Indications
Vinorelbine is a chemotherapy medicine used to treat non small cell lung cancer and advanced breast cancer, either alone or combined with other cancer medicines. It may sometimes be used for other cancers as decided by a cancer specialist.
How It Works
Vinorelbine is a vinca alkaloid. It binds to tubulin, the protein that forms the internal scaffolding (microtubules) a cell needs to divide. By disrupting this, it stops cancer cells from dividing and causes them to die.
Dosage and Administration
Vinorelbine injection is given by trained doctors or nurses as a short infusion into a vein, usually over 6 to 10 minutes, followed by flushing the vein, typically once a week or on a cycle set by the cancer team. The dose is calculated from body surface area and adjusted according to blood counts and side effects. It must only be given into a vein, never into the spine, as this can be fatal. Oral capsules, where used, are taken exactly as prescribed. Dosing is as prescribed.
Interactions
- Strong CYP3A4 inhibitors such as Ketoconazole, Itraconazole and Clarithromycin may increase toxicity.
- Strong inducers such as Rifampicin, Phenytoin and Carbamazepine may reduce its effect.
- Other medicines that lower blood counts or affect nerves, such as Cisplatin or Paclitaxel, may add to side effects.
- Live vaccines, such as yellow fever vaccine, must be avoided during treatment.
Contraindications
- Allergy to Vinorelbine or other vinca alkaloids.
- Very low white cell (neutrophil) or platelet counts, or a severe current infection.
- Pregnancy and breastfeeding.
- Use with yellow fever vaccine.
Side Effects
Common side effects include low white cell count with higher infection risk, anaemia, tiredness, nausea, vomiting, constipation, hair thinning, mouth sores, numbness or tingling in the hands and feet, jaw or muscle pain, and pain, redness or vein irritation at the injection site.
Get urgent medical help if you develop fever of 38°C or more, chills or other signs of infection, severe constipation or abdominal pain, shortness of breath or chest pain, severe pain or blistering at the injection site, or signs of a severe allergic reaction.
Pregnancy and Lactation
Vinorelbine can harm an unborn baby and must not be used in pregnancy. Women and men should use effective contraception during treatment and for several months after (as advised by the cancer team). Breastfeeding must stop during treatment.
Precautions and Warnings
- Blood counts are checked before each dose.
- Leakage outside the vein can cause serious tissue damage; tell the nurse immediately if the drip site hurts or swells.
- Laxatives may be needed to prevent constipation.
- Use with care in liver disease and after radiotherapy to the liver.
- Avoid contact with the eyes; handled only by trained staff using safety precautions.
Overdose
Overdose can cause severe bone marrow suppression, infections, nerve damage and paralysis of the bowel. There is no antidote; hospital staff will give supportive care.
Therapeutic Class
Antineoplastic, vinca alkaloid.
Storage
Hospital medicine: injection vials are usually stored in a fridge at 2 to 8°C, do not freeze, protected from light, as directed on the pack and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.