빈블라스틴
Vinblastine
Vinblastine sulfate
다른 이름: 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 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 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible neoplasms | 2-2.2 mg/m2 | IV | every 1-2 weeks | — | 🌎 NA |
- Susceptible neoplasms: Often used in combination with other chemo drugs.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
빈블라스틴은 일일초 식물에서 유래한 빈카 알칼로이드계 항종양제입니다. 수의 종양학에서 림프종, 암종, 비만세포종, 비장 종양 등 소동물의 다양한 악성 종양 치료에 주로 사용됩니다.
임상 요점:
- 반려견의 비만세포종 치료에 있어 유사 약물인 빈크리스틴보다 눈에 띄게 효과적입니다.
- 강력한 발포제(vesicant)로, 혈관 밖으로 유출될 경우 심각한 조직 괴사 및 연조직염을 유발할 수 있습니다.
- 빈크리스틴보다 골수 억제 작용이 더 강한 편이나, 표준 용량에서 말초 신경 독성은 덜 심각한 경향이 있습니다.
- MDR1 (ABCB1) 유전자 돌연변이가 있는 목양견 품종은 심각한 골수 억제 및 위장관 독성 위험이 크게 증가하므로 각별한 주의가 필요합니다.
작용 기전
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.
안전성·주의사항
금기사항
- 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)
부작용
- 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)
주의
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.
약물 상호작용
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.
모니터링
- 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
약동학
반감기
흡수
Administered strictly IV.
분포
Rapidly distributed to tissues after injection. In humans, approximately 75% is bound to tissue proteins. Does not appreciably enter the CNS.
대사
Extensively metabolized by the liver.
배설
Primarily excreted in the bile and feces; lesser amounts are eliminated in the urine.
과다투여
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).
제품
제형
- Injection solution (1 mg/mL)
- Powder for injection (10 mg)
- 1 mg/mL injectable solution
인용의약품
- 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
규제 현황
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.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
- 독성 위험: 이 약은 강력한 화학요법 약물입니다. 약물과 관련된 사망을 포함하여 심각한 독성이 발생할 수 있습니다.
- 수의사에게 연락해야 할 때: 반려동물이 극심한 우울감, 무기력, 비정상적인 출혈(혈변 포함), 멍, 또는 지속적인 구토나 식욕 부진을 보이면 즉시 수의사에게 연락하십시오.
- 배설물 처리: 치료 후 며칠 동안은 반려동물의 소변과 대변을 안전하게 처리하기 위해 수의사의 지시를 따르십시오.
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