金剛胺鹽酸鹽
Amantadine HCl
Adamantanamine hydrochloride
別名: Symmetrel · Adekin · Amantagamma · Amantrel · Amixx · Antiflu-DES · Atarin · Atenegine · Cerebramed · Endantadine · Infectoflu · Influ-A · Lysovir · Mantadix · Mantidan · Padiken · Symadine · Viroifral · Virucid · Adamantanamine HCl · Amantadine HCl · Amantadini hydrochloridum
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
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 |
|---|---|---|---|---|---|
| Osteoarthritis pain when NSAIDs alone are not effective | 3-5 mg/kg PO once daily in addition to an NSAID | PO | q24h | — | 🌎 NA |
| Adjunctive therapy for chronic pain | 3-5 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| To decrease wind-up | 3-5 mg/kg PO once daily for one week | PO | q24h | 1 week | 🌎 NA |
| Analgesia (adjunct for chronic pain) | 3-5 mg/kg | PO | sid to bid | Chronic | 🌍 EU |
- Osteoarthritis pain when NSAIDs alone are not effective: Meloxicam at approved doses was used for this study.
- Analgesia (adjunct for chronic pain): Potentiates the effects of other analgesics. Often combined with NSAIDs.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Adjunctive therapy for chronic pain | 3 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Adjunctive therapy for chronic pain | 3-5 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Adjunctive therapy for chronic pain | 3 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Analgesia (adjunct for chronic pain) | 3-5 mg/kg | PO | sid | Chronic | 🌍 EU |
- Adjunctive therapy for chronic pain: May be useful addition to NSAIDs; has not been evaluated for toxicity. May need to be compounded.
- Analgesia (adjunct for chronic pain): Liquid formulations may be bitter and difficult to administer.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Acute treatment of equine-2 influenza | 5 mg/kg IV q4h | IV | q4h | — | 🌎 NA |
- Acute treatment of equine-2 influenza: Not commonly used due to expense, PK variability, and seizure risk.
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
金剛胺 (Amantadine) 最初是作為預防和治療A型流感的抗病毒藥物開發的，但在現代獸醫學中，它主要被利用其 NMDA（N-甲基-D-天冬氨酸）受體拮抗劑 的特性。
主要臨床應用包括：
- 輔助鎮痛：主要用於犬貓治療慢性、神經病理性或對鴉片類藥物產生耐受性的疼痛（例如嚴重的骨關節炎、骨肉瘤）。它很少作為單一鎮痛劑發揮作用，但與非類固醇抗發炎藥 (NSAIDs)、鴉片類藥物或加巴噴丁 (Gabapentin) 併用時，能有效對抗中樞敏感化。
- 馬流感：曾被研究用於馬-2型流感病毒，但由於成本高、口服吸收不穩定以及靜脈注射有引發癲癇的風險，臨床使用受到限制。
臨床要點：金剛胺是治療「痛覺纏繞 (wind-up pain)」（觸發痛和痛覺過敏）的關鍵藥物，適用於神經系統對疼痛訊號變得過度敏感的情況。
作用機制
Amantadine has distinct mechanisms depending on the therapeutic target:
- Analgesia (NMDA Antagonism): Chronic pain causes excessive release of excitatory neurotransmitters (glutamate and aspartate). These bind to the NMDA receptor on postsynaptic neurons in the dorsal horn of the spinal cord. Amantadine acts as a non-competitive antagonist, blocking the open ion channel of the NMDA receptor → prevents calcium (Ca2+) influx → reduces central sensitization and "wind-up" pain.
- Antiviral: Interferes with the influenza A virus M2 transmembrane protein → blocks the uncoating of the virus particle and prevents viral replication.
- Antiparkinsonian (Human): Potentiates dopaminergic neurotransmission in the CNS and exhibits mild anticholinergic activity.
