秋水仙鹼
Colchicine
別名: Colcrys · Artrex · Colchily · Colchicquim · Colchis · Colcine · Colgout · Goutichine · Goutnil · Reugot · Ticolcin · Tolchicine · Colchicine · colchicinum
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 |
|---|---|---|---|---|---|
| Adjunctive treatment of hepatic cirrhosis/fibrosis | 0.03 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of hepatic cirrhosis/fibrosis | 0.025-0.03 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Periodic fever syndrome in Shar Pei dogs | 0.03 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| To reduce the frequency and severity of fever and prevent the development of amyloidosis in dogs with Shar Pei Fever | 0.025-0.03 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Fibrosis / Renal amyloidosis | Initial dose 0.01 mg/kg, increase in incremental amounts every 3-4 days to a maximum dose of 0.03 mg/kg | PO | q24h initially, up to q12h | Long-term | 🌍 EU |
- Adjunctive treatment of hepatic cirrhosis/fibrosis: Probenecid-free drug. Not recommended for initial use with azathioprine, chlorambucil or methotrexate due to similar side effects. Used in many dogs and fewer cats without problems.
- To reduce the frequency and severity of fever and prevent the development of amyloidosis in dogs with Shar Pei Fever: No evidence supports use of colchicine once amyloidosis has resulted in renal failure.
- Fibrosis / Renal amyloidosis: Increase dose only if no adverse GI effects occur.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Fibrosis | Not recommended | PO | N/A | N/A | 🌍 EU |
- Fibrosis: No evidence for its efficacy as an antifibrotic in cats.
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As an antifibrotic for the adjunctive treatment of hepatic fibrosis (Psittacines) | 0.2 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
- As an antifibrotic for the adjunctive treatment of hepatic fibrosis (Psittacines): May potentiate gout in some cases.
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
秋水仙鹼是一種源自秋水仙植物（Colchicum autumnale）的獨特生物鹼，在人類醫學中傳統上以其抗痛風特性而聞名。在獸醫藥理學中，它主要作為試驗性或仿單標示外療法，用於特定的纖維化和發炎性疾病。
主要的獸醫應用包括：
- 肝硬化/肝纖維化： 用於減緩或逆轉肝臟的纖維化病變。
- 沙皮狗熱（家族性澱粉樣變性）： 用於預防澱粉樣蛋白在腎臟中的沉積。
- 氣管支架肉芽組織增生： 曾被實驗性地用於治療支架置入後的肉芽組織狹窄。
臨床重點： 秋水仙鹼的治療指數狹窄。腸胃道不適通常是毒性的首發徵兆，一旦出現應立即重新評估病患狀況。
作用機制
Colchicine exerts its effects through several distinct mechanisms depending on the target tissue:
- Microtubule Disruption: Binds irreversibly to tubulin → inhibits microtubule polymerization → interferes with sol-gel formation and the mitotic spindle → arrests cell division in metaphase.
- Antifibrotic Activity: Stimulates collagenase activity → increases the breakdown of collagen and decreases its formation, mitigating hepatic fibrosis.
- Anti-Amyloid Effect: Blocks the synthesis and secretion of Serum Amyloid A (SAA) (an acute-phase reactant protein) by hepatocytes → prevents the formation of amyloid-enhancing factor → halts amyloid deposition in tissues.
- Anti-inflammatory (Gout): Inhibits neutrophil motility and phagocytosis of monosodium urate crystals → reduces the release of inflammatory mediators.
安全性與警告
禁忌症
- Serious renal dysfunction
- Serious gastrointestinal dysfunction
- Serious cardiac dysfunction
- Pregnancy (unless benefits strictly outweigh risks)
- Severe renal impairment
不良反應
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Anorexia
- Bone marrow suppression (with prolonged use)
- Neutropenia (rare)
- Severe local irritation/thrombophlebitis (if extravasated IV)
- Diarrhoea
- Renal damage (rare)
- Bone marrow suppression (rare)
- Myopathy (rare)
- Peripheral neuropathy (rare)
- Increased serum ALP
- Decreased platelet counts
注意事項
Contraindications & Warnings
- Absolute Contraindications: Patients with serious renal, gastrointestinal, or cardiac dysfunction.
