阿昔洛韋
Acyclovir
Acycloguanosine
別名: Zovirax · Aciclobene · Aciclotyrol · Acivir · Acyrax · Cicloviral · Geavir · Herpotern · Isavir · Nycovir · Supraviran · Viclovir · Virherpes · Viroxy · Xorox · aciclovirum · acycloguanosine · ACV · BW248U
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
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Herpesvirus-1 infections | 10-25 mg/kg PO twice daily | PO | q12h | — | 🌎 NA |
- Herpesvirus-1 infections: Never begin therapy until diagnostic evaluation is completed. May be toxic in cats; monitor CBC every 2-3 weeks.
鳥
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Treatment of Pacheco's Disease | 80 mg/kg PO q8h or 40 mg/kg q8h IM | PO/IM | q8h | Maximum 72 hours for IM | 🌎 NA |
| Treatment of Pacheco's Disease | 80 mg/kg in oral suspension once daily PO; mix suspension with peanut butter or add to drinking water 50 mg in 4 oz of water | PO | q24h | 7-14 days | 🌎 NA |
| Individual treatment | 80 mg/kg PO or IM twice daily | PO/IM | q12h | — | 🌎 NA |
| Prophylaxis (Exposed birds) | 25 mg/kg IM once, then acyclovir is added to drinking water at 1 mg/mL and to the food at 400 mg/quart of seed | IM, then PO | Once IM, then continuous PO | Minimum of 7 days | 🌎 NA |
| Prophylaxis (Quaker parrots) | 80 mg/kg q8h | PO (gavage) | q8h | 7 days | 🌎 NA |
- Treatment of Pacheco's Disease: Do not use parenterally for more than 72 hours as it can cause tissue necrosis at site of injection.
- Prophylaxis (Exposed birds): Give IM with caution as it is very irritating.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| EHV-1 outbreaks (prevention or treatment) | 10 mg/kg PO 5 times daily or 20 mg/kg PO q8h | PO | 5 times daily or q8h | — | 🌎 NA |
- EHV-1 outbreaks (prevention or treatment): Although efficacy is undetermined, anecdotal use may have had some efficacy. However, the drug's very low oral bioavailability suggests that oral dosing is unlikely to be of much benefit.
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。
概覽
阿昔洛韋 (Acyclovir) 是一種合成的嘌呤核苷類似物，在獸醫學中主要用於對抗特定皰疹病毒的感染。
主要臨床應用包括：
- 禽類醫學：用於治療和預防帕切科氏病 (Pacheco's disease)（一種對鳥類具高度致命性的皰疹病毒感染）。
- 貓科醫學：用於控制貓皰疹病毒-1型 (FHV-1) 感染，特別是角膜或結膜的病變。臨床提示：與泛昔洛韋 (famciclovir)、更昔洛韋 (ganciclovir) 或西多福韋 (cidofovir) 等較新的抗病毒藥物相比，它對 FHV-1 的活性較弱，且在貓身上引發全身性毒性的風險較高。
- 馬科醫學：研究用於治療馬皰疹病毒-1型 (EHV-1) 引起的脊髓腦病，但由於其在馬體內的口服生物利用度極低（<4%），使得治療效果面臨挑戰。
雖然在人類醫學中效果顯著，但其在獸醫物種中的應用常受限於藥代動力學的差異、某些物種（如馬）口服吸收不良，以及潛在的毒性（如貓的腎毒性和骨髓抑制）。
作用機轉
Acyclovir is a prodrug that requires activation by viral enzymes, making it highly specific to infected cells.
- Viral Entry: Acyclovir enters the virus-infected cell.
- Initial Phosphorylation: It is preferentially phosphorylated by viral thymidine kinase into acyclovir monophosphate.
- Subsequent Phosphorylation: Host cell kinases further convert it into the active form, acyclovir triphosphate.
- DNA Chain Termination: Acyclovir triphosphate acts as a competitive inhibitor of viral DNA polymerase. It incorporates into the growing viral DNA chain → lacks the 3'-hydroxyl group needed for further elongation → causes premature DNA chain termination and halts viral replication.
安全性與警告
禁忌症
- Dehydrated states
- Pre-existing renal function impairment
- Hypersensitivity to acyclovir or related antivirals
- Pre-existing neurologic deficits
- Previous neurologic reactions to other cytotoxic drugs
不良反應
- Thrombophlebitis (with parenteral use)
- Acute renal failure
- Encephalopathologic changes (rare)
- Gastrointestinal disturbances (vomiting, diarrhea)
- Leukopenia (cats)
- Anemia (cats)
- Tissue necrosis (if given IM for >72 hours in birds)
注意事項
Renal Warning: Acyclovir is primarily excreted by the kidneys and can precipitate in renal tubules, especially if given rapidly IV or in dehydrated patients. Ensure adequate hydration during therapy.
