Care During Chemotherapy and Beyond
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Trade name: Navelbine®
Chemocare.com uses generic names in all descriptions of drugs. Navelbine is the
trade name for vinorelbine. vinorelbine tartrate is another name for vinorelbine.
In some cases, health care professionals may use the trade name navelbine or other
names vinorelbine tartrate when referring to the generic drug name vinorelbine.
Other name: Vinorelbine tartrate
Drug type: Vinorelbine is an anti-cancer ("antineoplastic"
or "cytotoxic") chemotherapy drug. This medication is classified as a "plant
alkaloid." (For more detail, see "How this drug works" section below).
What Vinorelbine Is Used For:
- Non-small cell lung cancer
- Some healthcare providers may also give this drug for breast cancer, ovarian cancer,
or Hodgkin's disease.
Note: If a drug has been approved for one use, physicians sometimes
elect to use this same drug for other problems if they believe it might be helpful.
How Vinorelbine Is Given:
- Vinorelbine is given through a vein by intravenous injection (IV push) or infusion
(IV). There is no pill form.
- Vinorelbine is a vesicant. A vesicant is a chemical that causes extensive
tissue damage and blistering if it escapes from the vein. The nurse or doctor
who gives this drug must be carefully trained. If you notice pain, redness
or swelling at the IV site while you are receiving vinorelbine tartrate, alert your
health care professional immediately.
- The amount of vinorelbine you will receive depends on many factors, including your
height and weight, your general health or other health problems, and the type of
cancer being treated. Your doctor will determine your dose and schedule.
Along with its needed effects, this medicine may cause some unwanted side effects.
Important things to remember about the side effects of vinorelbine include:
- Most people do not experience all of the side effects listed
- Side effects are often predictable in terms of their onset and duration
- Side effects are almost always reversible and will go away after treatment is complete
- There are many options to help minimize or prevent side effects
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication.
The following side effects are common (occurring in greater than 30%) for
patients taking Vinorelbine:
- Low blood counts. Your white and red blood cells may temporarily decrease.
This can put you at increased risk for infection or anemia.
Nadir: Meaning low point, nadir is the point in time between chemotherapy
cycles in which you experience low blood counts.
Onset: 4-7 days
Nadir: 7-10 days
Recovery: 14-21 days
- Nausea or vomiting
- Muscle weakness
The following are less common side effects (occurring in 10-29%) for
patients receiving vinorelbine:
- Pain along the site where the medication was given
- Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated
doses. This should be reported to your healthcare provider.
- Hair loss
- Low platelet (these help to clot the blood) counts. This can put you at increased
risk for bleeding.
Not all side effects are listed above, some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your
health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you
should experience any of the following symptoms:
- Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
The following symptoms require medical attention, but are not emergency situations.
Contact your health care provider within 24 hours of noticing any of the
- Nausea (interferes with ability to eat and unrelieved with prescribed medications)
- Vomiting (vomiting more than 4-5 times in a 24-hour period)
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools or urine
- Diarrhea (4-6 episodes in a 24-hour period)
- Lip or mouth sores
Always inform your health care provider if you experience any unusual symptoms.
- Before starting vinorelbine treatment, make sure you tell your doctor, as well as
all healthcare providers, about any other medications you are taking (including
over-the-counter, vitamins, or herbal remedies). Do not take aspirin or products
containing aspirin unless your healthcare provider permits this.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (vinorelbine may be hazardous to
the fetus. Women who are pregnant or become pregnant must be advised of the
potential hazard to the fetus).
- For both men and women: Do not conceive a child (get pregnant) while taking vinorelbine.
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast feed while taking this medication.
- Apply warm compress if you have any pain, redness or swelling at the IV site, and
notify your doctor.
- Keep your bowels moving. Your health care provider may prescribe a stool softener
to help prevent constipation that may be caused by this medicine.
- If you experience diarrhea of greater than 3-5 stools per day, contact your healthcare
provider and increase your fluid intake.
- Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your
fluid intake, and maintain good nutrition. This will decrease your chances of being
constipated, and prevent dehydration.
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your healthcare provider.
- Wash your hands often.
- Use an electric razor and soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- Avoid sun exposure. Wear SPF 15 (or higher) sun block and protective clothing.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and
eat small, frequent meals.
- Keep your mouth clean with baking soda and salt rinses. You can mix 1/4 tsp. of
baking soda and 1/4 tsp. salt in 8 ounces of water, and use as a mouthwash, to avoid
or decrease the severity of mouth sores.
- In general, drinking alcoholic beverages should be minimized or avoided. You
should discuss this with your doctor.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and Testing:
- Periodic blood work will be obtained to monitor your complete blood count (CBC).
Your doctor will order blood tests and other tests as needed to monitor side effects
and check your response to therapy.
How Vinorelbine Works:
Cancerous tumors are characterized by cell division, which is no longer controlled
as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous
cells lose this ability. Cancer cells no longer have the normal checks and
balances in place that control and limit cell division. The process of cell
division, whether normal or cancerous cells, is through the cell cycle. The
cell cycle goes from the resting phase, through active growing phases, and then
to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells
the cell how to copy itself in division. If the cells are unable to divide,
they die. The faster the cells are dividing, the more likely it is that chemotherapy
will kill the cells, causing the tumor to shrink. They also induce cell suicide
(self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the
type of cells, rate at which they divide, and the time at which a given drug is
likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing.
Unfortunately, chemotherapy does not know the difference between the cancerous cells
and the normal cells. The "normal" cells will grow back and be healthy but in the
meantime, side effects occur. The "normal" cells most commonly affected by
chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and
the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea,
and/or hair loss. Different drugs may affect different parts of the body.
Vinorelbine belongs to a class of chemotherapy drugs called plant alkaloids. Plant
alkaloids are made from plants. The vinca alkaloids are made from the periwinkle
plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew
tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule
agents. The podophyllotoxins are derived from the May apple plant. Camptothecan
analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins
and camptothecan analogs are also known as topoisomerase inhibitors. The plant
alkaloids are cell-cycle specific. This means they attack the cells during
various phases of division.
- Vinca alkaloids: Vincristine, Vinblastine and Vinorelbine
- Taxanes: Paclitaxel and Docetaxel
- Podophyllotoxins: Etoposide and Tenisopide
- Camptothecan analogs: Irinotecan and Topotecan
Antimicrotubule agents (such as vinorelbine), inhibit the microtubule structures
within the cell. Microtubules are part of the cell's apparatus for dividing
and replicating itself. Inhibition of these structures ultimately results
in cell death.
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org