依替膦酸二鈉
Etidronate Disodium
EHDP, Na2EHDP, sodium etidronate
別名: Anfozan · Bonemass · Didronate · Difosfen · Diphos · Dralen · Dronate-OS · Etidrate · Etiplus · Feminoflex · Ostedron · Osteodidronel · Osteum · Ostogene · Ostopor · Somaflex · Sviroxit · disodium etidronate · Na2EHDP
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 |
|---|---|---|---|---|---|
| For severe hypercalcemia associated with neoplastic disease | 5-15 mg/kg daily to twice daily PO | PO | q12-24h | — | 🌎 NA |
- For severe hypercalcemia associated with neoplastic disease: for moderate to severe hypercalcemia
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For severe hypercalcemia associated with neoplastic disease | 5-20 mg/kg/day PO | PO | q24h | — | 🌎 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
依替膦酸二鈉 (Etidronate disodium) 是一種第一代雙膦酸鹽類藥物，在獸醫學中主要用於控制嚴重的惡性腫瘤伴隨之高血鈣症。
- 作為強效的正常與異常骨吸收抑制劑。
- 雖然具有歷史意義，但其臨床應用已大半被更新、更強效的含氮雙膦酸鹽（如 pamidronate, zoledronate）所取代，因為後者給藥頻率較低且安全性更高。
- 臨床要點：長期使用第一代雙膦酸鹽（如依替膦酸）可能導致骨礦化受損，而新一代藥物已大幅降低此風險。
作用機制
Etidronate is a non-nitrogenous bisphosphonate that acts as a non-hydrolyzable analog of pyrophosphate.
- Binds strongly to hydroxyapatite crystals in the bone matrix.
- During bone resorption, the drug is taken up by osteoclasts.
- Intracellularly, it is incorporated into non-hydrolyzable, cytotoxic ATP analogs → inhibits ATP-dependent intracellular enzymes → induces osteoclast apoptosis.
- Decreased osteoclast activity → reduced bone resorption → lowered serum calcium levels.
- Additionally increases serum phosphate, presumably by enhancing renal tubular reabsorption.
安全性與警告
禁忌症
- Severe renal function impairment (serum creatinine >5 mg/dL)
不良反應
- Diarrhea
- Nausea (with higher oral doses)
- Bone pain/tenderness
- Increases in serum creatinine
- 'Frozen bone' syndrome in dogs (weakened bones and fractures due to inhibited bone remodeling)
注意事項
Risk vs. benefit should be carefully considered in patients with bone fractures (delays healing), enterocolitis (higher risk of diarrhea), cardiac failure (especially with parenteral etidronate as patients may not tolerate the extra fluid load), or those with moderate renal function impairment (serum creatinines 2.5-5 mg/dL).
Warning: Do not confuse etidronate with etretinate or etomidate.
Safety during pregnancy has not been established (FDA Category C). It is unknown if the drug enters milk.
藥物相互作用
Absorption of oral etidronate may be inhibited; separate etidronate doses from these substances by at least two hours.
監測
- Serum calcium
- Serum protein
藥物動力學
吸收
Oral absorption is poor and dose dependent (1-20%). Food substantially reduces the amount absorbed.
分佈
Rapidly cleared from blood and 50% of the drug absorbed goes into bone. At usual doses, it appears that etidronate does not cross the placenta.
代謝
Not metabolized; excreted unchanged.
排除
Approximately 50% of the absorbed dose is excreted unchanged by the kidneys within 24 hours; the remainder is chemisorbed to bone and then slowly eliminated.
過量
Overdoses may result in hypocalcemia (ECG changes may occur), bleeding problems (secondary to rapid chelation of calcium), and proximal renal tubule damage.
- Treatment: Use standard gut emptying protocols after oral ingestion when warranted.
- IV calcium administration (e.g., calcium gluconate) may be used to reverse hypocalcemia.
- Intensive monitoring is suggested.
可用產品
劑型
- Tablets
人用標示
- Etidronate Disodium Tablets: 200 mg & 400 mg (Didronel, generic)
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 in tight containers at room temperature.
飼主須知
重要給藥提示：此藥物必須在空腹時給予，以確保適當吸收。食物（尤其是乳製品）會阻礙藥物進入寵物體內。
- 注意副作用：如果您的寵物出現食慾不振、嘔吐或腹瀉，請立即聯繫您的獸醫師。
- 骨骼健康：在極少數情況下，長期使用會影響骨骼強度。請觀察寵物是否有骨痛或跛行的跡象。
- 請勿在服用此藥物前後2小時內給予制酸劑或礦物質補充劑（如鈣或鐵）。
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠方最新藥品說明書。