VetSheet

독소루비신

Doxorubicin

Doxorubicin Hydrochloride

항종양제 - 안트라사이클린계IV개고양이페렛

다른 이름: Doxil · Adriamycin RDF · Adriamycin PFS · Rubex · Caelyx · Myocet · cloridrato de doxorrubicina · doxorubicin hydrochloride liposome · doxorubicini hydrochloridum · liposomal doxorubicin hydrochloride · NSC-123127 · Hydroxydaunorubicin

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

30 mg/m2 IV every 2-3 weeksIV· every 2-3 weeks

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

적응증용량경로빈도기간지역
Antineoplastic30 mg/m2 IV every 2-3 weeksIVevery 2-3 weeks—🌎 NA
Lymphoma, sarcomas, carcinomas30 mg/m2 (Use 1 mg/kg in dogs weighing <10 kg)IVq3wkMaximum total cumulative dose not to exceed 240 mg/m2🌍 EU
  • Antineoplastic: Depending on the protocol used. Maximum cumulative dose = 240 mg/m2.
  • Lymphoma, sarcomas, carcinomas: Administer over a minimum of 10 minutes into side port of freely running 0.9% NaCl.

고양이

적응증용량경로빈도기간지역
Antineoplastic20-30 mg/m2 IV every 2-4 weeksIVevery 2-4 weeks—🌎 NA
Lymphoma, soft tissue sarcomas1 mg/kg or 20-25 mg/m2IVq3-5wkMaximum total cumulative dose not to exceed 240 mg/m2🌍 EU
  • Antineoplastic: Depending on the protocol used. Maximum cumulative dose is usually 240 mg/m2.
  • Lymphoma, soft tissue sarcomas: Nephrotoxicity is a major risk in cats, especially at cumulative dosages >100 mg/m2.

페렛

적응증용량경로빈도기간지역
Antineoplastic30 mg/m2 IV every 3 weeksIVevery 3 weeks—🌎 NA
  • Antineoplastic: Depending on the protocol used.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

진료 중이신가요? VetSheet의 AI가 약물, 용량, 투여 기간을 구조화된 진료 기록에 바로 기입합니다.VetSheet 작동 방식 보기

개요

​독소루비신(Doxorubicin)​은 소동물 수의 종양학에서 가장 널리 사용되는 안트라사이클린계 항종양제 중 하나입니다. 밝은 붉은색과 강력한 부작용으로 인해 종종 "붉은 악마(Red Devil)"라고 불리며, 단일 약물 또는 다제 병용 화학요법 프로토콜에 사용됩니다.

  • ​광범위한 효능​: 개와 고양이의 ​림프종, 암종, 백혈병 및 육종​을 포함한 다양한 악성 종양에 매우 효과적입니다.
  • ​기원​: 원래 Streptomyces peucetius에서 분리되었습니다.
  • ​임상 요점​: 항균 특성을 가지고 있지만, 강력한 세포 독성으로 인해 항감염제로의 사용은 완전히 배제됩니다. 심각한 ​발포제(vesicant)​이므로, 치명적인 혈관 외 유출 손상을 방지하기 위해 완벽한 정맥 경로를 확보하는 데 극도의 주의를 기울여야 합니다.

작용 기전

Doxorubicin is a cell-cycle non-specific cytotoxic agent with multiple mechanisms of action:

  • Topoisomerase II Inhibition: Intercalates between DNA base pairs and inhibits topoisomerase II → prevents DNA resealing → causes double-strand DNA breaks → triggers apoptosis.
  • Macromolecular Synthesis Inhibition: Directly inhibits DNA synthesis, DNA-dependent RNA synthesis, and protein synthesis.
  • Free Radical Generation: Undergoes electron reduction to form anthracycline semiquinone free radicals (often iron-mediated) → causes severe oxidative stress and lipid peroxidation.
  • Clinical Pearl: The heart is particularly susceptible to doxorubicin-induced oxidative damage because cardiac tissue has inherently low levels of catalase, an enzyme necessary to neutralize hydrogen peroxide. This is the primary mechanism behind its cumulative cardiotoxicity.

