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氫嗎啡酮

Hydromorphone

Hydromorphone hydrochloride

鴉片類促效劑 / 鎮痛藥IVIMSCPORectal狗貓小型哺乳類雪貂

別名: Dilaudid-HP · Exalgo · Palladone · dihydromorphinone hydrochloride · Dolonovag · Hydal · HydroStat IR · Opidol · Sophidone

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

0.08-0.2 mg/kg IV, IM, or SCIV/IM/SC· Not specified
— 🐕

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
As an analgesic0.1 mg/kg IV or SC q2h or as a CRI at 0.03 mg/kg/hrIV/SCq2h or CRI—🌎 NA
For cancer pain0.08-0.2 mg/kg IV, IM, or SCIV/IM/SCNot specified—🌎 NA
As an analgesic0.05-0.2 mg/kg IV, IM, SC q2-4hIV/IM/SCq2-4h—🌎 NA
As an analgesic0.2-0.6 mg/kg PO q6-8hPOq6-8h—🌎 NA
For perioperative pain0.1-0.2 mg/kg IV, IM, SC q2-4hIV/IM/SCq2-4h—🌎 NA
As a premed prior to moderately painful procedures0.1 mg/kgNot specifiedOnce—🌎 NA
As a sedative/restraint agent for fractious or aggressive dogs0.1-0.2 mg/kg mixed with acepromazine (0.05 mg/kg) IMIMOnce—🌎 NA
As an alternate induction method (especially in critical patients)0.05-0.2 mg/kg IV, slowly to effect followed by diazepam 0.02 mg/kg IVIVOnce—🌎 NA
  • As an analgesic: Suggested doses based on pharmacokinetic study
  • As a premed prior to moderately painful procedures: May be combined with acepromazine (0.02-0.05 mg/kg) in young, healthy patients.
  • As a sedative/restraint agent for fractious or aggressive dogs: Maximal effect usually reached in about 15 minutes, but an additional wait of another 15 minutes may be necessary in some dogs.
  • As an alternate induction method (especially in critical patients): Do not mix two drugs together. Positive pressure ventilation likely necessary. Treat bradycardia with glycopyrrolate or atropine if needed.

貓

適應症劑量途徑頻次療程地區
As an analgesic0.05-0.1 mg/kg IM, IV or SC q2-6 hoursIM/IV/SCq2-6h—🌎 NA
For cancer pain0.08-0.2 mg/kg IV, IM, or SCIV/IM/SCNot specified—🌎 NA
For moderate to severe pain0.08-0.3+ mg/kg IV, IM or SC q2-6 hoursIV/IM/SCq2-6h—🌎 NA
As a premed prior to moderately painful procedures0.1 mg/kgNot specifiedOnce—🌎 NA
As an alternate induction method (especially in critical patients)0.05-0.2 mg/kg IV, slowly to effect followed by diazepam 0.02 mg/kg IVIVOnce—🌎 NA
  • As a premed prior to moderately painful procedures: May be combined with acepromazine (0.05-0.2 mg/kg) in young, healthy patients.
  • As an alternate induction method (especially in critical patients): Do not mix two drugs together. Positive pressure ventilation likely necessary.

小型哺乳類

適應症劑量途徑頻次療程地區
As a pre-op (Rabbits)0.05-0.1 mg/kg IVIVOnce—🌎 NA
As a CRI post-op (Rabbits)0.05 mg/kg IV loading dose, then 0.05-0.1 mg/kg/hrIVCRI—🌎 NA

雪貂

適應症劑量途徑頻次療程地區
As a pre-op0.05-0.1 mg/kg IVIVOnce—🌎 NA
As a CRI post-op0.05 mg/kg IV loading dose, then 0.05-0.1 mg/kg/hrIVCRI—🌎 NA

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概覽

氫嗎啡酮是一種強效的半合成​純μ-鴉片受體促效劑​，在獸醫學中廣泛用作鎮靜劑、保定劑、鎮痛藥和麻醉前用藥。

主要臨床特徵包括：

  • ​效力​：按重量計算，其效力約為嗎啡的5倍，與羥嗎啡酮（oxymorphone）大致相當。
  • ​優於嗎啡之處​：通常鎮靜作用較輕，靜脈注射後引起的組織胺釋放極少，且極少引起顯著的血管擴張或低血壓。
  • ​臨床實用性​：由於鎮痛效果和作用時間與羥嗎啡酮相似，但成本顯著較低，在獸醫臨床上正迅速取代羥嗎啡酮。
  • ​管制狀態​：由於具有高度濫用和生理依賴潛力，屬於​第二級（C-II）​管制藥品。

作用機制

Hydromorphone exerts its effects by binding to opioid receptors, primarily the mu (μ) receptors, with some affinity for delta (δ) receptors.

Mechanism pathway: Agonist binding to mu-receptors in the CNS (limbic system, spinal cord, thalamus, midbrain) and peripheral tissues (GI tract, smooth muscle) → activation of G-proteins → inhibition of adenylate cyclase → decreased intracellular cAMP → opening of potassium channels (causing hyperpolarization) and closing of voltage-gated calcium channels → decreased presynaptic release of excitatory neurotransmitters (e.g., Substance P, glutamate) → profound analgesia and altered pain perception.

Secondary effects include respiratory depression (decreased sensitivity of the respiratory center to CO2), antitussive activity, and increased GI sphincter tone leading to decreased motility.

