醋酸甲羥孕酮
Medroxyprogesterone Acetate
17-hydroxy-6alpha-methylpregn-4-ene-3,20-dione acetate
別名: Depo-Provera · depo-subQ provera 104 · MPA · MAP · acetoxymethylprogesterone · medroxyprogesteroni acetas · methylacetoxyprogesterone · metipregnone · NSC-26386
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 |
|---|---|---|---|---|---|
| Apparent luteal insufficiency in bitches | 0.1 mg/kg PO once daily | PO | q24h | Discontinue several days prior to expected due date | 🌎 NA |
| Long-term reproductive control | 2.5-3 mg/kg IM q5 months | IM | q5 months | — | 🌎 NA |
| Adjunctive treatment of aggressive behaviors | 10 mg/kg IM or SC | IM/SC | As necessary | — | 🌎 NA |
| Young German shepherd dwarfs | 2.5-5 mg/kg initially at 3 week intervals and subsequently at 6 week intervals | IM/SC | q3w initially, then q6w | — | 🌎 NA |
| Benign prostatic hypertrophy | 0.3 mg/kg SC once | SC | Once | Effects last approximately 10 months | 🌎 NA |
| Progestin-responsive dermatitis | 20 mg/kg IM | IM | May repeat in 3-6 months if needed | — | 🌎 NA |
- Apparent luteal insufficiency in bitches: Potential benefits outweigh risks in second half of pregnancy, though fetal deformities are possible.
- Adjunctive treatment of aggressive behaviors: Works best with behavior modification. For inter-male aggression: do not exceed 3 treatments per year.
- Young German shepherd dwarfs: Has resulted in some increase in body size and adult hair coat development.
- Benign prostatic hypertrophy: Best used to maintain breeding potential for short time prior to castration; use with caution.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Behavioral disorders (reduce marking in neutered males) | 5-20 mg/kg SC or IM three to four times yearly | SC/IM | 3-4 times yearly | — | 🌎 NA |
| Feline psychogenic alopecia and dermatitis | 75-150 mg IM or SC | IM/SC | Repeat as necessary, but never more often than every 2-3 months | — | 🌎 NA |
| Progestagen-responsive dermatitis | 50-100 mg IM | IM | May repeat in 3-6 months if needed | — | 🌎 NA |
| Recurrent abortion secondary to progesterone-deficiency | 1-2 mg/kg IM once weekly | IM | q7d | Stop treatment 7-10 days prior to parturition | 🌎 NA |
| Long-term reproductive control | 2.5-5 mg PO once weekly; 25 mg injected every 6 months to postpone estrus | PO/IM/SC | q7d (PO) or q6mo (Injection) | — | 🌎 NA |
| Long-term reproductive control | 2 mg/kg IM q5 months | IM | q5 months | — | 🌎 NA |
- Behavioral disorders (reduce marking in neutered males): Use when all other drugs have been unsuccessful.
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Antipruritic and to suppress ovulation | 0.025-1 mL (3 mg/100 grams body weight) IM once every 4-6 weeks | IM | q4-6w | — | 🌎 NA |
- Antipruritic and to suppress ovulation: May cause obesity, fatty liver, polydipsia/polyuria and lethargy if used repeatedly.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Management of spring transition, prevention of estrus behavior, induction of estrous cycle synchrony, pregnancy maintenance, modification of stallion behavior | 500 to 800 mg IM | IM | Interval varies | Most injections last 2 to 3 months | 🌎 NA |
- Management of spring transition, prevention of estrus behavior, induction of estrous cycle synchrony, pregnancy maintenance, modification of stallion behavior: Will not prevent pregnancy loss and does not stop cyclicity.
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
醋酸甲羥孕酮 (MPA) 是一種強效的合成孕激素（黃體素衍生物）。
過去在獸醫學中，它常被用於行為修飾（例如：遊蕩、雄性間的攻擊行為、噴尿）和皮膚疾病（如貓心因性脫毛）。然而，由於其引發嚴重副作用的風險極高，目前的使用已大幅減少。
臨床要點： 對於行為問題，現在強烈建議使用更安全的替代方案（如 SSRIs、TCAs 或外科結紮）。MPA 偶爾仍用於特定的生殖適應症，例如懷孕母犬的黃體功能不全、良性前列腺肥大的短期管理，或德國牧羊犬的腦下垂體侏儒症。由於其具有深遠的全身性影響，在使用前必須仔細權衡潛在益處與引發內分泌及生殖系統併發症的巨大風險。
作用機制
MPA mimics endogenous progesterone by binding to intracellular progesterone receptors, translocating to the nucleus, and altering gene transcription. It transforms the proliferative endometrium into a secretory endometrium and inhibits spontaneous uterine contractions.
