カルボプラチン
Carboplatin
cis-Diammine-1,1cyclobutanedicarboxylato-platinum
別名: Paraplatin · carboplatinum · CBDCA · JM-8 · NSC241240
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
これは体表面積（mg/m²）に基づく用量です。投与前に体重を体表面積へ換算してください。
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Antineoplastic | 300-350 mg/m2 | IV | every 3 weeks | — | 🌎 NA |
| Neoplastic diseases (All uses) | 300 mg/m2 | IV | q3-4wk | As determined by oncology protocol | 🌍 EU |
| Neoplastic diseases (Intrapleural/intraperitoneal) | 225-300 mg/m2 | Intrapleural/Intraperitoneal | As directed by specialist | As determined by oncology protocol | 🌍 EU |
- Antineoplastic: Dosage may need adjustment in patients with reduced renal function.
- Neoplastic diseases (All uses): Injected into the side port of a freely running i.v. infusion of 0.9% NaCl over a 10-15 min period.
- Neoplastic diseases (Intrapleural/intraperitoneal): Diluted in 0.9% NaCl or 5% dextrose water over a 5-10 min period. Consult a veterinary oncology specialist before administering via this route.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Antineoplastic | 180-260 mg/m2 | IV | every 3 weeks | — | 🌎 NA |
| Neoplastic diseases (All uses) | 200 mg/m2 | IV | q3-4wk | As determined by oncology protocol | 🌍 EU |
| Neoplastic diseases (Intrapleural/intraperitoneal) | 200-240 mg/m2 | Intrapleural/Intraperitoneal | As directed by specialist | As determined by oncology protocol | 🌍 EU |
- Antineoplastic: Has also been administered intratumorally for nasal planum carcinomas.
- Neoplastic diseases (All uses): Injected into the side port of a freely running i.v. infusion of 0.9% NaCl over a 10-15 min period. Monitor for delayed/unpredictable side effects.
- Neoplastic diseases (Intrapleural/intraperitoneal): Diluted in 0.9% NaCl or 5% dextrose water over a 5-10 min period. Consult a veterinary oncology specialist before administering via this route.
小型哺乳類
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Antineoplastic | 180-260 mg/m2 | IV | every 3 weeks | — | 🌎 NA |
- Antineoplastic: Dose for rabbits.
鳥
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Adenocarcinoma | Intralesional use may be considered | Intralesional | — | — | 🌎 NA |
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Equine sarcoids | Intralesional use may be considered | Intralesional | — | — | 🌎 NA |
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
カルボプラチンは、獣医腫瘍学で広く使用されている第2世代の白金系抗悪性腫瘍薬です。主に様々な癌や肉腫の治療に使用され、特に断脚後の犬の骨肉瘤に対する補助療法として最もよく知られています。
臨床的特徴と利点：
- 猫に対する安全性： 前世代のシスプラチン（猫に致命的な肺水腫を引き起こす）とは異なり、カルボプラチンは比較的安全であり、猫の患者にも日常的に使用されます。
- 毒性の軽減： カルボプラチンは一般的に「より穏やかな」白金系薬剤と見なされています。シスプラチンと比較して腎毒性や催吐性（嘔吐）のリスクが著しく低いため、治療前後の積極的な静脈内輸液による利尿を必要としません。
- 多様な投与経路： 全身的な静脈内投与に加えて、体腔内（胸水）、動脈内、および病変内（馬のサルコイド、猫の鼻鏡扁平上皮癌）への応用も期待されています。
作用機序
Carboplatin acts as a bifunctional alkylating agent.
- Cellular Entry & Activation: Once inside the cell, the drug undergoes aquation (water molecules replace the cyclobutanedicarboxylate leaving group), forming highly reactive, positively charged platinum complexes.
- DNA Crosslinking: These active complexes bind covalently to nucleophilic sites on DNA (primarily the N7 position of guanine and adenine).
- Inhibition: This binding creates intra-strand and inter-strand crosslinks in the DNA double helix, physically obstructing DNA polymerases and RNA polymerases.
- Apoptosis: The resulting DNA damage inhibits DNA replication, RNA transcription, and protein synthesis, ultimately triggering apoptosis (programmed cell death).
Note: Carboplatin is cell-cycle nonspecific, meaning it can damage cells during any phase of the cell cycle, though cells are most vulnerable during the G1 and S phases.
