Vinorelbine (Navelbine)

Vinorelbine is a type of chemotherapy. You pronounce it as vin-oh-rel-been. It is also known as Navelbine. 

It is a treatment for:

• advanced breast cancer
• non small cell lung cancer
• cancer of the outer covering of the lung (mesothelioma)
• a type of soft tissue sarcoma called rhabdomyosarcoma

You might have vinorelbine on its own, with other chemotherapy drugs or radiotherapy .

How does vinorelbine work?

Vinorelbine is a type of chemotherapy drug called a vinca alkaloid. It works by stopping the cancer cells from separating into 2 new cells. So it blocks the growth of the cancer.

How do you have vinorelbine?

You have vinorelbine as capsules or you might have it as a drip into your bloodstream (intravenously).

Into your bloodstream

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

• central line
• PICC line
• portacath

Taking your capsules

Swallow the capsules whole with water. 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.

Take vinorelbine capsules with food as this helps reduce the chance of you being or feeling sick.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

How often do you have vinorelbine?

You usually have vinorelbine in cycles of treatment . Each cycle lasts 21 days (3 weeks).

You may have vinorelbine:

• once a week
• once a week for the first 2 weeks, then no treatment in the third week

Depending on your cancer type, you may have vinorelbine for between 6 and 8 cycles of treatment. You might have it for longer than this if the treatment is working and you’re not experiencing too many side effects. Your doctor or nurse will tell you more about this. 

Tests during treatment

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Before treatment starts you may have a blood test to check for viruses such as hepatitis B, hepatitis C, and HIV . This is called a viral screen.

It’s important for your doctor to know if you have had any of these viruses. This is because this treatment can weaken your immune system and can cause the virus to become active again (reactivation). 

What are the side effects of vinorelbine?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.

Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Increased risk of infection

Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Bruising and bleeding

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs. This is known as petechiae.

Breathlessness

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Loss of appetite and weight loss (anorexia)

You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss. 

Problems with the nervous system 

You may find you have changes to your reflexes. For example, your knee may not jerk when you tap the knee tendon.

You may also have weakness in your legs and changes in your sense of touch.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Diarrhoea

Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a stoma , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.

Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables. 

Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.

Constipation

Constipation is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a laxative if needed.

Sore mouth and throat

It may be painful to swallow drinks or food. Painkillers and mouth washes can help to reduce the soreness and keep your mouth healthy. 

Hair thinning

Your hair may thin, but you're unlikely to lose all your hair. It is almost always temporary, and your hair will grow back when you finish your treatment.

High temperature (fever)

Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.

Fatigue (during and after treatment)

Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Liver changes

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes.

You have regular blood tests to check for any changes in the way your liver is working.

Pain in different parts of the body

You may have tummy (abdominal) pain. Less commonly, you may have pain in different parts of the body, such as your chest, joints, muscles, jaw, and where the cancer is.

Tell your doctor or nurse. They can tell you what painkilling medication you can have.

Indigestion or heartburn

Contact your doctor or pharmacist if you have indigestion or heartburn. They can prescribe medicines to help.

General feeling of discomfort

You might have a feeling of general discomfort, uneasiness or pain. This is called malaise. Call the advice line or talk to your doctor or nurse if you do.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• headaches and dizziness

• skin reaction such as rash, blisters and hives

• chills

• high blood pressure or low blood pressure

• coughing and shortness of breath

• a blood test showing that you have high levels of a waste product called creatinine. The kidneys remove this from our blood and get rid of it in our urine

• disorders of the nerves and muscles

As well as the above, the following occasional side effects may happen when you take vinorelbine orally as a capsule:

• taste changes

• eyesight changes

• difficulty sleeping

• difficulty swallowing

• inflammation of the throat and food pipe causing symptoms such as heartburn and indigestion

• weight gain

• pain, burning or difficulty passing urine

• symptoms affecting the urinary and genital (sex) organs such as vaginal dryness and pain when having sex

Rare side effects

This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

• slowing or stopping of the bowels which can cause severe constipation, stomach pain, feeling or being sick and bloating

• problems with balance and body movements

• flushing (redness) of your hands and feet

• a drop in the levels of sodium in your body which can cause headaches and sickness

• heart problems such as heart failure, chest pain (angina), heart attack and changes to heartbeat

As well as the above, the following rare side effects may happen when you have vinorelbine intravenously into your bloodstream:

• • a serious infection - signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering - contact your advice line straight away if you have any of these symptoms

• severe nerve problems causing abnormal sensations, tingling and prickling (pins and needles) that usually goes away after treatment. Your doctor might reduce the dose if it is very severe

• having cold hands and feet

• flushing

• inflammation of the pancreas (pancreatitis) causing symptoms such as sudden and severe tummy pain

Other side effects

There isn't enough information to work out how often these side effects might happen. You might have one or more of them. They include:

• an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life threatening, alert your nurse or doctor if notice any of these symptoms
• a blood clot in the lung (pulmonary embolism) causing breathless and chest pain - call 999 or go to your nearest accident and emergency department (A&E)
• bleeding in the digestive system, symptoms include blood in your urine or poo and vomiting or coughing up blood – contact your advice line or doctor immediately if you have this
• a condition where the body retains too much water 

As well as the above, you might have the following side effects if you have vinorelbine intravenously into your bloodstream:

• severe difficulty breathing 
• redness, soreness or peeling on palms or soles of feet (palmar plantar syndrome)

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do you need to know?

Other medicines, foods and drinks

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility

You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

Contraception and pregnancy

This drug may harm a baby developing in the womb. It is important not to become pregnant while you are having treatment for at least 3 months afterwards.

For men you should not father a child during treatment and for at least 6 months after.

Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.

Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.

You can usually have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine

Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.

Contact with others who have had immunisations 

You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your immune system is weakened.

Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.