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阿維A

Acitretin

維生素A衍生物 (Retinoid)PO狗貓

別名: Soriatane · acitretinum · etretin · Ro-10-1670 · Ro-101670/000 · Acetrizoic Acid · Iodophil Viscous

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

0.5-1 mg/kgPO· once daily
— 🐕

劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
Dermatologic conditions where retinoids may be useful0.5-1 mg/kgPOonce daily—🌎 NA
Dermatologic conditions where retinoids may be useful0.5-2 mg/kgPOonce daily—🌎 NA
Sebaceous adenitis0.5-1 mg/kgPOonce daily—🌎 NA

貓

適應症劑量途徑頻次療程地區
Actinic keratosis/solar-induced squamous cell carcinoma; or Bowen's Disease10 mg per catPOonce daily—🌎 NA
Bowen's Disease3 mg/kg/dayPOonce daily—🌎 NA
  • Actinic keratosis/solar-induced squamous cell carcinoma; or Bowen's Disease: Note: This dose is for etretinate, but as the smallest capsule is 10 mg, this dose may need to suffice as well for cats.

劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。

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概覽

​阿維A (Acitretin)​ 是一種第二代全身性維生素A衍生物，也是依曲替酯 (etretinate) 的活性代謝物。

  • 主要用於獸醫皮膚科，治療嚴重的角化異常、皮脂腺異常及某些皮膚腫瘤。
  • 由於其半衰期明顯較短，減少了在組織中蓄積的時間及相關的長期毒性，因此在人類市場上取代了依曲替酯。
  • ​臨床要點​：雖然對犬層狀魚鱗癬、皮脂腺炎和日光性癌前病變等疾病非常有效，但其在獸醫學中的應用常受限於高昂的成本、致畸胎風險，以及小型病患需要重新配藥以達到準確劑量的問題。

作用機轉

Acitretin works by interacting with intracellular receptors to modulate cellular differentiation and proliferation.

  • Binds to nuclear ​Retinoic Acid Receptors (RARs)​ and ​Retinoid X Receptors (RXRs)​.
  • Receptor-ligand complexes bind to specific DNA sequences → alters gene transcription.
  • Pharmacodynamic Effects: Normalizes keratinocyte differentiation, reduces epidermal hyperproliferation, decreases sebum production, and exerts anti-inflammatory and antineoplastic effects (particularly against squamous cell carcinomas).

安全性與警告

禁忌症

  • Pregnancy (absolute contraindication)
  • Cardiovascular disease
  • Hypertriglyceridemia
  • Known sensitivity to acitretin or other retinoids

不良反應

  • Anorexia
  • Vomiting
  • Diarrhea
  • Cracking of foot pads
  • Pruritus
  • Ventral abdominal erythema
  • Polydipsia
  • Lassitude
  • Joint pain/stiffness
  • Eyelid abnormalities
  • Keratoconjunctivitis sicca (KCS)
  • Swollen tongue
  • Behavioral changes
  • Weight loss (especially in cats)

注意事項

TERATOGEN WARNING: Acitretin is a known teratogen (FDA Category X). It should not be handled by pregnant women nor used in a household where women are pregnant or planning to become pregnant.

  • Use with caution in patients with renal or hepatic failure.
  • May cause significant alterations in lipid profiles (hypertriglyceridemia, hypercholesterolemia) and liver enzymes.

藥物交互作用

Alcohol

Acitretin can form etretinate in the presence of alcohol; etretinate is a teratogen with an extremely long terminal half-life that can persist in adipose tissue for years.

Hepatotoxic drugs (e.g., methotrexate, ketoconazole, sulfonamides, fluconazole, macrolides)

May increase the potential for hepatotoxicity.

Other retinoids (isotretinoin, tretinoin, vitamin A)

May cause additive toxic effects.

Tetracyclines

May increase the potential for the occurrence of pseudotumor cerebri (cerebral edema and increased CSF pressure).

監測

  • Clinical efficacy
  • Liver function tests (baseline and if clinical signs appear)
  • Schirmer tear tests (monthly, especially in older dogs)
  • Serum triglycerides and cholesterol (recommended based on human data)

藥物動力學

吸收

Absorption is enhanced by food in the gut.

分佈

Highly bound to plasma proteins.

代謝

Metabolized to conjugate forms.

排除

Excreted in the bile and urine.

過量

Information on overdoses with this agent remains limited. One oral overdose (525 mg) in a human patient resulted only in vomiting. The oral LD50 in rats and mice is >4 grams/kg.

可用產品

劑型

  • Capsules

人用標示

  • Acitretin Capsules: 10 mg, 17.5 mg, 22.5 mg & 25 mg (Soriatane)

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 at room temperature and protected from light. After bottle is opened, protect from high temperature and humidity.

飼主須知

​嚴重的安全警告​：阿維A會導致嚴重的出生缺陷。​孕婦或計畫懷孕的女性絕對不可接觸此藥物。​ 獸醫師和飼主必須嚴格管理接觸風險。

  • ​給藥方式​：請固定與食物一起餵食，以增加藥物的吸收和療效。
  • ​副作用​：觀察您的寵物是否有「乾眼症」的跡象（瞇眼、濃稠的眼分泌物）、腳墊乾燥或龜裂、嘔吐或食慾不振。
  • ​貓咪特別注意​：如果您的貓咪停止進食或體重減輕，請立即聯繫您的獸醫師。可能需要調整給藥時間表（例如改為隔日給藥）。
  • ​費用​：請注意，長期使用此藥物的治療費用可能相當昂貴。

VetSheet 藥物參考供合格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商最新仿單。