氯法齊明
Clofazimine
別名: Lamprene · Clofozine · Hansepran · Lamcoin · B-663 · G-30320 · NSC-141046 · Chlofazimine · Clofazimina · Clofaziminum
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 |
|---|---|---|---|---|---|
| Mycobacterium avium complex (MAC) as part of a multi-drug regimen | 4 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| M. avium intracellularae complex infections, leprosy, or opportunistic mycobacteriosis | 4-8 mg/kg PO once a day | PO | q24h | 4 weeks | 🌎 NA |
| Mycobacterial infections | 4-8 mg/kg | PO | q24h | 2-6 months | 🌍 EU |
- Mycobacterium avium complex (MAC) as part of a multi-drug regimen: Other drugs that may be used in combination include doxycycline, clarithromycin, and/or enrofloxacin.
- M. avium intracellularae complex infections, leprosy, or opportunistic mycobacteriosis: Usually as part of a multi-drug protocol.
- Mycobacterial infections: Generally used in combination therapy with other antimicrobials including fluoroquinolones and clarithromycin.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Treatment of feline leprosy | 25-50 mg once per day or 50 mg every other day | PO | q24h or q48h | — | 🌎 NA |
| Treatment of localized atypical mycobacterial infections | 8 mg/kg PO once daily | PO | q24h | At least 4 weeks beyond complete clinical resolution | 🌎 NA |
| M. avium intracellularae complex infections, leprosy or opportunistic mycobacteriosis | 4-8 mg/kg PO once a day | PO | q24h | 4 weeks | 🌎 NA |
| Mycobacterial infections (including feline leprosy) | 4-8 mg/kg | PO | q24h | 2-6 months | 🌍 EU |
- Treatment of feline leprosy: Using a regimen of either two or three drugs (with clarithromycin and/or rifampin).
- Treatment of localized atypical mycobacterial infections: Perform wide surgical excision of lesion if possible. Base antibiotic selection on culture and susceptibility results.
- M. avium intracellularae complex infections, leprosy or opportunistic mycobacteriosis: Usually as part of a multi-drug protocol.
- Mycobacterial infections (including feline leprosy): Generally used in combination therapy with other antimicrobials including fluoroquinolones and clarithromycin.
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Avian mycobacteriosis | 6 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Avian mycobacteriosis (recommended regime for raptors) | 1.5 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
- Avian mycobacteriosis: Protocol 1: with rifampin 45 mg/kg and ethambutol 30 mg/kg.
- Avian mycobacteriosis (recommended regime for raptors): Protocol 2: with ethambutol 20 mg/kg, cycloserine 5 mg/kg, enrofloxacin 15 mg/kg q12h.
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
氯法齊明（Clofazimine）是一種高度脂溶性的吩嗪類染料抗分枝桿菌抗生素。在獸醫學中，它主要作為多重藥物療法的一部分，用於治療類麻風症候群（例如貓麻風、犬類麻風肉芽腫）和鳥型分枝桿菌複合群（MAC）感染。
臨床要點：
- 合併療法： 由於分枝桿菌極難根除且容易產生抗藥性，氯法齊明幾乎從不作為單一療法使用。
- 脂溶性： 其極高的脂溶性使其大量積聚在脂肪和網狀內皮系統（巨噬細胞）中。
- 染色作用： 該藥物具有染料特性，導致其標誌性的副作用：皮膚、眼睛和體液出現明顯且持久的變色。
- 取得困難： 獸醫可能很難取得此藥物並為小型動物準確調配劑量，通常需要專業調劑藥師的協助。
作用機制
Clofazimine exerts a slowly bactericidal effect against susceptible mycobacteria (M. leprae, M. tuberculosis, M. avium complex, M. bovis, M. chelonei).
- DNA Binding: It binds directly to mycobacterial DNA (preferentially at guanine base sequences) → blocks template function → inhibits DNA replication and cell growth.
- Intracellular Accumulation: It is heavily taken up by macrophages, concentrating the drug exactly where intracellular mycobacteria reside.
- Immunomodulation: Exhibits anti-inflammatory and immunosuppressive properties, likely by inhibiting T-lymphocyte activation and proliferation, though the exact mechanism remains poorly understood.
安全性與警告
禁忌症
- Use with caution in patients with pre-existing gastrointestinal conditions (diarrhea, abdominal pain)
- Known hypersensitivity to clofazimine
不良反應
- Skin, eye, and body fluid discoloration (pink to brownish-black)
- Gastrointestinal pain, nausea, vomiting, diarrhea (dose-limiting)
- Hepatotoxicity (reported in a dog receiving concurrent rifampin)
- Photosensitization (reported in a cat)
- Diarrhoea
- Discoloration of skin, eyes, and body fluids (red-brown/orange)
- Renal impairment
- Hepatic impairment
注意事項
Use with caution in patients with pre-existing gastrointestinal conditions such as diarrhea or abdominal pain. The drug is highly lipophilic and has an extremely long half-life, meaning adverse effects (like skin discoloration) can persist for months to years after discontinuation. It may be difficult to obtain and accurately dose for small animals.
藥物相互作用
May reduce clofazimine levels in the skin and increase amounts in plasma and urine; clinical significance is unclear.
May reduce the anti-inflammatory effects of clofazimine; clinical significance is unclear.
監測
- Efficacy against mycobacterial disease
- Adverse effects (primarily gastrointestinal)
- Hepatic function (especially in dogs)
- Hepatic function (ALT, AST, ALP, Bilirubin)
- Renal function (BUN, Creatinine, SDMA)
- Clinical signs of photosensitization
- Gastrointestinal tolerance
藥物動力學
吸收
Variably absorbed after oral administration (bioavailability 45-70% in humans). Food enhances absorption, but increasing the dosage decreases the percentage absorbed.
分佈
Highly lipid soluble; distributes primarily to lipid tissue and the reticuloendothelial system. Taken up by macrophages throughout the body. Crosses the placenta and distributes into milk, but does not apparently cross into the CNS or CSF.
代謝
Not well defined in veterinary species.
排除
Retained in the body for a long period. Bile excretion may be responsible for the majority of excretion, but sputum, sebum, and sweat may also contribute.
過量
Very limited data is available. The LD50 for rabbits is 3.3 g/kg and is greater than 5 g/kg in mice, rats, and guinea pigs. Treatment, if required, would include gut emptying and supportive care. Contact an animal poison control center for additional guidance.
可用產品
劑型
- Oral capsules (micronized form in a wax matrix base)
- 100 mg oral capsule
人用標示
- Lamprene (restricted availability via Investigational New Drug [IND] protocols only)
- Lamprene 100 mg capsules
各地核准狀態
POM (Prescription Only Medicine). Human drug used off-label under the cascade.
POM (Prescription Only Medicine). Human drug used off-label under the cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Clofazimine oral capsules should be stored in tight containers, protected from moisture at temperatures less than 30°C.
飼主須知
給藥方式：
- 除非獸醫另有指示，否則請隨餐給予此藥物，以增加吸收並減少腸胃不適。
重要警告：
變色反應： 此藥物是一種染料。它很可能會使您寵物的皮膚變色（通常是粉紅色，但也可能從紅色、橘色到棕色不等）。它還可能導致眼淚、尿液、糞便和其他體液變成棕黑色。
- 這種變色是藥物正常且預期的反應，並無害處，但可能會弄髒布料，並且在治療結束後可能持續數月才會消退。
治療療程：
- 分枝桿菌感染的治療時間非常長（通常需要數月）。即使您的寵物看起來已經好轉，除非獸醫指示，否則請勿提早停藥。
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