Vinstin
Generic Name
Vinorelbine
Manufacturer
Generic Pharmaceutical Company (e.g., Beacon Pharmaceuticals, Incepta Pharmaceuticals)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vinstin 2 mg injection | ৳ 400.00 | N/A |
Description
Overview of the medicine
Vinstin 2 mg Injection contains Vinorelbine, a vinca alkaloid antineoplastic agent used in the treatment of various cancers, primarily non-small cell lung cancer and certain types of breast cancer. It interferes with cell division by disrupting microtubule formation, leading to programmed cell death in rapidly dividing cancer cells.
Uses & Indications
Dosage
Adults
Typically 25-30 mg/m² intravenously once weekly. Dosage may be adjusted based on blood counts and liver function. Administered over 6-10 minutes followed by saline flush.
Elderly
Dosage adjustment may be necessary in elderly patients with impaired liver function or bone marrow reserve, but generally similar to adults if organ function is normal.
Renal_impairment
No specific dose adjustment is generally required for renal impairment, as primary excretion is hepatic. However, caution is advised in severe cases.
How to Take
Administer intravenously over 6-10 minutes, usually into a peripheral vein, followed by a flush with 200-500 mL of 0.9% sodium chloride injection. Ensure proper dilution and avoid extravasation. This is a hazardous drug; proper handling and administration precautions must be observed.
Mechanism of Action
Vinorelbine binds to tubulin, the main component of microtubules, inhibiting the assembly of microtubules. This disruption leads to the arrest of mitotic cell division at metaphase, ultimately causing apoptosis (programmed cell death) in cancer cells. Its binding to tubulin is preferential to mitotic microtubules compared to axonal microtubules.
Pharmacokinetics
Onset
Not acutely observable in terms of anti-cancer effect; effects are cumulative over cycles.
Excretion
Mainly excreted via bile/feces (approximately 46% to 70%), with a small percentage excreted in urine (less than 20%).
Half life
Terminal half-life ranges from 27.7 to 43.6 hours.
Absorption
Administered intravenously, hence 100% bioavailability. Rapid distribution to tissues.
Metabolism
Extensively metabolized in the liver, primarily by CYP3A4, to several metabolites, including 4-O-deacetylvinorelbine (an active metabolite).
Side Effects
Contraindications
- Severe neutropenia (absolute neutrophil count < 1000 cells/mm³)
- Significant hepatic impairment (Child-Pugh Class B or C)
- Pregnancy and lactation
- Hypersensitivity to vinorelbine or other vinca alkaloids
Drug Interactions
Phenytoin
Decreased phenytoin levels and increased risk of seizures.
Live vaccines
Avoid use due to immunosuppression; increased risk of infection.
Other myelosuppressive agents
Increased risk of severe bone marrow suppression.
CYP3A4 inducers (e.g., rifampicin, phenytoin)
May decrease vinorelbine levels and efficacy.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase vinorelbine levels and toxicity.
Storage
Store refrigerated at 2°C to 8°C (36°F to 46°F). Protect from light. Do not freeze. Diluted solutions should be used within 24 hours.
Overdose
Symptoms of overdose include severe myelosuppression, severe infections, and peripheral neuropathy. Management involves supportive care, including blood transfusions, granulocyte colony-stimulating factors (G-CSFs) to manage neutropenia, and close monitoring of vital signs and neurological status. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category D. Vinorelbine can cause fetal harm when administered to a pregnant woman. Should not be used during pregnancy. Women of childbearing potential should be advised to use effective contraception. It is not known whether vinorelbine is excreted in human milk, but due to potential serious adverse reactions in nursing infants, breastfeeding should be discontinued during treatment.
Side Effects
Contraindications
- Severe neutropenia (absolute neutrophil count < 1000 cells/mm³)
- Significant hepatic impairment (Child-Pugh Class B or C)
- Pregnancy and lactation
- Hypersensitivity to vinorelbine or other vinca alkaloids
Drug Interactions
Phenytoin
Decreased phenytoin levels and increased risk of seizures.
Live vaccines
Avoid use due to immunosuppression; increased risk of infection.
Other myelosuppressive agents
Increased risk of severe bone marrow suppression.
CYP3A4 inducers (e.g., rifampicin, phenytoin)
May decrease vinorelbine levels and efficacy.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin)
May increase vinorelbine levels and toxicity.
Storage
Store refrigerated at 2°C to 8°C (36°F to 46°F). Protect from light. Do not freeze. Diluted solutions should be used within 24 hours.
Overdose
Symptoms of overdose include severe myelosuppression, severe infections, and peripheral neuropathy. Management involves supportive care, including blood transfusions, granulocyte colony-stimulating factors (G-CSFs) to manage neutropenia, and close monitoring of vital signs and neurological status. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category D. Vinorelbine can cause fetal harm when administered to a pregnant woman. Should not be used during pregnancy. Women of childbearing potential should be advised to use effective contraception. It is not known whether vinorelbine is excreted in human milk, but due to potential serious adverse reactions in nursing infants, breastfeeding should be discontinued during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when stored as recommended.
Availability
Hospitals, specialized oncology pharmacies
Approval Status
Approved for various cancers (e.g., NSCLC, breast cancer) in many countries.
Patent Status
Generally off-patent for the generic molecule Vinorelbine.
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established vinorelbine's efficacy and safety in various cancer types, particularly NSCLC and breast cancer, often in combination with other chemotherapy agents.
Lab Monitoring
- Complete blood count (CBC) with differential, weekly or before each dose
- Liver function tests (LFTs) before each dose
- Renal function tests periodically
- Electrolytes (especially sodium)
Doctor Notes
- Strict adherence to blood count monitoring is essential before and during treatment.
- Manage extravasation promptly if it occurs (apply warmth, hyaluronidase).
- Careful assessment of liver function is critical for dose adjustments.
Patient Guidelines
- Report any fever, signs of infection, or unusual bleeding/bruising immediately.
- Be aware of and report any numbness, tingling, or weakness in hands or feet.
- Stay well-hydrated and manage constipation proactively.
- Use effective contraception during and for several months after treatment.
Missed Dose Advice
If a dose is missed, contact your oncologist immediately for advice. Do not double the dose. The schedule may need to be adjusted.
Driving Precautions
May cause fatigue, dizziness, or vision disturbances. Patients should be advised not to drive or operate machinery if they experience these symptoms.
Lifestyle Advice
- Maintain good hygiene to prevent infections.
- Avoid contact with people who are sick.
- Follow a balanced diet and stay physically active as tolerated.
- Avoid alcohol, especially if liver function is compromised.
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