卡鉑
Carboplatin
cis-Diammine-1,1cyclobutanedicarboxylato-platinum
別名: Paraplatin · carboplatinum · CBDCA · JM-8 · NSC241240
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
這是按體表面積（mg/m²）計算的劑量；給藥前須先把體重換算為體表面積。
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Antineoplastic | 300-350 mg/m2 | IV | every 3 weeks | — | 🌎 NA |
| Neoplastic diseases (All uses) | 300 mg/m2 | IV | q3-4wk | As determined by oncology protocol | 🌍 EU |
| Neoplastic diseases (Intrapleural/intraperitoneal) | 225-300 mg/m2 | Intrapleural/Intraperitoneal | As directed by specialist | As determined by oncology protocol | 🌍 EU |
- Antineoplastic: Dosage may need adjustment in patients with reduced renal function.
- Neoplastic diseases (All uses): Injected into the side port of a freely running i.v. infusion of 0.9% NaCl over a 10-15 min period.
- Neoplastic diseases (Intrapleural/intraperitoneal): Diluted in 0.9% NaCl or 5% dextrose water over a 5-10 min period. Consult a veterinary oncology specialist before administering via this route.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Antineoplastic | 180-260 mg/m2 | IV | every 3 weeks | — | 🌎 NA |
| Neoplastic diseases (All uses) | 200 mg/m2 | IV | q3-4wk | As determined by oncology protocol | 🌍 EU |
| Neoplastic diseases (Intrapleural/intraperitoneal) | 200-240 mg/m2 | Intrapleural/Intraperitoneal | As directed by specialist | As determined by oncology protocol | 🌍 EU |
- Antineoplastic: Has also been administered intratumorally for nasal planum carcinomas.
- Neoplastic diseases (All uses): Injected into the side port of a freely running i.v. infusion of 0.9% NaCl over a 10-15 min period. Monitor for delayed/unpredictable side effects.
- Neoplastic diseases (Intrapleural/intraperitoneal): Diluted in 0.9% NaCl or 5% dextrose water over a 5-10 min period. Consult a veterinary oncology specialist before administering via this route.
小型哺乳類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Antineoplastic | 180-260 mg/m2 | IV | every 3 weeks | — | 🌎 NA |
- Antineoplastic: Dose for rabbits.
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Adenocarcinoma | Intralesional use may be considered | Intralesional | — | — | 🌎 NA |
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Equine sarcoids | Intralesional use may be considered | Intralesional | — | — | 🌎 NA |
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
卡鉑（Carboplatin）是獸醫腫瘤學中廣泛使用的第二代鉑類抗腫瘤藥物。主要用於治療多種癌和肉瘤，最常見的是作為截肢後犬骨肉瘤的輔助治療。
臨床要點與優勢：
- 貓的安全性： 與其前代藥物順鉑（Cisplatin，會導致貓發生致命性肺水腫）不同，卡鉑相對安全，常規用於貓科病患。
- 毒性較低： 卡鉑通常被認為是「較溫和」的鉑類藥物。與順鉑相比，其腎毒性和致吐（嘔吐）可能性顯著較低，因此不需要在治療前後進行積極的靜脈輸液利尿。
- 多用途性： 除了全身靜脈注射外，它在體腔內（胸腔積液）、動脈內和病灶內（馬類肉瘤、貓鼻平面癌）的應用也顯示出潛力。
作用機制
Carboplatin acts as a bifunctional alkylating agent.
- Cellular Entry & Activation: Once inside the cell, the drug undergoes aquation (water molecules replace the cyclobutanedicarboxylate leaving group), forming highly reactive, positively charged platinum complexes.
- DNA Crosslinking: These active complexes bind covalently to nucleophilic sites on DNA (primarily the N7 position of guanine and adenine).
- Inhibition: This binding creates intra-strand and inter-strand crosslinks in the DNA double helix, physically obstructing DNA polymerases and RNA polymerases.
- Apoptosis: The resulting DNA damage inhibits DNA replication, RNA transcription, and protein synthesis, ultimately triggering apoptosis (programmed cell death).
Note: Carboplatin is cell-cycle nonspecific, meaning it can damage cells during any phase of the cell cycle, though cells are most vulnerable during the G1 and S phases.
