Minor/Significance Unknown. Minor/Significance Unknown. 2001 Dec;18(12):1660-8. [, Ekins S, Kim RB, Leake BF, Dantzig AH, Schuetz EG, Lan LB, Yasuda K, Shepard RL, Winter MA, Schuetz JD, Wikel JH, Wrighton SA: Application of three-dimensional quantitative structure-activity relationships of P-glycoprotein inhibitors and substrates. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC. apalutamide will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. It is the salt of an alkaloid extracted from Vinca rosea Linn., a common owering herb known as the periwinkle (more properly known as Catharanthus roseus G. Don). This medication should not be mixed in a large amount of solution and/or injected over a long time (such as 30 to 60 minutes) unless directed by your doctor. Before using vinblastine, make sure your doctor knows if you have liver disease, severe sores on your skin, or lung disease or other breathing problems. Use Caution/Monitor. [, Jordan A, Hadfield JA, Lawrence NJ, McGown AT: Tubulin as a target for anticancer drugs: agents which interact with the mitotic spindle. Tecovirimat is a weak CYP3A4 inducer. [, Kumar S, Kwei GY, Poon GK, Iliff SA, Wang Y, Chen Q, Franklin RB, Didolkar V, Wang RW, Yamazaki M, Chiu SH, Lin JH, Pearson PG, Baillie TA: Pharmacokinetics and interactions of a novel antagonist of chemokine receptor 5 (CCR5) with ritonavir in rats and monkeys: role of CYP3A and P-glycoprotein. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. commonly, these are generic drugs. Monitor Closely (2)vinblastine will decrease the level or effect of duvelisib by P-glycoprotein (MDR1) efflux transporter. Concomitant therapy is expected to increase the risk of immunosuppression. anastrozole will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)lovastatin will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown. The first look at the 'middle aged Love Island' set has been released, which has already been nicknamed the 'Viagra House' by locals after single parents searched for love maitake increases effects of vinblastine by pharmacodynamic synergism. verapamil will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. deferiprone, vinblastine. Minor/Significance Unknown. Monitor Closely (2)ketoconazole will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Otherwise, call a poison control center right away. Vinblastine is cell cycle phase specific; it binds to microtubular proteins in the mitotic spindle, thereby preventing cell division during metaphase. nifedipine will decrease the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. It works by slowing or stopping the growth of cancer cells. Serious - Use Alternative (1)vinblastine, tofacitinib. [, Chen C, Mireles RJ, Campbell SD, Lin J, Mills JB, Xu JJ, Smolarek TA: Differential interaction of 3-hydroxy-3-methylglutaryl-coa reductase inhibitors with ABCB1, ABCC2, and OATP1B1. Minor/Significance Unknown. Minor/Significance Unknown. tipranavir will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 2003 Sep;285(3):C584-91. Monitor Closely (1)vinblastine will decrease the level or effect of linagliptin by P-glycoprotein (MDR1) efflux transporter. Monitor Closely (2)vinblastine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 2005 Oct 7;335(4):1179-84. amobarbital will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. nelfinavir will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. Use Caution/Monitor. 1998 Jul;18(4):259-96. tazemetostat will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Minor/Significance Unknown. Manage and view all your plans together even plans in different states. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown. Minor/Significance Unknown. Biochem Biophys Res Commun. Use Caution/Monitor. Minor/Significance Unknown. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. duvelisib will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. trastuzumab, vinblastine. Minor/Significance Unknown. Use Caution/Monitor. d) Fibromatosis can also be treated with help of this drug. Tecovirimat is a weak CYP3A4 inducer. Avoid or Use Alternate Drug. Minor/Significance Unknown. [, Troutman MD, Thakker DR: Novel experimental parameters to quantify the modulation of absorptive and secretory transport of compounds by P-glycoprotein in cell culture models of intestinal epithelium. tucatinib will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration. Use Caution/Monitor. Use Caution/Monitor. rufinamide will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consult your pharmacist or local waste disposal company. trazodone will decrease the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. atorvastatin will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Pharm Res. Serious Side Effects. Information last revised May 2023. Use Caution/Monitor. Avoid or Use Alternate Drug. MISSED DOSE: It is important to get each dose of this medication as scheduled. Coadministration may lead to significant hematologic or gastrointestinal side effects. belatacept and vinblastine both increase immunosuppressive effects; risk of infection. vinblastine decreases levels of phenytoin by increasing metabolism. This drug is available at a middle level co-pay. