ビンブラスチン
Vinblastine
Vinblastine sulfate
別名: Velban · Alkaban · Blastovin · Cellblastin · Cytoblastin · Ifabla · Lemblastine · Periblastine · Serovin · Solblastin · Velbe · Velsar · Xintoprost · 29060-LE · NSC-49842 · sulfato de vimblastina · vinblastini sulfas · vincaleukoblastine sulphate · VBL · Vinblastine sulfate · VLB
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 |
|---|---|---|---|---|---|
| Susceptible neoplasms (e.g., mast cell tumors, lymphoma) | 2-2.2 mg/m2 | IV | every 1-2 weeks | — | 🌎 NA |
| Mast cell tumors (specific protocol) | Given on four subsequent days | IV | every 3 weeks | — | 🌎 NA |
- Susceptible neoplasms (e.g., mast cell tumors, lymphoma): Often used in combination with other chemo drugs (e.g., cyclophosphamide and prednisolone).
- Mast cell tumors (specific protocol): Consult specialized oncology references for exact protocol details.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Susceptible neoplasms | 2-2.2 mg/m2 | IV | every 1-2 weeks | — | 🌎 NA |
- Susceptible neoplasms: Often used in combination with other chemo drugs.
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
ビンブラスチンは、ニチニチソウ由来のビンカアルカロイド系抗悪性腫瘍薬です。獣医腫瘍学において、リンパ腫、癌腫、肥満細胞腫、脾臓腫瘍など、小動物の様々な悪性腫瘍の治療に主に使用されます。
臨床上のポイント:
- 犬の肥満細胞腫の治療において、同効薬のビンクリスチンよりも著効を示します。
- 強力な発泡性物質（壊死起因物質）であり、血管外に漏出すると重篤な組織壊死や蜂窩織炎を引き起こします。
- ビンクリスチンと比較して骨髄抑制作用が強い傾向がありますが、標準用量での末梢神経毒性は比較的軽度です。
- MDR1 (ABCB1) 遺伝子変異を持つ牧羊犬種では、重篤な骨髄抑制および消化管毒性のリスクが著しく高まるため、細心の注意が必要です。
作用機序
Vinblastine is a cell-cycle specific agent that halts cell division.
- Microtubule Inhibition: It binds specifically to microtubular proteins (tubulin) in the mitotic spindle.
- Mitotic Arrest: By preventing microtubule assembly, it arrests cell division during metaphase.
- Metabolic Interference: It also interferes with amino acid metabolism by inhibiting glutamic acid utilization and preventing purine synthesis, the citric acid cycle, and urea formation.
安全性・警告
禁忌
- Preexisting leukopenia or granulocytopenia (unless caused by the disease being treated)
- Active bacterial infection
- Pre-existing severe myelosuppression or active infection
- Pre-existing severe myelosuppression (Neutrophil count < 3 x 10^9/L or Platelet count < 100 x 10^9/L)
有害事象
- Gastroenterocolitis (nausea, vomiting, anorexia)
- Myelosuppression (neutropenia, thrombocytopenia, anemia; nadir at 4-9 days)
- Neurotoxicity (constipation, paralytic ileus, jaw and muscle pain, loss of deep tendon reflexes)
- Alopecia
- Stomatitis
- Syndrome of inappropriate ADH secretion (SIADH)
- Severe tissue irritation and cellulitis (if extravasated)
- Cats: Reversible axon swelling and paranodal demyelination
- Myelosuppression (primarily neutropenia)
- Gastrointestinal toxicity (vomiting, diarrhea, anorexia)
- Severe tissue necrosis (if extravasated)
注意事項
Vesicant Warning: Vinblastine is a severe tissue irritant. Strict IV administration is required. Avoid extravasation. Use a different needle for injection than the one used to draw up the drug. If extravasation occurs, stop immediately, apply moderate heat, and consider hyaluronidase injections to disperse the drug.
