Vinorelbine !

A vinca alkaloid for non-small cell lung cancer. Neutropenia limits its dose; constipation and ileus are the bowel risks.

Updated 2026-11-01

Class: Microtubule inhibitors
Target: β-tubulin (vinca site, at the junction between tubulin dimers)
ATC code: L01CA04
WHO Model List of Essential Medicines

β-tubulin (vinca site, at the junction between tubulin dimers)Vinorelbine

The structure shows vinorelbine bound to porcine tubulin at the vinca site.

Target in 3D: β-tubulin (vinca site, at the junction between tubulin dimers). PDB structure 7CNN (RCSB PDB, public domain). View the structure at RCSB PDB

Mechanism of action

Vinorelbine binds tubulin and interferes with microtubule assembly, so mitosis stops at metaphase.

Vinorelbine binds tubulin
Microtubule assembly is blocked
Mitosis stops in metaphase

Pharmacokinetics

Absorption: Intravenous only.
Metabolism: Liver, by CYP3A; doses are reduced when bilirubin rises.

Indications

Non-small cell lung cancer: first line with cisplatin, or alone for metastatic disease. Lung cancer →

Adverse effects

Common

Neutropenia, anaemia and thrombocytopenia
Constipation, nausea
Injection-site reactions
Peripheral neuropathy

Contraindications

None listed in the US label; it is not given when the neutrophil count is low

Key interactions

CYP3A inhibitors: Earlier or more severe adverse reactions.
Mitomycin: Vinca alkaloids with mitomycin have caused acute bronchospasm.

What is monitored

Blood count before each dose
Liver tests
Bowel function, neuropathy and breathing symptoms

Administration and safety

Intravenous only, as a short infusion into a free-flowing line followed by a flush.
Vesicant: the catheter position is confirmed first; if leakage occurs the infusion is stopped and managed per protocol.
Hazardous drug: prepared and given following hazardous-drug handling procedures (impervious gloves, no skin contact) and disposed of as cytotoxic waste.

Nursing care

Independent double check of drug, patient, route and cycle before giving it (high-alert medicine).
Bowel regimen from the start (fluids, fibre, stool softeners); ask about stools every day and report abdominal pain or no bowel movement.
Blood count before each cycle; fever with neutropenia is treated as an emergency.
Teaching: report pain or burning at the injection site, numbness, or new cough or breathlessness.

Pregnancy and breastfeeding

Can cause fetal harm; effective contraception is used during treatment by women and by men with female partners.

Test yourself

Think of the answer, then tap the question to see it.

What is vinorelbine's main indication?

Non-small cell lung cancer, with cisplatin or alone.

What is the dose-limiting toxicity of vinorelbine?

Neutropenia.

Which bowel complication can be fatal with vinorelbine, and how is it prevented?

Paralytic ileus or bowel obstruction; a prophylactic bowel regimen (fibre, fluids, stool softeners) is started.

Add to my cards (3)

Lung cancer

← Back to the class: Microtubule inhibitors

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: DailyMed - VINORELBINE injection, solution (DailyMed (U.S. National Library of Medicine), 2024); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 70 (McGraw Hill, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026); eEML - Electronic Essential Medicines List (World Health Organization, 2025).

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Representative model, for educational purposes only.