Patients should be informed that the major acute toxicity of intravenous NAVELBINE (vinorelbine tartrate) Injection is bone marrow toxicity, in particular granulocytopenia. Because granulocytopenia can result in an increased risk of infection, patients should immediately report any potential signs of infection, including fever and chills, to their physician. Women of childbearing potential should be advised to avoid becoming pregnant during treatment with NAVELBINE. See Tables 5 and 6 for patient information on possible side effects of single-agent NAVELBINE and NAVELBINE in combination with cisplatin. It is important to review this information with your patient, emphasizing management strategies.

When Might I Expect to Have This Side Effect?

Within the first 2 to 3 weeks of treatment

What Should I Do If I Have This Side Effect?

Reduce risk of infection:

• Wash hands frequently
• Avoid crowds
• Eat well/take vitamins
• Get plenty of rest

When Should I Call My Doctor or Oncology Nurse?

If you have:

• A fever of 101° or more anytime, day or night
• Chills or night sweats
• Sore throat or mouth sores

When Might I Expect to Have This Side Effect?

During administration or for a few days thereafter

What Should I Do If I Have This Side Effect?

• Place arm on pillow above rest of body

When Should I Call My Doctor or Oncology Nurse?

If you have:

• Pain, redness, or swelling at injection site

When Might I Expect to Have This Side Effect?

Increases after several treatments

What Should I Do If I Have This Side Effect?

• Respond immediately to the urge to have a bowel movement
• Eat high fiber foods such as whole-grain cereal, bran, raw vegetables, and fruits
• Avoid eating cheese, peanut butter, and refined grain products
• Drink plenty of fluids
• Take a stool softener as needed

When Should I Call My Doctor or Oncology Nurse?

Whenever you:

• Are unable to relieve constipation using the measures listed

When Might I Expect to Have This Side Effect?

Within 24 hours of treatment

What Should I Do If I Have This Side Effect?

• Hold cold cloth to throat
• Eat soda crackers
• Sip ginger ale or flat cola
• Breathe deeply

When Should I Call My Doctor or Oncology Nurse?

Whenever you:

• Are very nauseated
• Have vomited for more than a day
• Are unable to keep liquids down

When Might I Expect to Have This Side Effect?

This rarely occurs

What Should I Do If I Have This Side Effect?

• Try suggestions for mild nausea
• Take antinausea medication as directed

When Should I Call My Doctor or Oncology Nurse?

Whenever you:

• Are very nauseated
• Have vomited for more than a day
• Are unable to keep liquids down

When Might I Expect to Have This Side Effect?

After several treatments

What Should I Do If I Have This Side Effect?

• Consider getting a short haircut, which can minimize impact of thinning hair

When Should I Call My Doctor or Oncology Nurse?

• Discuss at your next visit

When Might I Expect to Have This Side Effect?

After several treatments

What Should I Do If I Have This Side Effect?

• Be careful when handling hot liquids or sharp items
• Avoid lifting heavy objects
• Wear shoes or slippers except when bathing

When Should I Call My Doctor or Oncology Nurse?

If you experience:

• Numbness
• Tingling
• Weakness in hands or feet

When Might I Expect to Have This Side Effect?

After several treatments

What Should I Do If I Have This Side Effect?

• Limit your activities
• Get plenty of rest
• Ask for help when you need it

When Should I Call My Doctor or Oncology Nurse?

• Discuss at your next visit

When Might I Expect to Have This Side Effect?

Within the first 2 to 3 weeks of treatment

What Should I Do If I Have This Side Effect?

Reduce risk of infection:

• Wash hands frequently
• Avoid crowds
• Eat well/take vitamins
• Get plenty of rest

When Should I Call My Doctor or Oncology Nurse?

If you have:

• A fever of 101° or more anytime, day or night
• Chills or night sweats
• Sore throat or mouth sores

When Might I Expect to Have This Side Effect?

During administration or for a few days thereafter

What Should I Do If I Have This Side Effect?

• Place arm on pillow above rest of body

When Should I Call My Doctor or Oncology Nurse?

If you have:

• Pain, redness, or swelling at injection site

When Might I Expect to Have This Side Effect?

Increases after several treatments

What Should I Do If I Have This Side Effect?

• Respond immediately to the urge to have a bowel movement
• Eat high fiber foods such as whole-grain cereal, bran, raw vegetables, and fruits
• Avoid eating cheese, peanut butter, and refined grain products
• Drink plenty of fluids
• Take a stool softener as needed

When Should I Call My Doctor or Oncology Nurse?

Whenever you:

• Are unable to relieve constipation using the measures listed

When Might I Expect to Have This Side Effect?

1 to 4 hours after receiving cisplatin

What Should I Do If I Have This Side Effect?

• Hold cold cloth to throat
• Eat soda crackers
• Sip ginger ale or flat cola
• Breathe deeply

When Should I Call My Doctor or Oncology Nurse?

Whenever you:

• Are very nauseated
• Have vomited for more than a day
• Are unable to keep liquids down

When Might I Expect to Have This Side Effect?

1 to 4 hours after receiving cisplatin

What Should I Do If I Have This Side Effect?

• Same as for mild nausea
• Take antinausea medication as directed

When Should I Call My Doctor or Oncology Nurse?

Whenever you:

• Are very nauseated
• Have vomited for more than a day
• Are unable to keep liquids down

When Might I Expect to Have This Side Effect?

After several treatments

What Should I Do If I Have This Side Effect?

Watch for:

• Swelling in hands or feet
• Increased weight
• Weakness or fatigue
• Unusual itching
• Pain in side, ribs, back or hip

When Should I Call My Doctor or Oncology Nurse?

If you have

• Swelling in hands or feet
• Increased weight
• Weakness or fatigue
• Unusual itching
• Pain in side, ribs, back or hip

When Might I Expect to Have This Side Effect?

After several treatments

What Should I Do If I Have This Side Effect?

• Be careful when handling hot liquids or sharp items
• Avoid lifting heavy objects
• Wear shoes or slippers except when bathing

When Should I Call My Doctor or Oncology Nurse?

If you have:

• Numbness
• Tingling
• Weakness in hands or feet

When Might I Expect to Have This Side Effect?

After several treatments

What Should I Do If I Have This Side Effect?

• Watch for times when you don't hear as well as you did before treatment

When Should I Call My Doctor or Oncology Nurse?

If you:

• Experience hearing difficulties

When Might I Expect to Have This Side Effect?

After several treatments

What Should I Do If I Have This Side Effect?

• Consider using hat, wig, scarf, or other head covering, particularly in cold weather

When Should I Call My Doctor or Oncology Nurse?

• Discuss at your next visit

When Might I Expect to Have This Side Effect?

After several treatments

What Should I Do If I Have This Side Effect?

• Limit your activities
• Get plenty of rest
• Ask for help when you need it

When Should I Call My Doctor or Oncology Nurse?

• Discuss at your next visit

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