Venorelbine tartrate (Navelbine, Glaxo Smith Kline) is a vinca alkaloid used as a intravenous chemotherapeutic agent. The dose should be reduced if hematologic and/or hepatic toxicity develop during therapy.
Parameters:
(1) granulocyte count on the day of therapy
(2) history of previous granulocyte counts
(3) history of fever and/or sepsis
(4) total serum bilirubin
Adjustments for Hematologic Toxicity
Causes for further reductions include:
(1) presence of fever and/or sepsis while granulocytopenic
(2) previous 2 weeks had dose held for granulocytopenia
Granulocyte Count |
Percent of Starting Dose to Administer |
Causes for Further Reductions |
>= 1,500 per µL |
100% |
75% |
1,000 - 1,499 per µL |
50% |
37.5% |
< 1,000 per µL |
hold dose |
hold dose |
If the dose is held for 3 weeks in a row, then discontinue the vinorelbine.
Adjustments for Hepatic Toxicity
Total Serum Bilirubin |
Percentage of Starting Dose |
<= 2.0 mg/dL |
100% |
2.1 - 3.0 mg/dL |
50% |
> 3.0 mg/dL |
25% |
Adjustments for Mixed Hematologic and Hepatic Toxicity
If both hematologic and hepatic toxicity are present, then the lower of the 2 dosage adjustments should be used.
Specialty: Hematology Oncology, Surgery, general
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