順鉑
Cisplatin
cis-diamminedichloroplatinum
別名: Platinol-AQ · cis-Platinum II · cis-DDP · CDDP · cis-diamminedichloroplatinum · cisplatina · cisplatinum · NSC-119875 · Peyrone's salt · platinum diamminodichloride
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
這是依體表面積（mg/m²）計算的劑量；給藥前須先將體重換算為體表面積。
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For potentially susceptible carcinomas and sarcomas | 30-70 mg/m2 (NOT mg/kg) IV over 20 minutes to several hours every 3-5 weeks | IV | every 3-5 weeks | — | 🌎 NA |
| Intracavitary administration for palliative control of neoplastic pulmonary effusions | 50 mg/m2 (NOT mg/kg) (diluted in normal saline to a total volume of 250 mL/m2) | Intracavitary | every 3-4 weeks as needed | Discontinue after 4th treatment if resolved completely | 🌎 NA |
- For potentially susceptible carcinomas and sarcomas: Warning: Do not confuse cisplatin and carboplatin dosages; cisplatin dosages are much lower. Dogs must undergo saline diuresis before and after cisplatin therapy.
- Intracavitary administration for palliative control of neoplastic pulmonary effusions: Give IV normal saline at 10 mL/kg/hr for 4 hours prior. Warm solution to body temp. Remove pleural fluid first, then slowly infuse.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For intralesional injection of skin tumors | 1 mg per cm3 of tumor/tumor bed intralesionally | Intralesional | at 2-week intervals | for 4 total treatments | 🌎 NA |
- For intralesional injection of skin tumors: Add 10 mg powder to 1 mL water and 2 mL medical-grade sesame oil (3.3 mg/mL). Inject in multiple planes no further than 0.6 to 1 cm apart.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
順鉑 (Cisplatin) 是一種含鉑的重金屬抗腫瘤藥物，在獸醫腫瘤學中主要用於治療犬隻的多種癌和肉瘤，以及用於馬匹皮膚腫瘤的病灶內注射。
臨床關鍵要點：
- 高度致吐性： 它會直接刺激化學受體催吐區 (CTZ)。標準做法是在給藥前預先使用強效止吐藥（如 maropitant、ondansetron、butorphanol）。
- 腎毒性： 在給藥前、中、後需要積極進行靜脈輸液利尿（通常使用 0.9% 生理食鹽水），以防止腎小管損傷。
- 物種特異性： 絕對禁止用於貓，因為會導致致命的、與劑量相關的原發性肺毒性（臨床上常以「cisplatin splats cats」來提醒其對貓的致命性）。
- 操作安全： 作為一種危險的化療藥物，在配製和給藥過程中需要嚴格的安全規範（戴手套、穿防護服、使用封閉式傳輸系統）。
作用機轉
Cisplatin acts as a bifunctional alkylating agent.
- The platinum compound enters the cell and loses its chloride atoms in the low-chloride intracellular environment.
- It then binds covalently to the N7 reactive center on purine residues (guanine and adenine) on the DNA.
- This binding produces interstrand and intrastrand crosslinks in the DNA → alters DNA structure → inhibits DNA replication and transcription → leads to cell cycle arrest and apoptosis.
- It is considered cell cycle nonspecific, though cells are most vulnerable during the G1 and S phases.
安全性與警告
禁忌症
- Cats (causes fatal pulmonary edema and dyspnea)
- Preexisting significant renal impairment
- Preexisting myelosuppression
- History of hypersensitivity to platinum-containing compounds
- Caution in patients with congestive heart failure (due to required fluid loading)
不良反應
- Severe vomiting (acute and delayed)
- Nephrotoxicity (renal tubular damage)
- Myelosuppression (thrombocytopenia, granulocytopenia)
- Ototoxicity (high-frequency hearing loss, tinnitus)
- Anorexia
- Diarrhea (including hemorrhagic)
- Seizures
- Peripheral neuropathies
- Electrolyte abnormalities
- Hyperuricemia
- Increased hepatic enzymes
- Anaphylactoid reactions
- Death
注意事項
WARNING: FATAL TO CATS. Do not administer to felines under any circumstances.
- Nephrotoxicity: Mandatory saline diuresis is required before and after IV therapy in dogs.
- Administration Rate: Direct IV infusion over <5 minutes should be avoided as it increases nephrotoxicity and ototoxicity.
- Handling: Wear gloves and protective clothing. Wash thoroughly with soap and water if accidental exposure occurs.
- Equipment: Do NOT use aluminum hub needles or aluminum-containing IV sets; aluminum displaces platinum, forming a black precipitate.
- Reproductive Safety: Teratogenic, embryotoxic, and may cause azoospermia. Use extreme caution.
藥物交互作用
Potential for increased risk for nephrotoxicity; if possible, delay aminoglycoside administration by at least two weeks after cisplatin.
Potential for increased risk for nephrotoxicity; if possible, delay amphotericin B administration by at least two weeks after cisplatin.
Potential for increased ototoxicity.
Cisplatin may reduce serum levels of phenytoin.
監測
- Urinalysis, BUN, and serum creatinine (baseline and before each dose)
- Hemogram and platelet count (baseline and before each dose)
- Serum electrolytes and acid-base status
- Tumor measurement and radiography (at least monthly to assess efficacy)
- Monitor for signs of vomiting, dehydration, or ototoxicity
藥物動力學
半衰期
吸收
Administered IV, intracavitary, or intralesionally. Highly bound (90%) to serum proteins.
分佈
Concentrates in the liver, intestines, and kidneys. Platinum will accumulate in the body and may be detected 6 months after a course of therapy has been completed.
代謝
Undergoes nonenzymatic conversion to active and inactive metabolites.
排除
Primarily excreted by the kidneys. Approximately 80% of a dose can be recovered as free platinum in the urine within 48 hours of dosing in dogs.
過量
The minimum lethal dose of cisplatin in dogs is reportedly 2.5 mg/kg (≈80 mg/m2). Because of the potential for serious toxicity (severe nephrotoxicity, myelosuppression, intractable vomiting, and death), dosage calculations must be checked thoroughly. Overdose management involves aggressive IV fluid diuresis, antiemetics, and supportive care for bone marrow suppression.
可用產品
劑型
- Injection solution (1 mg/mL)
- Powder for compounding (for intralesional use)
人用標示
- Cisplatin Injection: 1 mg/mL in 50 mL, 100 mL & 200 mL multi-dose vials
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store injection at room temperature and away from light. Do NOT refrigerate as a precipitate may form. Protect from direct bright sunlight during use. Discard if a precipitate forms from cold temperatures or aluminum contact.
飼主須知
寵物主人重要須知：
- 這是什麼藥物？ 順鉑是一種強效的化療藥物，用於治療犬隻和馬匹的多種癌症。
- 僅限犬馬使用： 此藥物對貓咪是致命的，絕對不會開立給貓咪使用。
- 需要住院： 因為這種藥物對腎臟負擔很大，您的狗狗需要住院，在治療前後接受數小時的靜脈輸液（打點滴），以沖洗並保護腎臟。
- 副作用： 噁心和嘔吐非常常見。獸醫師會在治療前給予強效止吐藥，但您在家仍需密切觀察。如果嘔吐嚴重或持續，請聯繫您的獸醫師。
- 免疫系統： 此藥物會降低白血球數量，使您的寵物更容易感染。請讓牠們遠離生病的動物，若有嗜睡或發燒現象請立即回報。
- 居家安全： 因為這是化療藥物，請遵循獸醫師的指示，在治療後的幾天內安全地處理寵物的尿液和糞便。
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