達貝泊汀α
Darbepoetin Alfa
Darbepoetin alfa (recombinant DNA-produced 165-amino acid glycoprotein)
別名: Aranesp · Nespo · novel erythropoiesis stimulating protein · darbepoetina · darbepoetinum · Darbepoetin alfa · rhEPO derivative
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 |
|---|---|---|---|---|---|
| Anemia of chronic kidney disease | 0.45 micrograms/kg | SC/IV | once weekly | — | 🌎 NA |
- Anemia of chronic kidney disease: Initial human dose. Adjust using clinical judgment and careful monitoring. Alternatively, convert from epoetin alfa: Total weekly dose of epoetin in Units divided by 200 = once weekly dose in micrograms darbepoetin.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Anemia of chronic kidney disease | 0.45 micrograms/kg | SC/IV | once weekly | — | 🌎 NA |
- Anemia of chronic kidney disease: Initial human dose. Adjust using clinical judgment and careful monitoring. Alternatively, convert from epoetin alfa: Total weekly dose of epoetin in Units divided by 200 = once weekly dose in micrograms darbepoetin.
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
達貝泊汀α（Darbepoetin alfa）是一種合成的長效紅血球生成刺激劑（ESA）。它是透過重組DNA技術在中國倉鼠卵巢細胞中生產的165個胺基酸蛋白質。
臨床要點：與依泊汀α（epoetin alfa）相比，達貝泊汀含有兩個額外的N-連接碳水化合物鏈。這種結構修飾增加了其分子量，並顯著提高了其代謝穩定性和半衰期，從而允許較低頻率的給藥（例如，每週一次而不是每週三次）。
在獸醫學中，它主要用於標示外使用（off-label），以控制犬貓因慢性腎病（CKD）引起的非再生性貧血。理論上，額外的碳水化合物屏障可能使其免疫原性低於依泊汀α，從而潛在地降低純紅血球再生不良（PRCA）的風險，儘管這在獸醫病患中尚未得到證實。
作用機制
Darbepoetin alfa mimics endogenous erythropoietin by binding to the erythropoietin receptor (EpoR) on the surface of erythroid progenitor stem cells in the bone marrow.
- Binding induces receptor dimerization → activates the JAK2/STAT5 intracellular signaling pathway.
- This cascade → inhibits apoptosis of progenitor cells → stimulates their proliferation and differentiation into mature red blood cells (RBCs).
- The increased RBC mass subsequently raises the packed cell volume (PCV) and improves tissue oxygenation.
安全性與警告
禁忌症
- Patients with documented anti-rHuEPO antibodies
- Uncontrolled hypertension
- Hypersensitivity to darbepoetin or excipients in the formulation
不良反應
- Anti-rHuEPO antibody formation leading to pure red blood cell aplasia (PRCA)
- Hypertension
- Seizures
- Iron deficiency (due to rapid RBC production depleting iron stores)
注意事項
Use with extreme caution in patients with pre-existing hypertension; blood pressure must be monitored. Monitor closely for the development of anti-rHuEPO antibodies, which is diagnosed by a sudden, severe drop in PCV, a high myeloid:erythroid ratio on bone marrow cytology, and the exclusion of other causes of anemia. Ensure adequate iron stores prior to and during therapy, as rapid erythropoiesis can quickly deplete iron.
藥物相互作用
May increase the sensitivity of erythroid progenitors (interaction has been used for therapeutic effect with epoetin)
Can decrease bleeding times when used concurrently with erythropoietin agents
監測
- PCV/Hematocrit (check before each re-dosing)
- Iron stores (supplement with iron if necessary)
- Blood pressure
藥物動力學
吸收
Humans (SC): Bioavailability is about 37% and the drug is absorbed slowly.
分佈
Humans: Distribution half-life is about 1.4 hours.
代謝
Extensively metabolized.
排除
Humans: Terminal elimination half-life averages 21 hours (about 3 times greater than that of epoetin alfa).
過量
Little information is available in veterinary species. In humans, therapeutic dosages of up to 8 micrograms/kg every week for 12 weeks have been administered. Polycythemia (excessive red blood cells) is possible with overdosage, and therapeutic phlebotomy may be required to reduce blood viscosity.
可用產品
劑型
- Injection solution (polysorbate or albumin-based)
- Prefilled syringes
人用標示
- Darbepoetin Alfa Solution for Injection (preservative free); Aranesp®: 25 mcg/0.42 mL, 40 mcg/0.4 mL, 60 mcg/0.3 mL, 100 mcg/0.5 mL, 150 mcg/0.3 mL, 200 mcg/0.4 mL, 300 mcg/0.6 mL in single-dose prefilled syringes
- Darbepoetin Alfa Solution for Injection (preservative free); Aranesp®: 25 mcg/mL, 40 mcg/mL, 60 mcg/mL, 100 mcg/mL, 150 mcg/0.75 mL, 200 mcg/mL, 300 mcg/mL, 500 mcg/mL in single-dose vials
各地核准狀態
POM (Prescription Only Medicine). Human product used under the cascade.
POM (Prescription Only Medicine). Human product used under the cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store at 2-8°C (36-46°F) and protect from light. Do not freeze or shake the vials or syringes.
飼主須知
重要提示：此藥物用於治療由慢性腎病引起的嚴重貧血。它有助於身體產生更多的紅血球，但並不能治癒潛在的腎臟疾病。
- 需要耐心：開始治療後可能需要幾週時間才能觀察到療效。請不要期望寵物的精力會立即增加。
- 承諾：此治療需要顯著的財務承諾，因為該藥物價格昂貴。
- 頻繁監測：您的寵物需要定期回診，以檢查其紅血球數量（PCV）、鐵濃度和血壓。
- 注意副作用：如果您發現高血壓的跡象（例如突然失明、行為改變、步態不穩）或精力突然嚴重下降（這可能表明身體完全停止製造紅血球的罕見免疫反應），請立即聯繫您的獸醫師。
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