vinorelbine (Navelbine)
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Indications
- lymphoma
- metastatic breast cancer
- non-small cell lung cancer, alone or in combination with cisplatin
- small cell carcinoma[3]
- uterine cancer
- Kaposi's sarcoma[3]
Dosage
- 15-30 mg/m2 IV weekly
- dosage adjustment for bilirubin > 3.0 mg/dL: 7.5 mg/m2
- dilute prior to administration
- ensure IV access
Injection: 10 mg/mL (1 mL, 5 mL).
Pharmacokinetics
- widely distributed
- metabolized by the liver
- eliminated in the urine & feces
- elimination 1/2life approximately 23 hours
elimination via kidney
1/2life = 23 hours
Adverse effects
- not common (1-10%)
- chest pain, decreased deep tendon reflexes, tumor pain, jaw pain, paresthesia, phlebitis at site of infusion, nausea/vomiting, constipation, abnormal liver function tests, dyspnea (acute & reversible), hypoxemia, interstitial pulmonary infiltrates, SIADH, fatigue, hemorrhagic cystitis
- uncommon (< 1%)
- other
- myelosuppression
- leukopenia, neutropenia, anemia
- thrombocytopenia (uncommon)
- nadir 7-8 days
- recovery 15-17 days
- irritant/extravasation
- peripheral neuropathy
- ileus
- urinary retention
- ototoxicity
- myelosuppression
Drug interactions
- aminoglycosides given within 3-5 days can increase the risk of ototoxicity
- mitomycin-C in combination may result in acute pulmonary syndrome which may occur up to 2 weeks after last dose of mitomycin-C
Mechanism of action
- vinca alkaloid
- inhibits microtubule formation in the mitotic spindle arresting cell division