昂丹司瓊
Ondansetron
Ondansetron hydrochloride dihydrate
別名: Zofran · Setofilm · GR-38032F · ondansetroni hydrochloridum · Ondansetronum
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
經審核的 v13 劑量證據
結構化劑量計算證據Vomiting associated with chronic kidney disease (extra-label) — IRIS Stage 3
須由已驗證獸醫確認
- q6-12h
NA
必須同時考慮的臨床上下文 (4)
- NOTE: In humans, it is recommended that IV administration of ondansetron occur over at least 30 seconds, and preferably over 2 to 5 minutes. 24
- Vomiting associated with chronic kidney disease (extra-label):
- Unless otherwise labeled, store oral products in tight, light-resistant containers between 20°C and 25°C (68°F-77°F); temperature excursions of 15°C to 30°C (59°F-86°F) are permitted for the oral solution. Store orally disintegrating tablets in the original foil blisters and administer immediately upon opening; discard opened/unused tablets or tablet remnants. Store the injection between 2°C and 25°C (36°F-77°F) and protected from light. Solutions diluted for IV infusion retain potency for 48 hours at room temperature, but the manufacturer recommends discarding them 24 hours after dilution.
- ■ This medicine is used to treat or prevent severe vomiting. The oral medication may be given with or without food.
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
昂丹司瓊是一種強效的、具有中樞與周邊作用的止吐藥，屬於 5-HT3 受體拮抗劑。
主要臨床重點：
- 頑固性嘔吐：當常規療法（如馬羅匹坦或甲氧氯普胺）無效時，常作為救援或二線止吐藥。
- 化療與嚴重疾病：被視為預防和治療化療引起之噁心與嘔吐（CINV）的黃金標準，特別是針對順鉑等高致吐性藥物。廣泛應用於犬小病毒腸炎、胰臟炎及尿毒症的嚴重病例。
- 物種考量：犬隻通常耐受性良好。過去在貓的使用上存在爭議，但目前在貓科臨床上頻繁用於治療頑固性嘔吐及嚴重胰臟炎，且臨床效果良好。
臨床提示：昂丹司瓊不具備促腸胃動力作用。若存在胃排空延遲或腸阻塞，它無法解決動力問題，且可能掩蓋潛在的胃擴張症狀。
作用機制
Ondansetron is a highly selective and competitive 5-HT3 (serotonin type 3) receptor antagonist.
- Peripheral Action: Cytotoxic drugs, severe inflammation (e.g., pancreatitis), or viral infections (e.g., parvovirus) cause cellular damage in the GI tract, triggering the release of serotonin from enterochromaffin cells. This serotonin binds to 5-HT3 receptors on vagal afferent nerve terminals, sending emetogenic signals to the brain. Ondansetron blocks these peripheral receptors.
- Central Action: It also directly antagonizes 5-HT3 receptors located in the Chemoreceptor Trigger Zone (CTZ) within the area postrema of the brainstem, preventing central emetic signaling to the vomiting center.
- Net Effect: Profound inhibition of the vomiting reflex without altering GI motility or causing significant sedation.
安全性與警告
禁忌症
- Hypersensitivity to ondansetron or other 5-HT3 antagonists
- Concurrent use with apomorphine (due to risk of severe hypotension)
- Intestinal obstruction
不良反應
- Constipation
- Sedation
- Extrapyramidal clinical signs (head shaking)
- Arrhythmias
- Hypotension
- Headaches (reported in humans)
- Alterations in liver enzymes
- Hypersensitivity reactions (rare)
注意事項
Ondansetron may mask ileus or gastric distention; it should not be used in place of nasogastric suction. Use with caution in patients with hepatic dysfunction as the half-life may be prolonged. Caution is advised when administering to dogs with the MDR1/ABCB1 mutation, as it is a known P-glycoprotein substrate in humans. Exercise caution in nursing patients as it is excreted in maternal milk.
藥物相互作用
Severe hypotension reported in humans; concurrent use is contraindicated.
Theoretically may have additive effects on QTc interval, potentially resulting in serious arrhythmias.
May reduce the efficacy of both drugs (human data); veterinary significance is unknown.
監測
- Clinical efficacy (reduction or cessation of vomiting)
- Hydration status and electrolyte balance (due to underlying vomiting)
- Resolution of nausea and vomiting
- Liver enzymes (with prolonged use)
- Bowel movements (monitor for constipation)
藥物動力學
半衰期
吸收
In humans, well absorbed from the GI tract but exhibits first-pass hepatic metabolism. Bioavailability is about 50-60%. Peak plasma levels occur about 2 hours after an oral dose.
分佈
No veterinary species data located.
代謝
Extensively metabolized in the liver.
排除
Elimination half-lives in humans are about 3-4 hours, prolonged in elderly patients or those with hepatic dysfunction.
過量
Overdoses of up to 10X did not cause significant morbidity in human subjects. If an overdose occurs, treat supportively.
可用產品
劑型
- Orally disintegrating tablets (ODT)
- Oral solution
- Injection
- Injectable: 2 mg/ml solution in 2 ml and 4 ml ampoules
- Oral: 4 mg, 8 mg tablets
- Oral: 4 mg/5 ml syrup
- Rectal: 16 mg suppositories
人用標示
- Ondansetron HCl Tablets: 4 mg, 8 mg, 16 mg & 24 mg
- Ondansetron Orally Disintegrating Tablets: 4 mg & 8 mg
- Ondansetron HCl Oral Solution: 0.8 mg/ml (4 mg/5 mL)
- Ondansetron HCl Injection: 2 mg/mL in 2 mL & 20 mL vials; 32 mg/50 mL premixed
- Setofilm
- Zofran (2 mg/ml injectable, 4 mg and 8 mg tablets, 4 mg/5 ml syrup, 16 mg suppositories)
各地核准狀態
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
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儲存與穩定性
Unless otherwise labeled, store oral products in tight, light-resistant containers between 2-30°C. The injection should be stored between 2-30°C and protected from light.
飼主須知
昂丹司瓊是一種強效的止吐藥物，通常在其他常見藥物無效，或針對如小病毒、胰臟炎或化療期間等嚴重情況時使用。
- 給藥方式：可與食物一起或空腹給予。如果您的寵物在服藥後不久嘔吐，請在給予下一劑前聯繫您的獸醫師。
- 口腔崩解錠 (ODT)：如果您拿到的是「口溶錠」，請保持雙手乾燥處理。請勿將藥片硬擠出鋁箔包裝；應將鋁箔撕開後取出藥片。輕輕將其放入寵物口中，藥片會迅速溶解。
- 副作用：通常耐受性極佳。偶爾可能出現輕微嗜睡或便秘。如果您發現寵物有異常的搖頭或極度嗜睡，請聯繫您的獸醫師。
- 儲存方式：請放置於兒童及其他寵物無法觸及之處。室溫保存，避免光線直射與潮濕。
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