安全性與警告
禁忌症
- History of hypersensitivity to carboplatin or other platinum agents
- Severe bone marrow depression
- Pregnancy (fetotoxic and embryotoxic - Category D)
不良反應
- Bone marrow suppression (neutropenia, thrombocytopenia)
- Anorexia
- Vomiting (typically 2-4 days post-dose)
- Hepatotoxicity (elevated bilirubin and liver enzymes)
- Nephrotoxicity (less frequent than cisplatin)
- Neuropathies (rare)
- Ototoxicity (rare)
- Anaphylactoid reactions (rare)
- Hyperuricemia
注意事項
DO NOT give IM or SC. Extreme caution is advised in patients with active infections, hearing impairment, or preexisting renal or hepatic disease. Patients with severe carboplatin-induced myelosuppression must recover their cell counts before additional therapy. Equipment Warning: Do not prepare, store, or administer using aluminum-containing needles or IV sets, as aluminum displaces platinum, causing a black precipitate and loss of potency.
藥物相互作用
Potential for increased risk of nephrotoxicity or ototoxicity.
Patients previously treated with cisplatin have an increased risk of developing neurotoxicity or ototoxicity after receiving carboplatin.
The leukopenic or thrombocytopenic effects secondary to carboplatin may be enhanced.
Potential for increased hematologic toxicity.
Live or killed virus vaccines administered after therapy may have reduced efficacy. Carboplatin may also potentiate live virus vaccine replication and increase adverse effects.
Increased risk of cumulative nephrotoxicity.
May adversely affect the safety and efficacy of vaccinations due to immunosuppression.
Potential to act as a radiosensitizer for patients receiving concomitant radiotherapy.
監測
- CBC (Complete Blood Count) to monitor nadir
- Serum electrolytes
- Uric acid
- Baseline renal and hepatic function tests
藥物動力學
吸收
Administered intravenously; 100% bioavailable.
分佈
Well distributed throughout the body; highest concentrations are found in the liver, kidney, skin, and tumor tissue.
代謝
The parent drug degrades into platinum and platinum-complexed compounds.
排除
Primarily eliminated by the kidneys. In dogs, almost one half of the dose is excreted in the urine within 24 hours and approximately 70% of the platinum administered is secreted in the urine after 72 hours.
過量
An overdose of carboplatin is expected to cause severe, aggravated effects associated with the drug's primary toxicities: bone marrow suppression, nephrotoxicity, and hepatotoxicity.
- Monitoring: Closely monitor for neurotoxicity, ototoxicity, hepatotoxicity, and nephrotoxicity.
- Treatment: Therapy is primarily supportive as no specific antidote is available. Plasmapheresis or hemodialysis could potentially be of benefit in rapidly removing the drug from systemic circulation.
可用產品
劑型
- Lyophilized powder for injection
- Injection solution
人用標示
- Carboplatin lyophilized Powder for reconstitution and IV Injection: 50 mg, 150 mg, & 450 mg in single-dose vials
- Carboplatin Injection: 10 mg/mL in 5 mL, 15 mL & 45 mL single-use vials
各地核准狀態
Cytotoxic agent. Must be handled and administered according to strict hazardous drug protocols.
Prescription Only Medicine. Cytotoxic handling rules apply.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store powder for injection at room temperature and protect from light. After reconstitution to 10 mg/mL, solutions are stable for at least 8 hours (manufacturer recommends discarding unused portions after 8 hours due to lack of preservatives). Do not prepare, store, or administer using aluminum-containing items, as contact with aluminum forms a black precipitate and inactivates the drug.
飼主須知
卡鉑是一種強效的化療藥物，用於治療您寵物的癌症。雖然通常耐受性良好，但您必須在家中遵守以下重要的安全和護理指引：
- 排泄物處理： 由於藥物及其活性代謝物會在治療後數天內隨尿液排出，請避免直接接觸寵物的尿液、糞便和嘔吐物。清理排泄物時請戴上拋棄式手套，並在事後徹底洗手。
- 「最低點（Nadir）」時期： 卡鉑會暫時降低寵物的白血球數量，使其更容易受到感染。這個最低點通常發生在狗治療後約14天和貓治療後約21天。
- 何時聯繫獸醫： 在最低點期間請密切觀察您的寵物。如果寵物出現發燒、嚴重嗜睡、嘔吐或腹瀉，請立即聯繫您的獸醫。
- 食慾與噁心： 輸液後2至4天可能會出現輕微的噁心或食慾不振。您的獸醫可能會開立止吐藥物以保持寵物的舒適。
- 懷孕警告： 孕婦、哺乳期婦女和免疫力低下的人應完全避免接觸寵物的排泄物。
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