Vinorelbine
Cytostatic · Vinca alkaloid
Indications
As a single agent or in combination therapy for first line treatment of stage 3 or 4 non-small cell lung cancer. Treatment of stage 3 or 4 advanced breast cancer relapsing or refractory to anthracycline containing regimens.
Dosage
Adults & Elderly: Refer to individual protocols. IV: Single-agent therapy: 30 mg/m² every 7 day. Combination therapy with Cisplatin: 25 mg/m² every 7 day (with cisplatin 100 mg/m² every 4 wk); Alternatively: 30 mg/m² in combination with cisplatin 120 mg/m² on days 1 & 29, then every 6 wk. Children: Not recommended.
Administration
IV: Administer as a direct IVP or IV rapid bolus, over 6-10 min (up to 30 min). Longer infusions may increase the risk of pain and phlebitis. IV doses should be followed by 150-250 mL of NS or D5W to reduce the incidence of phlebitis and inflammation. Central line only for IVP bolus administration. Reconstitution: Dilute in 10-50 mL D5W or NS. Compatibility: Stable in D5½NS, D5W, LR, ½NS. Stability: Store unopened vials under refrigeration at 2°C-8°C (36°F-46°F) in the carton. Protect from light. Do not freeze. Unopened vials are stable at temperatures up to 25°C (77°F) for up to 72 hours. Product should not be frozen. Diluted vinorelbine may be used for up to 24 hours under normal room light when stored in polypropylene syringes or PVC bags at 5°C-30°C (41°F-86°F).
Adverse Effects
Neutropenia, anaemia, thrombocytopenia, GI upsets, elevated LFTs, insomnia, dyspnoea, weight loss, alopecia, fatigue, fever, infections, blood dyscrasias, neurological disorders, visual disorders, altered blood pressure, cough, dysuria and other genitourinary disorders, wt changes. Inj site reactions, myalgia, arthralgia, asthenia, malaise, chills.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Myelosuppression. Neutrophil count <1500/mm3 or severe infection current or recent (within 2 weeks), platelet count <100000/mm3. Radiotherapy that includes the liver. Precautions: Hepatic impairment, ischaemic heart disease, history of constipation, monitor haematology, poor performance status. Risk of irreversible infertility in men.
Interactions
Yellow fever vaccine, live vaccines, cisplatin, mitomycin C, anticoagulants, opiate analgesics, lapatinib, cyclosporin, tacrolimus, inhibitors or inducers of CYP3A4 or P-gp.
Advice to Patient
Take oral form after meals. Do not chew or suck. Swallow whole. Report immediately redness/swelling/pain/burning at infusion site. Contact prescriber if there is fever, chills, sore throat, burning on urination, fatigue, muscle pain/weakness, jaw pain/weakness, numbness or tingling in toes or fingers, unusual bruising or bleeding, dark coloured stool, blood in stool/urine/mouth, difficulty in breathing, skin rash, skin itching, unrelieved mouth sores. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Take small, frequent meals to maintain good nutritional status. Avoid highly crowded places to prevent infection. Do not get vaccinated without consulting prescriber. Avoid direct sunlight, wear sunscreen, proper eyewear and protective clothing to prevent photosensitivity. Using soft toothbrush, cotton swabs, waxed dental…
Pharmacokinetics
Metabolism: Extensively hepatic. Half-life elimination: Triphasic: Children and adolescents 2 to 17 years: Terminal: 16.6 ± 9.7 hours. Adults: Terminal: 28 to 44 hours. Excretion: Feces (46%); urine 18%, 10 to 20% (as unchanged drug).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.