Navelbine (vinorelbine) dosing, indications, interactions, adverse effects, and more , , , Navelbine (vinorelbine) dosing, indications, interactions, adverse effects, and more, , , , , , , , , , , , , , , , , Edition:EnglishFrançaisDeutsch, Search, , No Results, News & Perspective, Drugs & Diseases, CME & Education, Log In, Register, , , , , https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cDovL3JlZmVyZW5jZS5tZWRzY2FwZS5jb20vZHJ1Zy9uYXZlbGJpbmUtdmlub3JlbGJpbmUtMzQyMjQ2, , , processing.... , , , , , vinorelbine (Rx)Brand and Other Names:Navelbine, Classes: Antineoplastics, Vinca Alkaloid, , Dosing & Uses, Interactions, Adverse Effects, Warnings, Pregnancy, Pharmacology, Administration, Images, Patient Handout, Formulary, Dosing & Uses, AdultPediatric, Dosage Forms & Strengths, , injectable solution, , 10mg/mL, , , more... Non-small Cell Lung Carcinoma , , Monotherapy: 30 mg/sq.meter IV over 6-10 minutes qWeek, , Combo Therapy, , 25 mg/sq.meter IV qWeek with IV cisplatin 100 mg/sq.meter q4Weeks OR, , 30 mg/sq.meter IV qWeek with cisplatin 120 mg/sq.meter on Days 1 & 29 & then q6Weeks, , , Breast Cancer (Off-label), , 20-30 mg/sq.meter qWeek, has been administered as IV infusion, slow (3-5 minutes) or rapid IV injection, , Ovarian Cancer (Off-label), , 25 mg/sq.meter q7Days, , 25-30 mg/sq/meter/day on days 1 & 8 of 21 day cycle, , Administration, , Dilute IV concentration 0.5-2 mg/mL , , Infuse over 6-10 minutes to reduce toxicity, , Other Information, , Hematologic toxicity (Granulocyte Count), , >1500 cells/cu. mm: 100 % of dose, , 1000-1499 cells/cu. mm: Decrease dose 50%, , < 1000 cells/cu mm: Do not administer, , , Hepatic Insufficiency (total bilirubin), , <2 mg/dL: 100% of dose, , 2.1-3 mg/dL: Decrease dose 50%, , >3 mg/dL: Decrease dose 75%, , , Neurotoxicity, , Grade > 2: Discontinue, , , Safety & efficacy not established, Interactions, Interaction Checker, vinorelbine and , No Results, No Interactions Found, Interactions Found, Contraindicated, Serious - Use Alternative, Significant - Monitor Closely, Minor, Sort by : , , Adverse Effects, , >10%, , Leukopenia (92%), , Granulocytopenia (90%), , Anemia (83%), , Elev AST (67%), , Nausea (44%), , Asthenia (36%), , Constipation (35%), , Fatigue (27%), , Peripheral neuropathy (25%), , Vomiting (20%), , Anorexia (20%), , Stomatitis (20%), , Alopecia (12%), , , 1-10%, , Dyspnea (7%), , Chest pain (5%), , Rash (5%), , SOB (3%), , Hemorrhagic cystitis (1%) , , SIADH (1%), , , Warnings, , Black Box Warnings, , The drug should be administered under the supervision of an experienced cancer chemotherapy physician in a facility equipped to diagnose and manage complications, , The needle should be properly positioned in the vein before this product is injected. Leakage to surrounding tissue during IV administration may cause considerable irritation. Immediately discontinue the injection, and introduce any remaining portion of the dose into another vein. Local injection of hyaluronidase and the application of moderate heat to the area of leakage will help disperse the drug and may minimize the discomfort and possibility of cellulitis. , , Intrathecal use may be fatal , , , Contraindications, , Hypersensitivity, , Acute bacterial infection, ANC <1000/cu.mm, intrathecal (IT) administration, intestinal obstruction, paralytic ileus, pregnancy, lactation, , , Cautions, , Vesicant: moderate, , Likely fatal if given intrathecally, , Bone marrow depression, neuropathy, neuromuscular dz, neurotoxic agents, ototoxic agents, pulmonary dz, hepatic impairment, potential CYP3A4 intxns, , Avoid extravasation, , Avoid pregnancy, , , Pregnancy & Lactation, , Pregnancy Category: D, , Lactation: not known if excreted in breast milk; do not nurse, , Pregnancy Categories, A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA:Information