替米沙坦
**替米沙坦 (Telmisartan)** 是一種血管張力素II受體拮抗劑 (ARB)，在獸醫學中主要用於管理**貓慢性腎病 (CKD)** 以減少蛋白尿，以及治療貓的**全身性高血壓**。本品為口服液劑，通常耐受性良好。 > **臨床警告：** 尚未評估替米沙坦用於控制高於 200 mmHg 全身性高血壓的安全性與療效。對於出現低血壓臨床症狀或正在接受全身麻醉的貓，強烈建議監測血壓。 **臨床提示：** 在延緩患有 CKD（IRIS 分期 IIa 至 IV）貓咪6個月內的蛋白尿惡化方面，替米沙坦的療效似乎與貝那普利 (benazepril) 相當。
作用機制: Telmisartan is a specific **Angiotensin II receptor (type AT1) antagonist**. By blocking this receptor, it inhibits the detrimental effects of angiotensin II, including: * **Vasoconstriction** → lowers systemic blood pressure. * **Aldosterone synthesis** → reduces sodium and water retention. * **Renal, vascular, and cardiac remodelling**. In the kidneys, blocking angiotensin II reduces **glomerular capillary hypertension** and decreases protein in the glomerular filtrate, which helps prevent the triggering or potentiation of interstitial fibrosis.
各物種劑量
- Protein-losing nephropathy and hypertension · 0.5-1 mg/kg · PO · q24h · Limited information; successful case reports exist for use in combination with amlodipine.
- Reduction of proteinuria associated with chronic kidney disease · 1 mg/kg · PO · q24h · Authorized indication. Use 4 mg/ml solution.
- Treatment of systemic hypertension · 2 mg/kg · PO · q24h · Authorized indication. Use 10 mg/ml solution.
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。
給藥途徑
禁忌症
- Breeding cats
- Pregnant cats
- Lactating cats
- Cats under 6 months of age
不良反應
- Regurgitation
- Vomiting
- Diarrhoea
- Increased ALT activity (rare, transient)
- Hypotension
- Decreased RBC count
- Increased BUN
藥物相互作用
- Amlodipine · Safe concurrent use for hypertension; no clinical evidence of hypotension at recommended doses. · minor
- ACE inhibitors (e.g., benazepril) · Avoid concurrent use due to potential for excessive hypotension and renal impairment. · major
監測
- Systemic blood pressure
- Urine protein:creatinine ratio (UPC)
- Renal parameters (BUN, creatinine)
- Liver enzymes (ALT)
- Red blood cell count / PCV
過量
In healthy cats administered **5 times the recommended dose for 6 months**, observed effects included decreases in blood pressure, decreases in red blood cell (RBC) count, and increases in blood urea nitrogen (BUN).
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。