伊米帕明
Imipramine
Imipramine hydrochloride, Imipramine pamoate
別名: Tofranil-PM · imipramini chloridum · imipramini hydrochloridum · imizine · Antidep · Celamine · Depramina · Depsonil · Elepsin · Ethipramine · Imiprex · Imiprin · Imp-Tab · Impril · Janimine · Melipramine · Mipralin · Novo-Pramine · Praminan · Primonil · Pryleugan · Sermonil · Surplix · Talpramin · Imipraminum
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 |
|---|---|---|---|---|---|
| Urethral incompetence | 5-15 mg (total dose) | PO | q12h | — | 🌎 NA |
| Urinary incontinence when other agents fail | 5-20 mg (total dose) | PO | q12h | — | 🌎 NA |
| Cataplexy | 0.5-1 mg/kg | PO | q8h | — | 🌎 NA |
| Adjunctive treatment of separation anxiety or other tricyclic antidepressant-responsive behavior disorders | 2.2-4.4 mg/kg | PO | once to twice daily | — | 🌎 NA |
| Adjunctive cancer pain treatment | 0.5-1 mg/kg | PO | q8h | — | 🌎 NA |
| Anxiety, inappropriate urination, narcolepsy | 1-2 mg/kg | PO | q12h | — | 🌍 EU |
| Anxiety, inappropriate urination, narcolepsy | 2-4 mg/kg | PO | q24h | — | 🌍 EU |
- Cataplexy: Titrate dose based on clinical effect
- Anxiety, inappropriate urination, narcolepsy: Alternatively, 2-4 mg/kg p.o. q24h
- Anxiety, inappropriate urination, narcolepsy: Alternatively, 1-2 mg/kg p.o. q12h
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Urethral incompetence | 2.5-5 mg (total dose) | PO | q12h | — | 🌎 NA |
| Adjunctive cancer pain treatment | 2.5-5 mg (total dose) | PO | q12h | — | 🌎 NA |
| Anxiety, inappropriate urination | 0.5-1 mg/kg | PO | q12-24h | — | 🌍 EU |
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Pharmacologic induced ejaculation | 2 mg/kg | IV | once | — | 🌎 NA |
| Narcolepsy/cataplexy | 0.55 mg/kg IV or 250-750 mg (total dose) orally | IV, PO | once | — | 🌎 NA |
- Pharmacologic induced ejaculation: If imipramine alone does not induce erection and ejaculation in 10-15 minutes, give xylazine 0.2-0.3 mg/kg IV. (Note: ARCI UCGFS Class 2 Drug)
- Narcolepsy/cataplexy: PO administration produces inconsistent results.
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
伊米帕明 (Imipramine) 是一種三環類抗憂鬱藥 (TCA)，在獸醫學中常作為仿單標示外使用。雖然主要用於行為問題（如分離焦慮），但其獨特的受體作用使其具有多種用途。
- 在犬貓中，常被用於治療尿失禁和猝倒症 (cataplexy)。
- 在馬匹醫學中，則用於控制猝睡症 (narcolepsy)及誘導藥理性射精。
臨床要點：伊米帕明是一種三級胺 TCA，在肝臟中會迅速代謝為具活性的二級胺代謝物去甲伊米帕明 (desipramine)。這種雙重作用擴大了其藥理範圍，同時影響血清素和正腎上腺素途徑。
作用機制
Imipramine and its active metabolite, desipramine, exert their effects through a complex, multi-receptor pharmacologic profile:
- Monoamine Reuptake Inhibition: Blocks the presynaptic amine pump, preventing the reuptake of serotonin (5-HT) and norepinephrine (NE) → increases neurotransmitter concentrations in the synaptic cleft → modulates mood, arousal, and pain pathways.
- Anticholinergic Activity: Antagonizes muscarinic receptors centrally and peripherally. This mechanism is primarily responsible for its efficacy in treating urinary incontinence (facilitating urine storage by relaxing the detrusor muscle) and its common side effects (dry mouth, tachycardia).
- Alpha-Adrenergic Agonism/Antagonism: Exhibits complex interactions at alpha receptors, which may contribute to increasing internal urethral sphincter tone.
- Antihistaminic (H1) Activity: Contributes to its significant sedative properties.
