Generic Name: Vinorelbine (vi-nor-EL-been), vinorelbine tartrate
Trade Name: Navelbine®
How is this drug used? Vinorelbine is FDA approved for the treatment of advanced non-small cell lung cancer (NSCLC). Vinorelbine is approved for use as a single agent or in combination with the chemotherapy agent cisplatin, as initial therapy for ambulatory patients with inoperable advanced NSCLC or patients with stage IV NSCLC, and for use in combination with cisplatin for patients with stage III NSCLC. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.
What is the mechanism of action? Vinorelbine is classified as an antimicrotubule agent or vinca alkaloid. Vinorelbine produces its anti-cancer effects by causing abnormalities in microtubule formation in cells. Microtubules are components of cells that provide structural framework that enables cells to divide and grow. The abnormal microtubule formation caused by vinorelbine inhibits cellular replication and ultimately causes cell death. Vinorelbine may also interfere with DNA, RNA or protein synthesis, all of which causes cell death.
How is vinorelbine given (administered)? Vinorelbine is administered in a vein (intravenous) and the dose depends on several factors, including the condition being treated, the size of the patient, the particular treatment regimen being used, and the overall health of the patient. If patients experience redness, swelling or pain at the site that vinorelbine is being delivered, they should tell their healthcare provider immediately, as vinorelbine may cause serious damage to tissues it comes in contact with if it escapes from the vein.
How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with vinorelbine. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys and liver. Physical examinations, scans or other measures may also be used to determine side effects and response to therapy.
What are the common (occur in 30% or more of patients) side effects of treatment with vinorelbine?
• Low levels of white blood cells – increases risk of infection
• Low levels of red blood cells – increases risk of anemia
• Nausea and vomiting
• Muscle weakness
• Abnormalities in liver function
What are the less common (occur in 10% to 29% of patients) side effects of treatment with vinorelbine?
• Numbness or tingling of finger or toes
• Pain at the site of delivery
• Vein discoloration
• Loss of appetite
• Mouth sores
• Hair loss
This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.
Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?
• If pain, redness or swelling at the site of medication delivery occurs after a patient leaves the medical facility, they should place a warm compress on the site and notify a healthcare provider.
• Pay careful attention to the physician’s instructions and inform the physician of any side effects.
• Maintain adequate rest and nutrition.
• Wear sunscreen and protective clothing and try to minimize sun exposure.
• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)
• If possible, patients should avoid large crowds or persons who are sick or not feeling well, as this drug may leave some patients susceptible to infection.
• Wash hands often to reduce the risk of infection.
• For mouth sores, patients should rinse their mouth three times a day with a salt and soda solution (8 ounces of water mixed with ½ to 1 tsp baking soda and/or ½ to 1 tsp salt) and brush their teeth with a soft toothbrush to help prevent the development of mouth sores.
• Eat small meals frequently to help alleviate nausea.
Are there any special precautions patients should be aware of before starting chemotherapy?
• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.
• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.
• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
• Patients should check with their physician before starting any new drug or nutritional supplement.
• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.
• Patients should use caution when driving or completing tasks that require mental alertness until effects of the drug are known, as they may experience weakness or fatigue.
When should patients notify their physician?
• Prolonged nausea or vomiting
• Prolonged or severe diarrhea
• Abdominal pain
• Mouth sores
• Unusual bleeding, such as nosebleeds or bruising
• Blood in urine, or black, tarry stools, bruising, unusual bleeding
• Signs of infection – redness, swelling, cough, sore throat,pain or urgency to urinate
• Blistering or persistent pain, redness or swelling at the site of drug administration
• Numbness, tingling or pain in fingers or toes
• Loss of balance or unsteadiness
• Unusual tiredness of weakness
• Skeletal pain
• Muscle pain, joint pain, jaw pain
• Skin rash or itching
• Difficulty breathing, shortness of breath
• Yellowing of skin or eyes
What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. Click here to view the package insert for vinorelbine.Click here to view the package insert
Copyright © 2005 Cancer Consultants Last updated 01/05.
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