Vindesine is a chemotherapy drug that is given as a treatment for some types of cancer, including leukaemia, lymphoma, melanoma, breast, and lung cancer. This information describes vindesine, how it is given and some of its possible side effects. It should ideally be read with our general information about chemotherapy and about your type of cancer.

If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.

Vindesine is a colourless fluid after being dissolved from powder.

Vindesine may be given:

• by injection into a vein (intravenously) through a fine tube (cannula) inserted into the vein
• through a central line, which is inserted under the skin into a vein near the collarbone, or through a PICC line, which is inserted into a vein in the crook of the arm.

Chemotherapy is usually given as a course of several sessions (or cycles) of treatment over a few months. The length of your treatment and the number of cycles you have will depend on the type of cancer for which you are being treated. Your nurse or doctor will discuss your treatment plan with you.

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given vindesine, and may be different if you are having more than one chemotherapy drug.

We have outlined the most common side effects as well as rarer ones, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you do notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss these with your doctor or chemotherapy nurse.

Lowered resistance to infection Vindesine can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given, and your resistance to infection usually reaches its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal levels before your next cycle of chemotherapy is due.

Contact your doctor or the hospital straightaway if:

• your temperature goes above 38ºC (100.5ºF)
• you suddenly feel unwell (even with a normal temperature).

You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.

Bruising or bleeding Vindesine can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.

Anaemia (low number of red blood cells) While having treatment with vindesine you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these symptoms are a problem.

Hair loss This usually starts 3–4 weeks after the first dose of vindesine, although it may occur earlier. Your hair may fall out completely, but it is more usual for it to just thin. You may also have thinning and loss of eyelashes, eyebrows and other body hair. Hair loss is temporary and your hair will grow back again once the treatment is finished.

Abdominal cramps and constipation These can usually be relieved by drinking plenty of fluids, eating a high fibre diet and taking gentle exercise. Sometimes you may need to take medicines to stimulate your bowel. These can be prescribed by your doctor.

Numbness or tingling in hands or feet This is due to the effect of vindesine on nerves and is known as peripheral neuropathy. You may also notice that you have difficulty doing up buttons or similar fiddly tasks. Tell your doctor if you notice any numbness or tingling in your hands or feet. This usually improves slowly a few months after the treatment is finished. Very rarely, other nerves may be affected (eg neck nerves) which may cause jaw pain or double vision.

Tiredness and feeling weak You may feel very tired. It is important to allow yourself plenty of time to rest.

Skin changes Vindesine can cause a rash which may be itchy. Your doctor can prescribe medicine to help with this.

Sore mouth and ulcers Your mouth may become sore, or you may notice small ulcers during this treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.

Taste changes You may notice that your food tastes different. Normal taste will usually come back after the treatment finishes.

Diarrhoea This can usually be easily controlled with medicine but let your doctor know if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea.

Feeling sick (nausea) and being sick (vomiting) This is usually very mild and there are very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce, nausea and vomiting. If you do feel sick it may begin soon after the treatment is given and can last for up to a day. If the sickness is not controlled or continues tell your doctor, who can prescribe other anti-sickness drugs which may be more effective. Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.

Leakage into the tissue If vindesine leaks into the tissue around the vein it can damage the tissue in that area. If you notice any stinging or burning around the vein while the drug is being given, or any leakage of fluid from the cannula site, tell the doctor or nurse immediately.

If the area around the injection site becomes red or swollen at any time tell the doctor or nurse on the ward, or if you are at home, ring the clinic or ward and ask to speak to the doctor or nurse.

Risk of blood clots Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious so it is important to tell your doctor straightaway if you have any of these symptoms. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.

Other medicines Some medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.

Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.

Contraception It is not advisable to become pregnant or father a child while taking vindesine, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.

This section is based on our Vindesine factsheet which has been compiled using information from a number of reliable sources, including:

• Martindale: The Complete Drug Reference (35th edition). Eds. Sweetman et al. Pharmaceutical Press, 2007.
• British National Formulary (54th edition). British Medical Association and Royal Pharmaceutical Society of Great Britain, September 2007.
• The Medicines.org.uk website – www.medicines.org.uk (November 2007).
• The Chemotherapy Source Book (3rd edition). Ed. Perry. Lippincott Williams and Wilkins, 2001.

For further references, please see general bibliography.