III. Mechanism

  1. See Mitotic Inhibitor Chemotherapy
  2. Vinorelbine is a semisynthetic Vinca Alkaloid, Antineoplastic Agent
  3. Vinorelbine is an antitubulin agent similar to the natural Vinca Alkaloids (e.g. Vincristine)
    1. Binds tubulin and inhibits microtubule formation
    2. Disrupts mitotic spindle formation
    3. Arrests cell cycle in M phase (metaphase)
  4. Other possible activity
    1. Interferes with metabolism of Amino Acids cAMP, glutathione
    2. Interferes with calmodulin-dependent Calcium transport ATPase activity
    3. Interferes with biosynthesis of Nucleic Acids and lipids

IV. Medications

  1. Vinorelbine Injection Solution: 10 mg/ml and 50 mg/5 ml vials

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Alopecia
  2. Bronchospasm (and other pulmonary toxicity)
  3. Peripheral Neuropathy
    1. Less neurotoxicity than other Vinca Alkaloids (lower affinity for nerve tubules)
  4. Severe skin and soft tissue necrosis on extravasation
    1. Vinblastine is a strong Vesicant (causes Blistering)
  5. Hepatotoxicity
    1. Increased Liver Function Tests
  6. Myelosuppression (Bone Marrow suppression)
    1. Granulocytopenia (including Neutropenia)

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count

X. References

  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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