Navelbine-Vinorelbine

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

WARNING Blood related problems: Vinorelbine may cause serious decreases in red blood cell, white blood cell and platelet levels which can cause infections, anemia, bruising and bleeding (see Precautions To Be Aware Of Before Taking This Medication). Low white blood cell levels: Vinorelbine should not be given to patients whose white blood cell levels are too low. Your doctor or healthcare provider will check your blood before starting vinorelbine treatment to make sure that it is safe to start this medication (see Who Should Not Take This Medication). Infusion related problems: Vinorelbine is given by injection into a vein (IV) and can cause serious skin and tissue problems if it leaks out of the vein while being given. Your doctor or healthcare provider will monitor you carefully during the administration of vinorelbine to make sure that this does not happen. Uses For This Medication
  • Vinorelbine is used alone or in combination with other chemotherapy medications to treat adults with breast cancer, lung cancer, esophageal cancer, cervical cancer, ovarian cancer, head and neck cancer, Kaposi’s sarcoma, melanoma, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma.
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works Vinorelbine is a chemotherapy medication that doesn’t allow cancer cells, also known as tumor cells, to divide and grow normally, which leads to tumor cell death. Benefits of This Medication Vinorelbine, given alone or together with other chemotherapy medications, can shrink the size of some tumors and may lengthen the lives of some patients with advanced lung cancer as well as other cancers. Who Should Not Take This Medication You should not take this medication if you:
  • Have very low white blood cell levels. Your doctor or healthcare provider will check your white blood cell levels before starting vinorelbine treatment to make sure that it is safe to start this medication.
  Precautions to be Aware of Before Taking This Medication

Blood related precautions

  • This medication may temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if youdevelop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands with soap and water well and often, and brush and floss your teeth daily.
  • This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
  • Rarely, this medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises.
 

Organ related precautions

  • This medication can cause cough and shortness of breath after vinorelbine is given. In addition, these problems can occur up to one week following your vinorelbine treatment and can be sign of more serious lung problems. Your doctor or healthcare provider will watch you carefully during and after the administration of vinorelbine to make sure that you do not experience any cough or shortness of breath. In addition, you should let your doctor or healthcare provider know if you experience these symptoms at a later time.
  • Vinorelbine can cause serious constipation, which, if not treated, can lead to bowel obstruction (a blockage) and/or perforation (a tear in the lining). Contact your doctor or healthcare provider if you experience symptoms of stomach pain and/or constipation.
  • This medication can cause changes in the ability of your liver to work normally. In addition, this medication is broken down by enzymes (chemicals) in the liver and cleared from the body. In patients with severe liver disease, vinorelbine may not break down normally which can lead to high levels of this medication in the body and a greater chance of side effects. Your doctor or healthcare provider will check your liver regularly, usually through blood tests, while you are on this medication to make sure that your liver is working properly. If you have any liver problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.
  Miscellaneous precautions
  • In patients who have had radiation therapy in the past, the skin or tissue damage from radiation therapy can become red and appear damaged again after receiving vinorelbine. Contact your doctor or healthcare provider if your skin gets red in areas where radiation was given.
  • This medication can cause nerve problems in the hands and feet. Symptoms can include numbness, pain or a burning feeling in the feet or hands. Contact your doctor or healthcare provider if you experience new symptoms or if your symptoms get worse.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
 

Patient specific precautions

  • It is not known if this medication is safe and effective in children.
  Pregnancy and breastfeeding precautions This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant. It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided. Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future. Medication and Food Interactions Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval. Possible interactions can occur with vinorelbine and the following foods or medications:
  • Amiodarone (Cordarone®)
  • Aprepitant (Emend®)
  • Atazanavir (Reyataz®)
  • Carbamazepine
  • Clarithromycin (Biaxin®)
  • Erythromycin
  • Fluconazole (Diflucan®)
  • Grapefruit or grapefruit juice
  • Imatinib mesylate (Gleevec®)
  • Indinavir (Crixivan®)
  • Itraconazole (Sporanox®)
  • Ketoconazole (Nizoral®)
  • Mitomycin (Mutamycin®)
  • Nefazodone (Serzone®)
  • Nelfinavir (Viracept®)
  • Paclitaxel
  • Phenytoin (Dilantin®)
  • Phenobarbital
  • Rifampin (Rifadin®)
  • Rifabutin (Mycobutin®)
  • Ritonavir (Norvir®)
  • Saquinavir
  • St.John’s wort
  • Voriconazole (Vfend®)
  NOTE: This list may not include all medications that can have interactions with vinorelbine. Side Effects
  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when vinorelbine is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with vinorelbine alone.
 

More common side effects

  • Decreased red blood cell and/or white blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
  • Numbness and tingling in hands and/or feet from nerve irritation (see Precautions To Be Aware Of Before Taking This Medication)
  • Injection site reactions (see Warning)
  • Temporary increase in blood levels of liver function enzymes
  • Fatigue (tiredness)
  • Nausea
  • Constipation (see Precautions To Be Aware Of Before Taking This Medication)
  • Weakness, loss of strength and energy
  • Loss of appetite
 

Less common side effects

  • Vomiting, diarrhea
  • Hair loss
  • Injection site pain
 

Rare side effects

This is not a complete list of the rare side effects reported with vinorelbine. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Shortness of breath (see Precautions To Be Aware Of Before Taking This Medication)
  • Decreased platelet levels (see Precautions To Be Aware Of Before Taking This Medication)
  • Chest pain
  • Rash
  • Jaw pain
  • Muscle pain, joint pain
  How To Take This Medication
  • This medication may only be given by injection into a vein (IV) by a healthcare professional. This medication can be given in different doses depending on your weight, your type of condition and whether vinorelbine is being given with other chemotherapy medications.
  • In the unlikely event of an overdose of this medication contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
  Proper Storage
  • It is unlikely that you will need to store this medication. However, in the event that you do, unopened containers should be stored in the refrigerator. Keep in original package to protect from light.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.