安全性與警告

禁忌症

  • Hypersensitivity to narcotic analgesics
  • Diarrhea caused by toxic ingestion (until toxin is eliminated)
  • Prior to GI obstructive surgery (due to vomiting risk)
  • Patients stung by scorpion species Centruroides sculpturatus Ewing and C. gertschi Stahnke (may potentiate venom)

不良反應

  • Dogs: Nausea, vomiting, defecation, panting, vocalization, sedation, CNS depression, respiratory depression, bradycardia, decreased GI motility (constipation with chronic use)
  • Cats: Nausea, ataxia, hyperesthesia, hyperthermia, behavioral changes (mania/excitement if given without tranquilization)
  • Mild histamine release (infrequent compared to morphine)

注意事項

Black Box Warning / Extreme Caution: Use with extreme caution in patients with respiratory disease, acute respiratory dysfunction, head injuries, increased intracranial pressure, and acute abdominal conditions (e.g., colic) as it may obscure diagnosis.

  • Vomiting Risk: Contraindicated as a preanesthetic in animals with suspected gastric dilation, volvulus, or intestinal obstruction.
  • Systemic Disease: Use cautiously in hypothyroidism, severe renal insufficiency (acute uremia), adrenocortical insufficiency (Addison's), and severe hepatic disease (prolonged duration of action).
  • Cardiovascular: Can cause bradycardia; use cautiously in patients with preexisting bradyarrhythmias.
  • Feline Hyperthermia: Can cause self-limiting hyperthermia in cats. High doses in cats should be combined with a tranquilizer to prevent bizarre behavioral changes.
  • Vulnerable Populations: Geriatric, debilitated, or neonatal patients may be more susceptible and require lower dosages.

藥物相互作用

Butorphanol, Nalbuphine

Potentially could antagonize opiate effects

CNS Depressants

Additive CNS depression effects possible

Diuretics

Opiates may decrease diuretic efficacy in CHF patients

Monoamine Oxidase Inhibitors (e.g., amitraz, selegiline)

Severe and unpredictable opiate potentiation; not recommended if MAOI used within 14 days

Skeletal Muscle Relaxants

Hydromorphone may enhance muscle relaxant effects

Phenothiazines

May antagonize analgesic effects and increase risk for hypotension

Tricyclic Antidepressants (clomipramine, amitriptyline)

Hydromorphone may exacerbate the effects of tricyclic antidepressants

Warfarin

Opiates may potentiate anticoagulant activity

監測

  • Respiratory rate and depth (pulse oximetry highly recommended)
  • CNS level of depression or excitation
  • Blood pressure (especially with IV use)
  • Cardiac rate (monitor for bradycardia)
  • Analgesic efficacy

藥物動力學

半衰期

貓Prolonged (due to glucuronidation deficiency)狗35 minutes to 1 hour (route and dose dependent)

吸收

Absorbed when given by IV, IM, SC, and rectal routes. Peak levels occur between 10-30 minutes after SC dosing in dogs.

分佈

High volume of distribution in dogs (> 4 L/kg with both IV and SC dosing).

代謝

Metabolized in the liver, primarily by glucuronidation. Cats are deficient in this metabolic pathway, leading to prolonged half-lives.

排除

The glucuronidated metabolite is excreted by the kidney.

過量

Massive overdoses may produce profound respiratory and/or CNS depression in most species.

Other potential effects include:

  • Cardiovascular collapse
  • Hypothermia
  • Skeletal muscle hypotonia
  • Mania (especially in cats)

Treatment:

  • Naloxone is the specific reversal agent of choice for treating respiratory depression.
  • In massive overdoses, naloxone doses may need to be repeated, as naloxone's duration of action may be shorter than that of hydromorphone.
  • Mechanical respiratory support should be considered in cases of severe respiratory depression.
  • Provide supportive care as needed.

可用產品

劑型

  • Powder for injection (lyophilized)
  • Oral tablets
  • Oral capsules (extended-release)
  • Oral liquid
  • Suppositories

獸醫用

  • None

人用標示

  • Hydromorphone HCl Injection: 1 mg/mL, 2 mg/mL, 4 mg/mL, 10 mg/mL (Dilaudid, Dilaudid-HP, generic)
  • Hydromorphone HCl Powder for Injection, lyophilized: 250 mg (Dilaudid-HP)
  • Hydromorphone HCl Oral Tablets: 2 mg, 4 mg, 8 mg (Dilaudid, generic)
  • Hydromorphone HCl Oral Capsules (extended-release): 8 mg, 12 mg, 16 mg (Exalgo)
  • Hydromorphone HCL Oral Liquid: 1 mg/1 mL (Dilaudid, generic)
  • Hydromorphone Suppositories: 3 mg (Dilaudid, 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

Injection should be stored at room temperature and protected from light. A slight yellowish tint does not indicate loss of potency. Stable for at least 24 hours when mixed with commonly used IV fluids if protected from light. Tablets should be stored at room temperature in tight, light-resistant containers. Suppositories should be kept in the refrigerator.

飼主須知

氫嗎啡酮是一種強效的鴉片類止痛藥。

  • ​監督使用​：當以注射方式給藥時，通常是在動物醫院內由獸醫直接監督下使用。
  • ​居家口服​：如果獸醫開立口服藥錠或藥水讓您帶回家，請將藥物存放在兒童和其他寵物接觸不到的安全地方。這是一種嚴格管制的藥物。
  • ​預期反應​：您的寵物可能會顯得鎮靜或昏昏欲睡。在狗身上，喘氣和發出嗚嗚聲是常見的副作用，這並不一定代表寵物在疼痛。貓咪偶爾可能會表現出焦躁不安或體溫微升。
  • ​需注意的副作用​：請密切觀察是否有嚴重嗜睡、極度呼吸困難或嚴重便秘的情況。如果出現這些症狀，請立即聯繫您的獸醫。
  • ​請勿分享藥物​：絕對不可將此藥物給予其他寵物或人類使用，不當使用可能會有致命危險。

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。