柳氮磺吡啶 / 磺胺沙拉嗪
Sulfasalazine
Salicylazosulfapyridine
別名: Azulfidine EN-tabs · salazosulfapyridine · salicylazosulfapyridine · sulfasalazinum · sulphasalazine · Aculfin · Azulfin · Colo-Pleon · Pleon RA · Pyralin · SAS · Salazopirina · Salazoprin · Salazopyrina · Salazopyrine · Salisulf Gastroprotetto · Salopyrine · Saridine · Sazo · Sulazine · Ulco
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 |
|---|---|---|---|---|---|
| Inflammatory large bowel disease | 20-40 mg/kg PO q8h for 3 weeks, followed by 20-40 mg/kg q12h for 3 weeks, and 10-20 mg/kg q12h for 3 weeks. | PO | q8h then q12h | 9 weeks | 🌎 NA |
| Inflammatory large bowel disease | 20-48.4 mg/kg (maximum total dose of one gram in refractory patients) PO q8h. | PO | q8h | Minimum 4 weeks | 🌎 NA |
| Chronic colitis | 20-50 mg/kg (up to a maximum of 1 gram) three times daily. | PO | q8h | Variable | 🌎 NA |
| Inflammatory large bowel disease | 10-25 mg/kg PO three times a day for 4-6 weeks. | PO | q8h | 4-6 weeks | 🌎 NA |
| Adjunctive treatment of vasculitis | 20-40 mg/kg PO q8h | PO | q8h | Unspecified | 🌎 NA |
| Adjunctive treatment of vasculitis | 25 mg/kg PO three times a day. | PO | q8h | Unspecified | 🌎 NA |
| All uses (Management of colitis) | 15-30 mg/kg | PO | q8-12h | — | 🌍 EU |
- Inflammatory large bowel disease: May consider an initial dose of 12.5 mg/kg, q8h. After signs resolve, reduce dosage by 25% at 2 week intervals.
- Chronic colitis: Initial dosage usually 20-30 mg/kg TID. Reduce dose at 2-4 week intervals if stool remains normal.
- Inflammatory large bowel disease: With resolution of clinical signs, reduce dose by 25 percent at 2 week intervals.
- All uses (Management of colitis): maximum 6 g/day
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Inflammatory large bowel disease | 10-20 mg/kg PO once daily. | PO | q24h | Unspecified | 🌎 NA |
| Inflammatory large bowel disease | 10-20 mg/kg PO q24 hours (once daily) tapered to the lowest effective dose | PO | q24h | Unspecified | 🌎 NA |
| Inflammatory large bowel disease | 10-20 mg/kg PO q8-12h (maximum of 10 days) | PO | q8-12h | Maximum 10 days | 🌎 NA |
| Inflammatory large bowel disease | 10-20 mg/kg PO q8-24h; up to a maximum of 10 days treatment | PO | q8-24h | Maximum 10 days | 🌎 NA |
| All uses (Management of colitis) | 10-20 mg/kg | PO | q8-12h | — | 🌍 EU |
- Inflammatory large bowel disease: Use cautiously in cats because of their sensitivity to salicylates.
雪貂
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| General | 10-20 mg/kg PO 2-3 times a day | PO | q8-12h | Unspecified | 🌎 NA |
| General | 25 mg (total dose) PO twice daily | PO | q12h | Unspecified | 🌎 NA |
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
柳氮磺吡啶 (Sulfasalazine) 是一種獨特的局部作用前驅藥，透過偶氮鍵結合了磺胺類抗生素（磺胺吡啶）和水楊酸類抗發炎藥（美沙拉嗪或 5-ASA）。
- 主要用途：它是治療犬貓特發性炎症性腸病 (IBD)，特別是漿細胞-淋巴細胞性結腸炎（大腸性腹瀉）的基石療法。也曾作為犬血管炎的輔助治療。
- 限制：對小腸疾病無效，因為它需要結腸細菌來活化。
- 臨床要點：雖然對結腸炎非常有效，但在獸醫學中使用需要仔細監測，因為有導致犬隻發生乾眼症 (KCS) 的風險，若未及早發現可能造成不可逆的傷害。貓對水楊酸鹽天生敏感，因此需要謹慎給藥。
作用機制
Sulfasalazine acts as a targeted delivery vehicle to transport anti-inflammatory medication directly to the colon.
- Delivery: The intact drug passes mostly unabsorbed (only 10-33% absorbed) through the stomach and small intestine.
- Activation: In the colon, bacterial azoreductase enzymes cleave the diazo bond.
