長春新鹼

Vincristine

Vincristine sulfate

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

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

0.02 mg/kgIV· once

體重— 🐕

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
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.

貓

適應症	劑量	途徑	頻次	療程	地區
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.

馬

適應症	劑量	途徑	頻次	療程	地區
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.

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。

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概覽

長春新鹼是一種源自長春花（Catharanthus roseus）的細胞週期特異性（M期）抗腫瘤藥物。它是獸醫腫瘤學中的基石，主要用於淋巴和造血系統腫瘤（如淋巴瘤）的聯合化療方案（如CHOP）。

主要臨床重點：

骨髓保護性：與許多其他化療藥物（如其類似物長春花鹼）不同，長春新鹼在標準劑量下對骨髓的抑制作用較小，這使其在聯合方案中極具價值。
傳染性性病腫瘤 (TVT)：作為單一藥物治療犬隻TVT具有極高的療效。
免疫介導性血小板減少症 (IMT)：長春新鹼獨特地用於治療難治性IMT。它能促進巨核細胞的碎裂，導致血小板快速釋放到血液循環中。
發泡劑：它是一種嚴重的組織發泡劑；必須透過完美放置的導管嚴格進行靜脈注射，以防止毀滅性的藥物外滲損傷。

作用機轉

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.

安全性與警告

禁忌症

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

不良反應

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)

注意事項

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).

藥物交互作用

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)