안전성·주의사항

금기사항

  • Pre-existing severe myelosuppression
  • Impaired cardiac function
  • Patients who have reached the total cumulative dose limit of doxorubicin and/or daunorubicin
  • Cats with pre-existing renal insufficiency

부작용

  • Bone marrow suppression (nadir 5-10 days)
  • Cardiac toxicity (acute arrhythmias and cumulative cardiomyopathy)
  • Nephrotoxicity (particularly in cats)
  • Gastroenteritis (anorexia, vomiting, diarrhea)
  • Alopecia
  • Stomatitis
  • Immediate hypersensitivity/anaphylaxis (primarily in dogs)
  • Severe tissue ulceration and necrosis (if extravasated)

주의

WARNING: Severe Vesicant & Cardiotoxin

  • Extravasation Risk: Doxorubicin is extremely irritating to tissues. Perivascular administration can cause severe tissue ulceration and necrosis. Must be administered IV slowly (over at least 10 minutes) via a perfectly placed, free-flowing catheter. If extravasation occurs, treat immediately (e.g., topical DMSO or IV dexrazoxane).
  • Cardiotoxicity: Risk increases greatly when cumulative dose exceeds 240 mg/m2 in dogs (and likely cats). Breeds predisposed to cardiomyopathy (Dobermans, Great Danes, Rottweilers, Boxers) require extremely careful monitoring.
  • MDR1/ABCB1 Mutation: Actively transported by p-glycoprotein. Dogs with MDR1 mutations (Collies, Australian Shepherds, etc.) are at high risk for severe toxicity. Dose reduction of 25-30% is recommended.
  • Hypersensitivity: Immediate reactions (urticaria, facial swelling, hypotension) can occur, especially in dogs. Pretreatment with antihistamines (e.g., diphenhydramine) or dexamethasone is often recommended.
  • Handling: Teratogenic and embryotoxic. Prepare in a biological safety cabinet. Wear gloves. Wash immediately if skin contact occurs.

약물 상호작용

Antineoplastic agents, other

May potentiate the toxic effects of doxorubicin

Calcium-channel blockers

Potentially could increase risk for cardiotoxicity associated with doxorubicin

Carbamazepine

Decreased carbamazepine levels

Cisplatin

Increased risk of toxicity for both agents; carefully weigh risks versus benefits

CyclophosphamideMajor

May increase doxorubicin blood levels (AUC); doxorubicin may potentiate and prolong hematologic toxicity; coma and seizures have been reported in human patients

Cyclosporine

Can increase doxorubicin and doxorubicinol (active metabolite) levels

Glucosamine

May reduce doxorubicin effectiveness; use together not recommended in humans

Phenytoin

Doxorubicin may decrease phenytoin levels

Phenobarbital

May increase elimination and reduce blood levels of doxorubicin

Streptozocin

May inhibit doxorubicin metabolism

Verapamil

May increase doxorubicin levels

Warfarin

Increased risk for bleeding

Zidovudine

Increased risk for neutropenia

BarbituratesModerate

Increases plasma clearance of doxorubicin

DigoxinModerate

Causes a reduction in serum digoxin levels

DexamethasoneMajor

Incompatible in syringe/line; leads to precipitate formation

5-fluorouracilMajor

Incompatible in syringe/line; leads to precipitate formation

HeparinMajor

Incompatible in syringe/line; leads to precipitate formation

SpinosadMajor

Increased risk of toxicity

모니터링

  • Efficacy of tumor response
  • CBC with platelets (monitor for myelosuppression, nadir at 5-10 days)
  • ECG and/or echocardiogram (especially in dogs with pre-existing heart disease or predisposed breeds)
  • Hepatic function prior to and during therapy
  • Urinalysis, serum creatinine, and BUN (especially in cats due to nephrotoxicity risk)

약동학

반감기

개Phase 1: 0.6 hours; Phase 2: 3.3 hours; Terminal phase: 17 hours (doxorubicin), 32 hours (metabolites)

흡수

Not absorbed from the GI tract. Must be administered IV. Extremely irritating to tissues if administered SC or IM.