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. Most nevirapine will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Use Caution/Monitor.erythromycin base will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Monitor Closely (1)vinblastine and olaparib both increase pharmacodynamic synergism. Minor/Significance Unknown. The antitumor activity of vinblastine is thought to be due primarily to inhibition of mitosis at metaphase through its interaction with tubulin. Normal hair growth should return after treatment has ended.Many people using this medication may have serious side effects. Napumpujte ho antioxidantmi a vitamnmi! c) It is used for the treatment of Kaposi's sarcoma. Comment: Combination may increase risk of myelosuppression. itraconazole will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Maitake mushroom has anti-tumor effects (animal/in vitro research). Use of alternative treatments is strongly recommended when linagliptin is to be administered with a P-gp inducer. Sofosbuvir and velpatasvir are substrates of the drug transporter P-gp. erythromycin base will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. These CBD candies offer a simple and flexible . 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. Serious - Use Alternative (1)enzalutamide will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. clotrimazole will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. The serum concentration of Vinblastine can be increased when it is combined with Abrocitinib. Avoid tanning booths and sunlamps. Use Caution/Monitor. Coadministration may increase risk for adverse effects of CYP3A4 substrates. Common side effects of Vinblastine include: pain or redness at the injection site, nausea, Consider temporarily withholding antiretroviral regimen in patients who develop significant hematologic or gastrointestinal side effects. Monitor Closely (1)loratadine will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. cyclosporine will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. rifabutin will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. fedratinib will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor (1)artemether/lumefantrine will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Ask your pharmacist which type of laxative is right for you.Temporary hair loss is another common side effect. Maitake mushroom has anti-tumor effects (animal/in vitro research). vinblastine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. erythromycin ethylsuccinate will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Use Caution/Monitor.vinblastine will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vinblastine, a vinca alkaloid, is an antimitotic drug that inhibits the polymerization of microtubules and thus prevents vesicular transport (Larsson et al., 1979). vitamin E, vinblastine. Queens of the Stone Age will bring Phantogram, Viagra Boys, the Armed, and Savages' Jehnny Beth on their fall North American tour. and formulary information changes. Use Caution/Monitor. Consider increasing CYP3A substrate dose if needed. Minor/Significance Unknown. Use Caution/Monitor. If not feasible, avoid use of abametapir. Other (see comment). ofatumumab SC, vinblastine. Coadministration of letermovir with P-gp inducers is not recommended. Avoid or Use Alternate Drug. Serious - Use Alternative (1)chloramphenicol will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor Closely (2)levoketoconazole will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Monitor Closely (1)sarecycline will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Adjust dose of drugs that are CYP3A4 substrates as necessary. 1999 Apr;437(5):652-60. Build, train, & validate predictive machine-learning models with structured datasets. Monitor Closely (1)eliglustat increases levels of vinblastine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor CYP3A substrates if coadministered. Use Caution/Monitor. Avoid contact with people who have recently received live vaccines (such as 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. [, Pouliot JF, L'Heureux F, Liu Z, Prichard RK, Georges E: Reversal of P-glycoprotein-associated multidrug resistance by ivermectin. Minor/Significance Unknown. [, Bedford laboratories div ben venue laboratories inc, Jordan MA, Kamath K: How do microtubule-targeted drugs work? Common side effects of vinblastine include hair loss, nausea, vomiting, constipation, and diarrhea. Monitor Closely (2)clarithromycin will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. If the medication starts to leak into tissue, the injection should be stopped and the remaining solution should be given into a different vein.The dosage is based on your medical condition, body size, and response to treatment. Monitor Closely (1)ceritinib will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Prostate. If you believe you are experiencing an interaction, contact a healthcare provider immediately. Use Caution/Monitor. Epub 2009 Jul 21. Use Caution/Monitor. 