安全性與警告
禁忌症
- Known hypersensitivity to amantadine or rimantadine
- Untreated angle-closure glaucoma
- Extra-label use in chickens, turkeys, and ducks (Prohibited by FDA)
不良反應
- Agitation or restlessness (especially early in therapy)
- Loose stools, flatulence, or diarrhea
- Narrow safety margin in cats (potential for neurotoxicity)
- Seizures (reported in horses given IV)
注意事項
Use with caution in patients with liver disease, renal disease (dosage adjustment may be required as it is primarily renally excreted), congestive heart failure, active psychoses, eczematoid dermatitis, or seizure disorders.
Warning: The FDA strictly prohibits the extra-label use of amantadine and other influenza antivirals in poultry (chickens, turkeys, ducks).
藥物相互作用
May enhance the anticholinergic effects of amantadine.
Concomitant use may increase the CNS stimulatory effects of amantadine.
May decrease the renal excretion of amantadine, yielding higher and potentially toxic blood levels.
May increase the renal excretion of amantadine, potentially decreasing its efficacy.
Decreased renal clearance of amantadine, potentially leading to toxicity
Increased anticholinergic side effects (e.g., dry mouth, urine retention)
Increased risk of agitation, restlessness, or seizures
監測
- Adverse effects (especially GI upset and agitation/behavioral changes)
- Clinical efficacy (reduction in pain scores, improved mobility)
藥物動力學
半衰期
吸收
Horses: Wide interpatient variability after oral dosing; bioavailability ranges from 40-60%. Humans: Well absorbed orally with peak plasma concentrations at ~3 hours.
分佈
Horses: Steady state volume of distribution is approximately 5 L/kg. Humans: Vd is 3-8 L/kg.
代謝
Not well described in veterinary species.
排除
Humans: Primarily eliminated via renal mechanisms. Oral clearance is ~0.28 L/hr/kg.
過量
Overdoses are potentially very serious due to a fairly narrow therapeutic index.
- Cats: Toxic dose reported is 30 mg/kg. Behavioral effects may be noted at 15 mg/kg.
- Dogs: Behavioral effects noted at 15 mg/kg.
- Humans: Overdoses as low as 2 grams have been fatal. Signs include cardiac dysfunction (arrhythmias, hypertension, tachycardia), pulmonary edema, CNS toxicity (tremors, seizures, psychosis, agitation, coma), hyperthermia, and renal dysfunction.
Treatment: No specific antidote. Empty the gut if possible. Provide intensive monitoring and supportive therapy. Forced urine acidifying diuresis may increase renal excretion. Physostigmine has been suggested for cautious use in treating CNS effects.
可用產品
劑型
- Oral Tablets
- Oral Capsules
- Oral Syrup/Solution
人用標示
- Amantadine HCl Oral Tablets & Capsules: 100 mg (Symmetrel®, generic)
- Amantadine HCl Oral Syrup: 10 mg/mL in 480 mL (Symmetrel®, generic)
各地核准狀態
POM. Used off-label under the prescribing cascade.
POM. Used off-label under the prescribing cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Tablets, capsules, and oral solution should be stored in tight containers at room temperature. Limited exposures to temperatures as low as 15°C and as high as 30°C are permitted. Avoid freezing the liquid.
飼主須知
- 耐心是關鍵：用於治療慢性疼痛時，必須按照處方持續給藥。可能需要一週或更長時間才能看到寵物舒適度有明顯改善。
- 副作用：可能會出現輕微的胃腸道反應（軟便、脹氣、腹瀉）或輕微的焦躁不安，特別是在治療的前幾天。如果這些症狀變得嚴重或持續存在，請聯繫您的獸醫師。
- 適口性：如果使用液體劑型，請注意它有非常苦的味道。您的獸醫師或調劑藥局可能會提供調味版本。
- 安全警告：過量服用可能危及生命。請務必將此藥物放在兒童和所有寵物絕對接觸不到的地方。
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