Parenteral Manual

VinORELbine

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
NAVELBINE®
Classification: 
Antineoplastic, Vinca Alkaloid - CYTOTOXIC
Original Date: 
August 2005
Revised Date: 
June 2015
Indications: 
  • Non-small cell lung cancer; metastatic breast cancer
  • Being studied for other types of cancers; being studied in children

THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.

Reconstitution and Stability: 
  • Available as a 10 mg/mL solution; (clear solution and may become yellow to light amber)
  • Refrigerate vials; unopened vials stable 72 hrs at room temperature. Protect from light
  • Diluted to 1.5-3 mg/mL, stable in syringe 24 hours refrigerated or room temperature
  • Diluted to 0.5-2 mg/mL, stable in minibag/buretrol 24 hrs refrigerated or room temp
  • Stable in D5W for 7 days and NS for 3 days in fridge at a concentration of 0.5 mg/mL
Compatibility: 

- Solutions Compatible: D5W, NS

- Additive/buretrol Compatible: no information

- Y-site Compatible: calcium gluconate, ceftazidime, dexamethasone, diphenhydramine, hydrocortisone, hydromorphone, ifosfamide, metoclopramide, morphine, KCl, ondansetron

- Incompatible: sodium bicarbonate, cefuroxime

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct YES, certified RN only
Usual dilution: 1.5-3 mg/mL
Infusion time: 6-10 minutes into tubing of running IV, then flush line with 75-125 mL D5W or NS
IV Intermittent Infusion YES
Usual dilution: 0.5-2 mg/mL
Infusion time: 6-20 minutes, then flush line with 75-125 mL D5W or NS
IV Continuous Infusion YES
Intrathecal Injection ABSOLUTE CONTRAINDICATION; WILL RESULT IN FATALITY
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

20-35 mg/m2 weekly

  • Total dose per 3-week cycle: 50-60 mg/m2

DOSAGE IN HEPATIC DYSFUNCTION:

Bilirubin (micromol/L)

% Usual Dose

36-50

50%

>50

25%

  • See individual protocols for dose reduction in myelosuppression
  • See individual protocols for dose modification in neurotoxicity
  • No dose adjustment necessary in renal failure
Potential hazards of parenteral administration: 

Immediate (within a few minutes to hours):

  • Nausea, vomiting (mild to moderate emetogenic potential)
  • Diarrhea
  • Injection site reaction
  • Dyspnea (rare)

VESICANT: extreme irritation with extravasation; refer to Treatment of Infiltration, Section H, Infusion Therapy Manual. If extravasation occurs, click HERE for treatment guidelines.   

Delayed (within a few days to weeks):

  • Neurotoxicity (sensory) including constipation (less than vincristine and vinblastine)
  • Bone marrow depression (nadir: 7-10 days)
  • Pain
  • SIADH (rare)
  • Transient elevation of liver enzymes, bilirubin

- Treatment for unusual side effects are available through the study chair identified on the front page of the protocol and/or pharmacy

Notes: 
  • Monitor bowel function and administer laxatives when necessary
  • INTRATHECAL ADMINISTRATION IS FATAL

 

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.