Epirubicin
**Epirubicin** is a semisynthetic stereoisomer of doxorubicin used in veterinary oncology. It is a cytotoxic anthracycline glycoside antibiotic that demonstrates efficacy against several neoplasms, including lymphoma, splenic haemangiosarcoma, and histiocytic sarcoma. > **Clinical Warning:** Epirubicin is a potent vesicant. Extravasation will cause severe tissue necrosis. It must be administered via a perfectly placed and taped indwelling IV catheter.
Mecanismo: Epirubicin enters the cell where its intracellular metabolism results in the production of **cytotoxic free radicals**. It also binds irreversibly to **DNA** → prevents DNA replication and alters cell membrane functions, ultimately leading to cell death.
Dosificación por especie
- Feline injection site sarcoma · 25 mg/m2 or 1 mg/kg · IV · q3wk · Administer over a minimum period of 10 minutes into the side port of a freely running IV infusion of 0.9% NaCl.
- Lymphoma, splenic haemangiosarcoma, histiocytic sarcoma, and other sarcomas/carcinomas · 30 mg/m2 (In dogs weighing <10 kg a dose of 1 mg/kg should be used) · IV · q3wk · Maximum total dose not to exceed 240 mg/m2 · Administer over a minimum period of 10 minutes into the side port of a freely running IV infusion of 0.9% NaCl.
Las dosis son una referencia clínica para veterinarios colegiados. Confirme siempre con la ficha técnica vigente y el paciente individual.
Vías de administración
Contraindicaciones
- No specific absolute contraindications listed, but use with extreme caution in patients with pre-existing cardiac disease or the ABCB1 (MDR1) mutation.
Efectos adversos
- Acute anaphylaxis
- Dose-dependent cumulative cardiotoxicity (cardiomyopathy, congestive heart failure)
- Tachycardia and arrhythmias (during administration)
- Anorexia
- Vomiting
- Pancreatitis
- Severe leucopenia
- Thrombocytopenia
- Haemorrhagic gastroenteritis
- Nephrotoxicity
- Severe tissue necrosis (if extravasated)
Interacciones farmacológicas
- Heparin · Incompatible; a precipitate will form if mixed. · major
- Cyclophosphamide · Increased risk of myelosuppression when used in combination. · major
- Cimetidine · Increases the area under the dose curve (AUC) of epirubicin by 50%; should not be used concurrently. · major
Monitorización
- Complete Blood Count (CBC) and platelet count prior to every dose
- Physical examination and auscultation
- Electrocardiogram (ECG)
- Echocardiogram (especially in breeds predisposed to cardiac disease)
- Renal parameters
- Gastrointestinal signs
Sobredosis
Overdosage increases the risk of severe myelosuppression, severe gastrointestinal toxicity (haemorrhagic gastroenteritis), and acute cardiotoxicity. Treatment is supportive and symptomatic, including aggressive fluid therapy, broad-spectrum antibiotics (if neutropenic), and antiemetics.
La referencia de fármacos de VetSheet está destinada a veterinarios colegiados como apoyo a la decisión clínica, no sustituye el juicio profesional ni la ficha técnica vigente del fabricante.