撲熱息痛 (乙醯胺酚)
Paracetamol (Acetaminophen)
N-acetyl-p-aminophenol
別名: Pardale-V · Perfalgan · Panadol · Tylenol · Acetaminophen · APAP · N-acetyl-p-aminophenol
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 |
|---|---|---|---|---|---|
| Mild to moderate pain / Antipyretic | 10-20 mg/kg | PO/IV | q8h | 5-7 days (for acute pain) | 🌍 EU |
| Mild to moderate pain (Pardale-V preparation) | 1 tablet per 12 kg body weight (equivalent to 33 mg/kg) | PO | q8h | Max 7 days before titrating down | 🌍 EU |
- Mild to moderate pain / Antipyretic: For acute pain management, doses at the top of the range (20 mg/kg) can be used for up to 5-7 days.
- Mild to moderate pain (Pardale-V preparation): Authorized dose for Pardale-V. After 7 days, titrate down to the lowest effective dose. Codeine component is not bioavailable.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| All indications | Do not use | PO/IV | N/A | N/A | 🌍 EU |
- All indications: Absolute contraindication. Fatal toxicosis due to methaemoglobinaemia.
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
撲熱息痛是一種中樞作用的止痛退燒藥，用於控制輕至中度的疼痛和發燒。與傳統的非類固醇消炎藥 (NSAIDs) 相比，它的抗發炎效果較差，但一般認為其腸胃道副作用較少，因此對於患有胃潰瘍的病患是一個有用的替代選擇。注射型撲熱息痛也可用於犬隻圍手術期的輔助鎮痛。
嚴重警告： 貓咪絕對禁用撲熱息痛，因為貓缺乏安全代謝該藥物的酵素，會導致極高毒性甚至死亡。
臨床提示： 獲准的獸醫口服製劑 (Pardale-V) 含有可待因 (codeine)；然而，由於犬隻對鴉片類藥物具有很高的首過代謝率，該可待因成分的生物利用度極低，對鎮痛效果並無顯著貢獻。
作用機制
The exact mechanism of action remains partially unclear. It is proposed that its antipyretic and analgesic actions are due to:
- Decreased prostaglandin synthesis specifically within the central nervous system (CNS).
- Possible indirect actions on the cannabinoid system. Unlike traditional NSAIDs, it has minimal peripheral cyclooxygenase (COX) inhibition, which explains its lack of significant anti-inflammatory activity and reduced gastrointestinal toxicity.
安全性與警告
禁忌症
- Cats (absolute contraindication due to fatal toxicosis)
- Patients with pre-existing severe hepatic impairment
不良反應
- Hepatotoxicity (dose-dependent)
- Methaemoglobinaemia (especially in cats)
- Facial edema
- Cyanosis
注意事項
Feline Toxicity: Do not use in cats. They lack the glucuronyl transferase enzymes required to metabolize the drug, leading to fatal methaemoglobinaemia and hepatotoxicity even at very low doses.
- Use with caution in dogs with pre-existing liver disease.
- The combination of an NSAID and paracetamol for perioperative analgesia is common in human medicine but has not undergone rigorous safety or efficacy investigation in dogs.
藥物相互作用
Enhances the absorption of paracetamol, thereby enhancing its clinical and potentially toxic effects.
May increase the production of toxic metabolites (NAPQI), enhancing the risk of hepatotoxicity.
監測
- Liver enzyme panel (ALT, AST, ALP, Bilirubin) if prolonged use or overdose is suspected
- Clinical signs of toxicity (jaundice, vomiting, lethargy)
- Mucous membrane color (monitoring for cyanosis/brown blood indicative of methaemoglobinaemia)
藥物動力學
半衰期
吸收
Rapidly and well absorbed from the gastrointestinal tract. Absorption is enhanced by metoclopramide.
分佈
Widely distributed throughout most body tissues and fluids.
代謝
Undergoes extensive hepatic metabolism. A minor pathway utilizes cytochrome P450 to form the toxic intermediate N-acetyl-p-aminobenzoquinonimine (NAPQI). Cats are deficient in glucuronyl transferase, forcing metabolism down the toxic NAPQI pathway.
排除
Metabolites are primarily excreted in the urine.
過量
Overdose of paracetamol causes severe liver damage. Metabolism produces the toxic intermediate N-acetyl-p-aminobenzoquinonimine (NAPQI), which depletes hepatic glutathione, leading to hepatocyte cell death and centrilobular hepatic necrosis. In cats, it causes fatal methaemoglobinaemia.
Treatment:
- Decontamination (emesis/activated charcoal) if ingestion is recent.
- Antidote: Oral methionine or IV acetylcysteine (N-acetylcysteine). These are directed at replenishing hepatic glutathione stores to neutralize NAPQI, though clinical data in veterinary species is limited.
- Supportive care (IV fluids, oxygen therapy, blood transfusions if severe methaemoglobinaemia occurs).
可用產品
劑型
- 500 mg tablet
- 120 mg/5 ml oral suspension
- 250 mg/5 ml oral suspension
- 400 mg paracetamol / 9 mg codeine phosphate tablet (Pardale-V)
- 10 mg/ml injectable solution
獸醫用
- Pardale-V (400 mg paracetamol / 9 mg codeine phosphate tablet)
人用標示
- Paracetamol 500 mg tablets
- Paracetamol 120 mg/5 ml oral suspension
- Paracetamol 250 mg/5 ml oral suspension
- Perfalgan 10 mg/ml injectable solution
各地核准狀態
Pardale-V is authorized for dogs.
Pardale-V is POM-V. Human preparations may be P or POM.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store at room temperature (15-30°C), protected from light and moisture. Keep liquid suspensions tightly closed.
飼主須知
撲熱息痛是一種用於緩解犬隻輕至中度疼痛和退燒的藥物。當其他止痛藥（如 NSAIDs）會引起狗狗腸胃不適時，有時會改用此藥。
極度危險警告： 絕對不可以將此藥物給貓咪服用。 即使是極微量對貓咪來說也具有高度毒性，甚至致命，因為貓咪缺乏處理該藥物的肝臟酵素。
- 請務必嚴格按照獸醫師開立的劑量給藥。未經獸醫師明確指示，請勿使用人類的撲熱息痛產品，因為狗狗的劑量與人類完全不同。
- 如果您的狗狗出現嘔吐、精神不振、牙齦或眼睛發黃、或呼吸困難等症狀，請立即聯絡您的獸醫師。
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