- Caution: Use with extreme care in geriatric or debilitated patients, and those in the early stages of organ dysfunction.
- Reproductive Safety: Colchicine is teratogenic (FDA Category C for oral, Category D for parenteral) and reduces spermatogenesis. Use during pregnancy only if the potential benefits strictly outweigh the risks. Use cautiously in nursing mothers.
- Veterinary Status: Use is considered somewhat controversial and experimental, as safety and efficacy are not definitively documented in all target species.
藥物相互作用
May cause additive myelosuppression when used concurrently with colchicine.
Possible increased risk of nephrotoxicity and myotoxicity
May increase the risks of thrombocytopenia, leucopenia, or bone marrow depression
May cause additive myelosuppressive effects
監測
- Clinical efficacy
- Adverse effects (especially GI signs as early indicators of toxicity)
- CBC (to monitor for bone marrow suppression)
- Gastrointestinal signs (vomiting, diarrhea)
- Complete Blood Count (platelets, WBCs)
- Liver enzymes (ALP)
- Renal function parameters
- Urinalysis
藥物動力學
半衰期
吸收
Absorbed from the GI tract with a significant first-pass effect.
分佈
Distributed into several tissues, but highly concentrated in leukocytes.
代謝
Metabolized in the liver (deacetylated) and other tissues. Undergoes extensive enterohepatic recycling (biliary secretion and GI reabsorption), which contributes to its intestinal toxicity.
排除
Primarily excreted in feces (as unchanged drug and metabolites), with some renal excretion. Patients with severe renal disease may have prolonged half-lives.
過量
Toxicity Profile
Colchicine has a narrow therapeutic index and can be highly toxic even after relatively small overdoses. In humans, ingestion of as little as 7 mg has been fatal, with 65 mg considered a lethal dose in adults.
Clinical Signs of Overdose
- Early Signs: Severe gastrointestinal distress (anorexia, vomiting, bloody diarrhea, paralytic ileus).
- Advanced Signs: Renal failure, hepatotoxicity, pancytopenia, ascending paralysis, shock, and vascular collapse.
Management
- No specific antidote exists.
- Decontamination: Gut removal techniques should be employed when applicable. Due to extensive enterohepatic recycling, administering repeated doses of activated charcoal along with a saline cathartic is highly recommended to interrupt systemic reabsorption.
- Supportive Care: Aggressive fluid therapy, symptomatic management, and potentially peritoneal dialysis.
可用產品
劑型
- Oral tablets
- Injection (human-labeled)
- 0.5 mg tablets
人用標示
- Colchicine Oral Tablets: 0.6 mg (1/100 gr) (Colcrys, generic)
- 0.5 mg tablets
各地核准狀態
POM (Prescription Only Medicine). Used off-label under the cascade.
POM (Prescription Only Medicine). Used off-label under the cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store tablets in tight, light-resistant containers. Injection should be diluted only in 0.9% sodium chloride or sterile water for injection. Do not use D5W or bacteriostatic sodium chloride as precipitation may occur. Discard turbid solutions.
飼主須知
寵物主人重要須知
秋水仙鹼是一種專門的藥物，用於治療特定的肝臟疾病或遺傳性發燒症候群（如沙皮狗熱）。由於它是一種強效藥物，因此必須進行仔細的監測。
- 注意腸胃不適： 最常見且最早出現的問題徵兆是噁心、嘔吐、腹瀉或食慾不振。如果您注意到任何這些症狀，請立即停藥並聯絡您的獸醫師。
- 試驗性使用： 此藥物在獸醫學中通常是「仿單標示外」使用，這意味著它是基於臨床經驗開立，而非經過正式的獸醫藥物核准。
- 安全預防措施：
- 請將此藥物嚴格放置在兒童和其他寵物接觸不到的地方。即使是少量的意外劑量也可能非常危險。
- 孕婦應避免接觸該藥物或接觸正在接受治療的寵物的尿液。如果必須處理，請戴上手套。
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