丙酸氟替卡松
Fluticasone Propionate
Fluticasone propionate (trifluorinated glucocorticoid)
別名: Flovent · Advair Diskus · Cutovate · Flixotide · Flixonase · Flutivate · CCI-18781 · fluticasoni propionas
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 |
|---|---|---|---|---|---|
| Adjunctive treatment of chronic tracheobronchial disease (excessive side effects from oral steroids) | 110 microgram or 220 microgram (1 puff) | Inhalation | q12h | — | 🌎 NA |
| Adjunctive treatment of chronic tracheobronchial disease | 2 puffs of the 220 micrograms/puff MDI | Inhalation | q12h | — | 🌎 NA |
- Adjunctive treatment of chronic tracheobronchial disease (excessive side effects from oral steroids): Use a delivery device (e.g., AeroDawg). Ensure a tightly fitting face mask and count 7-10 respirations after actuating the MDI into the spacer.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Treatment of feline 'asthma' | one puff of the 44 micrograms/puff MDI | Inhalation | q12h | — | 🌎 NA |
| Feline asthma (signs occurring more than once per week) | one puff of 110 micrograms fluticasone MDI | Inhalation | q12h | — | 🌎 NA |
- Treatment of feline 'asthma': Initially try this dose. Study showed 44, 110, and 220 mcg all significantly reduced eosinophils in airway lavage fluid.
- Feline asthma (signs occurring more than once per week): Use a delivery device (e.g., AeroKat) with a spacer. Cats with more serious disease may require the 220 micrograms MDI. Breathe in and out 7-10 times with mask in place. Give prednisolone at 1-2 mg/kg PO twice daily for 5-7 days initially, then taper over 2-3 months.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Inflammatory airway disease (IAD) in young racehorses | Weeks 1 and 2: 2200 micrograms (10 puffs) twice daily. Weeks 3 and 4: 2200 micrograms (10 puffs) once daily. | Inhalation | q12h then q24h | 4 weeks | 🌎 NA |
| Moderate recurrent airway obstruction (RAO/heaves) | Week 3: 2200 micrograms (10 puffs) twice daily. Week 4: 2200 micrograms (10 puffs) once daily. End of 4 weeks (if good response): 2200 micrograms (10 puffs) once every other day. | Inhalation | q12h, then q24h, then EOD | Maintenance | 🌎 NA |
| Prevention of exacerbations of RAO | 6 mg | Inhalation | q12h | — | 🌎 NA |
- Inflammatory airway disease (IAD) in young racehorses: Use a delivery device (e.g., Aeromask or Equine-haler). Recheck in 4 weeks to determine further treatment.
- Moderate recurrent airway obstruction (RAO/heaves): Begin stringent environmental control and systemic prednisone. Add fluticasone at week 3 with salmeterol 210 mcg (10 puffs).
- Prevention of exacerbations of RAO: Using the EquineHaler. Highly likely that a lower dose can be used.
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
丙酸氟替卡松（Fluticasone propionate）是一種強效的合成糖皮質激素，在獸醫學中主要作為吸入劑使用。
- 主要用途：它對於控制慢性發炎性呼吸道疾病非常有效，例如貓氣喘、犬慢性氣管支氣管疾病以及馬的反覆性呼吸道阻塞（RAO/氣喘）或發炎性呼吸道疾病（IAD）。鼻腔噴劑也可用於過敏相關的慢性鼻鼻竇炎。
- 臨床優勢：由於藥物透過定量吸入器（MDI）及專用輔助吸入器直接遞送至呼吸道黏膜，它能提供極佳的局部抗發炎效果，同時將口服或注射類固醇常見的全身性副作用降至最低。
- 效力：其對人類糖皮質激素受體的親和力是地塞米松（Dexamethasone）的18倍。
作用機制
Fluticasone exerts its effects by binding to cytosolic glucocorticoid receptors in the respiratory mucosa.
