表阿黴素
**表阿黴素 (Epirubicin)** 是多柔比星 (Doxorubicin) 的半合成立體異構物，在獸醫腫瘤學中用於治療多種腫瘤（如淋巴瘤和肉瘤）。 > **臨床警告：** 本藥為強效發泡劑。若發生血管外滲漏，將導致嚴重的組織壞死。必須透過妥善固定的留置靜脈導管給藥。
作用機制: Epirubicin enters the cell where its intracellular metabolism results in the production of **cytotoxic free radicals**. It also binds irreversibly to **DNA** → prevents DNA replication and alters cell membrane functions, ultimately leading to cell death.
各物種劑量
- Feline injection site sarcoma · 25 mg/m2 or 1 mg/kg · IV · q3wk · Administer over a minimum period of 10 minutes into the side port of a freely running IV infusion of 0.9% NaCl.
- Lymphoma, splenic haemangiosarcoma, histiocytic sarcoma, and other sarcomas/carcinomas · 30 mg/m2 (In dogs weighing <10 kg a dose of 1 mg/kg should be used) · IV · q3wk · Maximum total dose not to exceed 240 mg/m2 · Administer over a minimum period of 10 minutes into the side port of a freely running IV infusion of 0.9% NaCl.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- No specific absolute contraindications listed, but use with extreme caution in patients with pre-existing cardiac disease or the ABCB1 (MDR1) mutation.
不良反應
- Acute anaphylaxis
- Dose-dependent cumulative cardiotoxicity (cardiomyopathy, congestive heart failure)
- Tachycardia and arrhythmias (during administration)
- Anorexia
- Vomiting
- Pancreatitis
- Severe leucopenia
- Thrombocytopenia
- Haemorrhagic gastroenteritis
- Nephrotoxicity
- Severe tissue necrosis (if extravasated)
藥物相互作用
- Heparin · Incompatible; a precipitate will form if mixed. · major
- Cyclophosphamide · Increased risk of myelosuppression when used in combination. · major
- Cimetidine · Increases the area under the dose curve (AUC) of epirubicin by 50%; should not be used concurrently. · major
監測
- Complete Blood Count (CBC) and platelet count prior to every dose
- Physical examination and auscultation
- Electrocardiogram (ECG)
- Echocardiogram (especially in breeds predisposed to cardiac disease)
- Renal parameters
- Gastrointestinal signs
過量
Overdosage increases the risk of severe myelosuppression, severe gastrointestinal toxicity (haemorrhagic gastroenteritis), and acute cardiotoxicity. Treatment is supportive and symptomatic, including aggressive fluid therapy, broad-spectrum antibiotics (if neutropenic), and antiemetics.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。