孟魯司特鈉
Montelukast Sodium
Cyclopropaneacetic acid derivative leukotriene inhibitor
別名: Singulair · MK-476 · L-706631 · montelukastum
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
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Feline asthma | 0.5-1 mg/kg PO once daily (q24h) | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of the chronic 'snuffler' | 0.25-0.5 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Inflammatory Bowel Disease (IBD) | 0.5-1 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of feline heartworm | 2 mg total dose (PO) once daily | PO | q24h | — | 🌎 NA |
- Feline asthma: Anecdotal reports of efficacy; more conclusive evidence is needed before regular use.
- Adjunctive treatment of the chronic 'snuffler': i.e., 1/8th of a 10 mg Singulair tablet.
- Inflammatory Bowel Disease (IBD): For mild cases involving eosinophils and lymphocytes. May be used in combination with other drugs.
- Adjunctive treatment of feline heartworm: Anecdotal evidence suggests it may help thwart acute, fatal lung injury when an adult worm dies.
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
孟魯司特鈉 (Montelukast sodium) 是一種白三烯受體拮抗劑。在獸醫學中，主要用於貓的標示外治療，包括：
- 貓氣喘
- 炎症性腸病 (IBD)
- 慢性上呼吸道感染
- 心絲蟲相關呼吸道疾病 (HARD)
臨床提示： 雖然理論上可透過阻斷發炎介質來治療貓氣喘，但臨床療效通常不如預期。一般作為二線或三線輔助療法，而非首選藥物。一項針對患有反覆性呼吸道阻塞 (RAO) 馬匹的小型試驗也未能顯示其療效。在人類醫學中，獲 FDA 核准用於過敏性鼻炎和氣喘。
作用機制
Montelukast acts as a highly selective and competitive cysteinyl leukotriene receptor (CysLT1) antagonist.
- Arachidonic acid → 5-lipoxygenase pathway → Cysteinyl leukotrienes (LTC4, LTD4, LTE4).
- These leukotrienes are potent inflammatory mediators released by mast cells and eosinophils.
- By blocking the CysLT1 receptor in the airways and gastrointestinal tract, montelukast prevents leukotriene-mediated bronchoconstriction, mucosal edema, vascular permeability, and eosinophil recruitment.
安全性與警告
禁忌症
- Hypersensitivity to montelukast or any component of the product
- Not for use in reversing acute bronchospasm (asthma attacks)
不良反應
- No significant adverse effects reported in cats to date
- Humans (rare): behavioral effects (aggression, suicidal thoughts), palpitations, cholestatic hepatitis, allergic granulomatous angiitis
注意事項
Warnings and Precautions:
- Not a rescue medication: Do not use to attempt to reverse acute bronchospasm or acute asthma attacks.
- Pregnancy/Nursing: Appears safe to use during pregnancy (FDA Category B in humans). Likely safe to use during nursing, though it is excreted in milk.
- Hepatic metabolism: Use with caution in patients with severe hepatic impairment, as the drug is extensively metabolized in the liver.
藥物相互作用
CYP-450 enzyme inducer; may reduce montelukast plasma concentrations and efficacy.
CYP-450 enzyme inducer; may reduce montelukast plasma concentrations and efficacy.
Severe peripheral edema has been reported in a human receiving both drugs, presumably due to increased renal tubular sodium and fluid retention. Clinical significance in veterinary patients is unclear.
監測
- Clinical efficacy (improvement in respiratory or GI signs)
藥物動力學
吸收
No feline data available. In humans: Oral bioavailability is 64%; peak levels occur 3-4 hours after dosing. Presence of food does not affect bioavailability.
分佈
In humans: Highly bound (99+%) to plasma proteins.
代謝
In humans: Extensively metabolized in the liver via cytochrome P450 isoenzymes CYP3A4, CYP2A6, and CYP2C9.
排除
In humans: Metabolites are excreted primarily in the bile and eliminated in the feces.
過量
Overdose Toxicity: Montelukast is relatively safe in overdose situations.
- Animal Data: Rats and mice survived oral doses of approximately 230X to 335X the usual human adult dose.
- Human Data: Doses as high as 1,000 mg have been reported with the majority having no adverse effects.
- Clinical Signs (if present): Headache, vomiting, psychomotor hyperactivity, thirst, somnolence, mydriasis, hyperkinesia, and abdominal pain.
- Treatment: Basically supportive. No specific antidote is known.
可用產品
劑型
- Oral tablets
- Chewable tablets
- Oral granules
人用標示
- Montelukast Sodium Oral Tablets: 10 mg
- Montelukast Sodium Chewable Tablets: 4 mg, 5 mg
- Montelukast Sodium Oral Granules: 4 mg/packet
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 or granules at room temperature; excursions are permitted to 15°-30°C (59°-86°F). Protect from moisture and light.
飼主須知
- 給藥方式： 可與食物一起或空腹餵食。
- 非急救藥物： 本藥物為長期保養用藥，不可用於氣喘急性發作或嚴重呼吸困難的緊急治療。
- 觀察與回報： 本藥物在動物上的使用經驗較少。請密切觀察您的寵物，若發現任何異常反應（如行為改變或腸胃不適），請立即聯繫您的獸醫師。
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。