金諾芬
Auranofin
別名: Crisinor · Crisofin · Goldar · Ridauran · SKF-39162 · SKF-D-39162
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
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Immune-mediated arthropathies and dermatopathies | 0.05-0.2 mg/kg (up to 9 mg/day total dose) | PO | q12h | — | 🌎 NA |
| Treatment of pemphigus complex (with corticosteroids) | 0.12-0.2 mg/kg | PO | twice daily | — | 🌎 NA |
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Rescue drug for feline pemphigus and for idiopathic dermatoses and plasma cell pododermatitis/stomatitis | 0.2-0.3 mg/kg | PO | twice daily | — | 🌎 NA |
- Rescue drug for feline pemphigus and for idiopathic dermatoses and plasma cell pododermatitis/stomatitis: Must be reformulated for accurate dosing.
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
金諾芬 (Auranofin) 是一種口服金鹽製劑，在獸醫學中主要用於其免疫調節特性（此療法稱為金療法 chrysotherapy）。
- 臨床應用：歷史上曾用於治療犬貓的落葉型天皰瘡和特發性多發性關節炎等免疫介導疾病。
- 療效與毒性：與注射型金製劑（如金硫葡萄糖）相比，它的毒性通常較低，但療效也較弱。
- 現代背景：其應用已逐漸被更新、更安全且更有效的免疫抑制劑（如環孢素、黴酚酸酯）所取代。
- 需要重新配製：由於人類商業膠囊劑量為 3 mg，通常需要重新配製才能準確用於小動物。
作用機轉
The exact mechanism of gold salts is not fully elucidated, but they possess anti-inflammatory, antirheumatic, and immunomodulating effects.
- Macrophage Inhibition: Auranofin is taken up by macrophages → inhibits phagocytosis and suppresses lysosomal enzyme activity.
- Mediator Suppression: Inhibits the release of histamine and the production of prostaglandins.
- T-Cell Modulation: Selectively suppresses helper T-cells (CD4+) without significantly affecting suppressor T-cell populations, thereby dampening the autoimmune response.
安全性與警告
禁忌症
- Systemic Lupus Erythematosus (SLE) - may exacerbate signs
- Pregnancy (known teratogen and maternotoxic)
不良反應
- Immune-mediated thrombocytopenia (dose-dependent)
- Hemolytic anemia
- Leukopenia
- Gastrointestinal disturbances (particularly diarrhea, dose-dependent)
- Renal toxicity (proteinuria)
- Hepatotoxicity (increased liver enzymes)
- Dermatosis
- Corneal ulcers
注意事項
High-Risk Therapy: Should only be administered when other less expensive and toxic therapies are ineffective. Veterinarians and owners must be willing to accept associated risks and expenses.
- Teratogenicity: Known teratogen and maternotoxic; do not use during pregnancy unless risks are accepted.
- Nursing: Gold is excreted in milk and persists even after discontinuation. Switch to milk replacer if the dam is treated.
- Toxicity Monitoring: Intensive ongoing monitoring is required due to potential for severe hematologic, renal, and hepatic toxicity.
藥物交互作用
Safety when used with these agents has not been established; use with caution.
Increased potential for hematologic or renal toxicity; use with gold salts is not recommended.
Increased potential for hematologic or renal toxicity; use with gold salts is not recommended.
監測
- Hepatic function tests (baseline, monthly for 2-3 months, then every other month)
- Renal function tests including urinalysis (baseline, monthly for 2-3 months, then every other month)
- CBC with platelet counts (baseline, monthly for 2-3 months, then every other month). Note: eosinophilia may denote impending reactions.
藥物動力學
吸收
Absorbed when given by mouth (20-25% of the gold) primarily in the small and large intestines.
分佈
Moderately bound to plasma proteins. Crosses the placenta and is distributed into maternal milk. Highest levels found in kidneys, spleen, lungs, adrenals, and liver. Accumulation does not appear to occur (unlike parenteral gold salts).
排除
About 15% of an administered dose (60% of the absorbed dose) is excreted by the kidneys, the remainder in the feces.
過量
Very limited data is available. The minimum lethal oral dose in rats is 30 mg/kg.
- Decontamination: Gut-emptying protocols should be employed after an acute overdose when applicable.
- Antidotes: Chelating agents (e.g., penicillamine, dimercaprol) have been used for severe toxicities, but their use is controversial.
可用產品
劑型
- Capsules
人用標示
- Auranofin Capsules: 3 mg; Ridaura® (SK-Beecham)
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 capsules in tight, light-resistant containers at room temperature. After manufacture, expiration dates of 4 years are assigned to the capsules.
飼主須知
重要提示：此藥物需要嚴格遵守給藥和監測時間表。
- 需要耐心：通常需要持續服藥數個月才能看到寵物病情有明顯改善。
- 嚴格的用藥時間表：必須承諾每天兩次的給藥時間表才能取得成功。
- 定期監測：絕對需要頻繁進行血液和尿液檢查，以便及早發現潛在的嚴重副作用（如腎臟、肝臟或骨髓問題）。
- 副作用：密切觀察是否有腹瀉、嗜睡或異常出血/瘀傷。如果出現這些情況，請立即聯繫您的獸醫。腹瀉是常見的劑量相關副作用。
- 懷孕警告：此藥物可能導致出生缺陷。如果您懷孕，請勿接觸此藥物，也不要用於繁殖、懷孕或哺乳期的寵物。
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