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多塞平

Doxepin

Doxepin hydrochloride

三環類抗憂鬱藥 / 抗組織胺藥POTopical狗貓鳥

別名: Sinequan · Anten · Aponal · Deptran · Desidoxepin · Doneurin · Doxal · Doxepia · Gilex · Mareen · Quitaxon · Triadapin · Zonalon · Sinepin · doxepini hydrochloridum · NSC-108160 · P3693A · Doxepinum · Doxepin 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

3-5 mg/kg PO q12h; maximum dose is 150 mg (per dog) q12hPO· 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。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
Treatment of psychogenic dermatoses3-5 mg/kg PO q12h; maximum dose is 150 mg (per dog) q12hPOq12h—🌎 NA
Treatment of psychogenic dermatoses3-5 mg/kg, PO q8-12h. Begin at 3 mg/kg PO q12h for 2 weeks, then increase by 1 mg/kg PO q12h for 2 weeks up to the maximum dosage as needed; if no clinical response after at least 3-4 weeks of therapy, decrease dosage by 1 mg/kg PO q12h for 2 weeks until at the initial dosagePOq8-12hTitrated over weeks🌎 NA
Antihistaminic effects in treatment of atopy2.2 mg/kg PO three times dailyPOTID—🌎 NA
Antihistaminic effects in treatment of atopy3-5 mg/kg twice dailyPOBID—🌎 NA
Antihistaminic effects in treatment of atopy0.5-2 mg/kg PO q12hPOq12h—🌎 NA
Antihistaminic effects in treatment of atopy1-2 mg/kg PO q12hPOq12h—🌎 NA
Treatment of behavior problems (OCD)0.5-1 mg/kg PO twice dailyPOBID—🌎 NA
Treatment of behavior problems (acral lick granulomas)3-5 mg/kg PO q12h (up to 150 mg per dog)POq12h—🌎 NA
  • Antihistaminic effects in treatment of atopy: Used especially if dog has anxiety or other behavioral condition
  • Antihistaminic effects in treatment of atopy: May be best in nervous or highly strung dogs
  • Treatment of behavior problems (acral lick granulomas): Doses as above for psychogenic dermatoses

貓

適應症劑量途徑頻次療程地區
Treatment of psychogenic dermatoses0.5-1 mg/kg PO q12-24h. Up to 25-50 mg (total dose) per cat.POq12-24hAllow 3-4 weeks for initial trial🌎 NA
Excessive grooming0.5-1 mg/kg PO q12h.POq12h—🌎 NA
Treatment of behavior problems (e.g., overgrooming, intercat aggression)0.5-1 mg/kg PO once to twice daily.POSID to BID—🌎 NA

鳥

適應症劑量途徑頻次療程地區
Treatment of anxiety, pruritus caused feather plucking in psittacines1-2 mg/kg PO q12hPOq12h—🌎 NA
Treatment of anxiety, pruritus caused feather plucking in psittacines0.5-1 mg/kg PO twice dailyPOBID—🌎 NA

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概覽

多塞平（Doxepin）是一種二苯駢氧氮雜䓬衍生物的​三環類抗憂鬱藥（TCA）​，在獸醫學中主要用於輔助治療具有焦慮成分的心因性皮膚病。

雖然它被歸類為抗憂鬱藥，但它具有極強的​H1-抗組織胺特性​，使其成為控制搔癢和行為問題的雙效藥物。其作為異位性皮膚炎單一抗組織胺療法的療效尚有爭議，但當搔癢加劇焦慮和強迫行為（如肢端舔舐性肉芽腫、過度理毛）時，它具有極高的臨床價值。

​臨床重點​：由於其同時具有抗焦慮和抗組織胺作用，多塞平通常被選用於患有過敏性皮膚病且容易緊張或神經質的病患。

作用機制

Doxepin exerts its effects through multiple receptor pathways:

  • ​Monoamine Reuptake Inhibition:​ In the central nervous system, doxepin blocks the presynaptic reuptake of norepinephrine (moderate inhibition) and ​serotonin (5-HT)​ (weak inhibition) → increasing their synaptic concentrations and prolonging their activity, which contributes to its antidepressant and anxiolytic effects.
  • ​Receptor Antagonism:​ It exhibits potent H1-histamine receptor blockade (providing anti-pruritic and sedative effects), as well as ​anticholinergic (muscarinic)​ and alpha-1 adrenergic blocking activity. These latter receptor affinities are largely responsible for its side effect profile (e.g., dry mouth, urinary retention, hypotension).

