Abstract
Purpose
The intravenous injection of vinorelbine often causes venous irritation such as erythema, injection site pain, and phlebitis. The purpose of the present study was to investigate the risk factor associated with the vinorelbine-induced venous irritation and to establish a suitable administration method of vinorelbine.
Methods
We analyzed the risk factor associated with venous irritation in 63 patients administered vinorelbine from April 2006 to September 2008. We subsequently changed the regimen of vinorelbine and examined the incidence of venous irritation in 24 patients administered vinorelbine from October 2008 to March 2010.
Results
A multivariate logistic regression analysis revealed that the dose of vinorelbine (≥40 mg) was a significant predictor for venous irritation (adjusted odds ratio = 4.39; 95% confidence intervals, 1.33–14.49; p = 0.015). Moreover, the grade of venous irritation in patients administered vinorelbine at the doses of ≥40 mg was significantly higher than that in patients administered vinorelbine at the doses of <40 mg (p = 0.011). Based on this result, we altered the volume of normal saline for vinorelbine dissolution from 50 to 100 mL. After the change of regimen, the grade of venous irritation induce by vinorelbine was significantly decreased (p = 0.034), although the incidence was not significantly changed (46.0% versus 33.3%).
Conclusions
The change of regimen of vinorelbine based on the analysis significantly decreased the grade of venous irritation. Pharmacists can contribute to the management for the vinorelbine-induced venous irritation.
Similar content being viewed by others
References
Winton T, Livingston R, Johnson D et al (2005) Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer. N Engl J Med 352:2589–2597
Romero A, Rabinovich MG, Vallejo CT et al (1994) Vinorelbine as first-line chemotherapy for metastatic breast carcinoma. J Clin Oncol 12:336–341
Pérol M, Guérin JC, Thomas P et al (1996) Multicenter randomized trial comparing cisplatin–mitomycin–vinorelbine versus cisplatin–mitomycin–vindesine in advanced non-small cell lung cancer. Lung cancer 14:119–134
Rittenberg CN, Gralla RJ, Rehmeyer TA (1995) Assessing and managing venous irritation associated with vinorelbine tartrate (Navelbine). Oncol Nurs Forum 22:707–710
Vassilomanolakis M, Koumakis G, Barbounis V et al (2001) Prevention of vinorelbine phlebitis with cimetidine. A two-step design study. Support Care Cancer 9:108–111
Yoh K, Niho S, Goto K et al (2004) High body mass index correlates with increased risk of venous irritation by vinorelbine infusion. Jpn J Clin Oncol 34:206–209
Yoh K, Niho S, Goto K et al (2007) Randomized trial of drip infusion versus bolus injection of vinorelbine for the control of local venous toxicity. Lung Cancer 55:337–341
Yamada T, Egashira N, Imuta M et al (2010) Role of oxidative stress in vinorelbine-induced vascular endothelial cell injury. Free Radic Biol Med 48:120–127
Navelbine (vinorelbine) Physicians’ Desk Reference (2004) Medical Economics, Montvale
Navelbine (vinorelbine) Package Insert (2007) Pierre Fabre Pharmaceuticals Parsippany
Jackson A (1998) Infection control—a battle in vein: infusion phlebitis. Nurs Times 94:68–71
Nakayama S, Matsubara N, Sakai T et al (2002) The incidence of phlebitis in the patients administrated vinorelbine by intravenous bolus injection—a retrospective study. Gan To Kagaku Ryoho 29:633–635
Polovich M, White JM, Kelleher LO (2005) Chemotherapy and biotherapy guideline and recommendation for practice, 2nd edn. Oncology Nursing Society, Pittsburgh
Verso M, Agnelli G (2003) Venous thromboembolism associated with long-term use of central venous catheters in cancer patients. J Clin Oncol 21:3665–3675
Beckers MM, Ruven HJ, Seldenrijk CA et al (2010) Risk of thrombosis and infections of central venous catheters and totally implanted access ports in patients treated for cancer. Thromb Res 125:318–321
Conflict of interest
None declared.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yamada, T., Egashira, N., Watanabe, H. et al. Decrease in the vinorelbine-induced venous irritation by pharmaceutical intervention. Support Care Cancer 20, 1549–1553 (2012). https://doi.org/10.1007/s00520-011-1244-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-011-1244-3