Vinorelbine Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Non-Small Cell Lung Cancer

vinorelbine 30 mg/m2 administered weekly as a single agent. The recommended method of administration is an intravenous injection over 6 to 10 minutes. In controlled trials, single-agent vinorelbine was given weekly until progression or dose-limiting toxicity.

or

vinorelbine 25 mg/m2 weekly in combination with cisplatin. Blood counts should be checked weekly to determine whether dose reductions of vinorelbine and/or cisplatin are necessary. (In the SWOG study, most patients required a 50% dose reduction of vinorelbine at day 15 of each cycle and a 50% dose reduction of cisplatin by cycle 3.)

or

vinorelbine 30 mg/m2 weekly in combination with cisplatin.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

In patients who develop hyperbilirubinemia during treatment with vinorelbine, the dose should be adjusted for total bilirubin as follows:
If the total bilirubin is less than or equal to 2.0 mg/dL, then 100% of the starting dose may be administered.
If the total bilirubin is between 2.1 and 3.0 mg/dL, then 50% of the starting dose may be administered.
If the total bilirubin is greater than 3.0 mg/dL, then 25% of the starting dose may be administered.

The dosage should be adjusted according to hematologic toxicity or hepatic insufficiency, whichever results in the lower dose for the corresponding starting dose of vinorelbine.

Dose Adjustments

Dosages of vinorelbine may vary, depending on specific indication for use and choice of cytotoxic agents coadministered. Reference to specific protocols is recommended.

Granulocyte counts should be greater than or equal to 1000 cells/mm3 prior to the administration of vinorelbine.

Dose Modifications for Neurotoxicity:
If neurotoxicity greater than or equal to grade 2 develops, vinorelbine should be discontinued.

Dose Adjustments Based on Granulocyte Counts:
If the granulocyte count on the day of treatment is greater than or equal to 1500 cells/m3, then 100% of the starting dose may be administered.
If the granulocyte count on the day of treatment is 1000 to 1499 cells/m3, then 50% of the starting dose may be administered.
If the granulocyte count on the day of treatment is less than 1000 cells/m3, then do not administer. Repeat granulocyte count in one week. If three consecutive weekly doses are held because granulocyte count is less than 1000 cells/mm3, discontinue vinorelbine.

For patients who, during treatment with vinorelbine experienced fever and/or sepsis while granulocytopenic or had two consecutive weekly doses held due to granulocytopenia, subsequent doses of vinorelbine should be as follows:
If the granulocyte count on the day of treatment is greater than or equal to 1500 cells/m3, then 75% of the starting dose may be administered.
If the granulocyte count on the day of treatment is 1000 to 1499 cells/m3, then 37.5% of the starting dose may be administered.
If the granulocyte count on the day of treatment is less than 1000 cells/m3, then do not administer. Repeat granulocyte count in one week. If three consecutive weekly doses are held because granulocyte count is less than 1000 cells/mm3, discontinue vinorelbine.

Dose Modifications for Concurrent Hematologic Toxicity and Hepatic Insufficiency:
In patients with both hematologic toxicity and hepatic insufficiency, the lower of the doses based on the corresponding starting dose of vinorelbine as determined above.

Precautions

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

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