安全性與警告
禁忌症
- Prior sensitivity to any tricyclic antidepressant
- Concomitant use with monoamine oxidase inhibitors (MAOIs) within 14 days
- Glaucoma
- History of seizures
- Urinary retention
- Severe liver disease
- Hypersensitivity to tricyclic antidepressants
不良反應
- Sedation
- Dry mouth
- Constipation
- Tachycardia
- Hyperexcitability
- Tremors
- Seizures (CNS stimulation)
- Bone marrow suppression
- Diarrhea
- Vomiting
- Diarrhoea
- Arrhythmias
- Hypotension
- Syncope
- Increased appetite
注意事項
Use with extreme caution in patients with seizure disorders, as imipramine may lower the seizure threshold.
Pregnancy Warning: There are isolated reports of limb reduction abnormalities (teratogenic potential). Restrict use in pregnant animals to situations where benefits clearly outweigh the risks (FDA Category D in humans).
Nursing: Excreted into milk in low concentrations (milk:plasma ratio 0.4 to 1.5).
藥物相互作用
Additive anticholinergic effects; use cautiously
May inhibit tricyclic antidepressant metabolism and increase the risk of toxicity
Additive CNS depressant effects; use cautiously
Imipramine may decrease levodopa oral absorption
May decrease tricyclic levels
Increased risk for QTc interval prolongation and tricyclic adverse effects
May decrease tricyclic blood levels
Increased risk for serotonin syndrome
May increase the risk of cardiac effects (arrhythmias, hypertension, hyperpyrexia)
Concomitant use (within 14 days) is generally contraindicated due to risk of serotonin syndrome
May increase risk for cardiac arrhythmias
Increased risk for prolonged QT interval
Tricyclics may increase blood pressure
High risk of fatal serotonin syndrome
Altered metabolism via cytochrome P450 2D6 competition/inhibition
Increased risk of serotonin syndrome
Increased risk of serotonin syndrome (use only in exceptional cases with careful monitoring)
監測
- Clinical efficacy
- Adverse effects
- ECG (Tricyclics can widen QRS complexes, prolong PR intervals, and invert or flatten T-waves)
- Blood Glucose (Tricyclics may increase or decrease blood glucose levels)
- Heart rate and rhythm (ECG) in susceptible patients
- Signs of serotonin syndrome (agitation, tremors, hyperthermia, tachycardia) if used with other serotonergic drugs
- Liver function tests (baseline and periodic)
藥物動力學
吸收
Rapidly absorbed from both the GI tract and parenteral injection sites. Peak levels occur within 1-2 hours after oral dosing.
分佈
Enters the CNS and maternal milk in levels equal to that found in maternal serum.
代謝
Metabolized in the liver to several metabolites, including the active metabolite desipramine.
過量
Overdosage with tricyclics can be life-threatening, leading to severe arrhythmias and cardiorespiratory collapse. Because the toxicities and therapies for treatment are complicated and controversial, it is highly recommended to contact a poison control center for further information in any potential overdose situation.
可用產品
劑型
- Tablets
- Capsules
- Injection (Note: The injectable product is no longer marketed in the USA)
- 10 mg oral tablet
- 25 mg oral tablet
人用標示
- Imipramine HCl Tablets: 10 mg, 25 mg & 50 mg (Tofranil, generic)
- Imipramine Pamoate Capsules: 75 mg, 100 mg, 125 mg & 150 mg (Tofranil-PM, generic)
- Tofranil 10 mg tablets
- Tofranil 25 mg tablets
- Imipramine 10 mg tablets
- Imipramine 25 mg tablets
各地核准狀態
POM. Veterinary authorized products (e.g., clomipramine) are preferred under the cascade.
POM. Veterinary authorized products (e.g., clomipramine) are preferred under the cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Imipramine HCl tablets and pamoate capsules should be stored in tight, light-resistant containers, preferably at room temperature. The HCl injection should be stored at < 40°C; avoid freezing. Imipramine HCl will turn yellow to reddish on exposure. Slight discoloration will not affect potency, but marked changes in color are associated with a loss of potency.
飼主須知
- 需要耐心：行為改變可能需要數週才會顯現。請按照處方繼續餵藥，未經獸醫同意請勿突然停藥。
- 安全第一：此藥物對動物和人類過量時具有高度毒性。請將其保存在防兒童開啟的包裝中，並妥善鎖好，遠離寵物和兒童。
- 副作用：您可能會注意到寵物變得嗜睡、口乾或便秘。如果您的寵物顯得過度興奮、發抖或癲癇發作，請立即聯繫您的獸醫。
- 漏服劑量：如果您忘記餵藥，請在想起時盡快補餵，但絕對不要一次餵食雙倍劑量。
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