Protocolo de quimioterapia COP
COP Chemotherapy Protocol
Cyclophosphamide, Vincristine, Prednisolone
También conocido como: COP Protocol · High-dose COP · Cyclophosphamide, Oncovin, Prednisone · CVP protocol
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| COP Protocol - Induction (Cyclophosphamide) | 250 mg/m2 | PO | q21d | First 6 months | 🌍 EU |
| COP Protocol - Induction (Vincristine) | 0.70 mg/m2 | IV | q7d for 4 weeks, then q21d | First 6 months | 🌍 EU |
| COP Protocol - Induction (Prednisolone) | 2 mg/kg (week 1), 1.5 mg/kg (week 2), 1 mg/kg (week 3), 1 mg/kg thereafter | PO | q24h (weeks 1-3), then q48h | First 6 months | 🌍 EU |
| COP Protocol - Adjunct (Furosemide) | 1 mg/kg | PO | q12h | For 48h (4 doses) concurrent with cyclophosphamide | 🌍 EU |
| COP Protocol - Maintenance after 6 months (Cyclophosphamide) | 250 mg/m2 | PO | q28d | Months 6 to 12 | 🌍 EU |
| COP Protocol - Maintenance after 6 months (Vincristine) | 0.70 mg/m2 | IV | q28d | Months 6 to 12 | 🌍 EU |
| COP Protocol - Maintenance after 6 months (Prednisolone) | 1 mg/kg | PO | q48h | Months 6 to 12 | 🌍 EU |
| Alternative to Cyclophosphamide (Chlorambucil) | 20 mg/m2 | PO | As directed replacing cyclophosphamide | Ongoing | 🌍 EU |
- COP Protocol - Induction (Cyclophosphamide): Administer with Furosemide to prevent haemorrhagic cystitis.
- COP Protocol - Induction (Vincristine): On q21d schedule, give on the same day as cyclophosphamide.
- COP Protocol - Induction (Prednisolone): Tapering dose schedule.
- COP Protocol - Adjunct (Furosemide): Administered to promote diuresis and reduce risk of haemorrhagic cystitis.
- COP Protocol - Maintenance after 6 months (Cyclophosphamide): Stop protocol after 12 months and monitor for relapse.
- COP Protocol - Maintenance after 6 months (Vincristine): Administer with cyclophosphamide.
- COP Protocol - Maintenance after 6 months (Prednisolone): Stop protocol after 12 months and monitor for relapse.
- Alternative to Cyclophosphamide (Chlorambucil): Use if haemorrhagic cystitis develops or if blood is noted on urine dipstick and culture is negative.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El protocolo COP (Ciclofosfamida, Vincristina, Prednisolona) es una terapia citotóxica combinada utilizada comúnmente en oncología veterinaria, principalmente para el tratamiento del linfoma.
Advertencia clínica: La vincristina es un vesicante potente. La extravasación provoca necrosis tisular grave.
Perla clínica: Aunque la mayoría de los oncólogos prefieren un protocolo tipo CHOP, el COP a dosis altas es un protocolo muy útil y relativamente sencillo para su uso en entornos no especializados.
Mecanismo de acción
The COP protocol utilizes three distinct mechanisms to target neoplastic cells:
- Cyclophosphamide: An alkylating agent that cross-links DNA strands → prevents DNA replication and transcription → induces cell death.
- Vincristine: Binds to tubulin → inhibits microtubule formation and mitotic spindle assembly → arrests cell division in metaphase.
- Prednisolone: A glucocorticoid that binds to specific intracellular receptors → alters gene expression → induces apoptosis in neoplastic lymphocytes.
Seguridad y advertencias
Contraindicaciones
- Severe neutropenia (< 2 x 10^9/L)
- Pre-existing haemorrhagic cystitis
- Known MDR1 mutation (requires extreme caution/dose adjustment for vincristine)
Efectos adversos
- Myelosuppression (neutropenia)
- Haemorrhagic cystitis (cyclophosphamide)
- Gastrointestinal toxicity (vomiting, diarrhoea, anorexia)
- Tissue necrosis if extravasated (vincristine)
Precauciones
Vesicant Warning: Vincristine is a vesicant. IV catheters must be placed in all cases, and ONLY catheters placed by a clean 'first-stick' should be used.
Myelosuppression: Discontinue cyclophosphamide if neutrophil count decreases to < 2 x 10^9/L. Check weekly and do not resume until > 3 x 10^9/L. If neutropenia recurs, decrease dose by 10-25%.
MDR1 Mutation: Certain breeds (generally Collie type) are very sensitive to vincristine due to the MDR1 mutation; commercial testing is highly recommended prior to treatment.
Clinical Pearl: GI protectants (e.g., Omeprazole 1 mg/kg q12-24h or Ranitidine with sucralfate) are recommended for the first 21 days of the protocol.
Interacciones farmacológicas
Inhibits hepatic cytochrome P450 enzyme pathway, potentially altering the metabolism and increasing toxicity of chemotherapeutics.
Monitorización
- Haematology (prior to each vincristine treatment)
- Biochemistry (prior to first treatment, then minimum every 6 months)
- Free-catch urine dipstick (prior to each cyclophosphamide administration to check for blood)
- Urine culture (if blood is noted on dipstick)
Farmacocinética
Vida media
Absorción
Cyclophosphamide and Prednisolone are well absorbed orally. Vincristine must be given IV.
Distribución
Vincristine binds extensively to tissues. Cyclophosphamide is widely distributed.
Metabolismo
Cyclophosphamide requires hepatic activation (CYP450) to active alkylating metabolites. Vincristine is metabolized by the liver.
Eliminación
Cyclophosphamide metabolites are excreted in urine (causing local toxicity). Vincristine is primarily excreted in feces via bile.
Sobredosis
Severe toxicity: Overdose of these chemotherapeutics can lead to fatal myelosuppression, severe gastrointestinal sloughing, sepsis, and death. Extravasation of vincristine causes severe, progressive tissue necrosis requiring immediate management (e.g., hyaluronidase, warm compresses).
Productos disponibles
Formulaciones
- Oral tablets (Cyclophosphamide, Prednisolone, Chlorambucil, Furosemide)
- Intravenous injection (Vincristine)
Veterinario
- Prednisolone tablets (various strengths)
- Furosemide tablets (various strengths)
Etiquetado para humanos
- Cyclophosphamide tablets
- Vincristine sulfate injection
- Chlorambucil tablets
Estado regulador
Protocol utilizes a mix of veterinary-approved (prednisolone, furosemide) and human-approved (cyclophosphamide, vincristine) drugs under the cascade.
Administered under the prescribing cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store oral chemotherapeutics in their original, clearly labeled containers away from food and children. Vincristine injection requires refrigeration and protection from light. Follow strict hazardous drug handling protocols.
Información para el cliente
Su mascota está recibiendo un protocolo de quimioterapia combinado llamado COP.
- Manipulación segura: Los fármacos de quimioterapia se excretan en la orina y las heces de su mascota. Use guantes desechables al manipular sus desechos o limpiar accidentes durante al menos 48 horas después del tratamiento. Lávese bien las manos.
- Administración de medicamentos: Nunca triture ni parta las tabletas de quimioterapia.
- Qué observar: Vigile de cerca cualquier signo de infección (letargo, fiebre), malestar gastrointestinal (vómitos, diarrea, pérdida de apetito) o sangre en la orina.
- Si nota sangre en la orina, suspenda la ciclofosfamida inmediatamente y contacte a su veterinario, ya que esto puede indicar irritación de la vejiga (cistitis hemorrágica).
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.