분포

Rapidly and widely distributed after IV injection. Does not appreciably enter the CSF. Highly bound to tissue and plasma proteins. Probably crosses the placenta and is distributed into milk.

대사

Metabolized extensively by the liver and other tissues via aldo-keto reductase primarily to doxorubicinol, which is active; other inactive metabolites are also formed.

배설

Primarily excreted in the bile and feces. Only about 5% is excreted in the urine within 5 days of dosing. Eliminated in a triphasic manner.

과다투여

Inadvertent acute overdosage may be manifested by severe exacerbations of adverse effects (profound myelosuppression, severe GI toxicity, acute cardiotoxicity). A lethal dose for dogs has been reported as 72 mg/m2.

Treatment: Supportive and symptomatic therapy is required. Dexrazoxane may be useful to help prevent cardiac toxicity and should be considered in cases of massive overdose.

제품

제형

  • Lyophilized powder for injection
  • Aqueous injection
  • Liposomal injection

인용의약품

  • Doxorubicin HCl (Conventional) Lyophilized Powder for Injection: 10 mg, 20 mg, 50 mg, and 150 mg vials (Adriamycin RDF, generic)
  • Doxorubicin HCl (Conventional) Injection (aqueous): 2 mg/mL in 5 mL, 10 mL, 25 mL, and 100 mL (Adriamycin PFS, generic)
  • Doxorubicin, Liposomal Injection: 20 mg in 10 mL & 50 mg in 30 mL single-use vials (Doxil)

규제 현황

European Union✓ 승인됨처방전의약품EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine). Must be handled by trained personnel.

United Kingdom✓ 승인됨처방전의약품VMD
🐕 Dogs🐈 Cats

POM-V. Cytotoxic handling precautions apply.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Lyophilized powder: Store away from direct sunlight in a dry place. Reconstituted powder (with 0.9% NaCl) is stable for 24 hours at room temperature and 48 hours refrigerated. Aqueous injection: Stable for 18 months when refrigerated (2-8°C) and protected from light.

보호자 정보

​독소루비신 치료를 받는 반려동물 보호자를 위한 중요 정보:​

  • ​붉은 소변​: 독소루비신은 붉은색 약물이며, 치료 후 1~2일 동안 반려동물의 소변이 주황색에서 붉은색을 띠는 것은 지극히 정상입니다. 이는 피가 아니며 해롭지 않습니다.
  • ​배설물의 안전한 처리​: 약물은 반려동물의 배설물을 통해 배출됩니다. 소변이나 대변에 피부가 직접 닿지 않도록 주의하십시오. 치료받은 반려견의 소변에는 최대 21일, 대변에는 며칠 동안 약물 잔류물이 남아있을 수 있습니다. 배설물을 치울 때는 장갑을 착용하고 손을 깨끗이 씻으십시오.
  • ​신체 접촉​: 화학요법을 받는 동안 반려동물이 사람의 피부, 특히 어린이나 면역력이 저하된 사람의 얼굴을 핥지 못하게 하십시오.
  • ​예상되는 부작용​: 치료 후 2~5일 사이에 가벼운 식욕 부진과 간헐적인 구토가 흔하게 나타납니다.
  • ​수의사에게 연락해야 할 때​: 반려동물이 극심한 우울감, 비정상적인 출혈, 멍 또는 혈변을 보이면 즉시 수의사에게 연락하십시오.
  • ​탈모​: 일부 반려동물(특히 푸들이나 테리어처럼 털이 계속 자라는 견종)은 탈모나 털이 얇아지는 현상을 겪을 수 있습니다.

VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.