賽庚啶
Cyproheptadine
Cyproheptadine Hydrochloride
別名: Ciplactin · Cyheptine · Cyprogin · Cyprono · Cyprosian · Klarivitina · Nuran · Periactine · Periactinol · Periatin · Peritol · Polytab · Practin · Preptin · Supersan · Trimetabol · Cyproheptadini hydrochloridum · Cyproheptadine hydrochloride
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 |
|---|---|---|---|---|---|
| As an antihistamine | 0.3-2 mg/kg | PO | twice daily | — | 🌎 NA |
| As an appetite stimulant | 0.2 mg/kg | PO | q12h | — | 🌎 NA |
| For adjunctive treatment of serotonin syndrome | 1.1 mg/kg | PO | q4-6h | until signs have resolved | 🌎 NA |
| Management of allergic disease / Appetite stimulation | 0.1-0.5 mg/kg | PO | q8-12h | — | 🌍 EU |
- As an appetite stimulant: May be dosed less frequently if inappetence is mild.
- For adjunctive treatment of serotonin syndrome: In cases where PO dosing not possible (severe vomiting), may crush tablets and mix with saline and give rectally.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As an appetite stimulant | 2-4 mg per cat | PO | once or twice daily | — | 🌎 NA |
| As an appetite stimulant | 1-4 mg/cat, or 0.35-1 mg/kg | PO | once or twice a day | — | 🌎 NA |
| As an appetite stimulant | 2 mg per cat | PO | q12h | — | 🌎 NA |
| As an appetite stimulant | 0.35-1 mg/kg | PO | q12h | — | 🌎 NA |
| As an appetite stimulant in cats with renal insufficiency | 1 mg per cat | PO | q12h | — | 🌎 NA |
| As an antihistamine/antipruritic | 2 mg per cat | PO | q12h | — | 🌎 NA |
| As an antihistamine/antipruritic | 2 mg per cat or 1.1 mg/kg | PO | q12h | — | 🌎 NA |
| For feline asthma | 2 mg | PO | q12h | — | 🌎 NA |
| For adjunctive treatment of serotonin syndrome | 2-4 mg (total dose) | PO | q4-6h | until signs have resolved | 🌎 NA |
| Management of allergic disease / Appetite stimulation / Aortic thromboembolism | 0.1-0.5 mg/kg | PO | q8-12h | — | 🌍 EU |
- As an appetite stimulant: May be dosed less frequently if inappetence is mild.
- For feline asthma: Particularly when cats are maxed out on dosages of corticosteroids and terbutaline. Therapeutic response may not be seen for 4-7 days, but CNS depression can occur in 24 hours.
- For adjunctive treatment of serotonin syndrome: In cases where PO dosing not possible (severe vomiting), may crush tablets and mix with saline and give rectally.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For photic head shaking | 0.3-0.6 mg/kg | PO | q12h | — | 🌎 NA |
| For photic head shaking | 0.3 mg/kg | PO | twice daily | — | 🌎 NA |
| For treatment of equine Cushing's | 0.25 mg/kg | PO | once a day | 4-8 weeks | 🌎 NA |
| For treatment of equine Cushing's | 65-125 mg (total dose) | PO | once daily | — | 🌎 NA |
| For treatment of equine Cushing's (adjunctive) | 0.5 mg/kg | PO | q12h | — | 🌎 NA |
- For photic head shaking: ARCI UCGFS Class 4 Drug
- For photic head shaking: ARCI UCGFS Class 4 Drug
- For treatment of equine Cushing's: If no response (clinical signs and plasma ACTH), increase dosage frequency to twice daily. Approximately 1/3 of horses may benefit, non-responders should be switched to pergolide.
- For treatment of equine Cushing's: Pergolide is the drug of choice as it is much more effective then cyproheptadine.
- For treatment of equine Cushing's (adjunctive): Add if only a limited response to a pergolide dose of 0.006 mg/kg and endocrinologic tests remain abnormal. Continue to monitor blood glucose and endocrinologic tests.
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
賽庚啶是一種具有強效抗血清素特性的第一代抗組織胺。在獸醫學中，它最常被利用的是其「仿單標示外（off-label）」的作用，而非其抗組織胺功能。
主要獸醫臨床應用：
- 食慾促進劑： 過去常作為貓的第一線食慾促進劑，雖然現代臨床上已多被米氮平（Mirtazapine）或 Capromorelin 取代，但在其他藥物無法取得或有禁忌症時，仍是可行的替代方案。
- 血清素症候群解毒劑： 它是治療犬貓血清素毒性（例如誤食人類的 SSRI/SNRI 抗憂鬱藥或 5-HTP 補充劑）的黃金標準輔助治療藥物。
- 馬匹醫療： 用於治療馬匹的光照性甩頭症（photic head shaking），以及作為馬匹腦下垂體中葉功能異常（PPID / 馬庫興氏症）的二線或輔助療法（儘管 Pergolide 對 PPID 的療效遠優於此藥）。
- 貓氣喘與搔癢症： 偶爾用於貓的嗜酸性呼吸道發炎或過敏性皮膚病，但臨床療效通常有限。
臨床重點： 賽庚啶需要透過肝臟代謝並經由腎臟排泄；建議在患有慢性腎病（CKD）的貓咪身上調整劑量。
作用機制
Cyproheptadine exhibits a multi-receptor antagonism profile:
- Serotonin (5-HT) Antagonism: Competitively binds to 5-HT2A receptors in the hypothalamus → blocks serotonin-induced satiety → stimulates appetite. In serotonin syndrome, blocking these receptors reverses life-threatening neuromuscular and autonomic hyperactivity.