not available. more... Pharmacology, , Half-Life: 28-44 hr, , Peak Plasma: 234-1160 ng/mL, , Protein Bound: 80-92%, , Vd: 25-40 L/kg, , Metabolism: CYP3A isoenzymes, , Metabolites: vinorelbine N-oxide, deacetylvinorelbine, , Clearance: 0.97-1.26 L/hr/kg, , Excretion, , Feces: 46%, , Urine: 18%, , , Mechanism of Action, , Semi-synthetic vinca alkaloid; inhibits mitosis at metaphase by depolymerizing microtubules, , , Administration, , IV Incompatibilities, , Y-site: acyclovir, allopurinol, aminophylline, amphotericin B, ampho B cholesteryl sulfate, ampicillin, cefazolin, cefoperazone, cefotetan, ceftriaxone, cefuroxime, co-trimoxazole, fluorouracil, furosemide, ganciclovir, methylprednisolone sodium succinate, mitomycin, piperacillin, sodium bicarbonate, thiotepa, , , IV Compatibilities, , Solution: D5W, NS, , Y-site (partial list): buprenorphine, cisplatin, cyclophosphamide, diphenhydramine, gemcitabine, fluconazole, granisetron, hydromorphone, imipenem-cilastatin, lorazepam, meperidine, morphine, ondansetron, KCl, vancomycin, zidovudine, , , IV Preparation, , May be diluted in syringe or bag, , Syringe: dilute to 1.5-3 mg/mL in NS or D5W, , IV Bag: dilute to 0.5-2 mg/mL in NS, 1/2NS, D5W, D5/½NS, LR or Ringer's, , , IV Administration, , Vesicant, , For IV use only; fatal if given intrathecally, , Administer IV over 6-10 min through sidearm of free-flowing IV closest to IV bag, , Then flush with 75-125 mL of one of the IV fluids, , , Extravasation Management, , Mix 250 U hyaluronidase with 6 mL NS, , Inject hyaluronidase solution subcutaneously through 6 clockwise injections into infiltrated area using a 25-gauge needle, , Change needle with each new injection, , Elevate extremities, , Apply heat immediately for 1 hr, , Give QID for 3-5 days, , Application of cold or hydrocortisone is contraindicated, , , Storage, , Store intact vials under refrigeration protected from light, , Diluted solution may be stored in polypropylene syringes for 24 hr under normal light at 5-30°C, , , Images, , Patient Handout, Print w/ Office Info, Print w/out Office Info, , Formulary, FormularyPatient Discounts, To view formulary information first create a list of plans. Your list will be saved and can be edited at any time. Create Your List of Plans, Adding plans allows you to:, View the formulary and any restrictions for each plan. Manage and view all your plans together – even plans in different states. Compare formulary status to other drugs in the same class. Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions, Tier, Description, 1, This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2, This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3, This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4, This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 5, This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 6, This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. NC, NOT COVERED, – Drugs that are not covered by the plan. Code, Definition, PA, Prior Authorization, Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. , QL, Quantity Limits, Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered. , ST, Step Therapy, Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription. , OR, Other Restrictions, Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription. , Done, Add or Remove Plans, Plans for , Select State: , Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, , Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, Non-Medicare PlansMedicare Plans, Select a box to add or remove a plan. close, Select a class to view formulary status for similar drugs, CLOSE, Additional Offers, CLOSE, Email to Patient, From:, To:, The recipient will receive more details and instructions to access this offer. 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