Indications: used to treat a variety of cancers including leukaemias, lymphomas, and some solid tumours (e.g. breast and lung cancer).

Cautions: neuromuscular disease (caution in handling). Contraindicated: Hypersensitivity to vindesine, vinca alkaloids, or any component of the formulation; intrathecal administration (fatal); demyelinating form of Charcot-Marie-Tooth syndrome; severe granulocytopenia (<1500/mm3) or severe thrombocytopenia; bacterial infection.

Hepatic impairment dose reduction may be necessary Pregnancy avoid (teratogenic in animal studies).

Breast-feeding: discontinue breast-feeding

Side Effects: Many side effects of cytotoxic drugs often do not occur at the time of administration, but days or weeks later Most common: Central nervous system:

Pyrexia, malaise. Dermatologic: Alopecia.

Gastrointestinal: Mild nausea and vomiting, constipation (related to the neurotoxicity) Hematologic: Leukopenia and thrombocytopenia, may be dose limiting; thrombocytosis. Nadir: 6-12 days Recovery: Days 14-18 Neuromuscular & skeletal: Paresthesia, loss of deep tendon reflexes, myalgia Less common: Dermatologic: Rashes Gastrointestinal: Loss of taste Hematologic: Anemia Local: Phlebitis Neuromuscular & skeletal: Facial paralysis rare (Limited to important or life- threatening): Acute chest pain, ECG changes, paralytic ileus, jaw pain, photophobia.

Doses of cytotoxic drugs are determined using a variety of different methods including body-surface area or body- weight. Alternatively, doses may be fixed. Doses may be further adjusted following consideration of a patient’s neutrophil count, renal and hepatic function, and history of previous adverse effects to the cytotoxic drug. Doses may also differ depending on whether a drug is used alone or in combination