- MDR1 Mutation: Dogs with the ABCB1 (MDR1) mutation (e.g., Collies, Australian Shepherds) are highly susceptible to toxicity. Reduce dose by 25-30% in mutant/normal or mutant/mutant dogs.
- Hepatic Impairment: Extensive hepatic metabolism requires a 50% dose reduction if serum bilirubin is > 2 mg/dL.
- Handling: Wear gloves and protective clothing during preparation and administration. Wash thoroughly with soap and water if skin exposure occurs.
- Pregnancy/Nursing: Potentially teratogenic and embryotoxic (FDA Category D). Avoid in pregnant animals and use milk replacer if nursing.
医薬品相互作用
May cause additive risk for ototoxicity.
May cause additive risk for ototoxicity.
Can inhibit P-glycoprotein clearance of vinblastine, increasing the risk of severe toxicity, particularly in dogs with the MDR1 (ABCB1) mutation.
Inhibits hepatic cytochrome P450 enzymes, potentially decreasing vinblastine metabolism and increasing toxicity.
Additive bone marrow suppression.
監視
- Efficacy (tumor response)
- Complete blood counts (CBC) with platelets (monitor for nadir)
- Liver function tests (prior to therapy and repeated as necessary)
- Serum uric acid
- IV site for signs of extravasation during administration
- Haematology (CBC) prior to each treatment
- Biochemistry prior to first treatment
- Tumour restaging (lymph node palpation, cytology)
- Complete Blood Count (CBC) prior to every dose (specifically neutrophils and platelets)
- Tumor restaging at week 4 and week 12 (for high-risk tumors)
- IV catheter site for signs of extravasation during administration
薬物動態
半減期
吸収
Administered strictly IV.
分布
Rapidly distributed to tissues after injection. In humans, approximately 75% is bound to tissue proteins. Does not appreciably enter the CNS.
代謝
Extensively metabolized by the liver.
消失
Primarily excreted in the bile and feces; lesser amounts are eliminated in the urine.
過剰投与
The lethal dose in dogs is reported as 0.2 mg/kg.
Clinical Signs of Overdose: Exacerbation of adverse effects, including profound myelosuppression, severe gastrointestinal signs, and neurotoxicity (similar to vincristine).
- Feline Case Report (4X IV overdose): Depression, inability to jump, anorexia (days 1-11), neutropenia with fever, thrombocytopenia, anemia, vomiting, diarrhea, and syndrome of inappropriate ADH (SIADH).
Treatment: Aggressive supportive care is required. Monitor cardiovascular and hematologic status closely. Treatment may include anticonvulsants, prevention/management of ileus, and management of SIADH (fluid restriction and loop diuretics to maintain serum osmolality).
製品
製剤
- Injection solution (1 mg/mL)
- Powder for injection (10 mg)
- 1 mg/mL injectable solution
ヒト用医薬品
- Vinblastine Sulfate Injection: 1 mg/mL in 10 mL & 25 mL vials
- Vinblastine Powder for Injection: 10 mg in vials (Velban)
- Velbe 10mg powder for solution for injection
- Vinblastine sulfate 1mg/ml solution for injection
- Vinblastine sulfate 1 mg/mL injection
規制ステータス
Used under the cascade. Requires specialized handling and disposal as a cytotoxic agent.
Used under the cascade. Requires specialized handling and disposal as a cytotoxic agent.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Protect from light. Store powder for injection and injection solution in the refrigerator (2-8°C). Intact powder for injection is stable at room temperature for at least one month. After reconstituting with bacteriostatic saline, the powder for injection is stable for 30 days if refrigerated.
飼主向け情報
- 毒性のリスク: これは強力な化学療法薬です。薬物に関連した死亡を含む、重篤な毒性が発生する可能性があります。
- 獣医師への連絡の目安: ペットに極度の元気消失、異常な出血（血便を含む）、あざ、または持続的な嘔吐や食欲不振が見られた場合は、直ちに獣医師に連絡してください。
- 排泄物の取り扱い: 治療後数日間は、ペットの尿や便の安全な取り扱いについて獣医師の指示に従ってください。
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