右雷佐生
Dexrazoxane
2,6-Piperazinedione
別名: Zinecard · Cardioxane · Eucardion · Totect · ADR-529 · ICRF187 · NSC-169780 · ICRF-187
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 |
|---|---|---|---|---|---|
| Treatment of anthracycline (doxorubicin, epirubicin, etc.) extravasation | 1000 mg/m2 | IV | within 6 hours and again on day 2. Infuse 500 mg/m2 on day 3 | 3 days | 🌎 NA |
| Treatment of anthracycline extravasation | 10 times the doxorubicin dose | IV | within 3 hours and again at 24 and 48 hours after extravasation | 48 hours | 🌎 NA |
| Prevention of doxorubicin-induced cardiomyopathy | 10:1 ratio (e.g., 300 mg/m2 of dexrazoxane to 30 mg/m2 doxorubicin) | IV | starting 30 minutes of, and prior to the doxorubicin dose | — | 🌎 NA |
| Prevention of doxorubicin-induced cardiomyopathy | 10:1 ratio (e.g., 300 mg/m2 of dexrazoxane to 30 mg/m2 doxorubicin) | IV | starting 30 minutes before doxorubicin is administered | — | 🌎 NA |
- Treatment of anthracycline (doxorubicin, epirubicin, etc.) extravasation: Terminate doxorubicin infusion immediately, and infuse intravenously in a separate infusion. Acute surgical evaluation is performed. Dosage recommendations are for human patients, but may apply to veterinary patients.
- Treatment of anthracycline extravasation: Anecdotally; significantly reduces local tissue injury.
- Prevention of doxorubicin-induced cardiomyopathy: Given as slow IV bolus (as a short, IV bolus).
- Prevention of doxorubicin-induced cardiomyopathy: Given as slow IV bolus. Use can be considered in breeds at risk (Shelties, Collies, Australian Shepherds, etc.), dogs exceeding usual cumulative dose cutoff, and cases with preexisting cardiac disease where no effective chemo options exist.
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
右雷佐生 (Dexrazoxane) 是一種細胞內鐵蟲合劑和化學保護劑，主要用於獸醫腫瘤學。
- 心臟保護：用於減輕舉蒳環類藥物（如多柔比星）相關的累積性、劑量依賴性心臟毒性，適用於出現毒性跡象、患有心臟疾病或已達到最大累積劑量的患者。
- 外滲處理：作為重要的解毒劑，用於治療因意外血管外注射（外滲）多柔比星所引起的嚴重組織壞死。
臨床要點：
- 雖然在心臟保護方面非常有效，但其價格昂貴，許多飼主可能無法負擔。
- 理論上並且在人類醫學中有證據顯示，右雷佐生可能會部分保護癌細胞，從而降低化療方案的抗腫瘤療效。
作用機制
Dexrazoxane is a cyclic derivative of EDTA that readily penetrates cell membranes.
- Once intracellular, it is hydrolyzed into an active ring-opened chelating metabolite.
- Active Metabolite → Chelates intracellular iron → Prevents the formation of the highly reactive anthracycline-iron complex.
- This prevents the generation of destructive superoxide free radicals → Protects the myocardium from oxidative stress and irreversible anthracycline-induced cardiomyopathy.
- Mechanistic Note: It also acts as a reversible inhibitor of Topoisomerase II, which is believed to contribute to its protective effects against severe tissue necrosis during extravasation injuries.
安全性與警告
禁忌症
- Should not be used unless an anthracycline antineoplastic agent is being used
- Unknown based on monograph, but generally avoid in patients not receiving anthracyclines
不良反應
- Additive myelosuppression
- Potential reduction in efficacy of anthracycline antitumor agents
- Testicular atrophy (observed in dogs)
- Myelosuppression (documented in humans)
- Decreased clinical efficacy of anthracycline antineoplastic agents
注意事項
Important: Dexrazoxane should not be used unless an anthracycline antineoplastic agent is being administered.
- Species Limitations: Efficacy and safety for use in cats is not known.
- Reproductive Safety: Causes testicular atrophy in dogs when administered at usual doses for 13 weeks. Teratogenic in rats and rabbits at doses lower than human doses (FDA Category C). Nursing mothers should discontinue nursing.
- Handling Warnings: Wear gloves when handling. Use normal procedures for handling and disposal of anti-cancer medications. If unreconstituted powder contacts skin or mucous membranes, wash off thoroughly with soap and water.
藥物相互作用
Additive myelosuppression may occur when used concurrently.
May decrease the clinical efficacy of the chemotherapy
監測
- Echocardiogram (if used for cardioprotection)
- ECG (if used for cardioprotection)
- Complete blood count (CBC) for myelosuppression
- Cardiac monitoring (ECG, echocardiogram) if used for cardiotoxicity
- Extravasation site for healing or necrosis
藥物動力學
半衰期
分佈
Steady-state volume of distribution is 0.67 L/kg. The drug showed low tissue and protein binding.
代謝
Hydrolyzed to an active metabolite.
排除
Clearance is about 11 mL/min/kg (dose-independent). Primarily excreted in the urine as unchanged drug and metabolites.
過量
Because of the method of administration and drug expense, overdoses are unlikely in veterinary medicine. As there is no known antidote, treatment would be supportive. Potentially, the drug could be removed via hemodialysis.
可用產品
劑型
- Lyophilized Powder for Injection Solution
- Intravenous: 500 mg vials (reconstituted to 20 mg/ml solution for infusion)
人用標示
- Dexrazoxane Lyophilized Powder for Injection Solution: 250 mg in single-use vials with 25 mL vial of sodium lactate injection
- Dexrazoxane Lyophilized Powder for Injection Solution: 500 mg regular & preservative free in single-use vials with 50 mL vial of sodium lactate injection
- Cardioxane 500 mg vials
- Zinecard 500 mg vials
各地核准狀態
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Unreconstituted vials should be stored at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Once reconstituted with supplied diluent, stable for 6 hours at room temperature or refrigerated. Unused solutions after that time should be discarded. After reconstitution, may be diluted with 0.9% sodium chloride or D5W to 1.3-5 mg/mL. Do not mix with any other drug.
飼主須知
- 用藥目的：您的寵物接受此藥物是為了保護心臟免受某些化療藥物（如多柔比星）的副作用，或者在化療藥物意外漏出血管外時治療嚴重的組織損傷。
- 費用與期望：這是一種非常專業且昂貴的藥物。雖然它能顯葚降低心臟損傷或組織傷害的風險，但在所有情況下可能無法達到100%的效果。
- 副作用：它可能會降低您寵物的白血球數量，使其更容易感染。我們會密切監測牠們的血液指標。
- 安全性：由於此藥物與化療藥物一起使用，請遵循獸醫師的指示，在家中安全地處理寵物的排泄物。
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