although Vinblastine can affect both cancerous and normal cells, rapidly dividing cancer cells are more susceptible to the drug’s actions, making it an effective treatment for many malignancies.

Interaction

Vinblastine may interact with various medications, including: - **CYP3A4 Inhibitors/Inducers**: Vinblastine is metabolized by the **CYP3A4** enzyme in the liver. Medications that inhibit CYP3A4, such as **ketoconazole**, **clarithromycin**, or **ritonavir**, can increase Vinblastine levels, raising the risk of toxicity. Conversely, CYP3A4 inducers like **rifampin** or **phenytoin** may decrease its efficacy by accelerating its metabolism. - **Other Chemotherapy Agents**: When combined with other chemotherapy drugs (such as **cisplatin**, **cyclophosphamide**, or **doxorubicin**), the risk of side effects such as **bone marrow suppression**, **nephrotoxicity**, and **neuropathy** can be enhanced. These combinations require careful monitoring. - **Vaccines**: **Live vaccines** (e.g., **measles**, **mumps**, **rubella**) should be avoided during chemotherapy with Vinblastine, as the immune response may be suppressed, leading to inadequate vaccine efficacy or an increased risk of infection. - **Antibiotics and Antifungals**: Certain antibiotics (e.g., **erythromycin**) and antifungal agents (e.g., **fluconazole**) can interact with Vinblastine, altering its metabolism and increasing the risk of side effects. - **Anticonvulsants**: Some anticonvulsants, particularly **phenytoin**, can reduce the therapeutic effectiveness of Vinblastine by increasing its metabolism, leading to decreased drug levels.

Pregnancy Category Note

Information not available

Adult Dose

For **adult patients**, Vinblastine is typically administered intravenously: - **For Hodgkin's Lymphoma**: The standard dose is **6 mg/m²** of body surface area, administered every 14 days, as part of the **ABVD** chemotherapy regimen. - **For Non-Hodgkin's Lymphoma**: Vinblastine may be given at a dose of **0.04–0.1 mg/kg**, with the specific dose depending on the chemotherapy protocol used. - **For Testicular Cancer**: The usual dose for **testicular cancer** is **0.06 mg/kg** once per week, often in combination with other chemotherapy agents. - **For Breast Cancer**: The dose for **advanced breast cancer** typically ranges between **1.4–2.0 mg/m²** every 21 days. - **For Kaposi's Sarcoma**: The dose is often **2.0 mg/m²** every 7–10 days, depending on the treatment regimen.

Child Dose

In pediatric patients, Vinblastine dosage is typically adjusted based on body surface area (BSA): - **For Hodgkin’s Lymphoma**: The typical dose for children is **2 mg/m²** administered once a week as part of combination chemotherapy. - **For Other Cancers**: The dosing for **non-Hodgkin's lymphoma**, **testicular cancer**, or other malignancies varies but generally follows the guideline of **1.4–2.0 mg/m²** once per week, depending on the condition and the combination regimen. As always, pediatric dosing must be carefully managed by a healthcare provider based on individual needs and clinical condition. Always consult a healthcare provider before beginning any treatment to ensure the most appropriate and safe dosing based on the patient's condition and medical history.

Renal Dose

Vinblastine is primarily excreted through the liver, so dosage adjustments for **renal impairment** are generally not required. However, careful monitoring of kidney function should still be done, especially in patients with **severe renal dysfunction**, due to the possibility of altered drug metabolism or increased toxicity.

Administration

Information not available