L01CA03 - Vindesine |
Propably not porphyrinogenic |
PNP |
Rationale
Substrate for CYP 3A4, but no observations pointing to clinical CYP-induction or inhibition. Probably relatively low hepatic exposure. However, side effects such as anorexia, nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Chemical description
Semisynthetic derivative of the alkaloid vinblastine. Administered as sulphate salt, hygroscopic, freely soluble in water.
Therapeutic characteristics
Vindesine sulfate is an antineoplastic agent derived from vinblastine. It is used in the treatment of lung cancer, malignant melanoma, acute lymphatic leucemia, and non-Hodgkin lymphoma. Administered intravenously once weekly. Common adverse reactions of vindesine that can be confused with an acute porphyric attack are obstipation, abdominal pain, loss of deep tendon reflexes, paraestehesia in fingers and toes and myalgia are common. Nausea and vomiting are less common. Side effects such as anorexia, nausea and vomiting may be potentially porphyrinogenic through reduction in caloric intake.
Metabolism and pharmacokinetics
Metabolised by CYP3A4 in the liver, metabolites excreted via bile. No observations of interference with CYP-metabolism of other drugs. Listed as substrate of CYP3A4 by Rendic (2002) and Zhou (2007), but not as CYP-inducer or inhibitor.
IPNet drug reports
No.
References
- Scientific articles
- Rendic, S. Summery of information on human CYP enzymes: human P450 metabolism. Drug metabolism reviews 2002; 34(1&2), 83-448. #1025
- Zhou, S.F., Xue, C.C., et al. Clinicallay important drug interactions potentially involving mechanism-based inhibition of cytochrome P450 3A4 and the role of therapeutic drug monitoring. Ther Drug Monit 2007; 29(6):687:710. #1957
- Drug reference publications
- Sweetman SC, editor. Martindale: The complete drug reference. Vindesine Sulphate. Pharmaceutical Press 2009. #1965
- Other sources
- Swedish National Formulary. FASS. Eldisine®. www.fass.se (product leaflet). #1966
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