1. What is vinorelbine?
Vinorelbine is a drug used to treat breast cancer. You may hear it called by its brand name Navelbine.
2. When is vinorelbine given?
Vinorelbine is used to treat:
- Locally advanced breast cancer (sometimes called regional recurrence) – breast cancer that has spread to the chest wall or skin of the breast, or lymph nodes around the chest, neck and under the breastbone but has not spread to other areas of the body. It cannot be removed by surgery
- Secondary breast cancer– breast cancer that has spread to another part of the body, such as the bones, lungs, liver or brain
3. Before you start vinorelbine
Before starting your treatment, a member of the treatment team will discuss how and when you’ll have chemotherapy and how side effects can be managed.
You’ll have blood tests, and your height and weight will be measured.
You may also have tests to check your heart function.
You should be given a 24-hour contact number or told who to contact if you feel unwell at any time during your treatment, including overnight or at the weekends.
4. How is vinorelbine given?
You can have vinorelbine:
- By mouth (orally)
- Into a vein (intravenously) usually in the hand or arm
Both methods are equally effective.
Vinorelbine is given as part of a 21-day cycle. You will have vinorelbine on day 1, day 8 and day 15.
You may be prescribed vinorelbine on its own or with other drugs. Your treatment team will decide what dose you will need and how often.
You’ll have vinorelbine for as long as your treatment team feels you’re benefiting from the drug and any side effects are manageable.
By mouth
You may have several capsules to take together if you are given vinorelbine orally. It’s important to take them according to the instructions you’re given.
Swallow the capsules whole (do not suck or chew them) with a glass of water and some food.
Avoid taking them with a hot drink, as the capsules may dissolve in your mouth.
You should store the capsules in the fridge.
Into a vein
Vinorelbine can be given as an injection.
It can also be given as a drip, also called an infusion, into your hand or arm over 6 to 10 minutes.
Other intravenous methods may be used depending on how easy it is for the chemotherapy team to find suitable veins, and your preferences or individual situation.
5. Side effects of vinorelbine
Like any treatment, vinorelbine can cause side effects. Everyone reacts differently to drugs and some people may have more side effects than others. These side effects can usually be managed and those described here will not affect everyone.
If you’re worried about any side effects, regardless of whether they are listed here, talk to your chemotherapy nurse or treatment team.
Effects on the blood
Vinorelbine can temporarily affect the number of blood cells in the body. Blood is made up of red cells, white cells and platelets.
You'll have regular blood tests throughout your treatment. If these show the number of blood cells is too low, your next cycle of treatment may be delayed or the dose of chemotherapy reduced.
Doctors often tailor the dose of a drug by reducing it to suit an individual and to help manage its side effects. For some people this can help them stay on a treatment for longer.
Risk of infection
Not having enough white blood cells can increase the risk of getting an infection.
Signs of an infection
Your treatment team may give you guidelines to follow for reporting signs of an infection. But generally you should contact your hospital immediately if you experience any of the following:
- A high temperature (over 37.5°C) or low temperature (under 36°C), or whatever your treatment team has advised
- Suddenly feeling unwell, even with a normal temperature
- Symptoms of an infection, for example a sore throat, a cough, a need to pass urine frequently or feeling cold or shivery
Before starting chemotherapy, you should be given a 24-hour contact number or told how to get emergency care by your treatment team.
You may need treatment for an infection.
If needed, your doctor may recommend injections of drugs called growth factors to stimulate the production of white blood cells to reduce your risk of infection.
Anaemia
Having too few red blood cells is called anaemia. If you feel particularly tired, breathless or dizzy, let your treatment team know.
Bruising and bleeding
Vinorelbine can reduce the number of platelets, which help the blood to clot.
You may bruise more easily, have nosebleeds or your gums may bleed when you brush your teeth.
Tell your treatment team if you have any of these symptoms.
Feeling sick (nausea) and being sick (vomiting)
You may have nausea and vomiting, but many people will not actually be sick.
You’ll be given anti-sickness medication before you have chemotherapy. Your treatment team will also prescribe you anti-sickness drugs to take home to reduce or prevent nausea.
Making sure you take oral vinorelbine with food can also help reduce nausea and vomiting.
Extreme tiredness (cancer-related fatigue)
Fatigue is extreme tiredness that does not go away with rest or sleep. It’s a very common side effect of cancer treatment.
Cancer-related fatigue is one of the most common symptoms in people with secondary breast cancer.
If you think you have fatigue, tell your GP or treatment team. They can assess you and offer advice on how to manage your energy levels.
Find out more about managing fatigue.
Sore mouth
Looking after your mouth, including your teeth and gums, is very important during treatment.
You may be given mouthwash to try to reduce soreness and stop mouth ulcers developing. You may be advised to use a small, soft toothbrush during this time.
See your dentist for a check-up before treatment with chemotherapy begins. Avoid dental work during chemotherapy if possible.
If you do need to have dental work during treatment, talk with your oncologist about the best time to have this.
Constipation and diarrhoea
Vinorelbine can cause bowel problems, most often constipation.
Drinking plenty of water and eating a high-fibre diet can help make constipation less severe. If you’re constipated for more than 2 to 3 days, let your doctor know. Your treatment team or GP can prescribe medication to help control it.
Sometimes vinorelbine can cause mild diarrhoea. This is usually temporary, but speak to your treatment team or GP if it continues.
Skin problems
Vinorelbine given as an infusion can irritate the veins and surrounding skin, causing redness.
Vinorelbine may leak into the tissues around the vein. This is called extravasation. If this happens it can cause damage to the skin and surrounding tissue.
Let your treatment team know if you notice any stinging or burning when you’re being given vinorelbine.
