枸櫞酸乙胺嗪 / 迪愛西
Diethylcarbamazine Citrate
Diethylcarbamazine acid citrate
別名: Hetrazan · Banocide · Diethizine · Filarcidan · Notezine · DEC · Diethylcarbamazine acid citrate · Diethylcarbamazini citras · Ditrazini citras · RP-3799
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 |
|---|---|---|---|---|---|
| Heartworm prophylaxis | 6.6 mg/kg PO once a day preceding infection and for 60 days following last exposure to mosquitoes. | PO | q24h | 60 days post-exposure | 🌎 NA |
| Heartworm prophylaxis | 6.6 mg/kg PO daily from beginning of mosquito season and for two months thereafter. | PO | q24h | Seasonal + 2 months | 🌎 NA |
| Heartworm prophylaxis | 2.5-3 mg/kg PO daily; begin prior to mosquito season | PO | q24h | Continuous | 🌎 NA |
| Heartworm prophylaxis | 5-7 mg/kg PO daily. Begin before infection is likely and continue 60 days after mosquito season. | PO | q24h | Seasonal + 60 days | 🌎 NA |
| Treatment of ascarids | 55-110 mg/kg PO | PO | Once | Single dose | 🌎 NA |
| Treatment of lungworms (Crenosoma vulpis) | 80 mg/kg PO q12h for 3 days | PO | q12h | 3 days | 🌎 NA |
- Heartworm prophylaxis: In dogs that become microfilaremic while on DEC, may continue, but do not interrupt daily DEC therapy.
- Heartworm prophylaxis: Should be given year-round in areas where mosquitoes are active throughout the year. Re-examine 3 months after starting therapy and at 6-month intervals for microfilaria.
- Heartworm prophylaxis: Some areas will require year-round treatment.
- Treatment of ascarids: Must not be used in microfilaria positive patients. May be used as a preventative for ascaridiasis when dosed at 6.6 mg/kg PO per day.
- Treatment of lungworms (Crenosoma vulpis): Must not be used in microfilaria positive patients.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Treatment of ascarids | 55-110 mg/kg PO | PO | Once | Single dose | 🌎 NA |
雪貂
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Heartworm prophylaxis | 5.5 mg/kg PO once a day | PO | q24h | Continuous | 🌎 NA |
牛
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Treatment of early stages of Dictyocaulus viviparous infestations | 22 mg/kg IM for 3 successive days; or 44 mg/kg IM once. | IM | q24h or Once | 3 days or Single dose | 🌎 NA |
- Treatment of early stages of Dictyocaulus viviparous infestations: DEC is available in an injectable dosage form containing 400 mg/mL in the U.K., no FDA-approved injectable form is available in the U.S.A.
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
枸櫞酸乙胺嗪 (DEC) 是一種哌嗪衍生物驅蟲藥，過去曾是犬隻每日預防心絲蟲疾病的標準藥物。
- 現狀：目前已大多被現代的每月一次大環內酯類藥物（如伊維菌素、米爾貝肟）所取代。在美國已無獸醫專用的口服製劑上市。
- 適應症：FDA 批准用於犬隻心絲蟲 (D. immitis) 的預防及蛔蟲感染的治療。也可用於雪貂、動物園動物，以及牛羊的寄生蟲性支氣管炎（英國）。
- 臨床要點：與較新的每月預防藥不同，DEC 必須每天給藥，這在過去常造成飼主順從性不佳的挑戰。
作用機制
The exact mechanism of DEC is not completely understood, but it exhibits both direct paralytic and host-dependent immunomodulatory effects:
- Direct Paralysis: DEC acts as an agonist at nicotinic acetylcholine receptors (nAChRs) on the nematode somatic muscle → Depolarization of the muscle membrane → Spastic paralysis of the parasite.
- Immunomodulation: DEC alters the parasite's surface membrane (interfering with arachidonic acid metabolism) → Exposes hidden antigens → Enhances host immune system clearance of microfilariae.
安全性與警告
禁忌症
- Dogs with circulating microfilaria (due to risk of severe shock-like reaction)
不良反應
- Vomiting
- Diarrhea
- Fixed drug eruptions (rare)
- Severe anaphylactoid reaction (in microfilaremic dogs)
- Hepatic injury (reported in cats)
注意事項
CRITICAL WARNING: DEC is strictly contraindicated in dogs with circulating microfilariae.
- Administration to microfilaremic dogs can trigger a severe, potentially fatal anaphylactoid (shock-like) reaction within 20 minutes to 2 hours. Signs include salivation, vomiting, ataxia, shock, and DIC.
- Always verify a negative heartworm test (specifically checking for microfilaria) before initiating therapy.
- If microfilaria are detected in dogs undergoing adulticide therapy while on DEC, stop DEC immediately until microfilaria are eliminated.
- Rare reports of infertility in male dogs exist, though controlled studies show no adverse effects on semen.
藥物相互作用
Theoretical enhancement of toxic effects due to shared nicotine-like mechanism of action; use with intensified monitoring.
Theoretical enhancement of toxic effects due to shared nicotine-like mechanism of action; use with intensified monitoring.
Theoretical enhancement of toxic effects due to shared nicotine-like mechanism of action; use with intensified monitoring.
監測
- Microfilaria status (prior to and during heartworm prophylaxis)
- Clinical efficacy (when used as an anthelmintic)
藥物動力學
吸收
Rapidly absorbed after oral administration, with peak serum levels occurring in about 3 hours.
分佈
Distributed to all tissues and organs except fat.
代謝
Rapidly metabolized.
排除
Primarily excreted in the urine (70% of a dose within 24 hours) as metabolites or unchanged drug (10-25% of a dose).
過量
DEC is considered a relatively non-toxic compound with a wide margin of safety.
- Clinical Signs: Large overdoses generally result in self-limiting vomiting or CNS depression.
- Management: For very large, recent ingestions, consider GI decontamination (inducement of vomiting, activated charcoal, cathartics). If clinical signs occur, provide supportive care (e.g., IV fluids).
可用產品
劑型
- Tablets
- Injection (UK only)
獸醫用
- No oral products currently marketed in the USA (though 10 are FDA-approved).
- Injectable 400 mg/mL (Available in the U.K. only)
人用標示
- Diethylcarbamazine Citrate Tablets: 50 mg (Hetrazan®) - Available for compassionate use only.
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store in tight containers at room temperature and protect from light, unless otherwise specified by the manufacturer.
飼主須知
- 每日給藥：與現代每月一次的心絲蟲預防藥不同，此藥物必須每天服用才有效。請嚴格按照獸醫的指示給藥。
- 必須檢驗：在春季開始或重新開始使用此藥物前，必須檢查犬隻是否感染心絲蟲微絲蟲。若犬隻已感染心絲蟲卻服用此藥，可能會引發致命的過敏反應。
- 定期篩檢：全年服用此藥物的犬隻應每六個月進行一次心絲蟲檢測。
- 餵食建議：與食物一起餵食或在飯後立即餵食，有助於預防腸胃不適。
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