乙胺丁醇
Ethambutol
Ethambutol hydrochloride
別名: Myambutol · Etibi · CL-40882 · etambutol · ethambutoli
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 |
|---|---|---|---|---|---|
| Treatment of disseminated M. tuberculosis | 10-25 mg/kg PO once daily | PO | once daily | More than 9 months | 🌎 NA |
- Treatment of disseminated M. tuberculosis: Used in combination with rifampin (5-10 mg/kg PO q12-24h) and isoniazid (10-20 mg/kg PO once daily). May also add pyrazinamide (ineffective for M. bovis).
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Treatment of feline tuberculosis (resistant cases) | 15 mg/kg PO once daily | PO | once daily | Not specified | 🌎 NA |
- Treatment of feline tuberculosis (resistant cases): Considered if resistance develops to initial therapy. Used in combination with rifampin and isoniazid.
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Treatment of M. avium infections in caged birds (Protocol 1) | 20 mg/kg PO q12h | PO | q12h | 6-12 months | 🌎 NA |
| Treatment of M. avium infections in caged birds (Protocol 2) | 30 mg/kg PO once daily | PO | once daily | 6-12 months | 🌎 NA |
| Treatment of M. avium infections in caged birds (Protocol 3) | 30 mg/kg PO once daily | PO | once daily | 6-12 months | 🌎 NA |
| Avian mycobacteriosis | 30-85 mg/kg PO once daily | PO | once daily | 9-12 months | 🌎 NA |
- Treatment of M. avium infections in caged birds (Protocol 1): Used with Ciprofloxacin/Enrofloxacin, Clofazimine, and Cycloserine.
- Treatment of M. avium infections in caged birds (Protocol 2): Used with Clofazimine and Rifampin.
- Treatment of M. avium infections in caged birds (Protocol 3): Used with Ciprofloxacin/Enrofloxacin and Rifampin/Rifabutin.
- Avian mycobacteriosis: Used with Rifabutin, Clarithromycin, and Enrofloxacin.
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
乙胺丁醇是一種合成的抑菌性抗分枝桿菌藥物，主要作為多重藥物療法（「雞尾酒療法」）的一部分，用於治療頑固的分枝桿菌感染（如結核分枝桿菌、牛分枝桿菌、禽分枝桿菌複合群等）。
臨床重點： 由於會快速產生抗藥性，嚴禁單獨使用此藥。通常與利福平 (rifampin)、異煙肼 (isoniazid) 等藥物合併使用。
重要公共衛生注意事項： 由於具有顯著的人畜共通傳染潛在風險，特別是對家中免疫力低下的人群構成威脅，在獸醫學中治療這些感染存在高度爭議。
作用機制
Ethambutol is active only against actively dividing mycobacteria.
Mechanistically, it inhibits the enzyme arabinosyl transferase → disrupts the synthesis of arabinogalactan → prevents the incorporation of mycolic acid into the mycobacterial cell wall.
This disruption increases cell wall permeability, which allows other antimycobacterial drugs (like rifampin or isoniazid) to penetrate the cell more effectively. It also interferes with RNA synthesis. It has no appreciable activity against other non-mycobacterial bacteria or fungi.
安全性與警告
禁忌症
- Patients with a history of prior hypersensitivity reactions to ethambutol
不良反應
- Optic neuritis (decreased visual acuity, usually reversible)
- CNS degenerative changes (with prolonged use)
- Myocardial toxicity (at high doses)
- Depigmentation of the tapetum lucidum
- Bacterial or fungal overgrowth (due to prolonged multi-drug antimicrobial therapy)
注意事項
Use with caution in patients with markedly reduced renal function; dosage adjustments may be necessary. Treatment of mycobacterial infections in animals carries significant public health risks. Routine ophthalmologic exams are recommended for long-term use due to the risk of optic neuritis.
藥物相互作用
Can reduce oral absorption of ethambutol; separate dosing by at least 4 hours if both are necessary
監測
- Clinical efficacy
- Visual function (periodic monitoring with long-term therapy)
- Liver function
- Renal function
- CBC
- Monitor for fungal or bacterial overgrowth infections
藥物動力學
半衰期
吸收
In humans, rapidly absorbed after PO administration with bioavailability around 75%.
分佈
Distributed widely in the body. CSF levels range from 10-50% of serum levels. Erythrocyte concentrations are about twice that of serum and serve as a depot. Volume of distribution in dogs is 3.8 L/kg.
代謝
About 15% of absorbed drug is hepatically metabolized to inactive metabolites.
排除
Majority eliminated by both tubular secretion and glomerular filtration as unchanged drug in the urine. Total body clearance in dogs is 13.2 mL/min/kg.
過量
Very limited veterinary information exists. In humans, acute overdoses of >10 grams have caused optic neuritis. Other adverse effects noted with human overdoses include CNS effects (confusion, visual hallucinations), abdominal pain, nausea, fever, and headache. Treatment is supportive.
可用產品
劑型
- tablets
人用標示
- Ethambutol HCl Tablets: 100 mg & 400 mg (scored)
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 tablets below 40°C, preferably between 15-30°C, in well-closed containers.
飼主須知
- 公共衛生警告： 分枝桿菌感染（如結核病）可傳染給人類。強烈建議您諮詢人類傳染病專科醫師，特別是如果家中有免疫力低下的成員。
- 治療承諾： 治療過程非常漫長（通常需要數月至一年以上）且費用高昂。
- 給藥方式： 可與食物一起或空腹餵食。
- 視力監測： 此藥物可能影響視力。如果發現寵物視力改變（例如撞到家具、瞳孔異常），請立即聯繫獸醫師。
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