DBL Vinblastine Overdosage

Side effects following the use of vinblastine are dose related. Therefore, following administration of more than the recommended dose, patients can be expected to experience these effects in an exaggerated fashion. Any dose that results in elimination of platelets and neutrophils from blood and marrow and their precursors from marrow is life-threatening.
The major effect of excessive doses of DBL Vinblastine Injection will be on granulocytopoeisis, and this may be life-threatening.
In addition, neurotoxicity similar to that seen with vincristine sulfate may be observed.
Treatment: Supportive care should include: prevention of the side effects that result from the syndrome of inappropriate secretion of antidiuretic hormone. This includes restriction of fluid intake and perhaps the use of a diuretic acting on the loop of Henle and distal tubule function; administration of an anticonvulsant; prevention and treatment of ileus; monitoring the patient's cardiovascular system; and daily blood counts for guidance in transfusion requirement and assessing the risk of infection.
There is no specific antidote. The use of folinic acid in addition to the other supportive measures recommended may be considered, although, unlike vincristine sulfate, studies have not been conducted to confirm its protective action.
There is no information regarding the effectiveness of dialysis nor of cholestyramine for the treatment of overdose.
Vinblastine sulfate in the dry state is irregularly and unpredictably absorbed from the gastro-intestinal tract following oral administration. Absorption of the solution has not been studied. If vinblastine sulfate is swallowed, activated charcoal in a water slurry may be given by mouth along with a cathartic. The use of cholestyramine in this situation has not been reported.