Vinorelbine is a drug that can be administered either as monotherapy, or in combination with cisplatin or carboplatin, either intravenously or orally.
In association with cisplatin, it represents the standard of adjuvant chemotherapy, i.e. postoperative, the treatment used in patients undergoing surgery, to reduce a possible risk of relapse.
Potential side effects of Vinorelbine
Temporary reduction of bone marrow function. The main side effect is neutropenia, which is the decrease in neutrophils; however, it is reversible and not cumulative; the decrease in platelets (thrombocytopenia) and anemia are rarer. Vinorelbine may also cause a tendency to develop bruising, bleeding and infections. Reduced bone marrow function may occur approximately seven days after drug administration, usually reaching minimum values 10-14 days after chemotherapy. The blood cell counts start to rise constantly and normalizes within 21-28 days usually.
The blood cell counts decreases according to the dose of vinorelbine you receive and any other drugs with which chemotherapy is given with. The oncologist can tell you the chances your blood cell count will decrease following chemotherapy. You will undergo periodic blood tests to check bone marrow function.
If the temperature rises above 38° C or if you develop bruising or bleeding without apparent reason, or if you suddenly do not feel well even if the temperature is normal, immediately contact the oncologist or hospital.
Constipation. It is usually good to drink a lot, follow a high fiber diet and exercise lightly. Sometimes laxatives can be used, which the oncologist will have no difficulty prescribing for you.
Diarrhea. It can be easily controlled with medication but inform the oncologist if it is severe or persistent. In case of diarrhea, you have to drink a lot to replenish lost fluids.
Numbness or tingling in the hands and feet. It is determined by the action of vinorelbine on the nerves. Most cancer patients are not affected by this effect, but if this occurs, it is still mild. You may notice that you have difficulty buttoning your clothes. If you experience a numbness or tingling sensation in your hands or feet, inform the oncologist. The situation gradually improves within a few months after the end of the treatment.
Less frequent side effects
Nausea and vomiting. They usually occur in a mild form. Anti-emetics are very effective drugs that can prevent or significantly reduce nausea and vomiting. If the nausea is not controllable or persists, inform the oncologist, who will not hesitate to prescribe another more effective antiemetic.
Hair loss. Complete hair loss is rarely found (in about 10% of cases); more commonly, the hair thins out. In the event of hair loss, it usually develops 3-4 weeks after the first dose of vinorelbine is administered, but it may also occur earlier. In any case, it is a temporary phenomenon: the hair will grow back once the treatment is complete.
Allergic reactions. Signs of an allergic reaction include rash and itching, rising temperature, chills, flushing, dizziness, headache, shortness of breath and more frequent urination. You will be monitored during treatment to detect any signs of an allergic reaction. Inform the oncologist or nurse if you notice any signs.
Leakage of liquid from the puncture site. If vinorelbine escapes from the puncture site during administration, it can damage the surrounding tissue. If you experience pain or burning in the area around the puncture site or around the vein, or if you notice a leak, tell the oncologist or a nurse immediately. If the area around the puncture site appears to be irritated or swollen, inform the oncologist or a nurse in the ward or, if you are at home, call the hospital and ask to speak to one of them.
Fertility. The drug can affect the ability to conceive. It is important that you deal with fertility problems with the oncologist before treatment begins.
Exhaustion, asthenia.
Further information
Contraception. It is not advisable to start a pregnancy or conceive a child if you are being treated with vinorelbine, as the drug could compromise fetal development. Again, discuss it openly with the oncologist.
Some medicines may interfere with each other when you are on chemotherapy. For this reason, consult the oncologist before taking other drugs.