- Mechanism:
- 5-Aminosalicylic Acid (5-ASA / Mesalamine) → Acts locally on the colonic mucosa to inhibit cyclooxygenase (COX) and lipoxygenase (LOX) pathways → Decreases production of pro-inflammatory prostaglandins and leukotrienes. It also acts as a local free radical scavenger.
- Sulfapyridine → Provides local antibacterial effects, though it is rapidly absorbed systemically and is responsible for the majority of the drug's adverse effects (e.g., KCS, hepatotoxicity).
安全性與警告
禁忌症
- Hypersensitivity to sulfasalazine, sulfonamides, or salicylates
- Intestinal or urinary obstructions
- Doberman pinschers (highly susceptible to sulfonamide-induced polysystemic immune complex disease)
- Dobermanns (appear to be highly sensitive to adverse effects associated with sulfapyridine)
- Patients with known hypersensitivity to sulfonamides or salicylates
不良反應
- Keratoconjunctivitis sicca (KCS) in dogs
- Anorexia
- Vomiting
- Cholestatic jaundice
- Hemolytic anemia
- Leukopenia
- Decreased sperm counts
- Allergic dermatitis
注意事項
Use with caution in animals with preexisting liver, renal, or hematologic diseases.
Feline Warning: Because cats have a deficient glucuronidation pathway, they are highly sensitive to salicylates. Use extreme caution and strict dosing when using this drug in cats.
Use with caution in nursing patients, as sulfonamides are excreted in milk and may cause kernicterus in newborns.
藥物相互作用
Hypoglycemic effects could be potentiated
Sulfasalazine may reduce absorption of digoxin
May decrease the blood levels of sulfasalazine if administered concurrently
Oral absorption of folic acid may be inhibited
Potentially sulfasalazine could potentiate warfarin
Measurement of serum folate concentration may be affected
May cause a reduction in serum thyroxine concentrations
監測
- Clinical efficacy (resolution of diarrhea/colitis signs)
- Schirmer tear tests (STT) prior to therapy and on rechecks (especially in middle-aged to older dogs) to monitor for KCS
- Complete Blood Count (CBC) occasionally with chronic therapy
- Liver function tests occasionally with chronic therapy
- Schirmer tear test (STT) periodically
- Clinical signs of KCS (ocular discharge, blepharospasm)
- Liver enzymes (due to risk of cholestatic jaundice)
- Thyroid panel (if on long-term therapy)
藥物動力學
吸收
Only about 10-33% of an orally administered dose is absorbed. The unabsorbed drug is cleaved in the colon. The sulfapyridine component is rapidly absorbed from the colon, but only a small percentage of the 5-ASA is absorbed.
分佈
Sulfonamides are excreted in milk and can cross the placenta.
代謝
Unabsorbed and biliary excreted drug is cleaved into 5-ASA and sulfapyridine in the colon by bacterial flora. Absorbed sulfapyridine and 5-ASA are hepatically metabolized.
排除
Renally excreted. Some of the initially absorbed intact drug is excreted unchanged in the bile.
過量
Massive overdoses could cause significant salicylate and/or sulfonamide toxicity.
- Treatment: Standard protocols for decontamination (empty stomach, cathartics, etc.) should be considered.
- Supportive Care: Urine alkalinization and forced diuresis may be beneficial in selected cases to enhance elimination.
可用產品
劑型
- Delayed-Release Tablets (enteric coated)
- 500 mg tablet
- 250 mg/5 ml oral suspension
人用標示
- Sulfasalazine Tablets: 500 mg (Azulfidine, generic)
- Sulfasalazine Delayed-Release Tablets: 500 mg (enteric coated) (Azulfidine EN-tabs, generic)
- Salazopyrin 500 mg tablet
- Salazopyrin 250 mg/5 ml oral suspension
各地核准狀態
Used under the cascade. POM (Prescription Only Medicine).
Used under the prescribing cascade. POM-V.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Tablets (plain or enteric-coated) should be stored at temperatures less than 40°C, preferably at room temperature (15-30°C) in well-closed containers. Oral suspension should be stored at room temperature; avoid freezing.
飼主須知
重要警告：此藥物可能導致狗出現「乾眼症」（角膜結膜炎），若忽視可能導致永久性失明。
- 密切觀察寵物的眼睛。如果您發現寵物瞇眼、眼睛發紅、出現濃稠的黃綠色眼屎，或眼睛看起來混濁乾燥，請立即聯繫您的獸醫師。
- 給藥方式：請與食物一起餵食以減少腸胃不適。如果使用的是腸溶錠，請勿壓碎或剝半。
- 貓咪注意事項：貓對此藥物非常敏感。請嚴格遵守獸醫師的劑量指示，且勿超過處方的治療天數。
- 副作用：注意是否出現食慾不振、嘔吐或牙齦/眼睛發黃（黃疸）的現象。
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