Decrease in the vinorelbine-induced venous irritation by pharmaceutical intervention

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 vinorelbineinduced 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.