- Feline Toxicity: Cats are particularly sensitive to bone marrow suppression (leukopenia, anemia) from acyclovir. Use with extreme caution and monitor CBCs closely.
- Tissue Irritation: IM injections can be highly irritating and may cause tissue necrosis if used for more than 72 hours (noted in avian species).
- Pregnancy/Nursing: May be fetotoxic at high dosages (FDA Category C). It crosses the placenta and is excreted in milk at concentrations higher than maternal plasma. Use with caution in nursing patients.
- Renal Impairment: Dosage reduction is required in patients with renal insufficiency.
藥物交互作用
Concomitant administration with IV acyclovir may increase the potential for nephrotoxicity. Amphotericin B may potentiate antiviral effects but significantly increases nephrotoxic risk.
Concomitant use may cause additional CNS depression.
監測
- Renal function tests (BUN, Serum Creatinine) with prolonged or IV therapy
- Complete Blood Count (CBC) every 2-3 weeks in cats to monitor for leukopenia and anemia
- Hydration status
藥物動力學
半衰期
吸收
In dogs, bioavailability is dose-dependent (~80% at ≤20 mg/kg, declining to ~50% at 50 mg/kg). In horses, oral bioavailability is very low (<4%). In humans, oral absorption is poor (~20%) and not significantly affected by food.
分佈
Widely distributed throughout body tissues and fluids including the brain, semen, and CSF. It has low protein binding and crosses the placenta.
代謝
Primarily hepatically metabolized (in humans).
排除
Primarily eliminated via the kidneys. Renal disease does not significantly alter half-life unless anuria is present.
過量
Acute oral overdosage is unlikely to cause significant toxicity.
- Clinical Signs: Gastrointestinal signs (vomiting, diarrhea, lethargy) predominate. Renal failure is possible with higher doses due to drug crystallization in the renal tubules. Crystalluria and elevated renal values occurred at 188.7 mg/kg in a dog.
- Treatment: Consider gastrointestinal decontamination at doses of 150 mg/kg or higher. Below 150 mg/kg, manage symptomatically as GI signs will likely predominate. Ensure adequate hydration to maintain urine flow and prevent crystalluria.
可用產品
劑型
- Oral Tablets
- Oral Capsules
- Oral Suspension
- Powder for Injection
- Sodium Injection (IV infusion)
- Topical Ointment
- Topical Cream
獸醫用
- None
人用標示
- Acyclovir Oral Tablets: 400 mg & 800 mg (Zovirax®, generic)
- Acyclovir Oral Capsules: 200 mg (Zovirax®, generic)
- Acyclovir Oral Suspension: 200 mg/5 mL (Zovirax®, generic)
- Acyclovir Sodium Injection: 50 mg/mL (generic)
- Acyclovir Powder for Injection: 500 mg/vial, 1000 mg/vial (generic)
- Acyclovir Ointment: 5% (Zovirax®)
- Acyclovir Cream: 5% (Zovirax®)
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
Capsules and tablets should be stored in tight, light-resistant containers at room temperature. Suspension and sodium sterile powder should be stored at room temperature. Reconstituted solutions (with standard electrolyte/dextrose) are stable at 25°C for 24 hours. Do not use bacteriostatic water with parabens or benzyl alcohol for reconstitution.
飼主須知
阿昔洛韋 (Acyclovir) 是一種抗病毒藥物，用於治療特定的病毒感染（如皰疹病毒）。
- 給藥方式：請嚴格按照獸醫的指示給藥。切勿漏服，因為維持穩定的藥物濃度對於對抗病毒至關重要。
- 保持水分：確保您的寵物隨時有充足的新鮮飲水。此藥物經由腎臟代謝，良好的水分補充有助於預防腎臟損傷。
- 副作用：最常見的副作用是腸胃不適（嘔吐、腹瀉）和嗜睡。
- 貓咪特別注意事項：貓對這種藥物較為敏感。它可能會暫時降低貓咪的白血球和紅血球數量。請密切觀察是否有極度虛弱、牙齦蒼白或發燒的跡象，若出現這些情況請立即聯繫獸醫。您的獸醫可能會要求定期進行血液檢查以確保用藥安全。
- 儲存方式：請存放於室溫下，避光且防潮。
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