安全性與警告

禁忌症

  • Prior sensitivity to doxepin or other tricyclic antidepressants
  • Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) such as selegiline or amitraz (within 14 days)
  • Urinary retention
  • Glaucoma
  • Severe cardiac disease
  • History of seizures
  • Concurrent use with MAOIs

不良反應

  • Hyperexcitability (paradoxical)
  • Gastrointestinal distress
  • Lethargy and sedation
  • Ventricular arrhythmias (particularly in overdose)
  • Anticholinergic effects (dry mouth, urinary retention, constipation)
  • Altered blood glucose levels
  • Dry mouth (xerostomia)
  • Tachycardia

注意事項

​Pregnancy & Nursing:​ Safety during pregnancy has not been established (FDA Category C). Doxepin and its active metabolite distribute into milk; use with caution in nursing patients as sedation and respiratory depression have been reported in human infants.

​Cardiac Effects:​ Tricyclics can widen QRS complexes, prolong PR intervals, and invert or flatten T-waves on ECG. Use with caution in patients with pre-existing cardiac disease.

​Laboratory Alterations:​ May alter (increase or decrease) blood glucose levels.

藥物相互作用

Anticholinergic AgentsModerate

Additive anticholinergic effects; use cautiously.

CimetidineModerate

May inhibit tricyclic antidepressant metabolism and increase the risk of toxicity.

CNS DepressantsModerate

Additive CNS depression; use cautiously.

Meperidine, Pentazocine, Dextromethorphan

Increased risk for serotonin syndrome.

Monoamine Oxidase Inhibitors (MAOIs, e.g., amitraz, selegiline)

Concomitant use (within 14 days) is generally contraindicated due to high risk of serotonin syndrome.

Quinidine

Increased risk for QTc interval prolongation and tricyclic adverse effects.

SSRIs (e.g., fluoxetine, paroxetine, sertraline)

Increased risk for serotonin syndrome.

Sympathomimetic Agents

May increase the risk of cardiac effects (arrhythmias, hypertension, hyperpyrexia).

Monoamine Oxidase Inhibitors (MAOIs)Major

Risk of fatal serotonin syndrome

Selective Serotonin Reuptake Inhibitors (SSRIs)Major

Increased risk of serotonin syndrome

監測

  • Efficacy (reduction in pruritus, anxiety, or compulsive behaviors)
  • Adverse effects (GI distress, lethargy, hyperexcitability)
  • ECG (if arrhythmias are suspected or in cases of overdose)
  • Heart rate and rhythm
  • Resolution of pruritus or behavioral signs
  • Signs of excessive sedation or anticholinergic effects

藥物動力學

半衰期

貓Variable狗Variable

吸收

Appears to be well absorbed after oral administration.

分佈

Doxepin and its N-demethylated active metabolite are distributed into milk.

代謝

Extensively metabolized in the liver to an active N-demethylated metabolite.

排除

Excreted primarily via the kidneys as metabolites.

過量

Overdosage with tricyclic antidepressants can be life-threatening.

  • ​Clinical Signs:​ Severe ventricular arrhythmias, cardiorespiratory collapse, profound CNS depression or seizures.
  • ​Action:​ Because the toxicities and therapies for treatment are complicated and controversial, it is highly recommended to contact an animal poison control center immediately for further information in any potential overdose situation.

可用產品

劑型

  • Capsules: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg
  • Oral Concentrate: 10 mg/mL
  • Oral capsule (25 mg, 50 mg)
  • Topical cream

人用標示

  • Doxepin Capsules: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg & 150 mg (Sinequan, generic)
  • Doxepin Oral Concentrate: 10 mg/mL in 120 mL (generic)
  • Sinepin capsules (25 mg, 50 mg)
  • Sinequan capsules
  • Zonalon cream

各地核准狀態

European Union✓ 已核准處方藥EMA

POM (Prescription Only Medicine) status.

United Kingdom✓ 已核准處方藥VMD

POM (Prescription Only Medicine) status.

暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Store protected from direct sunlight in tight, light-resistant containers at room temperature.

飼主須知

  • ​耐心等待​：可能需要數週（通常為 3-4 週）才能看到明顯的行為或皮膚改善。請務必按照處方持續給藥。
  • ​安全第一​：所有三環類抗憂鬱藥都應使用兒童安全包裝，並放置於兒童和寵物接觸不到的地方。過量服用可能致命。
  • ​不可突然停藥​：在停止給藥前請諮詢您的獸醫師，以避免潛在的戒斷反應。
  • ​監測副作用​：如果您的寵物出現極度嗜睡、異常過動、嘔吐或心跳過快/不規律的跡象，請立即聯繫您的獸醫師。

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