氟氫可的松
Fludrocortisone Acetate
9alpha-fluorohydrocortisone 21-acetate
別名: Florinefe · Astonin H · Lonikan · Fluohydrisone acetate · Fluohydrocortisone acetate · 9alpha-fluorohydrocortisone acetate · Fludrocortisoni acetas
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 |
|---|---|---|---|---|---|
| Hypoadrenocorticism | Initial dose of 0.01 mg/kg PO twice daily | PO | twice daily | — | 🌎 NA |
| Maintenance of hypoadrenocorticism | Initially, 0.01-0.02 mg/kg/day PO and adjusted by 0.05-0.1 mg (total dose) increments | PO | daily | — | 🌎 NA |
| Hypoadrenocorticism | 0.01 mg/kg PO twice daily | PO | twice daily | — | 🌎 NA |
- Hypoadrenocorticism: Adjust dose based on monitoring serum electrolyte concentrations every 1-2 weeks until stable. Once stable, recheck every 3-4 months. Addition of NaCl (0.1 g/kg/day) can be useful in reducing the dose of fludrocortisone and reducing PU/PD.
- Maintenance of hypoadrenocorticism: Adjust based on serial electrolyte determinations. Most dogs will ultimately require 0.02-0.03 mg/kg/day.
- Hypoadrenocorticism: Titrate dose to effect; typically dose needs to be increased over time. Only 50% of dogs on fludrocortisone require supplemental prednisone.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Maintenance therapy of hypoadrenocorticism | 0.02 mg/kg PO once daily | PO | once daily | — | 🌎 NA |
| Maintenance therapy of hypoadrenocorticism | 0.1 mg total dose/cat PO once daily | PO | once daily | — | 🌎 NA |
- Maintenance therapy of hypoadrenocorticism: Prednisone or prednisolone (1.25 mg per cat PO once daily) can be used for glucocorticoid replacement.
- Maintenance therapy of hypoadrenocorticism: Administer with prednisolone (0.2 mg/kg PO once daily).
雪貂
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Hypoadrenocorticism | 0.05-0.1 mg/kg PO q24h or divided q12h | PO | q24h or divided q12h | — | 🌎 NA |
- Hypoadrenocorticism: For those animals that still exhibit Addisonian signs even with prednisone therapy.
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
氟氫可的松是一種強效的口服合成皮質類固醇，主要用於獸醫學中的鹽皮質激素特性。
- 主要適應症： 它是犬貓腎上腺皮質機能減退症（愛迪生氏病）的主要治療藥物，作為注射型 DOCP 的口服替代方案。
- 雙重作用： 雖然主要利用其鹽皮質激素效應（效力為氫化可的松的 125 倍），但它也具有顯著的糖皮質激素活性（效力為氫化可的松的 10-15 倍）。
- 臨床要點： 由於其固有的糖皮質激素活性，約 50% 使用氟氫可的松控制的犬隻不需要額外每日補充潑尼松/潑尼松龍（與使用 DOCP 的病患不同）。然而，在較高劑量下，這種糖皮質激素活性也可能導致醫源性腎上腺皮質機能亢進的症狀（多渴/多尿、多食）。
作用機制
Fludrocortisone acts as a potent agonist at mineralocorticoid receptors.
- Binds to cytosolic mineralocorticoid receptors in the principal cells of the renal distal tubules and collecting ducts → translocates to the nucleus.
- Upregulates the transcription of epithelial sodium channels (ENaC) on the apical membrane and Na+/K+-ATPase pumps on the basolateral membrane.
- This mechanism → promotes active sodium reabsorption (and obligate water retention) while accelerating the excretion of potassium and hydrogen ions into the tubular lumen.
- Also binds to glucocorticoid receptors, contributing to anti-inflammatory and metabolic effects (gluconeogenesis, protein catabolism).
安全性與警告
禁忌症
- Known hypersensitivity to fludrocortisone
不良反應
- Polyuria (PU)
- Polydipsia (PD)
- Hypertension
- Edema
- Hypokalemia
- Hypernatremia
- Signs of iatrogenic Cushing's syndrome (due to glucocorticoid effects)
注意事項
Stress Dosing: All animals with hypoadrenocorticism should receive additional glucocorticoids (2-10 times basal dose) during periods of stress, surgery, or acute illness.
- Glucocorticoid Supplementation: Some dogs or cats may require additional ongoing supplementation with a glucocorticoid agent (like prednisone) if fludrocortisone's inherent glucocorticoid activity is insufficient.
- Nursing Mothers: May be excreted in significant quantities in milk. Puppies or kittens of treated mothers should receive milk replacer after colostrum is consumed.
- Cost: Expense may be a limiting factor, especially in large breed dogs requiring high doses.
藥物相互作用
Patients may develop hypokalemia if administered concomitantly.
Fludrocortisone may reduce salicylate levels.
May cause hypokalemia; diuretics can cause sodium loss, counteracting the effects of fludrocortisone.
Potentially increases the insulin requirements of diabetic patients.
監測
- Serum electrolytes (Sodium, Potassium)
- BUN and Creatinine
- Body weight
- Physical examination for signs of edema or hypertension
- Clinical signs of PU/PD
藥物動力學
吸收
In humans, well absorbed from the GI tract with peak levels occurring in approximately 1.7 hours.
排除
In humans, biologic activity persists for 18-36 hours despite a shorter plasma half-life.
過量
Overdosage is typically characterized by excessive mineralocorticoid effects:
- Clinical Signs: Hypertension, edema, severe hypokalemia, and hypernatremia. Excessive glucocorticoid signs (severe PU/PD, panting) may also occur.
- Management: Discontinue the drug until clinical signs associated with overdosage have resolved. Electrolytes should be aggressively monitored. Potassium supplementation may be required. Once resolved, restart the drug at a lower dosage.
可用產品
劑型
- Tablets
人用標示
- Fludrocortisone Acetate Tablets: 0.1 mg (Florinef Acetate, 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 at room temperature (15-30°C) in well-closed containers; avoid excessive heat. The drug is relatively stable in light and air.
飼主須知
氟氫可的松是用於治療愛迪生氏病（腎上腺皮質機能減退症）的救命藥物，這是一種寵物腎上腺無法產生足夠必需激素的疾病。
- 按時服藥： 請嚴格按照處方給藥。切勿漏服或突然停藥，因為這可能導致危及生命的愛迪生氏危象。
- 壓力事件： 在壓力期間（如寄宿、旅行或生病），您的寵物可能需要額外的藥物（如潑尼松）。請與您的獸醫討論壓力應對計畫。
- 注意事項： 如果您發現愛迪生氏危象的跡象（虛弱、嚴重嗜睡、嘔吐、腹瀉、食慾不振）或過量用藥的跡象（過度口渴和排尿、腫脹/水腫或體重突然增加），請立即聯繫您的獸醫。
- 回診追蹤： 定期血液檢查對於確保劑量正確絕對必要。在寵物的一生中，通常需要不斷調整劑量。
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