Drug Action
Vinorelbine is a semi-synthetic vinca alkaloid.
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Drug reference
Vinorelbine is a semi-synthetic vinca alkaloid.
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Advanced breast cancer | Advanced non-small cell lung cancer ▶BY MOUTH ▶Adult: 60 mg/m2 once weekly for 3 weeks, then increased if tolerated to 80 mg/m2 once weekly (max. per dose 160 mg once weekly) ▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: (consult product literature)
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GENERAL CONTRA-INDICATIONS Concurrent radiotherapy if treating the liver SPECIFIC CONTRA-INDICATIONS ▶With oral use Long-term oxygen therapy. previous significant surgical resection of small bowel. previous significant surgical resection of stomach CONTRA-INDICATIONS, FURTHER INFORMATION Intrathecal injection contra-indicated.
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Caution in handling—irritant to tissues. ischaemic heart disease
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Vinorelbine injections are for intravenous administration only. Inadvertent intrathecal administration can cause severe neurotoxicity, which is usually fatal. The National Patient Safety Agency has advised (August 2008) that adult and teenage patients treated in an adult or adolescent unit should receive their vinca alkaloid dose in a 50 mL minibag. Teenagers and children treated in a child unit may receive their vinca alkaloid dose in a syringe. RISKS OF INCORRECT DOSING OF ORAL ANTI-CANCER MEDICINES See Cytotoxic drugs p. 938.
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→Appendix 1: vinca alkaloids
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GENERAL SIDE-EFFECTS ▶Common or very common Alopecia. anaemia. appetite Immune system and malignant disease decreased. arthralgia. bone marrow depression (dose- limiting). constipation. diarrhoea. dyspnoea. fever. hypertension. hypotension. increased risk of infection. leucopenia. myalgia. nausea. neutropenia (dose-limiting) . pain. reflexes absent. stomatitis. thrombocytopenia. vomiting ▶Uncommon Flushing. peripheral coldness. respiratory disorders. sepsis ▶Rare or very rare Circulatory collapse. hyponatraemia. myocardial infarction. pancreatitis ▶Frequency not known SIADH SPECIFIC SIDE-EFFECTS ▶Common or very common ▶With intravenous use Asthenia. cancer pain. chest pain. muscle weakness in legs. nervous system disorder. vein discolouration ▶With oral use Abdominal pain. chills. cough. dizziness. dysphagia. dysuria. fatigue. gastrointestinal disorders. headache. insomnia. liver disorder. neuromuscular disorders. sensory disorder. skin eruption. taste altered. urogenital disorder. vision disorder. weight changes ▶Uncommon ▶With intravenous use Paraesthesia ▶With oral use Ataxia ▶Rare or very rare ▶With intravenous use Arrhythmias. ischaemic heart disease. necrosis. palpitations. paralytic ileus. skin reactions ▶Frequency not known ▶With intravenous use Febrile neutropenia ▶With oral use Gastrointestinal haemorrhage. hypersensitivity SIDE-EFFECTS, FURTHER INFORMATION Bronchospasm Severe bronchospasm following administration of the vinca alkaloids is more common when used in combination with mitomycin-C. Neurotoxicity Neurotoxicity reported in clinical trials, most commonly as constipation, paresthesia, hypersthesia, and hyporeflexia.
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Manufacturer advises effective contraception during and for 3 months after treatment; men must avoid fathering a child during and for at least 3 months after treatment.
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Avoid unless essential (teratogenicity, and fetal loss in animal studies). See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Discontinue breast-feeding.
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▶With oral use Manufacturer advises caution in moderate impairment; avoid in severe impairment (no information available). ▶With intravenous use Manufacturer advises caution in severe impairment. Dose adjustments ▶With oral use Manufacturer advises dose reduction in moderate impairment—consult product literature. ▶With intravenous use Manufacturer advises dose reduction in severe impairment.
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There can be variation in the licensing of different medicines containing the same drug. Solution for infusion ▶Vinorelbine (Non-proprietary) Vinorelbine (as Vinorelbine tartrate) 10 mg per 1 ml Vinorelbine 50mg/5ml concentrate for solution for infusion vials | 1 vial P £139.00 (Hospital only) | 1 vial P £139.00 | 10 vial P £1,539.80 Vinorelbine 10mg/1ml concentrate for solution for infusion vials | 1 vial P £29.00 (Hospital only) | 1 vial P £29.00 | 10 vial P £329.50 ▶Navelbine (Pierre Fabre Ltd) Vinorelbine (as Vinorelbine tartrate) 10 mg per 1 ml Navelbine 10mg/1ml concentrate for solution for infusion vials | 10 vial P £297.45 (Hospital only) Navelbine 50mg/5ml concentrate for solution for infusion vials | 10 vial P £1,399.79 (Hospital only) Capsule CAUTIONARY AND ADVISORY LABELS 21, 25 ▶Vinorelbine (Non-proprietary) Vinorelbine (as Vinorelbine tartrate) 20 mg Vinorelbine 20mg capsules | 1 capsule P £43.98 (Hospital only) Vinorelbine (as Vinorelbine tartrate) 30 mg Vinorelbine 30mg capsules | 1 capsule P £65.98 (Hospital only) Vinorelbine (as Vinorelbine tartrate) 80 mg Vinorelbine 80mg capsules | 1 capsule P £175.92 (Hospital only) ▶Navelbine (Pierre Fabre Ltd) Vinorelbine (as Vinorelbine tartrate) 20 mg Navelbine 20mg capsules | 1 capsule P £43.98 (Hospital only) Vinorelbine (as Vinorelbine tartrate) 30 mg Navelbine 30mg capsules | 1 capsule P £65.98 (Hospital only) Vinorelbine (as Vinorelbine tartrate) 80 mg Navelbine 80mg capsules | 1 capsule P £175.92 (Hospital only) ANTINEOPLASTIC DRUGS › OTHER
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60 mg/m2 once weekly for 3 weeks, then
First-line fragment. Read the complete Indications and Dose section above.
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(consult product literature)
First-line fragment. Read the complete Indications and Dose section above.
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