Vinorelbine is a chemotherapy drug that is given as a treatment for some types of cancer. It's commonly used to treat breast cancer and non-small-cell lung cancer. This information describes vinorelbine, how it is given and some of its possible side effects. It will help you to read it with our general information about chemotherapy and about your type of cancer.

If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.

Vinorelbine is a colourless fluid. It is also available as 20mg capsules that are yellow, and 30mg capsules that are pink.

Vinorelbine may be given into a vein (intravenously), or taken as capsules (orally). The capsules should be swallowed whole with a glass of water and taken exactly as directed by the doctor or nurse.

When given intravenously vinblastine should only be given to adults and adolescents by drip (infusion):

• through a fine tube (cannula) placed into the vein, usually in the back of the hand
• through a fine plastic tube that is inserted under the skin into a vein
• near the collarbone (central line) into a fine tube that is inserted into a vein in the crook of your arm (PICC line).

The infusion takes around 5–10 minutes.

Children can be given vinorelbine by slow injection into a vein (intravenously) through a cannula or line.

Chemotherapy is usually given as a course of several sessions (or cycles) of treatment over a few months. The length of your treatment and the number of cycles you have will depend on the type of cancer for which you are being treated. Your nurse or doctor will discuss your treatment plan with you.

Each person’s reaction to chemotherapy is different. Some people have very few side effects, while others experience more. The side effects described in this information will not affect everyone who is given vinorelbine, and may be different if you are having more than one chemotherapy drug.

We have outlined the most common side effects and rarer ones, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor, chemotherapy nurse or pharmacist.

Lowered resistance to infection Vinorelbine can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given. Your white blood cells will then increase steadily, and will usually have returned to normal levels before your next cycle of chemotherapy is due.

Contact your doctor or the hospital straight away if:

• your temperature goes above 38ºC (100.5ºF)
• you suddenly feel unwell (even with a normal temperature).

You will have a blood test before having more chemotherapy to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.

Bruising or bleeding Vinorelbine can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding.

Anaemia (low number of red blood cells) While having treatment with vinorelbine you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these symptoms are a problem.

Constipation This can usually be relieved by drinking plenty of fluids, eating a high fibre diet and taking gentle exercise. Sometimes you may need to take medicines to stimulate your bowel. These can be prescribed by your doctor or bought from a pharmacy.

Diarrhoea This can usually be easily controlled with medicine, but tell your doctor if it is severe or if it continues. It's important to drink plenty of fluids if you have diarrhoea. If you have any change in bowel habit tell your doctor.

Feeling sick (nausea) and being sick (vomiting) This is usually mild. Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent or reduce nausea and vomiting. If the sickness isn't controlled, or continues, tell your doctor, who can prescribe other anti-sickness drugs that may be more effective. Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.

Numbness or tingling in hands or feet This is due to the effect of vinorelbine on the nerves and is known as peripheral neuropathy. Most people do not have this effect and if it occurs it is usually mild. You may also notice that you have difficulty doing up buttons or other fiddly tasks. Tell your doctor if you notice any numbness or tingling in your hands or feet. This effect usually improves slowly from a few months after the treatment is finished.

Pain along the vein used for the injection Vinorelbine can cause irritation along the vein used for the injection. If this happens, it is important to tell the person giving the drug, as they can reduce the problem by flushing the drug through with more fluid.

Tiredness and feeling weak It is important to allow yourself plenty of time to rest.

Hair loss This is rare, but hair may thin, or occasionally fall out completely. If this happens it usually begins about 3–4 weeks after starting treatment, although it may occur earlier. It is temporary and your hair will regrow once the treatment is finished. Your nurse can give you advice about coping with hair loss.

Allergic reaction Signs of an allergic reaction include skin rashes and itching, a high temperature, shivering, redness of the face, a dry mouth, headache, breathlessness, anxiety and a need to pass urine. You will be monitored for any signs of an allergic reaction during the treatment. Tell your doctor or nurse if you have any of these signs.

Leaking around the vein If vinorelbine leaks into the tissues around the vein it can damage the tissue in that area. If you notice any stinging or burning around the vein while the drug is being given, or any leakage of fluid from the cannula site, it is very important that you tell the doctor or nurse. If the area around the cannula site becomes red or swollen at any time you should tell either the doctor or nurse on the ward.

If the area around the cannula site becomes red or swollen at any time tell the doctor or nurse on the ward, or if you are at home, ring the clinic or ward and ask to speak to the doctor or nurse.

Risk of blood clots Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious so it is important to tell your doctor straightaway if you have any of these symptoms. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.

Other medicines Some medicines (including those you can buy from a shop or chemist) may be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.

Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It's important to discuss fertility with your doctor before starting treatment.

Contraception It is not advisable to become pregnant or father a child while taking vinorelbine, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.

• It is important to take your capsules at the right times. You must take them as directed by your doctor.
• If you are given capsules to take home, you should keep them in a safe place in the fridge and where children cannot reach them, as vinorelbine could harm them.
• If your doctor decides to stop the treatment, return any remaining capsules to the pharmacist at your next visit. Do not flush them down the toilet or throw them away.
• If you are sick just after taking the capsules let your nurse or doctor know straight away. Don't take more capsules unless told to by your nurse or doctor.
• If you forget to take a tablet, don't take a double dose. Inform your doctor and keep to your regular dose schedule.

This section is based on our Vinorelbine factsheet which has been compiled using information from a number of reliable sources, including:

• Martindale: The Complete Drug Reference (35th edition). Eds. Sweetman et al. Pharmaceutical Press, 2007.
• British National Formulary (56th edition). British Medical Association and Royal Pharmaceutical Society of Great Britain, September 2008.
• The Chemotherapy Source Book (4th edition). Ed. Perry. Lippincott Williams and Wilkins, 2007.
• Using Vinca Alkaloid Minibags (Adult/Adolescent Units). National Patient Safety Agency Rapid Response Report, August 2008.

For further references, please see general bibliography.