A vinca-alkaloid chemotherapy for advanced bladder cancer
Vinflunine
A chemotherapy medicine from the vinca-alkaloid group, given into a vein to treat advanced bladder cancer.
What is Vinflunine?
Vinflunine is a specialist chemotherapy from the vinca-alkaloid group, used to treat advanced bladder (urothelial) cancer that has spread. It works by stopping cancer cells from dividing. Its main side effects are a fall in blood cells, especially infection-fighting white cells (neutropenia), constipation that can become severe (bowel blockage, or ileus), and nerve damage in the hands and feet. Like all vinca alkaloids it is a vesicant and must ONLY ever be given into a vein: giving it into the spine is fatal. It is given by a cancer team.
Education and reference only. This is a plain-language guide to Vinflunine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Vinflunine is a chemotherapy medicine belonging to the vinca-alkaloid group. It is used to treat advanced bladder cancer (also called urothelial cancer), usually after other treatment has been tried. It is given as an injection into a vein under the close care of a cancer (oncology) team. As with all vinca alkaloids, it carries strict safety rules: it must never be given into the spine, and it can cause severe tissue damage if it leaks out of the vein. Because of these risks and its strong effects on the blood and bowel, it is given only by specialist chemotherapy teams.
How it works
Cancer cells divide by pulling their copied chromosomes apart using internal scaffolding fibres called microtubules. Vinflunine stops these microtubules from working, so the cancer cell cannot complete division and dies. Because it acts on dividing cells, it also affects healthy fast-growing cells, especially in the bone marrow, lowering blood counts. It also slows the muscle activity of the bowel, which is why constipation, sometimes severe enough to cause a blockage (ileus), is an important effect, and it can affect the nerves, causing tingling and weakness in the hands and feet.
Company & origin
Originated / developed by: Specialist manufacturers.
A specialist vinca-alkaloid chemotherapy used in the UK for advanced bladder (urothelial) cancer, given into a vein.
Practical use
How to take Vinflunine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given only by your cancer team, as an injection into a vein; it must never be given into the spine.
- Contact your cancer team urgently if you develop a high temperature or feel unwell, as this may be a serious infection.
- Take the constipation prevention you are advised, and tell your team about any tummy pain or change in bowel habit, as a blockage can develop.
- Tell the team straight away if you feel pain, burning, redness or swelling at the injection site, as the medicine can damage tissue if it leaks.
- Report numbness, tingling or weakness in your hands or feet, as these nerve effects may need the dose to be changed.
Weighing it up
Advantages & disadvantages of Vinflunine
Advantages
- A treatment option for advanced bladder cancer, often when other treatment has been tried.
- Given by an experienced cancer team with careful monitoring.
- Works by a well-understood mechanism shared with other vinca alkaloids.
Disadvantages
- Fatal if given into the spine, so strict safety checks are essential.
- A vesicant that causes severe tissue damage if it leaks out of the vein.
- Commonly causes a fall in white cells, severe constipation that can become a bowel blockage, and nerve damage.
Practical use
Good to know
As with all vinca alkaloids, the most important safety fact about vinflunine is that it must ONLY be given into a vein and NEVER into the spine, where it is fatal; specialist teams use strict checks to prevent this. It is also a vesicant, so if it leaks out of the vein it can cause serious tissue damage, and any pain, redness or swelling at the injection site should be reported immediately. Two effects deserve special attention: a marked fall in white blood cells (neutropenia), which raises the risk of serious infection, so a high temperature or feeling unwell is an emergency; and constipation, which can become severe and turn into a bowel blockage (ileus), so it is actively prevented and managed. Nerve symptoms in the hands and feet can also occur. Your cancer team monitors your blood, bowel and nerves throughout.
Who should not take it / use with caution
- It must never be given to anyone by injection into the spine, as this is fatal.
- People who have had a serious allergic reaction to vinflunine should not receive it.
- It is not used in pregnancy or breastfeeding, as it can harm a developing baby.
- It is used with great care in people whose bone marrow is already very suppressed or who have significant nerve problems.
Monitoring
- Regular full blood counts before and during treatment.
- Checking bowel habit closely to prevent and catch constipation and blockage.
- Watching for nerve symptoms and observing the injection site during the infusion.
Side effects
- A fall in white blood cells (neutropenia), raising the risk of serious infection.
- Constipation, which can become severe and develop into a bowel blockage (ileus).
- Nerve damage (peripheral neuropathy), tiredness, nausea, mouth soreness and hair loss.
- Rarely but seriously, severe tissue damage if it leaks from the vein, or serious infection, which need urgent care.
Key interactions
- Other medicines that cause constipation, such as some painkillers, add to the risk of a bowel blockage.
- Other treatments that lower blood counts, such as other chemotherapy or radiotherapy, add to its effects.
- Some medicines can affect vinflunine levels, so your team will review everything you take.
Available as: A solution given only as an injection into a vein.
Answers
Vinflunine: frequently asked questions
What is vinflunine used for?
It is a vinca-alkaloid chemotherapy used to treat advanced bladder (urothelial) cancer, usually after other treatment, by stopping cancer cells from dividing.
Why must it only be given into a vein?
Vinca alkaloids like vinflunine are fatal if given into the spine, so it must only ever be given into a vein, with strict safety checks to prevent a wrong route.
Why is constipation taken so seriously?
Vinflunine can cause severe constipation that may develop into a bowel blockage (ileus), so prevention is given and any tummy pain or change in bowel habit should be reported.
What should I do if I get a temperature?
A high temperature or feeling unwell can mean serious infection while your white cells are low; contact your cancer team urgently, day or night.
What if it leaks at the injection site?
It is a vesicant and can cause severe tissue damage if it leaks from the vein, so report any pain, redness or swelling at the site immediately.
The wider class
About Cytotoxic chemotherapy (vinca alkaloid)
Vinflunine belongs to the cytotoxic chemotherapy (vinca alkaloid) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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