This page tells you about the chemotherapy drug vinorelbine and its possible side effects. There is information about
Vinorelbine is a chemotherapy drug used to treat advanced breast cancer, non small cell lung cancer and mesothelioma. It belongs to the group of drugs called vinca alkaloids. These are often called plant alkaloids because the first of these drugs was developed from the periwinkle plant (vinca). These drugs are sometimes called microtubule inhibitors. This describes the way they work in damaging cancer cells. Vinorelbine stops the cancer cells from separating into two new cells. So it blocks the growth of the cancer.
Vinorelbine is a pale yellow liquid. You have the drugs as injections into a vein or through a drip. You may have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath or a PICC line. These are long, plastic tubes that give the drug directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.
Vinorelbine also comes as capsules of 20mg, 30mg and 80mg that you swallow with plenty of water, and ideally with something to eat. Don't chew or suck the capsules, because the drug could make your mouth sore if it leaks out. If you do this accidentally, rinse your mouth out over and over again with clean water and contact your doctor or nurse as soon as possible. Don't take the capsules with a hot drink as this can make them dissolve too quickly.
It is very important that you take the capsules according to the instructions your doctor or pharmacist gives you. For example, whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first.
You usually have vinorelbine chemotherapy as a course of several cycles of treatment. The treatment plan depends on which type of cancer you have. There is information about how doctors plan chemotherapy in the chemotherapy section.
Vinorelbine side effects are listed below. You can use the links to find out more about each side effect or go to the cancer drug side effects section.
More than 10 in every 100 people have one or more of the side effects listed below.
A temporary drop in the number of blood cells made by the bone marrow, causing
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
Some of these side effects can be life threatening, particularly infections. Contact your hospital straight away if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.
Other common side effects include
- Tiredness (fatigue) during and after treatment – most people find their energy levels are back to normal from 6 months to a year after their treatment finishes
- Constipation can be a problem in about 1 in 3 people (30%) but is generally prevented with regular laxatives – if you are constipated for more than 3 days, tell your doctor or nurse
- Feeling or being sick is usually moderate, is most likely to come on within the first 24 hours after treatment, and is easily controlled with anti sickness injections and tablets – tell your doctor or nurse if your sickness is not controlled as you can try other anti sickness medicines
- Vinorelbine can cause pain along the vein where you have the injection – tell the person giving the drug as they can help by flushing the drug through with more fluid
- Inflammation around the drip site – if you notice any signs of redness, pain, swelling or leaking at your drip site, tell your chemotherapy nurse straight away
- Vinorelbine can cause darkening or discoloration of the vein where you have the injection
- Hair loss, or more usually thinning, happens to about 1 in 10 people (10%)
- A sore mouth or mouth ulcers
- Leg weakness
- Temporary numbness and tingling in fingers and toes (peripheral neuropathy) can happen but is usually mild with this drug
- Liver changes that are very mild and unlikely to cause symptoms – they will almost certainly go back to normal when treatment is finished, but you will have regular blood tests to check how well your liver is working
- Women may stop having periods (amenorrhoea) but this may only be temporary
- Loss of fertility – you may not be able to get pregnant or father a child after treatment with vinorelbine. Talk to your doctor before starting treatment if you plan to have a baby in the future
Between 1 and 10 in every 100 people have one or more of these.
- Diarrhoea – contact your doctor or nurse straight away and they will give you anti diarrhoea tablets
- Bruising or bleeding more easily due to a drop in the number of platelets in the blood – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
- Joint or muscle pain
- Jaw pain
- Taste changes
- Skin rashes
- A high temperature
- Chest pain
- Pain in the area of the cancer
- Difficulty sleeping
- Eyesight changes
- Pain when passing urine – let your doctor or nurse know if you have this
Fewer than 1 in 100 people have these effects.
- An allergic reaction to vinorelbine – tell your doctor or nurse straight away if you have a sudden cough, wheezing or difficulty breathing
- Signs of severe infection such as a cough, high temperature, or breathing problems – tell your doctor or nurse straight away if you have this
- Difficulty moving and loss of sense of touch
- Dizziness or feeling faint due to low blood pressure
- High blood pressure leading to headaches
- Feeling cold in the hands and feet
The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
- Other drugs you are having
Coping with side effects
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and any over the counter remedies – some drugs can react together.
Other medicines that may react with vinorelbine include
- Some medicines used to thin the blood
- Some anti epilepsy drugs
- Some medicines to treat fungal infections
- Some anti cancer drugs – your doctor and pharmacist will check this
- Some medicines that lower immunity
Vinorelbine may harm a developing baby so it is important not to become pregnant or father a child if you are having this drug. Talk about contraception with your doctor or nurse before having the treatment if there is any chance you or your partner could become pregnant. You need to use reliable contraception during the treatment and for 3 months afterwards.
Breastfeeding is not advisable during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
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