Vinorelbine

Vinorelbine

Red Flag (Important Information)

• Myelosuppression is dose-limiting, especially neutropenia – check full blood count before every dose
• For intravenous use only – fatal outcomes reported with intrathecal administration
• Contraindicated in pregnancy and breastfeeding – teratogenic and embryotoxic
• Avoid live vaccines (especially yellow fever) due to risk of severe infection
• Use with caution in hepatic impairment
• Risk of severe infection and sepsis – any fever during treatment is a medical emergency
• Risk of thromboembolism and cardiac ischaemia – caution in patients with cardiovascular disease
• Extravasation risk – ensure secure IV access and monitor infusion site closely


1. Basic Information

Generic name: Vinorelbine (vinorelbine tartrate)
Drug class: Vinca alkaloid (antimitotic chemotherapy)
Formulation: Concentrate for solution for intravenous infusion
Strengths:
• 10 mg per 1 mL
• 50 mg per 5 mL

Mechanism of action:
Inhibits microtubule assembly by binding to tubulin, leading to mitotic arrest and tumour cell death.


2. Indications

Non-small cell lung cancer (NSCLC):
• Treatment of non-small cell lung cancer, used alone or in combination with other anticancer agents

Breast cancer:
• Advanced breast cancer that has not responded to other treatments
• Advanced breast cancer that has relapsed within 6 months of prior chemotherapy


3. Dosing and Administration

Route: Intravenous infusion only
Administration:
• Administered by trained healthcare professionals
• Must never be given intrathecally

Typical dose:
• 25–30 mg per square metre once weekly

Dose depends on indication, combination therapy, patient condition, and blood counts.


4. Dose Modifications

• Delay treatment in neutropenia or thrombocytopenia until recovery
• Withhold treatment in severe infection or sepsis
• Dose reduction may be required in hepatic impairment
• Discontinue if severe or persistent toxicity occurs


5. Contraindications

• Hypersensitivity to vinorelbine or other vinca alkaloids
• Pregnancy or breastfeeding
• Severe hepatic impairment
• Severe neutropenia or thrombocytopenia
• Concomitant or recent yellow fever vaccination


6. Monitoring Requirements

• Full blood count before each dose
• Monitor closely for signs of infection
• Liver function tests at baseline and periodically
• Monitor cardiac symptoms in patients with heart disease
• Observe infusion site for extravasation


7. Side Effects

Very common and common:
• Neutropenia, leukopenia, anaemia, thrombocytopenia
• Nausea, vomiting
• Constipation or diarrhoea (may be severe)
• Fatigue and weakness
• Alopecia
• Peripheral neuropathy
• Injection site reactions

Serious:
• Febrile neutropenia
• Sepsis and severe infections
• Pulmonary embolism
• Myocardial infarction, angina, heart failure
• Severe liver toxicity
• Posterior reversible encephalopathy syndrome


8. Drug Interactions

• Other myelosuppressive therapies
• CYP3A inhibitors (e.g. azole antifungals, macrolides)
• CYP3A inducers (e.g. rifampicin, phenytoin)
• Anticoagulants – monitor INR
• Live vaccines (contraindicated)


9. Use in Special Populations

• Pregnancy: Contraindicated
• Breastfeeding: Contraindicated
• Women of childbearing potential: Effective contraception required during treatment and for 7 months after
• Men: Avoid fathering a child during treatment and for 4 months after
• Elderly: No routine dose adjustment but close monitoring required
• Renal impairment: No specific dose adjustment required


10. Duration of Use and When to Stop

Continue treatment until disease progression or unacceptable toxicity.

Permanently discontinue if:
• Life-threatening infection or sepsis
• Persistent severe myelosuppression
• Serious cardiac or neurological toxicity
• Inability to safely resume treatment after dose delays

 

https://pi-pil-repository.sahpra.org.za/wp-content/uploads/2025/08/Sandoz-Vinorelbine-Final-PIL.pdf

Trade Name
Drug Class Alkylating Agents
Cost
Email
Company
Drug Rep Admin
Indications Breast Cancer, Lung Cancer
Dosage

Indications (Detailed)

Breast Cancer: HER2+ [Metastatic]
Websites:
Breast Cancer: Hormone Receptor Positive (HR+) [Metastatic]
Websites:
Breast Cancer: Triple Negative Breast Cancer (TNBC) [Metastatic]
Websites:
Lung Cancer: Non-small Cell Lung Cancer (NSCLC) [Non-metastatic]
Websites:
Lung Cancer: Non-small Cell Lung Cancer (NSCLC) [Metastatic]
Websites:
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