덱스라족산
Dexrazoxane
2,6-Piperazinedione
다른 이름: Zinecard · Cardioxane · Eucardion · Totect · ADR-529 · ICRF187 · NSC-169780 · ICRF-187
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
체표면적(mg/m²) 기반 용량입니다. 투여 전에 체중을 체표면적으로 환산해야 합니다.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Treatment of anthracycline (doxorubicin, epirubicin, etc.) extravasation | 1000 mg/m2 | IV | within 6 hours and again on day 2. Infuse 500 mg/m2 on day 3 | 3 days | 🌎 NA |
| Treatment of anthracycline extravasation | 10 times the doxorubicin dose | IV | within 3 hours and again at 24 and 48 hours after extravasation | 48 hours | 🌎 NA |
| Prevention of doxorubicin-induced cardiomyopathy | 10:1 ratio (e.g., 300 mg/m2 of dexrazoxane to 30 mg/m2 doxorubicin) | IV | starting 30 minutes of, and prior to the doxorubicin dose | — | 🌎 NA |
| Prevention of doxorubicin-induced cardiomyopathy | 10:1 ratio (e.g., 300 mg/m2 of dexrazoxane to 30 mg/m2 doxorubicin) | IV | starting 30 minutes before doxorubicin is administered | — | 🌎 NA |
- Treatment of anthracycline (doxorubicin, epirubicin, etc.) extravasation: Terminate doxorubicin infusion immediately, and infuse intravenously in a separate infusion. Acute surgical evaluation is performed. Dosage recommendations are for human patients, but may apply to veterinary patients.
- Treatment of anthracycline extravasation: Anecdotally; significantly reduces local tissue injury.
- Prevention of doxorubicin-induced cardiomyopathy: Given as slow IV bolus (as a short, IV bolus).
- Prevention of doxorubicin-induced cardiomyopathy: Given as slow IV bolus. Use can be considered in breeds at risk (Shelties, Collies, Australian Shepherds, etc.), dogs exceeding usual cumulative dose cutoff, and cases with preexisting cardiac disease where no effective chemo options exist.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
덱스라족산은 주로 수의 종양학에서 사용되는 세포 내 철 킬레이트제 및 화학 보호제입니다.
- 심장 보호: 독성 징후를 보이거나, 기저 심장 질환이 있거나, 최대 누적 용량에 도달한 환자에서 안트라사이클린(예: 독소루비신)과 관련된 누적적이고 용량 의존적인 심장 독성 효과를 완화하는 데 사용됩니다.
- 일출 관리: 독소루비신의 우발적인 혈관 외 투여(일출)로 인해 발생하는 심각한 조직 괴사에 대한 중요한 해독제 역할을 합니다.
임상 포인트:
- 심장 보호에 매우 효과적이지만, 비용이 매우 비싸서 많은 보호자에게 부담이 될 수 있습니다.
- 덱스라족산이 암 세포를 부분적으로 보호하여 항암제의 항종양 효능을 감소시킬 수 있다는 이론적인 우려와 인간에서의 증거가 있습니다.
작용 기전
Dexrazoxane is a cyclic derivative of EDTA that readily penetrates cell membranes.
- Once intracellular, it is hydrolyzed into an active ring-opened chelating metabolite.
- Active Metabolite → Chelates intracellular iron → Prevents the formation of the highly reactive anthracycline-iron complex.
- This prevents the generation of destructive superoxide free radicals → Protects the myocardium from oxidative stress and irreversible anthracycline-induced cardiomyopathy.
- Mechanistic Note: It also acts as a reversible inhibitor of Topoisomerase II, which is believed to contribute to its protective effects against severe tissue necrosis during extravasation injuries.
안전성·주의사항
금기사항
- Should not be used unless an anthracycline antineoplastic agent is being used
- Unknown based on monograph, but generally avoid in patients not receiving anthracyclines
부작용
- Additive myelosuppression
- Potential reduction in efficacy of anthracycline antitumor agents
- Testicular atrophy (observed in dogs)
- Myelosuppression (documented in humans)
- Decreased clinical efficacy of anthracycline antineoplastic agents
주의
Important: Dexrazoxane should not be used unless an anthracycline antineoplastic agent is being administered.
- Species Limitations: Efficacy and safety for use in cats is not known.
- Reproductive Safety: Causes testicular atrophy in dogs when administered at usual doses for 13 weeks. Teratogenic in rats and rabbits at doses lower than human doses (FDA Category C). Nursing mothers should discontinue nursing.
- Handling Warnings: Wear gloves when handling. Use normal procedures for handling and disposal of anti-cancer medications. If unreconstituted powder contacts skin or mucous membranes, wash off thoroughly with soap and water.
약물 상호작용
Additive myelosuppression may occur when used concurrently.
May decrease the clinical efficacy of the chemotherapy
모니터링
- Echocardiogram (if used for cardioprotection)
- ECG (if used for cardioprotection)
- Complete blood count (CBC) for myelosuppression
- Cardiac monitoring (ECG, echocardiogram) if used for cardiotoxicity
- Extravasation site for healing or necrosis
약동학
반감기
분포
Steady-state volume of distribution is 0.67 L/kg. The drug showed low tissue and protein binding.
대사
Hydrolyzed to an active metabolite.
배설
Clearance is about 11 mL/min/kg (dose-independent). Primarily excreted in the urine as unchanged drug and metabolites.
과다투여
Because of the method of administration and drug expense, overdoses are unlikely in veterinary medicine. As there is no known antidote, treatment would be supportive. Potentially, the drug could be removed via hemodialysis.
제품
제형
- Lyophilized Powder for Injection Solution
- Intravenous: 500 mg vials (reconstituted to 20 mg/ml solution for infusion)
인용의약품
- Dexrazoxane Lyophilized Powder for Injection Solution: 250 mg in single-use vials with 25 mL vial of sodium lactate injection
- Dexrazoxane Lyophilized Powder for Injection Solution: 500 mg regular & preservative free in single-use vials with 50 mL vial of sodium lactate injection
- Cardioxane 500 mg vials
- Zinecard 500 mg vials
규제 현황
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Unreconstituted vials should be stored at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Once reconstituted with supplied diluent, stable for 6 hours at room temperature or refrigerated. Unused solutions after that time should be discarded. After reconstitution, may be diluted with 0.9% sodium chloride or D5W to 1.3-5 mg/mL. Do not mix with any other drug.
보호자 정보
- 목적: 반려동물은 특정 항암제(독소루비신 등)의 부작용으로부터 심장을 보호하거나, 항암제가 혈관 밖으로 새어나가 심각한 조직 손상이 발생했을 때 이를 치료하기 위해 이 약을 투여받습니다.
- 비용 및 기대 효과: 이는 매우 전문적이고 비싼 약물입니다. 심장 손상이나 조직 손상의 위험을 크게 줄여주지만, 모든 경우에 100% 효과적이지는 않을 수 있습니다.
- 부작용: 반려동물의 백혈구 수치를 낮춰 감염에 더 취약해질 수 있습니다. 수의사가 혈액 검사를 면밀히 모니터링할 것입니다.
- 안전성: 이 약은 항암제와 함께 투여되므로, 가정에서 반려동물의 배설물을 안전하게 처리하는 방법에 대해 수의사의 지시를 따르십시오.
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