Navelbine (Vinorelbine Tartrate)

Vinorelbine is a Vinca alkaloid used in chemotherapy for solid tumours.

• Non‑small cell lung cancer: improves disease control and may extend survival in patients with advanced disease.
• Metastatic breast cancer: used after failure of anthracycline‑based therapy to reduce tumour burden.
• Solid tumours (in combination regimens): contributes to cytotoxic activity when combined with other chemotherapeutic agents.

• Vinorelbine binds to the tubulin protein within cells, inhibiting microtubule polymerisation. This disruption prevents the formation of a functional mitotic spindle, arresting cell division in the M phase and leading to apoptosis of rapidly proliferating cancer cells.

Vinorelbine may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Neutropenia: reduced white blood cell count increasing infection risk.
• Nausea and vomiting: gastrointestinal upset common during treatment.
• Fatigue: persistent tiredness affecting daily activities.
• Alopecia: hair loss that may be temporary.

Serious or Rare Side Effects

• Severe neutropenia with fever: requires immediate medical attention.
• Pulmonary toxicity: cough, dyspnoea, or interstitial pneumonitis.
• Hypersensitivity reactions: rash, flushing, or anaphylaxis.
• Peripheral neuropathy: tingling or numbness in extremities.
• Cardiac toxicity: arrhythmias or decreased cardiac function.

Before initiating therapy, clinicians should assess patient-specific risk factors and monitor for toxicity.

• Monitor blood counts: perform regular CBC to detect neutropenia and thrombocytopenia.
• Assess liver function: adjust therapy if hepatic impairment is present.
• Evaluate pulmonary status: baseline and periodic lung function tests are recommended.
• Use antiemetics prophylactically: to mitigate nausea and vomiting.
• Store at ambient temperature: keep in original container, protect from light and moisture.

Vinorelbine may interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole): increase vinorelbine exposure and toxicity.
• Concurrent myelosuppressive agents: exacerbate bone‑marrow suppression.
• Radiotherapy to the chest: may heighten risk of pulmonary toxicity.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampin): reduce vinorelbine plasma levels.
• Anticoagulants (e.g., warfarin): may increase bleeding tendency.
• Other anti‑emetics (e.g., ondansetron): can affect drug metabolism.
• Herbal supplements (e.g., St John's wort): may alter vinorelbine clearance.