If the infusion is causing discomfort, your treatment team may advise using another intravenous method or having vinorelbine capsules instead.
Numbness and tingling in the hands or feet (peripheral neuropathy)
You may have numbness or tingling in the hands and feet. This is due to the effect of vinorelbine on the nerves and is known as peripheral neuropathy.
In most cases it’s mild and goes away soon after treatment stops, although in some cases it can be permanent. If it’s severe, it may be necessary to reduce the dose of vinorelbine or to stop it completely.
If you have numbness or tingling, tell your treatment team so they can monitor your symptoms.
Hair thinning
When used on its own, vinorelbine may cause some mild, temporary hair thinning. Very rarely, it can cause complete hair loss.
Joint or muscle pain
Sometimes you may have joint, jaw or muscle pain. Let your treatment team know if this happens. They may prescribe medication for pain relief.
Liver changes
Vinorelbine can affect how the liver works.
You’ll have blood tests to check your liver function while you’re having treatment.
Sometimes treatment may need to be delayed or the dose reduced if the blood tests show any problems with your liver.
Other common side effects
Other common side effects of vinorelbine include:
- Difficulty sleeping
- Headache
- Dizziness
- Taste changes
Your treatment team can advise on you how to manage these.
6. Other important information
Allergic reaction
Having an allergic reaction to vinorelbine is rare.
If you do have an allergic reaction, it’s more likely to happen within the first few minutes of your first or second treatment.
You’ll be monitored closely so any reaction can be dealt with immediately.
Symptoms of an allergic reaction include:
- Flushing
- Skin rash
- Itching
- Back pain
- Shortness of breath
- Faintness
- High temperature or chills
If you have a severe reaction, treatment will be stopped immediately.
If you have a less severe reaction, you may need to take medication before future treatments to reduce the risk of further reactions.
Blood clots
People with breast cancer have a higher risk of blood clots. Having vinorelbine also increases the risk of blood clots such as a deep vein thrombosis (DVT).
If you have a DVT, there’s a risk part of the blood clot could break away and travel to the lung. This is known as a pulmonary embolism (PE).
Blood clots can be life-threatening and should be treated quickly.
Blood clot symptoms
Contact your treatment team or go to your local A&E department straight away if you have any of the following symptoms:
- Pain, redness/discolouration of the skin, heat and swelling of the arm or leg
- Swelling, redness or tenderness where a central line is inserted to give chemotherapy, for example in the arm, chest area or up into the neck
- Shortness of breath
- Pain or tightness in the chest
- Unexplained cough or coughing up blood
Find out more about blood clots.
Medicines to avoid when having vinorelbine
There are several drugs you should not take with vinorelbine.
Tell your treatment team about any prescribed or over-the-counter medicines you’re taking, particularly:
- Drugs used to thin the blood (anti-coagulants)
- Drugs to treat epilepsy (anti-epileptic)
- Drugs to treat fungal infections
- Medicines that reduce your natural immune system (such as ciclosporin)
Your treatment team can talk to you about how to manage this while you’re having vinorelbine.
Oral vinorelbine contains sorbitol, a type of sugar alcohol. Tell your treatment team if you know you have an intolerance to sugars.
Sex, contraception and pregnancy
You can still have sex during treatment. It’s thought chemotherapy drugs cannot pass into vaginal fluids or semen, but this cannot be completely ruled out.
Most treatment teams will advise using barrier methods of contraception, such as condoms, during treatment and for a few days after chemotherapy is given.
You’re advised not to become pregnant while having treatment because vinorelbine can harm a developing baby. If you have not been through the menopause, talk to your team about the most suitable method of contraception for you. It’s still possible to become pregnant even if your periods are irregular or have stopped.
Men having vinorelbine should not father a child during treatment and up to 4 months after treatment has finished.
Speak to your treatment team about the most suitable method of contraception for you and how long to use it for after the last dose of vinorelbine.
Find out more about how breast cancer and its treatment can affect sex and intimacy and read our tips on how to manage these changes.
Fertility
If you were diagnosed with locally advanced or secondary breast cancer before you started or completed a family, you may be concerned about your fertility. Depending on your diagnosis and treatment, you may be advised not to get pregnant.
You can talk to your treatment team about any possible fertility preservation options before starting treatment.
Breastfeeding
You’ll be advised not to breastfeed during treatment. This is because there’s a chance your baby may absorb the drug through your breast milk, which can cause harm.
Travel and vaccinations
If you’re planning a holiday or need to travel overseas, check with your treatment team first.
You should not have any live vaccines while you’re having chemotherapy.
Live vaccines include:
- Mumps
- Measles
- Rubella (German measles)
- Polio
- BCG (tuberculosis)
- Zostavax shingles vaccine
- Yellow fever
Live vaccines contain a small amount of live virus or bacteria. If you have a weakened immune system, which you may do during chemotherapy, they could be harmful.
Talk to your GP or treatment team before having any vaccinations.
If anyone you have close contact with needs to have a live vaccine, speak to your treatment team or GP. They can advise what precautions you may need to take depending on the vaccination.
COVID-19 vaccination
If you’re having chemotherapy or targeted therapies, you’re advised to speak to your treatment team about the best time to have a COVID-19 vaccination.
Flu vaccination
Anyone at risk of a weakened immune system, and therefore more prone to infection, should have the flu vaccine. This includes people due to have, or already having, chemotherapy.
The flu vaccine is not a live vaccine so does not contain any active viruses.
Talk to your chemotherapy team or breast care nurse about the best time to have your flu jab.
7. Further support
Your chemotherapy team and breast care nurse can help with any questions you have. You can also call our free helpline on 0808 800 6000 for information and support.
On our online forum, you can find people going through treatment at the same time as you on the monthly chemotherapy threads.