- Histamine (H1) Antagonism: Competes with histamine for H1-receptors on effector cells → prevents histamine-mediated capillary permeability, smooth muscle spasm, and pruritus. It does not prevent histamine release.
- Anticholinergic Activity: Weakly antagonizes muscarinic receptors → leads to common side effects like dry mouth and urinary retention.
- Calcium Channel Blockade: Exhibits mild calcium channel blocking properties, which may contribute to its efficacy in equine photic head shaking.
安全性與警告
禁忌症
- Hypersensitivity to cyproheptadine
- Prostatic hypertrophy
- Bladder neck obstruction
- Severe cardiac failure
- Pyeloduodenal obstruction
- Urinary retention (relative)
- Angle-closure glaucoma (relative)
- Pyloroduodenal obstruction (relative)
不良反應
- Sedation / CNS depression
- Paradoxical hyperexcitability or agitation (especially in cats)
- Anticholinergic effects (dry mucous membranes, urinary retention, tachycardia)
- Hemolytic anemia in cats (rare)
- Polyphagia (in dogs at higher doses)
- Mild depression, anorexia, or lethargy (in horses)
- Mild sedation
- Weight gain
- Reduced seizure threshold
注意事項
Use with caution in patients with conditions exacerbated by anticholinergic effects (e.g., glaucoma, urinary retention, GI stasis).
Laboratory Considerations:
- Allergy Testing: Antihistamines decrease the wheal and flare response. Discontinue 3-7 days prior to intradermal skin testing.
- Endocrine Testing: May increase amylase and prolactin serum levels when administered with thyrotropin-releasing hormone (TRH).
藥物相互作用
Additive CNS depression
Cyproheptadine may decrease the efficacy of the SSRI due to its serotonin antagonist properties
監測
- Clinical efficacy (e.g., body weight if used for anorexia, resolution of neurologic signs if used for serotonin syndrome)
- Adverse effects (sedation, anticholinergic signs)
- Serum BUN/Creatinine in cats with long-term use
- Appetite and weight gain
- Resolution of allergic signs
- Neurological status (seizure activity)
藥物動力學
半衰期
吸收
Well absorbed after oral administration.
分佈
Distribution characteristics are not well described. It is not known if cyproheptadine is distributed into milk.
代謝
Nearly completely metabolized in the liver.
排除
Metabolites are excreted in the urine; elimination is reduced in renal failure.
過量
There are no specific antidotes available for cyproheptadine overdose.
Clinical Signs of Toxicity:
- Extensions of pharmacological effects: profound CNS depression (though paradoxical CNS stimulation/seizures may occur).
- Severe anticholinergic effects: extreme drying of mucous membranes, tachycardia, urinary retention, hyperthermia.
- Hypotension.
Management:
- Decontamination: Standard gut emptying protocols (emesis/activated charcoal) if caught early and patient is stable.
- Supportive Care: IV fluids for hypotension, temperature regulation.
- Specific Interventions: Physostigmine may be considered for life-threatening central anticholinergic effects. Diazepam should be employed to treat seizures if they occur.
Note: Horses receiving 2x the recommended dose apparently showed no untoward effects.
可用產品
劑型
- Oral Tablets
- Oral Syrup
- 4 mg oral tablet
獸醫用
- None (No veterinary-labeled products available)
人用標示
- Cyproheptadine HCl Oral Tablets: 4 mg
- Cyproheptadine HCl Oral Syrup: 2 mg/5 mL
- Periactin 4 mg tablets
各地核准狀態
POM
POM
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store tablets and oral solution at room temperature in tight, light-resistant containers. Avoid freezing.
飼主須知
賽庚啶是一種常被用來促進貓咪食慾，或治療寵物特定過敏及神經系統疾病的藥物。
預期反應：
- 嗜睡： 您的寵物可能會變得想睡或無精打采。這是最常見的副作用。
- 口乾： 由於黏膜乾燥，您可能會注意到寵物一直舔嘴唇或喝更多的水。
重要警告：
- 異常興奮（矛盾反應）： 有些貓咪對此藥物會產生相反的反應，變得非常焦躁、愛叫或過度活躍。如果發生這種情況，請聯繫您的獸醫師，可能需要降低劑量或停藥。
- 立即就醫情況： 如果您的貓咪變得極度虛弱、無反應或牙齦變得蒼白，請立即尋求醫療協助。
- 馬匹： 可能會出現輕度憂鬱、食慾不振或嗜睡。
- 忘記餵藥： 如果忘記餵藥，想起來時請盡快補餵，但絕對不要一次給予雙倍劑量來彌補。
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠方最新藥品說明書。