2002 May;35(3):90-5. Use Caution/Monitor. Serious - Use Alternative (1)vinblastine will decrease the level or effect of letermovir by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling. prednisone will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. a) It is used for the treatment of some blood disorders like histiocytosis. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. 2005 Apr;33(4):537-46. Minor (1)butabarbital will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Minor/Significance Unknown. Avoid or Use Alternate Drug. CYP3A4 substrates may require dosage adjustment. Avoid or Use Alternate Drug. Use Caution/Monitor. Use Caution/Monitor. Minor/Significance Unknown. Controlled studies in pregnant women show no evidence of fetal risk. Applies only to oral form of both agents. Use Caution/Monitor. prescription products. Most saquinavir will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (2)erythromycin lactobionate will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. US residents can call their local poison control center at 1-800-222-1222. Minor/Significance Unknown. Use Caution/Monitor.Minor (1)phenobarbital will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider increasing CYP3A substrate dose if needed. Monitor Closely (1)vinblastine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vinblastine is often used in combination with other cancer drugs. Minor (1)cyclophosphamide will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. fluconazole will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Eur J Pharm Sci. InChI=1S/C46H58N4O9/c1-8-42(54)23-28-24-45(40(52)57-6,36-30(15-19-49(25-28)26-42)29-13-10-11-14-33(29)47-36)32-21-31-34(22-35(32)56-5)48(4)38-44(31)17-20-50-18-12-16-43(9-2,37(44)50)39(59-27(3)51)46(38,55)41(53)58-7/h10-14,16,21-22,28,37-39,47,54-55H,8-9,15,17-20,23-26H2,1-7H3/t28-,37-,38+,39+,42-,43+,44+,45-,46-/m0/s1, methyl (1R,9R,10S,11R,12R,19R)-11-(acetyloxy)-12-ethyl-4-[(13S,15R,17S)-17-ethyl-17-hydroxy-13-(methoxycarbonyl)-1,11-diazatetracyclo[13.3.1.0^{4,12}.0^{5,10}]nonadeca-4(12),5(10),6,8-tetraen-13-yl]-10-hydroxy-5-methoxy-8-methyl-8,16-diazapentacyclo[10.6.1.0^{1,9}.0^{2,7}.0^{16,19}]nonadeca-2,4,6,13-tetraene-10-carboxylate, [H][C@@]12N(C)C3=CC(OC)=C(C=C3[C@@]11CCN3CC=C[C@@](CC)([C@@H](OC(C)=O)[C@]2(O)C(=O)OC)[C@@]13[H])[C@]1(C[C@@]2([H])CN(C[C@](O)(CC)C2)CCC2=C1NC1=C2C=CC=C1)C(=O)OC, Use our structured and evidence-based datasets to. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. This document does not contain all possible drug interactions. Use Caution/Monitor. Avoid or Use Alternate Drug. [, Yamazaki M, Neway WE, Ohe T, Chen I, Rowe JF, Hochman JH, Chiba M, Lin JH: In vitro substrate identification studies for p-glycoprotein-mediated transport: species difference and predictability of in vivo results. ivacaftor increases levels of vinblastine by P-glycoprotein (MDR1) efflux transporter. Npoje s vysokm obsahom antioxidantov, ako s vitamny C a E, preukzatene zlepuj erektiln funkciu tm, e brnia pokodeniu buniek, produkujcich oxid dusnat," hovor Pearlmanov. Minor/Significance Unknown. For treatment of breast cancer, testicular cancer, lymphomas, neuroblastoma, Hodgkin's and non-Hodgkin's lymphomas, mycosis fungoides, histiocytosis, and Kaposi's sarcoma. 2001 Nov 30;289(2):580-5. Use Caution/Monitor. Modify Therapy/Monitor Closely. Use Caution/Monitor. Minor/Significance Unknown. Minor/Significance Unknown. Biochem Pharmacol. Use Caution/Monitor. Monitor Closely (1)rucaparib will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)berotralstat will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Elagolix is a weak-to-moderate CYP3A4 inducer. Use Caution/Monitor. increased risk of neurotoxicity, development of SIADH and other adverse effects. 1991 Nov;52(2):127-47. DESCRIPTION. vinblastine decreases levels of phenytoin by inhibition of GI absorption. Use Caution/Monitor. vinblastine will decrease the level or effect of letermovir by P-glycoprotein (MDR1) efflux transporter. lonafarnib will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Serious - Use Alternative (1)sotorasib will decrease the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. 2010 Nov;44(11):1709-17. doi: 10.1345/aph.1P354. Cancer Chemother Pharmacol. vinblastine will decrease the level or effect of phenytoin by P-glycoprotein (MDR1) efflux transporter. itraconazole will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Breast Cancer Res Treat. Stiripentol is a CYP3A4 inhibitor and inducer. Epub 2009 Jan 4. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. [, Lecureur V, Sun D, Hargrove P, Schuetz EG, Kim RB, Lan LB, Schuetz JD: Cloning and expression of murine sister of P-glycoprotein reveals a more discriminating transporter than MDR1/P-glycoprotein. Serious - Use Alternative (1)vinblastine decreases effects of influenza virus vaccine quadrivalent, adjuvanted by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. indinavir will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The vinca alkaloids (vincristine, vinblastine, vindesine, vinorelbine) are derivatives of the pink periwinkle plant. ketoconazole will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Applies only to oral form of both agents. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Un programa que dej de tener gracia cuando se. View the formulary and any restrictions for each plan. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects. [, Le Guellec C, Lacarelle B, Catalin J, Durand A: Inhibitory effects of anticancer drugs on dextromethorphan-O-demethylase activity in human liver microsomes. Use Caution/Monitor. Use Caution/Monitor. Minor (1)quinupristin/dalfopristin will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If unavoidable, reduce CYP3A substrate dose according to product labeling. Minor/Significance Unknown. Monitor for hematologic or GI adverse effects that may be associated with increased systemic exposure to vinblastine. Avoid or Use Alternate Drug. [, Jutabha P, Wempe MF, Anzai N, Otomo J, Kadota T, Endou H: Xenopus laevis oocytes expressing human P-glycoprotein: probing trans- and cis-inhibitory effects on [3H]vinblastine and [3H]digoxin efflux. Drug created at June 13, 2005 13:24 / Updated at June 08, 2023 10:19, Structured drug data for data science & ML, Clinical intelligence tool for your software, Search for drug interactions with our API, Get drug allergy and cross sensitivities info. Consider temporarily withholding antiretroviral regimen in patients who develop significant hematologic or gastrointestinal side effects. Rupard, in Encyclopedia of Respiratory Medicine, 2006 Overview. Antioxidants such as vitamin A enhance the efficacy, and reduce toxicity, of antineoplastic drugs. lapatinib will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Please confirm that you would like to log out of Medscape. Minor/Significance Unknown. Avoid coadministration, particularly for P-gp inducers that are also CYP3A4 inducers; nintedanib is a substrate of P-gp and to a less extent CYP3A4. Use Caution/Monitor. Serious - Use Alternative (1)vinblastine decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. etravirine will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Minor/Significance Unknown. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Adjust dosage of CYP3A4 substrates, if clinically indicated. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC. Minor/Significance Unknown. Use caution when switching patients from long-acting therapies with immune effects. Monitor Closely (1)nefazodone will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. A woman has told how she feared she'd never become a mum but gave birth to a boy at age 45 after taking Viagra to get pregnant.. Carin Rockind, 48, welcomed a "miracle" baby after trying to have a . Monitor Closely (1)nilotinib will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. 2004 Mar 19;315(4):942-9. Use Caution/Monitor. Phenytoin may be less likely to interact with vinblastine. Use Caution/Monitor. vinblastine decreases levels of nintedanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Vinblastine is a vinca alkaloid used to treat breast cancer, testicular cancer, neuroblastoma, Hodgkin's and non-Hodgkins lymphoma, mycosis fungoides, histiocytosis, and Kaposi's sarcoma. [, Duan L, Sterba K, Kolomeichuk S, Kim H, Brown PH, Chambers TC: Inducible overexpression of c-Jun in MCF7 cells causes resistance to vinblastine via inhibition of drug-induced apoptosis and senescence at a step subsequent to mitotic arrest. Elagolix is a weak-to-moderate CYP3A4 inducer. Use Caution/Monitor.vinblastine will decrease the level or effect of phenytoin by P-glycoprotein (MDR1) efflux transporter. Monitor Closely (1)cobicistat will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vinblastine administered intralesionally has been used for the treatment of Kaposi's sarcoma (KS). Modify Therapy/Monitor Closely. increased risk of neurotoxicity, development of SIADH and other adverse effects. Exercise caution with St. John's Wort. 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 (such as ibuprofen), hydantoins (such as phenytoin), tolterodine, drugs that may harm the ears (for example, cisplatin, carboplatin, aminoglycosides such as gentamicin).Other medications can affect the removal of vinblastine from your body, which may affect how vinblastine works. Use Caution/Monitor.vinblastine decreases levels of ethotoin by increasing metabolism. Use Caution/Monitor. Monitor Closely (1)cyclosporine will increase the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Vinblastine Sulfate Side Effects. vinblastine decreases levels of fosphenytoin by increasing metabolism. Modify Therapy/Monitor Closely. 2003 Apr 24;46(9):1716-25. Drug Metab Dispos. Use Caution/Monitor. 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