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동물 종별 용량

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

• Pre-existing severe bone marrow depression
• Active infections
• Pregnancy (Teratogenic - FDA Category D)
• Nursing/lactating animals
• Pre-existing bone marrow suppression
• Pre-existing liver disease
• Pregnancy and lactation

이상반응

• Bone marrow depression (anemia, thrombocytopenia, leukopenia) - nadirs typically at 1-6 weeks
• Hepatotoxicity (delayed, cumulative, chronic, and irreversible in dogs)
• Anorexia
• Vomiting
• Diarrhea
• Stomatitis
• Alopecia
• Corneal de-epithelization
• Renal toxicity (rare)
• Pulmonary infiltrates or fibrosis (rare)
• Myelosuppression (dose-limiting; severe neutropenia and thrombocytopenia)
• Hepatotoxicity (cumulative, dose-related, potentially irreversible in dogs)
• Gastrointestinal toxicity (vomiting, diarrhea, anorexia)

약물 상호작용

• Immunosuppressive drugs (e.g., azathioprine, cyclophosphamide, corticosteroids) · May increase the risk of severe infection due to additive immunosuppression.
• Myelosuppressive drugs (e.g., chloramphenicol, flucytosine, amphotericin B, colchicine) · Additive bone marrow depression; concurrent use should be avoided or strictly monitored.
• Live virus vaccines · Increased risk of vaccine-induced infection or decreased vaccine efficacy; use with extreme caution or avoid during therapy.
• Other myelosuppressive agents · Increased risk of severe and potentially fatal bone marrow suppression. · major
• Phenobarbital (and other liver enzyme inducers) · Altered metabolism of lomustine, which requires hepatic microsomal enzyme hydroxylation. Use with caution. · moderate
• Cimetidine · Enhances the toxicity of lomustine (reported in humans). · major

모니터링

• CBC with platelets one week after dosing and prior to next dose (If platelets < 200,000/mcl, stop therapy until thrombocytopenia is resolved)
• Liver function tests (ALT, AST, ALP, Bilirubin) initially before starting treatment and then every 3-4 months
• Complete Blood Count (CBC) including platelets, particularly 7-14 days post-administration (and up to 6 weeks in cats)
• Liver function tests (ALT, AST, ALP, Bilirubin) prior to every dose
• Clinical signs of gastrointestinal toxicity

과용량

Because of the severe potential toxicity of the drug (profound myelosuppression and hepatotoxicity), overdoses should be treated aggressively. * Employ **gut emptying protocols** (emesis, activated charcoal) immediately if exposure was recent and the patient is asymptomatic. * Provide aggressive supportive care and monitor CBC and liver enzymes closely. * Consult an animal poison control center or a veterinary oncologist for specific guidance.