Indications And Dose
Treatment of advanced or metastatic transitional cell carcinoma of the urothelial tract after failure of a platinum-containing regimen (monotherapy) ▶Adult: (consult local protocol)
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Drug reference
Treatment of advanced or metastatic transitional cell carcinoma of the urothelial tract after failure of a platinum-containing regimen (monotherapy) ▶Adult: (consult local protocol)
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Intrathecal injection contra- indicated.
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Cardiovascular disease. QT-interval prolongation (avoid hypokalaemia)
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NICE decisions ▶Vinflunine for the treatment of advanced or metastatic transitional cell carcinoma of the urothelial tract (January 2013) NICE TA272 Vinflunine (Javlor ®) is not recommended for the treatment of advanced or metastatic transitional cell carcinoma of the urothelial tract that has progressed after treatment with platinum-based chemotherapy. www.nice.org.uk/guidance/ta272
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Vinflunine injections are for intravenous administration only. Inadvertent intrathecal administration can cause severe neurotoxicity, which is usually fatal. The National Patient Safety Agency has advised (August 2008) that adult and teenage patients treated in an adult or adolescent unit should receive their vinca alkaloid dose in a 50 mL minibag. Teenagers and children treated in a child unit may receive their vinca alkaloid dose in a syringe.
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→Appendix 1: vinca alkaloids
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▶Common or very common Alopecia. anaemia. appetite decreased. arthralgia. asthenia. chest pain. chills. constipation. cough. dehydration. diarrhoea. dizziness. dyspnoea. ear pain. fever. gastrointestinal discomfort. gastrointestinal disorders. headache. hyperhidrosis. hypersensitivity. hypertension. hyponatraemia. hypotension. increased risk of infection. insomnia. leucopenia. muscle weakness. myalgia. nausea. neutropenia. oedema. oral disorders. pain. peripheral neuropathy. skin reactions. swallowing difficulty. syncope. tachycardia. taste altered. thrombocytopenia. venous thrombosis. vomiting. weight changes ▶Uncommon Acute respiratory distress syndrome (ARDS). cancer pain. laryngeal pain. myocardial infarction. myocardial ischaemia. neutropenic sepsis. renal failure. SIADH. tinnitus. vertigo. visual impairment ▶Rare or very rare Posterior reversible encephalopathy syndrome (PRES)
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Manufacturer advises effective contraception during and for up to 3 months after treatment.
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Avoid unless essential—teratogenicity and embryotoxicity in animal studies. See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Discontinue breast-feeding.
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Manufacturer advises caution (no Immune system and malignant disease information available in severe impairment). Dose adjustments Manufacturer advises dose reduction.
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Dose adjustments Reduce dose if creatinine clearance less than 60 mL/minute—consult product literature.
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There can be variation in the licensing of different medicines containing the same drug. Solution for infusion ▶Javlor (Pierre Fabre Ltd) Vinflunine (as Vinflunine ditartrate) 25 mg per 1 ml Javlor 250mg/10ml concentrate for solution for infusion vials | 1 vial P £1,062.50 Javlor 50mg/2ml concentrate for solution for infusion vials | 1 vial P £212.50
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(consult local protocol)
First-line fragment. Read the complete Indications and Dose section above.
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