Vinorelbine (Navelbine)

Vinorelbine is a type of chemotherapy. It is also known as navelbine. You might have it as a treatment for:

• advanced breast cancer
• non small cell lung cancer
• cancer of the outer covering of the lung (mesothelioma)

You might have vinorelbine on its own, with other chemotherapy drugs or radiotherapy.

How does vinorelbine work?

Vinorelbine is a type of drug called a vinca alkaloid. It stops the cancer cells from separating into 2 new cells. So it blocks the growth of the cancer.

How do you have vinorelbine?

You have vinorelbine as capsules or you might have it as a drip into your bloodstream (intravenously).

Into your bloodstream

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

• central line
• PICC line
• portacath

Taking your capsules

You swallow them with plenty of water.

Don’t chew or suck the capsules because the drug could make your mouth sore if it leaks out. If you do this accidentally, rinse your mouth out over and over again with clean water and contact your doctor or nurse as soon as possible.

Don’t take the capsules with a hot drink as this can make them dissolve too quickly.

Take vinorelbine capsules with food as this helps reduce the chance of you being or feeling sick.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

When do you have vinorelbine?

You usually have vinorelbine as a course of several cycles of treatment . Your doctor or nurse will tell you more about this and how many you are likely to have. The treatment plan depends on which type of cancer you have.

Tests during treatment

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of vinorelbine?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.

Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or burning feeling when weeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Diarrhoea or constipation

Tell your healthcare team if you have diarrhoea or constipation. They can give you medicine to help. 

Hair thinning

Your hair may thin but you’re unlikely to lose all your hair. This usually starts after your first or second cycle of treatment. It is almost always temporary and your hair will grow back when you finish your treatment.

Sore mouth and throat

It may be painful to swallow drinks or food. Painkillers and mouth washes can help to reduce the soreness and keep your mouth healthy. 

Loss of reflexes

You may find you have changes to your reflexes. For example, your knee may not jerk when you tap the knee tendon. 

You may also have weakness in your legs and changes in your sense of touch.

High temperature (fever)

Tell your healthcare team straightaway if you get a high temperature. Ask them if you can take paracetamol to help lower your temperature.

Bruising and bleeding

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Fatigue (during and after treatment)

Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Liver changes

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.

Inflammation around the drip site

Tell your nurse straight away if you have any pain, redness, swelling or leaking around your drip site.

Loss of appetite and weight loss

You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss. 

Pain

Pain in different parts of the body such as chest pain, tummy (abdominal) pain and pain where the cancer is.

Tell your doctor or nurse. They can tell you what painkilling medication you can have.

Indigestion or heartburn

Contact your doctor or pharmacist if you have indigestion or heartburn. They can prescribe medicines to help.

General feeling of discomfort

You might have a feeling of general discomfort, uneasiness or pain. This is called malaise. Call the advice line or talk to your doctor or nurse if you do.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life threatening, alert your nurse or doctor if notice any of these symptoms
• headaches and dizziness
• difficulty sleeping
• taste changes
• skin reaction such as a rash, blisters and hives
• inflammation of the throat and food pipe causing difficulty in swallowing food or liquids
• chills
• weight gain
• difficulty swallowing
• high blood pressure or low blood pressure
• eyesight changes
• pain, burning or difficulty passing urine
• problems with your nerves which can cause motor neurone diseases such as losing your reflexes
• coughing and shortness of breath
• joint and muscle pain
• jaw pain
• an increase of creatinine in the blood
• disorders of the nerves and muscles
• symptoms affecting the urinary system and genital (sex) organs such as burning or pain when passing urine

Rare side effects

This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

• a serious infection - signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering - contact your advice line straight away if you have any of these symptoms
• slowing or stopping of the bowels which can cause severe constipation, stomach pain, feeling or being sick and bloating
• problems with balance and body movements
• flushing (redness) of your hands and feet
• the immune system attacking the nervous system (Guillain-Barre syndrome) - causing numbness, weakness and pain in the body
• a drop in the levels of sodium in your body which can cause headaches and sickness
• heart problems such as heart failure, chest pain (angina), heart attack and changes to heartbeat
• severe difficulty breathing or wheezing
• feeling cold in the hands or feet
• severe nerve problems causing abnormal sensations, tingling and prickling (pins and needles) that usually goes away after treatment. Your doctor might reduce the dose if it is very severe.

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know

Other medicines, foods and drinks

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Loss of fertility

You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

Contraception and pregnancy

This drug may harm a baby developing in the womb. It is important not to become pregnant while you are having treatment  for at least 3 months afterwards.

For men you should not father a child during treatment and for at least 6 months after.

Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.