Vinorelbine

Vinorelbine is a semisynthetic vinca alkaloid with a modified catharanthine ring that provides preferential disruption of mitotic microtubules over axonal microtubules, resulting in less neurotoxicity than vincristine and less myelosuppression than vinblastine. It inhibits tubulin polymerization at the vinca binding domain, arresting cells in mitosis. Vinorelbine has good oral bioavailability and is primarily used in non-small cell lung cancer and metastatic breast cancer.

Adult

By mouth: 60 mg/m2 once weekly for 3 weeks, then increased if tolerated to 80 mg/m2 once weekly.

Hepatic adjustment

With oral use: caution in moderate impairment; avoid in severe impairment (no information available); dose reduction in moderate impairment (consult product literature). With intravenous use: caution in severe impairment; dose reduction in severe impairment.

Max dose

160 mg once weekly (oral)

• Intrathecal injection
• Concurrent radiotherapy if treating the liver
• Long-term oxygen therapy (with oral use)
• Previous significant surgical resection of small bowel (with oral use)
• Previous significant surgical resection of stomach (with oral use)