SIDE EFFECTS: See also Warning section. Pain/redness at the injection site, nausea, vomiting, constipation, tiredness, and loss of appetite may occur. Nausea and vomiting can be severe. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. If these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce constipation, increase your intake of fiber, drink plenty of water, and exercise. Stool softeners may be helpful. Ask your doctor or pharmacist about stool softeners and laxatives. Temporary hair loss is another common side effect. Normal hair growth should return after treatment has ended. Many people using this medication may have serious side effects. However, your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk. Painful sores on the lips, mouth, and throat may occur. To decrease the risk, limit hot foods and drinks, brush your teeth carefully, avoid using mouthwash that contains alcohol, and rinse your mouth frequently with cool water. Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, fast/pounding heartbeat, abdominal/stomach pain, bone/jaw pain, severe headache, hearing problems, unusual lumps/skin changes, dizziness/feeling of spinning, mental/mood changes (e.g., depression), pale/bluish fingers/toes, pain/coldness in fingers/toes, numbness/tingling, difficult/painful urination, pink/bloody urine. Get medical help right away if any of these rare but very serious side effects occur: sudden shortness of breath/wheezing, black/tarry stools, chest/left arm pain, confusion, seizures, slurred speech, weakness on one side of the body, vision changes, vomit that looks like coffee grounds. This medication can lower the body's ability to fight an infection. Tell your doctor promptly if you develop any signs of an infection such as fever, chills, or persistent sore throat. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using vinblastine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: bone marrow problems (e.g., low white count/platelets from previous chemotherapy/radiation treatment, tumor in the bone marrow), untreated bacterial infection. Before using this medication, tell your doctor or pharmacist your medical history, especially: blood vessel problems (e.g., blood clots, stroke, Raynaud's disease, varicose veins), heart disease (e.g., angina, heart attack), poor nutrition, liver disease, lung problems, stomach/intestinal sores (e.g., peptic ulcer), skin sores (ulcers). Wash your hands well to prevent the spread of infections. Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose. To lower your risk of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports. This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness. Caution is advised when using this drug in the elderly, especially if they have poor nutrition or skin sores, because they may be more sensitive to the risk of infection. This medication is not recommended for use during pregnancy. It may harm the unborn baby. Consult your doctor for more details. If you become pregnant or think you may be pregnant, tell your doctor right away. It is not known whether this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: aspirin and other NSAIDs (e.g., ibuprofen), hydantoins (e.g., phenytoin), tolterodine, drugs that may harm the ears (e.g., cisplatin, carboplatin, aminoglycosides such as gentamicin). Other medications can affect the removal of vinblastine from your body, which may affect how vinblastine works. Examples include azole antifungals (such as itraconazole, voriconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), among others. Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, or aspirin) that may increase your risk of bleeding. Low-dose aspirin should be continued if prescribed by your doctor for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day). Consult your doctor or pharmacist for more details. Your doctor may direct you to limit citrus (and other foods/products that increase the acid level of urine) during treatment. Consult your doctor.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: seizures.