Home Drug Guide Vinorelbine Tartrate

Drug Guide

Generic Name

Vinorelbine Tartrate

Brand Names Navelbine

Classification

Therapeutic: Antineoplastic agent

Pharmacological: Vinca alkaloid

FDA Approved Indications

  • Non-small cell lung cancer (NSCLC)
  • Breast cancer (adjuvant and metastatic)

Mechanism of Action

Vinorelbine inhibits microtubule polymerization by binding to tubulin, disrupting mitotic spindle formation, thereby arresting cell division in metaphase and inducing apoptosis.

Dosage and Administration

Adult: Typically 25 mg/m^2 IV on days 1 and 8 of a 21-day cycle, but regimens vary based on indication and patient response.

Pediatric: Use is investigational; dosing based on body surface area with close monitoring.

Geriatric: Adjustments based on renal and hepatic function; monitor closely due to increased sensitivity.

Renal Impairment: Use with caution; may require dose adjustment based on degree of impairment.

Hepatic Impairment: Reduce dose in patients with hepatic dysfunction due to decreased metabolism.

Pharmacokinetics

Absorption: Administered intravenously; no oral absorption.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Metabolized in the liver via CYP3A4 enzymes.

Excretion: Excreted primarily in feces; small amount in urine.

Half Life: Approximately 40-50 hours.

Contraindications

  • Hypersensitivity to vinorelbine or other vinca alkaloids.
  • Severe myelosuppression.
  • Pregnancy (category D).

Precautions

  • Monitor blood counts regularly.
  • Assess hepatic and renal function before and during treatment.
  • Use caution in patients with infections or other comorbidities.

Adverse Reactions - Common

  • Myelosuppression (neutropenia, thrombocytopenia, anemia) (Very common)
  • Nausea and vomiting (Common)
  • Alopecia (Common)
  • Peripheral neuropathy (Uncommon)

Adverse Reactions - Serious

  • Severe neutropenia leading to infection (Possible)
  • Thrombocytopenia leading to bleeding (Possible)
  • Severe hypersensitivity reactions (Rare)

Drug-Drug Interactions

  • CYP3A4 inhibitors (azole antifungals, macrolides) increase vinorelbine levels.
  • CYP3A4 inducers (rifampin, carbamazepine) decrease efficacy.

Drug-Food Interactions

  • Grapefruit juice may increase plasma levels.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood counts frequently, especially ANC.

Diagnoses:

  • Risk for infection due to myelosuppression.
  • Risk for bleeding due to thrombocytopenia.

Implementation: Administer IV as scheduled, monitor for signs of infection, bleeding, and peripheral neuropathy.

Evaluation: Assess blood counts, neurological status, and patient response to therapy.

Patient/Family Teaching

  • Report any signs of infection, unusual bleeding, or severe neuropathy.
  • Follow instructions for managing side effects.
  • Avoid live vaccines during therapy.

Special Considerations

Black Box Warnings:

  • Severe neutropenia leading to infection and death. Cannot be used in pregnancy due to teratogenicity.

Genetic Factors: CYP3A4 genetic polymorphisms can affect metabolism.

Lab Test Interference: May cause falsely low serum cholinesterase levels.

Overdose Management

Signs/Symptoms: Severe myelosuppression, neurotoxicity.

Treatment: Supportive care including growth factor support, blood and platelet transfusions, symptomatic management.

Storage and Handling

Storage: Store vials under refrigeration at 2-8°C.

Stability: Stable for specified period per manufacturer instructions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.