齊多夫定
Zidovudine
3'-azido-2',3'-dideoxythymidine
別名: Retrovir · AZT · ZDV · azidodeoxythymidine · 3'-azido-2',3'-dideoxythymidine · azidothymidine · BW-A509U · BW-509U · compound-S · zidovudinum
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
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Adjunctive therapy of FeLV and FIV | 5-10 mg/kg PO or SC q12h | PO, SC | q12h | — | 🌎 NA |
| Adjunctive therapy of FeLV and FIV | 5-10 mg PO or SC q12h | PO, SC | q12h | — | 🌎 NA |
| FeLV | 5 mg/kg PO or SC q12h | PO, SC | q12h | — | 🌎 NA |
| FIV encephalopathy | 20 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
- Adjunctive therapy of FeLV and FIV: Higher dose should be used carefully as side effects can develop. For SC injection, dilute lyophilized product in isotonic sodium chloride to prevent local irritation. For PO, syrup or gelatin capsules can be used.
- Adjunctive therapy of FeLV and FIV: Note: Dose is in mg per cat, not mg/kg. Higher dose should be carefully used in FeLV-infected cats because side effects, particularly non-regenerative anemia, can develop.
- FeLV: If giving SC, dilute in sterile normal saline to prevent local irritation. Check CBC weekly the first month.
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
齊多夫定 (Zidovudine, AZT) 是一種核苷酸反轉錄酶抑制劑 (NRTI)，在獸醫學中主要作為貓免疫缺陷病毒 (FIV) 或貓白血病病毒 (FeLV) 的輔助治療。
- 臨床應用：雖然它能降低受感染貓咪的病毒載量並改善臨床症狀（如口炎或神經系統症狀），但它無法治癒疾病，也可能無法大幅改變疾病的長期自然病程。
- 臨床要點：由於反轉錄病毒會整合到宿主基因組中，像齊多夫定這類的 NRTI 主要作用是防止新細胞被感染，而非清除已感染的細胞。
作用機制
Zidovudine is a synthetic thymidine analogue.
- Mechanism: It is converted in vivo by cellular kinases into its active metabolite, zidovudine triphosphate.
- Pathway: Zidovudine triphosphate competes with natural thymidine triphosphate for incorporation into viral DNA by viral RNA-directed DNA polymerase (→ reverse transcriptase).
- Effect: Because zidovudine lacks a 3'-OH group, its incorporation prevents the formation of phosphodiester linkages, leading to DNA chain termination and a virustatic effect against retroviruses.
- It also possesses some activity against gram-negative bacteria and can exhibit host cell cytotoxicity (particularly in rapidly dividing cells like bone marrow).
安全性與警告
禁忌症
- Patients with a history of life-threatening hypersensitivity reactions to zidovudine
不良反應
- Non-regenerative anemia (most common in cats, dose-dependent)
- Reductions in RBCs, PCV, and hemoglobin
- Diarrhea
- Weakness
- Granulocytopenia (reported in humans)
- Gastrointestinal effects
注意事項
Bone Marrow Suppression: Use with extreme caution in patients with pre-existing bone marrow dysfunction. Cats with bone marrow suppression should generally not be treated with zidovudine.
- Organ Dysfunction: Dosage adjustment may be necessary in cats with renal or hepatic dysfunction.
- Pregnancy: FDA Category C for use during pregnancy (animal studies show adverse fetal effects, but adequate human studies are lacking).
- Lactation: Excreted in milk; clinical significance for nursing offspring is unclear.
藥物相互作用
May increase zidovudine levels
May increase zidovudine levels
May antagonize each other's effects; avoid concurrent use. Also increases risk of hematologic toxicity.
Increased risk for hematologic and hepatotoxicity
May increase zidovudine levels
Administered with zidovudine may increase the risk of hematologic toxicity
May decrease blood levels (AUC) of zidovudine
監測
- CBC (Complete Blood Count): Weekly for the first month of treatment (non-regenerative anemia is common, especially at higher doses). If stable, monthly checks are sufficient.
- Hematocrit: If PCV drops below 20%, treatment should be discontinued (anemia usually resolves within a few days).
- CD4/CD8 ratios (if possible)
- Clinical efficacy and improvement of signs
藥物動力學
半衰期
吸收
Well absorbed after oral administration. In cats, oral bioavailability is approximately 95%. When administered with food, peak levels may be decreased, but total AUC is generally unaffected. Peak levels occur about 1 hour post-dosing in cats.
分佈
Widely distributed throughout the body, including penetration into the cerebrospinal fluid (CSF). It is only marginally bound to plasma proteins.
代謝
Rapidly metabolized in vivo.
排除
Excreted primarily in the urine.
過量
Human adults and children have survived massive oral overdoses (up to 50 grams) without permanent sequelae.
- Clinical Signs: Vomiting and transient hematologic effects (e.g., bone marrow suppression) are the most consistent adverse effects reported with acute overdoses.
- Management: Treatment is largely supportive and symptomatic, focusing on gastrointestinal decontamination if caught early, and monitoring hematologic parameters.
可用產品
劑型
- Tablets
- Capsules
- Syrup
- Injection solution
人用標示
- Zidovudine Oral Tablets: 300 mg (Retrovir, generic)
- Zidovudine Oral Capsules: 100 mg (Retrovir, generic)
- Zidovudine Oral Syrup: 50 mg/5 mL in 240 mL (Retrovir, generic)
- Zidovudine Injection Solution: 10 mg/mL in 20 mL single-use vials (Retrovir)
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
Oral tablets, capsules, and syrup should be stored at room temperature. Protect from heat, light, and moisture. Injection (for IV infusion) should be stored at room temperature and protected from light.
飼主須知
- 實驗性療法：此藥物對貓咪的病毒感染而言屬於「實驗性」或仿單標示外療法。
- 嚴格遵從醫囑：必須嚴格按照獸醫師的指示給藥，以確保對抗病毒的療效。
- 必須定期抽血：治療期間絕對需要定期回診抽血檢查（初期通常每週一次），因為此藥物可能會引起嚴重的貧血。
- 注意副作用：如果發現貓咪出現異常虛弱、嗜睡、牙齦蒼白或食慾不振，請立即聯繫您的獸醫師。
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