阿法依泊汀 (紅血球生成素)
Epoetin Alfa
Recombinant Human Erythropoietin (rHuEPO)
別名: Epogen · Procrit · Eprex · NeoRecormon · rHuEPO · epoetin alfa · r-HuEPO-alpha · Epoetin beta · rhEPO · Recombinant human erythropoietin
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
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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 therapy for anemia associated with endstage renal disease | Initially, 100 Units/kg SC 3 times weekly, until the bottom of the target hematocrit range of 37-45% is attained. Once attained, change to twice weekly. As hematocrit approaches upper target, reduce to once weekly. Maintenance generally 75-100 Units/kg SC 1-2 times weekly. | SC | 3 times weekly initially | Ongoing | 🌎 NA |
| Adjunctive therapy for anemia associated with endstage renal disease | Initially, 48.4-145 Units/kg SC three times a week. Most dogs should be started at 97 Units/kg SC 3 times a week. | SC | 3 times a week | Ongoing | 🌎 NA |
- Adjunctive therapy for anemia associated with endstage renal disease: A lower initial dosage of 50-100 Units/kg 3 times weekly may be used. Iron supplementation required.
- Adjunctive therapy for anemia associated with endstage renal disease: Monitor hematocrit weekly until target 37-45% is reached, then decrease to two times weekly. Oral iron supplements recommended.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Adjunctive therapy for anemia associated with endstage renal disease | Initially, 100 Units/kg SC 3 times weekly (or 48.4-145 Units/kg SC 3 times a week). | SC | 3 times weekly | Ongoing | 🌎 NA |
| Anemia associated with endstage renal disease (PCV <20%) | 75-100 Units/kg SC three times a week until PCV is in the low normal range (35%), then reduce dose and frequency to 50-75 Units/kg two times per week. | SC | 3 times a week initially | Ongoing | 🌎 NA |
| Problematic clinical signs and PCV <20% | Initially, 100 Units/kg SC 3 times per week. | SC | 3 times per week | Ongoing | 🌎 NA |
- Adjunctive therapy for anemia associated with endstage renal disease: Target hematocrit is 30-40%.
- Anemia associated with endstage renal disease (PCV <20%): Administer iron at start of regime and until appetite is good.
- Problematic clinical signs and PCV <20%: Provide oral supplementation with ferrous sulfate (5-50 mg per cat per day). Reduce to twice per week when target PCV (30-40%) is reached.
小型哺乳類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Anemia (Rabbits) | 50-150 Units/kg SC every 2-3 days until PVC is normal; then once weekly (q7 days) for at least 4 weeks | SC | every 2-3 days initially | at least 4 weeks maintenance | 🌎 NA |
雪貂
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Anemia | 50-150 Units/kg IM 3 times weekly; may decrease to once weekly if RBC indices are significantly improved | IM | 3 times weekly | Ongoing | 🌎 NA |
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
阿法依泊汀是一種重組人類紅血球生成素 (rHuEPO)，主要用於治療犬貓因慢性腎衰竭引起的非再生性貧血。由於在獸醫臨床上容易產生抗紅血球生成素的自體抗體（高達 20-70% 的機率），導致嚴重的難治性貧血，因此通常被視為「最後手段」。治療期間通常需要額外補充鐵質。
作用機制
Erythropoietin is an endogenous hormone primarily produced by the kidneys that regulates erythropoiesis.
- Receptor Binding: Epoetin alfa binds to erythropoietin receptors on the surface of committed erythroid progenitor cells in the bone marrow.
- Proliferation & Differentiation: This binding activates intracellular signaling pathways (such as JAK2/STAT5) → stimulates the survival, proliferation, and differentiation of red cell precursors.
- Reticulocyte Release: It also accelerates the release of reticulocytes from the bone marrow into the systemic circulation, ultimately increasing the hematocrit and hemoglobin levels.
安全性與警告
禁忌症
- Uncontrolled hypertension
- Hypersensitivity to epoetin alfa
- Formation of significant autoantibodies with prior treatment
- Equines (not recommended for use)
不良反應
- Autoantibody formation (leading to refractory anemia)
- Systemic hypertension
- Vomiting
- Seizures
- Uveitis
- Iron depletion
- Local reactions at injection sites
- Fever
- Arthralgia
- Mucocutaneous ulcers
- Polycythemia (with chronic overdosage)
注意事項
Therapy should be started with caution or withheld until corrected in animals with moderate to severe hypertension or iron deficiency.
Autoantibody Risk: Up to 30% of patients may develop antibodies significant enough to cause profound anemia and arrestment of erythropoiesis. A bone marrow aspirate showing a myeloid:erythroid ratio >6 predicts significant autoantibody formation and contraindicates further therapy. Discontinue therapy if polycythemia, fever, anorexia, joint pain, cellulitis, or cutaneous/mucosal ulceration occurs.
藥物相互作用
May increase the sensitivity of erythroid progenitors; safety of this combination is not fully determined.
Concurrent use with EPO can decrease bleeding times.
Has been demonstrated to reduce the renal tubular excretion of EPO; clinical significance remains unclear.
Synergistic/Required; EPO increases demand for iron to synthesize hemoglobin for new RBCs
監測
- Hematocrit / PCV (weekly to every other week initially, then every 1-2 months)
- Blood Pressure (at least monthly initially)
- Renal Function Status
- Iron status (serum iron, TIBC)
- RBC indices
藥物動力學
吸收
Absorbed only after parenteral administration.
分佈
It is unclear whether the drug crosses the placenta or enters milk.
代謝
The drug's metabolic fate is unknown.
排除
In patients with chronic renal failure, half-lives are prolonged approximately 20% over those with normal renal function.
過量
Acute overdoses appear to be relatively free of adverse effects. Single doses of up to 1600 Units/kg in humans demonstrated no signs of toxicity.
Chronic overdoses may lead to polycythemia or other adverse effects. Cautious phlebotomy may be employed should polycythemia occur.
可用產品
劑型
- Solution for Injection
人用標示
- Epoetin Alfa Solution for Injection: 2000 Units/mL, 3000 Units/mL, 4000 Units/mL, 10,000 Units/mL, 20,000 Units/mL and 40,000 Units/mL in single-dose and multidose vials (Epogen®, Procrit®)
各地核准狀態
POM (Prescription Only Medicine). Approved for human use, used off-label in veterinary medicine.
POM (Prescription Only Medicine). Approved for human use, used off-label in veterinary medicine.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store in the refrigerator (2-8°C); do not freeze. Do not shake the solution as denaturation of the protein with resultant loss of activity may occur. Protect from light. Because the solution contains no preservatives, the manufacturer recommends using each vial only as a single use.
飼主須知
若在家中自行施打，需接受獸醫團隊正確的皮下注射訓練。請冷藏保存（2-8°C），切勿冷凍或搖晃藥瓶（搖晃會破壞蛋白質活性）。治療期間需定期回診抽血，監測紅血球容積比 (PCV)、血壓及鐵質狀態。若寵物出現異常疲倦、虛弱或食慾不振，這可能是自體抗體產生的警訊，請立即聯繫獸醫師。
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