빈크리스틴

Vincristine

Vincristine sulfate

다른 이름: Oncovin · Vincasar PFS · leurocristine sulfate · VCR · LCR compound 37231 · NSC-67574 · 22oxovincaleukoblastine sulphate · sulfato de vincristina · vincristini sulfas · Vincristine sulfate

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

0.02 mg/kgIV· once

체중— 🐕

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
Neoplastic diseases (usually in combination protocols)	0.5-0.75 mg/m2	IV	every 1-2 weeks	—	🌎 NA
Transmissible venereal tumor (TVT)	0.5 mg/m2 (maximum dose 1 mg)	IV	once weekly	for 4-6 weeks	🌎 NA
Adjunctive treatment of immune-mediated thrombocytopenia (IMT)	0.5 mg/m2	IV	once	—	🌎 NA
Adjunctive treatment of immune-mediated thrombocytopenia (IMT) refractory to prednisone	0.5-0.7 mg/m2	IV	once	—	🌎 NA
Adjunctive treatment of immune-mediated thrombocytopenia (IMT)	0.02 mg/kg	IV	once	—	🌎 NA
Neoplastic diseases (particularly lymphoproliferative disorders), immune-mediated thrombocytopenia, transmissible venereal tumour	See Appendix for chemotherapy protocols and conversion of body weight to body surface area.	IV	Not specified	Not specified	🌍 EU

Neoplastic diseases (usually in combination protocols): Dosed in mg/m2, NOT mg/kg. Consultation with an oncologist recommended.
Transmissible venereal tumor (TVT): Used as sole therapy.
Adjunctive treatment of immune-mediated thrombocytopenia (IMT): If platelet count <10-20,000 cells/mcL or bleeding; consider bone marrow aspiration to document megakaryocytes.
Adjunctive treatment of immune-mediated thrombocytopenia (IMT) refractory to prednisone: Given as an IV bolus or as an infusion over 4-6 hours.
Adjunctive treatment of immune-mediated thrombocytopenia (IMT): Generally single use.
Neoplastic diseases (particularly lymphoproliferative disorders), immune-mediated thrombocytopenia, transmissible venereal tumour: Must be administered i.v. through a carefully pre-placed catheter.

고양이

적응증	용량	경로	빈도	기간	지역
Neoplastic diseases	0.5-0.75 mg/m2	IV	every 1-3 weeks	—	🌎 NA
Neoplastic diseases (particularly lymphoproliferative disorders)	See Appendix for chemotherapy protocols and conversion of body weight to body surface area.	IV	Not specified	Not specified	🌍 EU

Neoplastic diseases: Dosed in mg/m2, NOT mg/kg. Consultation with an oncologist recommended.
Neoplastic diseases (particularly lymphoproliferative disorders): Must be administered i.v. through a carefully pre-placed catheter.

말

적응증	용량	경로	빈도	기간	지역
Neoplastic diseases	0.5 mg/m2 (usually 2.5-3 mg total dose per horse)	IV	weekly	—	🌎 NA

Neoplastic diseases: Often used in CAP protocol with cytarabine and cyclophosphamide.

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

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개요

빈크리스틴은 일일초(Catharanthus roseus)에서 유래한 세포주기 특이적(M기) 항종양제입니다. 수의 종양학에서 매우 중요한 약물로, 주로 림프종과 같은 림프 및 조혈계 종양의 복합 화학요법(예: CHOP 프로토콜)에 사용됩니다.

주요 임상 특징:

골수 억제 최소화: 다른 많은 항암제(예: 유사체인 빈블라스틴)와 달리 표준 용량에서 골수 억제 작용이 적어 복합 프로토콜에서 매우 유용합니다.
전염성 성기 종양(TVT): 개 TVT 치료 시 단일 약물로서 매우 높은 효능을 보입니다.
면역 매개성 혈소판 감소증(IMT): 난치성 IMT 치료에 독특하게 사용됩니다. 거핵구의 분절을 촉진하여 혈소판이 순환계로 빠르게 방출되도록 합니다.
발포제(조직 괴사 유발): 심각한 조직 괴사를 유발할 수 있는 발포제입니다. 치명적인 일출(혈관 외 유출) 손상을 방지하기 위해 완벽하게 장착된 카테터를 통한 엄격한 정맥 내 투여가 필수적입니다.

작용 기전

Vincristine is a cell-cycle specific agent that acts during the M-phase (mitosis).

Antineoplastic Action: It binds specifically to tubulin dimers → inhibits microtubule polymerization → prevents the formation of the mitotic spindle → arrests cell division in metaphase, ultimately leading to apoptosis.
Metabolic Effects: It interferes with amino acid metabolism by inhibiting glutamic acid utilization and preventing purine synthesis, citric acid cycle, and urea formation.
Thrombocytosis: The exact mechanism is unknown, but it is believed to stimulate megakaryocyte fragmentation, accelerating the release of platelets into the peripheral blood.
Immunosuppression: Exhibits mild immunosuppressive activity, which may contribute to its efficacy in immune-mediated conditions.

안전성·주의사항

금기사항

Preexisting neuromuscular disease
Severe leukopenia
Uncontrolled infection
No specific absolute contraindications listed, but requires extreme caution in specific disease states

부작용

Peripheral neuropathy (proprioceptive deficits, spinal hyporeflexia)
Paralytic ileus and severe constipation
Mild leukopenia
Tissue necrosis and sloughing (if extravasated)
Anorexia, vomiting, diarrhea
Impaired platelet aggregation
Increased liver enzymes
Syndrome of inappropriate ADH secretion (SIADH)
Jaw pain
Alopecia
Stomatitis
Seizures
Pulmonary edema (rare, reported in cats)
GI tract toxicity
Severe local irritation/tissue necrosis (if administered perivascularly)
Myelosuppression (potential)

주의

Extravasation Warning: Vincristine is a potent vesicant. It must be given strictly IV. Use a different needle for injection than the one used to draw the drug from the vial. If extravasation occurs, stop immediately, apply moderate heat (or ice, depending on protocol), and consider topical DMSO or hyaluronidase injections.

ABCB1 (MDR1) Mutation: Herding breeds (e.g., Collies, Australian Shepherds) with this mutation are highly susceptible to severe bone marrow suppression and GI toxicity. Reduce dose by 25-30% in mutant/normal or mutant/mutant dogs.
Hepatic Impairment: Extensively metabolized by the liver. Consider a 50% dose reduction if serum bilirubin is > 2 mg/dL.
Neurotoxicity: Cats are particularly sensitive to neurotoxicity, which can manifest as paralytic ileus, severe constipation, and reversible axon swelling.
Handling: Wear gloves and protective clothing. Wash thoroughly with soap and water if skin exposure occurs.
Pregnancy: Potentially teratogenic and embryotoxic (FDA Category D).

약물 상호작용

Asparaginase

Additive neurotoxicity may occur; less common if asparaginase is administered after vincristine.

Mitomycin

Severe bronchospasm has occurred in humans receiving mitomycin-C with Vinca alkaloids.

Amiodarone

Inhibits P-glycoprotein; may increase vincristine toxicity, especially in MDR1/ABCB1 mutant dogs.

Azole Antifungals (e.g., ketoconazole)