複方樟腦鴉片酊 (Paregoric)
Paregoric
Camphorated Tincture of Opium
別名: Camphorated Tincture of Opium
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 |
|---|---|---|---|---|---|
| Acute colitis | 0.06 mg/kg PO three times daily | PO | TID | — | 🌎 NA |
| Maldigestion; malabsorption; antidiarrheal | 0.05-0.06 mg/kg PO two to three times daily | PO | BID to TID | — | 🌎 NA |
| Antidiarrheal | 0.05-0.06 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Maldigestion, malabsorption, anti-diarrheal | 0.05-0.06 mg/kg PO two to three times daily | PO | BID to TID | — | 🌎 NA |
- Maldigestion, malabsorption, anti-diarrheal: Use is controversial; this species may react with excitatory behavior.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Antidiarrheal | 15-30 mL PO (Foals); 15-60 mL PO (Adults) | PO | — | — | 🌎 NA |
- Antidiarrheal: May have a detrimental effect in acute/bacterial diarrhea by delaying microbe clearance.
牛
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Antidiarrheal | 15-30 mL PO | PO | — | — | 🌎 NA |
- Antidiarrheal: Dose for calves.
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
Paregoric 是一種鴉片類胃腸動力調節劑，偶爾用於獸醫病患的腹瀉症狀治療。
主要臨床重點：
- 成分： 每 5 mL 含有相當於 2 mg 的無水嗎啡，並含有茴香油、甘油、苯甲酸、樟腦和酒精。
- 法規狀態： 屬於第三級 (C-III) 管制藥品。
- 重要警告： 切勿將 Paregoric 與一般鴉片酊 (Opium tincture) 混淆。一般鴉片酊每 5 mL 含有 50 mg 無水嗎啡，效力是 Paregoric 的 25 倍。若誤用可能導致致命的過量中毒。
- 物種注意事項： 由於可能引起反常的中樞神經興奮，在貓的使用極具爭議。對於馬匹及其他可能患有感染性腹瀉的動物，鴉片類藥物會延遲病原體的清除並使病情惡化。
作用機制
Paregoric exerts its antidiarrheal effects primarily through the action of morphine on mu-opioid receptors in the gastrointestinal tract.
- Motility Inhibition: Binding to enteric opioid receptors decreases the release of acetylcholine → inhibits excessive GI propulsion and peristalsis, increasing intestinal transit time.
- Secretion Reduction: Decreases intestinal secretion induced by cholera toxin, prostaglandin E2, and calcium-mediated (non-cyclic AMP/GMP mediated) diarrheas.
- Absorption: Prolonged transit time allows for enhanced mucosal absorption of water and electrolytes, solidifying the stool.
安全性與警告
禁忌症
- Known hypersensitivity to narcotic analgesics
- Patients receiving monoamine oxidase inhibitors (MAOIs)
- Diarrhea caused by toxic ingestion (until the toxin is eliminated from the GI tract)
不良反應
- Dogs: Constipation, bloat, sedation, paralytic ileus, toxic megacolon, pancreatitis, CNS effects
- Cats: Excitatory behavior (controversial use)
- Horses: Delayed clearance of GI microbes, prolonged febrile state
注意事項
Diagnostic Warning: Opiates may obscure the diagnosis or clinical course of acute abdominal conditions (e.g., colic).
- Hepatic Disease: Use with extreme caution in patients with hepatic encephalopathy; hepatic coma may result.
- Respiratory Disease: Use with extreme caution in patients suffering from respiratory disease or acute respiratory dysfunction (e.g., pulmonary edema secondary to smoke inhalation).
- General Cautions: Use cautiously in patients with hypothyroidism, severe renal insufficiency, adrenocortical insufficiency (Addison's disease), head injuries, increased intracranial pressure, and in geriatric or severely debilitated patients.
- Infectious Diarrhea: May enhance bacterial proliferation and delay pathogen clearance.
藥物相互作用
May cause increased CNS or respiratory depression when used concurrently.
Contraindicated. Opiates should not be used for at least 14 days after receiving MAOIs due to the risk of severe, potentially fatal reactions.
監測
- Clinical efficacy (resolution of diarrhea)
- Fluid and electrolyte status (especially in severe diarrhea)
- CNS effects (sedation in dogs, excitation in cats), particularly if using high dosages
藥物動力學
吸收
The morphine in paregoric is absorbed in a variable fashion from the GI tract.
代謝
Rapidly metabolized in the liver. Serum morphine levels are considerably less than when morphine is administered parenterally.
過量
Acute overdosage of opiate antidiarrheals can result in severe CNS, cardiovascular, gastrointestinal, or respiratory toxicity.
- Because opiates significantly reduce GI motility, absorption of the drug from the GI tract may be delayed and prolonged, leading to a sustained toxic effect.
- Treatment: Naloxone is the specific reversal agent and may be necessary to reverse opiate-induced respiratory depression and CNS effects. Supportive care is essential.
可用產品
劑型
- Oral liquid: 2 mg morphine equivalent per 5 mL (with 45% alcohol)
人用標示
- Paregoric (camphorated tincture of opium): 2 mg of morphine equiv. per 5 mL (45% alcohol) in 473 mL; generic; (Rx; C-III)
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 in tight, light-resistant containers. Avoid exposure to excessive heat or direct exposure to sunlight.
飼主須知
- 密切觀察您的寵物： 如果腹瀉持續，或者您的寵物出現無精打采、過度鎮靜或發高燒的情況，請立即聯繫您的獸醫。
- 嚴格遵守劑量： 請完全按照處方給藥。因為此藥物含有鴉片成分，過量會導致嚴重的呼吸問題和極度鎮靜。
- 請勿替代： 未經獸醫明確許可，切勿使用其他人類止瀉產品或其他鴉片酊劑來替代此藥物。
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