Mechanism Pathway: Receptor binding → Translocation of the receptor-ligand complex to the nucleus → Alteration of gene transcription → Inhibition of pro-inflammatory mediators (such as cytokines, prostaglandins, and leukotrienes) → Decreased airway inflammation, reduced mucosal edema, and lowered airway hyperreactivity.
Note: The drug is highly lipophilic, allowing for prolonged retention in lung tissue, and undergoes extensive first-pass metabolism, which limits systemic bioavailability if swallowed.
安全性與警告
禁忌症
- Hypersensitivity to fluticasone
- Acute bronchospasm or status asthmaticus (not a rescue inhaler)
不良反應
- Pharyngitis (reported in humans)
- Upper respiratory infections (reported in humans)
- Hypothalamic-pituitary-adrenal (HPA) axis suppression (rare with inhaled therapy, but possible with chronic high doses)
- Cushingoid effects (with chronic overdosage)
- Paradoxical bronchospasm (rare)
注意事項
When transferring patients from systemic steroid therapy to inhaled steroids, wean slowly off systemic therapy to avoid acute adrenal insufficiency. Prepare to cover patients with additional systemic steroid therapy during periods of acute stress, severe asthma attacks occurring during the withdrawal stage, or after transfer to inhaled steroids. Fluticasone is not useful for acute bronchospasm. Use with caution in nursing dams. FDA Category C for pregnancy; use only when benefits clearly outweigh risks.
藥物相互作用
Inhibits CYP3A4 isoenzymes; theoretically could increase systemic fluticasone levels.
May decrease the metabolism of fluticasone, potentially increasing systemic exposure.
監測
- Clinical efficacy (reduction in coughing, wheezing, or respiratory effort)
- Signs of HPA axis suppression or cushingoid changes (rare with inhaled therapy)
藥物動力學
吸收
In humans, when administered via the lung, about 30% is absorbed into the systemic circulation. Peak plasma concentrations of 0.1 to 1 ng/mL seen after 880 mcg dose.
分佈
Volume of distribution averages 4.2 L/kg. It is 91% bound to human plasma proteins.
代謝
Metabolized via hepatic cytochrome P450 3A4 isoenzymes to a metabolite with negligible pharmacologic activity.
排除
Terminal elimination half-life is about 8 hours (in humans). Most of the drug is excreted in the feces as parent drug and metabolites.
過量
Acute overdoses of this medication are unlikely to require treatment. Chronic overdoses could result in significant HPA axis suppression and cushingoid effects.
可用產品
劑型
- Metered dose inhaler (MDI) aerosol
- Dry powder for inhalation
- Nasal spray/solution
- Topical cream and ointment
人用標示
- Fluticasone Propionate aerosol for inhalation: 44 mcg, 110 mcg, and 220 mcg per actuation (Flovent HFA)
- Fluticasone Propionate/Salmeterol Powder for Inhalation: 100/50 mcg, 250/50 mcg, 500/50 mcg (Advair Diskus)
- Fluticasone Propionate/Salmeterol Aerosol for Inhalation: 45/21 mcg, 115/21 mcg, 230/21 mcg
- Nasal solutions, topical creams, and ointments
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 between 2-30°C (36-86°F); protect from freezing and direct sunlight. Store canister with the mouthpiece down.
飼主須知
重要提示：此藥物是用於控制呼吸道發炎的預防性藥物，不能作為急性氣喘發作時的急救吸入劑。
- 準備：使用前請充分搖勻。若情況允許，請在給藥前讓藥罐恢復至室溫。
- 給藥方式：必須搭配適合您寵物物種的輔助吸入器（例如 AeroKat® 或 AeroDawg®）。將面罩輕輕罩住動物的口鼻，按壓吸入器將藥物釋放至儲霧罐中，讓動物戴著面罩正常呼吸 7 到 10 次後再移開。
- 儲存：請勿刺穿或焚燒藥罐。
- 使用期限：若按照標準處方每天早晚各噴一次，一瓶藥物大約可使用 2 個月。
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