安全性・警告
禁忌
- History of hypersensitivity to carboplatin or other platinum agents
- Severe bone marrow depression
- Pregnancy (fetotoxic and embryotoxic - Category D)
有害事象
- Bone marrow suppression (neutropenia, thrombocytopenia)
- Anorexia
- Vomiting (typically 2-4 days post-dose)
- Hepatotoxicity (elevated bilirubin and liver enzymes)
- Nephrotoxicity (less frequent than cisplatin)
- Neuropathies (rare)
- Ototoxicity (rare)
- Anaphylactoid reactions (rare)
- Hyperuricemia
注意事項
DO NOT give IM or SC. Extreme caution is advised in patients with active infections, hearing impairment, or preexisting renal or hepatic disease. Patients with severe carboplatin-induced myelosuppression must recover their cell counts before additional therapy. Equipment Warning: Do not prepare, store, or administer using aluminum-containing needles or IV sets, as aluminum displaces platinum, causing a black precipitate and loss of potency.
医薬品相互作用
Potential for increased risk of nephrotoxicity or ototoxicity.
Patients previously treated with cisplatin have an increased risk of developing neurotoxicity or ototoxicity after receiving carboplatin.
The leukopenic or thrombocytopenic effects secondary to carboplatin may be enhanced.
Potential for increased hematologic toxicity.
Live or killed virus vaccines administered after therapy may have reduced efficacy. Carboplatin may also potentiate live virus vaccine replication and increase adverse effects.
Increased risk of cumulative nephrotoxicity.
May adversely affect the safety and efficacy of vaccinations due to immunosuppression.
Potential to act as a radiosensitizer for patients receiving concomitant radiotherapy.
監視
- CBC (Complete Blood Count) to monitor nadir
- Serum electrolytes
- Uric acid
- Baseline renal and hepatic function tests
薬物動態
吸収
Administered intravenously; 100% bioavailable.
分布
Well distributed throughout the body; highest concentrations are found in the liver, kidney, skin, and tumor tissue.
代謝
The parent drug degrades into platinum and platinum-complexed compounds.
消失
Primarily eliminated by the kidneys. In dogs, almost one half of the dose is excreted in the urine within 24 hours and approximately 70% of the platinum administered is secreted in the urine after 72 hours.
過剰投与
An overdose of carboplatin is expected to cause severe, aggravated effects associated with the drug's primary toxicities: bone marrow suppression, nephrotoxicity, and hepatotoxicity.
- Monitoring: Closely monitor for neurotoxicity, ototoxicity, hepatotoxicity, and nephrotoxicity.
- Treatment: Therapy is primarily supportive as no specific antidote is available. Plasmapheresis or hemodialysis could potentially be of benefit in rapidly removing the drug from systemic circulation.
製品
製剤
- Lyophilized powder for injection
- Injection solution
ヒト用医薬品
- Carboplatin lyophilized Powder for reconstitution and IV Injection: 50 mg, 150 mg, & 450 mg in single-dose vials
- Carboplatin Injection: 10 mg/mL in 5 mL, 15 mL & 45 mL single-use vials
規制ステータス
Cytotoxic agent. Must be handled and administered according to strict hazardous drug protocols.
Prescription Only Medicine. Cytotoxic handling rules apply.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store powder for injection at room temperature and protect from light. After reconstitution to 10 mg/mL, solutions are stable for at least 8 hours (manufacturer recommends discarding unused portions after 8 hours due to lack of preservatives). Do not prepare, store, or administer using aluminum-containing items, as contact with aluminum forms a black precipitate and inactivates the drug.
飼主向け情報
カルボプラチンは、ペットの癌治療に使用される強力な抗がん剤です。一般的に忍容性は良好ですが、自宅で以下の重要な安全およびケアのガイドラインに従う必要があります：
- 排泄物の取り扱い： 治療後数日間は薬物およびその活性代謝物が尿中に排泄されるため、ペットの尿、便、嘔吐物に直接触れないようにしてください。粗相を片付ける際は使い捨て手袋を着用し、その後は手を十分に洗ってください。
- 「骨髄抑制の底（ナディア）」の時期： カルボプラチンは一時的にペットの白血球数を減少させ、感染症にかかりやすくします。この最も数値が下がる時期（ナディア）は、通常犬では治療後約14日、猫では約21日に発生します。
- 獣医師に連絡するタイミング： ナディアの期間中はペットを注意深く観察してください。ペットに発熱、重度の無気力、嘔吐、または下痢が見られた場合は、直ちに獣医師に連絡してください。
- 食欲と吐き気： 投与後2〜4日で軽度の吐き気や食欲不振が起こる場合があります。獣医師はペットが快適に過ごせるよう、吐き気止めを処方することがあります。
- 妊娠に関する警告： 妊娠中の女性、授乳中の母親、および免疫力が低下している方は、ペットの排泄物の取り扱いを完全に避けてください。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。