Vinorelbine

Vinorelbine Brand Name

Navelbine

What is Vinorelbine

Vinorelbine is a semi-synthetic vinca alkaloid derived from the Catharanthus roseus or Madagascar periwinkle plant.

It acts as a microtubule inhibitor, causing cellular instability and preventing mitosis at metaphase.

Microtubules are responsible for intracellular transport, maintenance of cell shape, polarity, cell signaling, and mitosis. During mitosis, microtubules form the mitotic spindle that transports daughter chromosomes to separate poles of the dividing cell.

Vinorelbine is more potent and less neurotoxic than vinblastine and vincristine.

Vinorelbine is indicated for the treatment of non-small cell lung cancer (NSCLC) as monotherapy and in combination with cisplatin. The primary dose-limiting toxicity is neutropenia.

Monitor complete blood counts prior to each dose; an adjustment to the dose of vinorelbine may be necessary for neutropenia. Vinorelbine is also a vesicant; monitor closely for signs of extravasation.

Indications

  1. breast cancer
  2. desmoid tumor
  3. head and neck cancer
  4. Hodgkin lymphoma
  5. non-small cell lung cancer (NSCLC)
  6. ovarian cancer

Side Effects

  1. abdominal pain
  2. acute respiratory distress syndrome (ARDS)
  3. alopecia
  4. alopecia
  5. anaphylactoid reactions
  6. anemia
  7. anemia
  8. angioedema
  9. anorexia
  10. arthralgia
  11. asthenia
  12. asthenia
  13. back pain
  14. bone marrow suppression
  15. bronchospasm
  16. chest pain (unspecified)
  17. constipation
  18. constipation
  19. diarrhea
  20. diarrhea
  21. dysgeusia
  22. dysphagia
  23. dyspnea
  24. dyspnea
  25. elevated hepatic enzymes
  26. elevated hepatic enzymes
  27. erythema
  28. esophagitis
  29. fatigue
  30. fever
  31. flushing
  32. GI obstruction
  33. GI perforation
  34. headache
  35. hearing loss
  36. hemorrhagic cystitis
  37. hyperbilirubinemia
  38. hyperbilirubinemia
  39. hyperesthesia
  40. hypertension
  41. hyponatremia
  42. hyporeflexia
  43. hypotension
  44. ileus
  45. infection
  46. injection site reaction
  47. injection site reaction
  48. lethargy
  49. leukopenia
  50. leukopenia
  51. malaise
  52. myalgia
  53. myasthenia
  54. myocardial infarction
  55. nausea
  56. nausea
  57. neurotoxicity
  58. neurotoxicity
  59. neutropenia
  60. neutropenia
  61. ototoxicity
  62. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  63. pancreatitis
  64. paresthesias
  65. peripheral neuropathy
  66. peripheral neuropathy
  67. peripheral vasodilation
  68. phlebitis
  69. phlebitis
  70. pneumonitis
  71. pruritus
  72. pulmonary edema
  73. pulmonary embolism
  74. pulmonary toxicity
  75. radiation recall reaction
  76. rash
  77. SIADH
  78. sinus tachycardia
  79. thrombocytopenia
  80. thrombocytopenia
  81. thrombosis
  82. tissue necrosis
  83. urticaria
  84. vomiting
  85. vomiting
  86. weakness
  87. weakness
  88. weight loss

Monitoring Parameters

  • CBC with differential
  • LFTs
  • pregnancy testing

Contraindications

  • anemia
  • autonomic neuropathy
  • bone marrow suppression
  • breast-feeding
  • children
  • constipation
  • contraception requirements
  • extravasation
  • GI obstruction
  • GI perforation
  • hepatic disease
  • ileus
  • infants
  • infection
  • infertility
  • intrathecal administration
  • male-mediated teratogenicity
  • neurotoxicity
  • neutropenia
  • ocular exposure
  • peripheral neuropathy
  • pneumonitis
  • pregnancy
  • pregnancy testing
  • pulmonary disease
  • pulmonary toxicity
  • reproductive risk
  • thrombocytopenia

Interactions

  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Alpha interferons
  • Amiodarone
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anticoagulants
  • Antithrombin III
  • Apixaban
  • Argatroban
  • Atazanavir
  • Atazanavir; Cobicistat
  • Betrixaban
  • Bicalutamide
  • Bivalirudin
  • Ceritinib
  • Chloramphenicol
  • Cimetidine
  • Ciprofloxacin
  • Clarithromycin
  • Clozapine
  • Cobicistat
  • Conivaptan
  • Crizotinib
  • Cyclosporine
  • Dabigatran
  • Dalfopristin; Quinupristin
  • Dalteparin
  • Danaparoid
  • Danazol
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desirudin
  • Diltiazem
  • Dronedarone
  • Duvelisib
  • Echinacea
  • Edoxaban
  • Elbasvir; Grazoprevir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enoxaparin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Everolimus
  • Febuxostat
  • Fedratinib
  • Filgrastim, G-CSF
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluvoxamine
  • Fondaparinux
  • Fosamprenavir
  • Fostamatinib
  • Gadobenate Dimeglumine
  • Ganciclovir
  • grapefruit juice
  • Heparin
  • Idelalisib
  • Imatinib
  • Indinavir
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Interferon Alfa-n3
  • Interferon Alfacon-1
  • Isavuconazonium
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Istradefylline
  • Itraconazole
  • Ketoconazole
  • Lapatinib
  • Larotrectinib
  • Lefamulin
  • Lepirudin
  • Letermovir
  • Live Vaccines
  • Lopinavir; Ritonavir
  • Mifepristone
  • Mitomycin
  • Nefazodone
  • Nelfinavir
  • Netupitant, Fosnetupitant; Palonosetron
  • Nicardipine
  • Nilotinib
  • Ombitasvir; Paritaprevir; Ritonavir
  • Palbociclib
  • Palifermin
  • Pazopanib
  • Pegfilgrastim
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Penicillamine
  • Pentosan
  • Perindopril; Amlodipine
  • Posaconazole
  • Quinine
  • Ranolazine
  • Ribociclib
  • Ribociclib; Letrozole
  • Ritonavir
  • Rivaroxaban
  • Rucaparib
  • Saquinavir
  • Selpercatinib
  • Simeprevir
  • Streptogramins
  • Tbo-Filgrastim
  • Telithromycin
  • Ticagrelor
  • Tinzaparin
  • Tipranavir
  • Trandolapril; Verapamil
  • Tuberculin Purified Protein Derivative, PPD
  • Tucatinib
  • Valganciclovir
  • Verapamil
  • Voriconazole
  • Warfarin
  • Zafirlukast
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