[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Microtubule inhibitors](https://durgical.com/en/pharmacology/classes/microtubule-inhibitors/) › Vinorelbine

[Pharmacology](https://durgical.com/en/pharmacology/) · [Microtubule inhibitors](https://durgical.com/en/pharmacology/classes/microtubule-inhibitors/)

# 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](https://durgical.com/en/pharmacology/classes/microtubule-inhibitors/)
- Target: β-tubulin (vinca site, at the junction between tubulin dimers)
- ATC code: L01CA04
- WHO Model List of Essential Medicines

## ⚠ High-alert medication

An error with this medicine can cause serious harm: double checks and protocols are used.

◆**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](https://www.rcsb.org/structure/7CNN) · Drag to rotate · pinch to zoom

## 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 →](https://durgical.com/en/conditions/lung-cancer/)

## Adverse effects

### Common

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

### Serious (rare, important)

- Severe myelosuppression with septic shock (boxed warning)
- Paralytic ileus, bowel obstruction, necrosis and perforation
- Interstitial pneumonitis, ARDS and severe bronchospasm
- Liver injury; tissue necrosis or thrombophlebitis after extravasation

## 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.

## Memory aid

VinoRELbine «RELates to the lung»: the vinca alkaloid of non-small cell lung cancer, limited by neutrophils.

## 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)](https://durgical.app/estudiar/?add=/en/pharmacology/vinorelbine/)

## Related drugs

- [Vinblastine](https://durgical.com/en/pharmacology/vinblastine/)
- [Vincristine](https://durgical.com/en/pharmacology/vincristine/)
- [Cisplatin](https://durgical.com/en/pharmacology/cisplatin/)

## Related conditions

- [Lung cancer](https://durgical.com/en/conditions/lung-cancer/)

[← Back to the class: Microtubule inhibitors](https://durgical.com/en/pharmacology/classes/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](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=10a70995-e04d-4044-b1dc-c9aa27460397) (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](https://atcddd.fhi.no/atc_ddd_index/?code=L01CA04) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/vinorelbine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/vinorelbine/