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Vinca alkaloids

Vinca alkaloids are derived from the Madagascar or Rose Periwinkle plant. They are given intravenously only (although an oral preparation of vinorelbine is available and currently used in small cell lung carcinoma). Drugs in this class are vinblastine, vincristine, vindesine and vinorelbine.

Method of action

This is similar to etoposide in that they bind to tubulin thereby, preventing microtubule formation. Thus mitosis is halted.1

Indications
Cautions
  • Not to be given intrathecally
  • Hepatic impairment
Side effects
  • Neurotoxicity: this manifests as paraesthesia, loss of reflexes and abdominal pain. May be a peripheral neuropathy or autonomic neuropathy. This is worst with vincristine and the dose has to be reduced.3 It is also a reason for discontinuation of therapy especially if motor weakness is present.
  • Myelosuppression can occur which is dose related (not seen with vincristine).
  • Necrosis is associated with extravasation.
  • Alopecia can occur.
Document references
  1. Rang HP, Dale MM, Ritter JM and Moore PK. (2003) Pharmacology, 5th ed, Bath, Churchill Livingstone.
  2. Breast cancer and Vinorelbine; NICE guidance on The clinical effectiveness and cost effectiveness of vinorelbine for breast cancer; December 2002.
  3. British National Formulary British Medical Association and Royal Pharmaceutical Society of Great Britain. London.
AcknowledgementsEMIS is grateful to Dr Gurvinder Rull for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2007.
DocID: 443
Document Version: 1
DocRef: bgp25223
Last Updated: 1 Oct 2007
Review Date: 30 Sep 2008






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