表阿黴素

用途

• Feline injection site sarcoma
• Lymphoma, splenic haemangiosarcoma, histiocytic sarcoma, and other sarcomas/carcinomas

給藥方式

可能的副作用

• 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)

注意事項與禁忌

• No specific absolute contraindications listed, but use with extreme caution in patients with pre-existing cardiac disease or the ABCB1 (MDR1) mutation.
• > **Extravasation Risk:** Severe tissue necrosis will occur if extravasated. Use of an indwelling catheter taped in place is essential. Administer into the side port of a freely running IV infusion of 0.9% NaCl over a minimum of 10 minutes. > **Cardiotoxicity:** May cause dose-dependent cumulative cardiotoxicity, though possibly at a lower incidence than doxorubicin. Caution in patients with pre-existing cardiac disease. > **Myelosuppression:** Suspend treatment if neutrophils drop below 2.5 × 10^9/L or platelets below 50 × 10^9/L. Reduce dose by 10-25% if haematological or GI toxicity is recurrent. > **Genetics:** Dogs with the **ABCB1 (MDR1)** mutation may be at higher risk of toxicity. **Clinical Pearl:** Premedication with IV chlorphenamine or dexamethasone is recommended to prevent acute anaphylactic reactions.

藥物相互作用

• Heparin: Incompatible; a precipitate will form if mixed.
• Cyclophosphamide: Increased risk of myelosuppression when used in combination.
• Cimetidine: Increases the area under the dose curve (AUC) of epirubicin by 50%; should not be used concurrently.

常見問題