- Endocrine/Reproductive: Exerts negative feedback on the hypothalamus and pituitary, decreasing GnRH → suppressing FSH and LH release, thereby inhibiting estrus and spermatogenesis. It also possesses anti-estrogenic properties and decreases plasma testosterone.
- Glucocorticoid Activity: MPA has significant intrinsic affinity for glucocorticoid receptors, leading to profound suppression of the hypothalamic-pituitary-adrenal (HPA) axis (decreased ACTH and cortisol release).
- Metabolic Effects: Induces peripheral insulin resistance, which can precipitate diabetes mellitus.
- Growth Hormone: In dogs, progestins can stimulate the mammary glands to produce growth hormone, potentially leading to acromegaly.
安全性與警告
禁忌症
- Pre-pubescent cats or dogs
- Diabetes mellitus
- Pseudopregnant bitches
- Females in diestrus or with prolonged heat
- Uterine hemorrhage or discharge
- Pregnancy (unless specifically treating hypoluteoidism)
不良反應
- Increased thirst (polydipsia) and urination (polyuria)
- Increased appetite (polyphagia) and weight gain
- Depression, lethargy, and personality changes
- Adrenocortical depression (HPA axis suppression)
- Mammary changes (enlargement, milk production, neoplasia)
- Diabetes mellitus
- Pyometra / Cystic endometrial hyperplasia
- Temporary inhibition of spermatogenesis
- Permanent local alopecia, skin atrophy, and depigmentation (with SC injection)
- Acromegaly (in dogs)
注意事項
Progestagen therapy can cause serious adverse effects; safer alternative treatments should be considered first. Do not use prior to puberty as severe mammary hypertrophy or subclinical uterine/endocrine conditions may result. Because this drug can suppress adrenal function, exogenous steroids may be needed during times of stress (e.g., surgery, trauma). Prior to reproductive use, perform a thorough history, physical exam, mammary palpation, and vaginal smear to rule out diestrus, estrus, or mammary nodules.
藥物相互作用
May decrease medroxyprogesterone effects
May increase medroxyprogesterone metabolism
May decrease progestin activity due to microsomal enzyme induction and increased progestin metabolism
監測
- Weight
- Blood glucose (draw baseline before therapy and monitor periodically)
- Mammary gland development
- Adrenocortical function
- Clinical efficacy
藥物動力學
半衰期
分佈
Can be detected in maternal milk.
代謝
Hepatic metabolism (susceptible to microsomal enzyme induction).
過量
No specific reports on inadvertent acute overdosage were located. Overdose is expected to manifest as an exaggeration of adverse effects, including profound adrenal suppression, lethargy, metabolic derangements (hyperglycemia), and reproductive tract changes. Treatment should be supportive and symptomatic.
可用產品
劑型
- Tablets
- Injection (suspension)
人用標示
- Medroxyprogesterone Acetate Tablets (scored): 2.5 mg, 5 mg & 10 mg (Provera)
- Medroxyprogesterone Acetate Injection: 104 mg (160 mg/mL) in 0.65 mL prefilled syringes; 150 mg/mL in 1 mL vials; 400 mg/mL in 2.5 mL & 10 mL vials and 1 mL U-ject (depo-subQ provera 104, Depo-Provera)
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
Suspensions for injection should be stored at room temperature (15-30°C); avoid freezing and temperatures above 40°C. Tablets should be stored in well-closed containers at room temperature.
飼主須知
重要提示： 此藥物具有顯著的風險，通常只有在其他更安全的替代療法無效時才會使用。
- 密切監測寵物是否出現口渴增加、排尿增加或食慾大增的情況。這些可能是糖尿病（一種嚴重的潛在副作用）的早期徵兆。
- 注意乳腺是否有任何變化，例如腫脹、硬塊或分泌乳汁。
- 對於未結紮的雌性動物，請監測是否有嚴重子宮感染（子宮蓄膿）的跡象，這可能包括嗜睡、嘔吐、食慾不振或陰道分泌物。如果出現這些情況，請立即就醫。
- 如果透過皮下注射給藥，可能會在注射部位造成永久性脫毛、皮膚變薄或色素改變。
- 您的寵物在服藥期間可能會出現性格改變、嗜睡或體重增加的情況。
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