卡麥角林
**卡麥角林 (Cabergoline)** 是一種合成的麥角衍生物，在獸醫學中主要用於其強效的降低催乳素作用。 * **主要適應症：** 治療犬貓的假懷孕、誘導/同步發情、終止妊娠以及乳腺炎的管理。 * **臨床優勢：** 與較舊的多巴胺促效劑（如溴隱亭 bromocriptine）相比，卡麥角林的耐受性更好，具有更高的受體特異性、更長的作用時間，且引發嘔吐的發生率顯著較低。 * **仿單標示外使用：** 在治療犬隻的腦下垂體依賴性腎上腺皮質機能亢進（庫興氏症）及鸚鵡的持續產卵方面顯示出部分療效。 * **成本考量：** 對於大型犬可能非常昂貴，但目前已有學名藥錠劑可供選擇。通常需要由藥師進行調劑以確保獸醫劑量的準確性。
作用機制: Cabergoline is a highly specific, long-acting **dopamine D2 receptor agonist**. * **Mechanism:** It binds with high affinity to **D2 receptors** on lactotroph cells in the anterior pituitary gland. * **Pathway:** **D2 receptor activation** → inhibition of adenylyl cyclase → decreased intracellular cAMP → direct suppression of **prolactin** synthesis and secretion. * **Reproductive Impact:** Because prolactin is luteotropic in dogs and cats (it maintains the corpus luteum during the second half of pregnancy), suppressing prolactin leads to a drop in progesterone. This mechanism is responsible for its ability to terminate pregnancy, resolve pseudopregnancy, and induce estrus.
各物種劑量
- Estrus induction · 5 micrograms/kg PO once daily induces fertile proestrus in 4-25 days. · PO · q24h · 4-25 days
- Estrus induction · 5 micrograms/kg PO once daily until an induced proestrus is pronounced for 2 days or until onset of estrus · PO · q24h · Until proestrus is pronounced for 2 days or onset of estrus
- Estrus induction · 0.6 micrograms/kg PO once daily. Make a 10 micrograms per mL solution by dissolving commercial tablets in warm distilled water (One 0.5 mg tablet (500 micrograms) per 50 mL of distilled water.) Give the appropriate dose for the patient within 15 minutes of preparation and discard the remaining solution. Continue until day 2 after the onset of the first signs of proestrus, or until day 42 without signs of proestrus. · PO · q24h · Until day 2 after onset of proestrus, or up to 42 days · 81% (22 of 27) of dogs treated at this low dose showed proestrus between days 4 and 48.
- Pseudocyesis (pseudopregnancy) · 5 micrograms/kg once a day PO for 5-10 days. · PO · q24h · 5-10 days
- Pseudocyesis · 5 micrograms/kg once a day or every other day SC · SC · q24h or q48h · Not specified · Likely needs to be compounded.
- Pseudocyesis · 5 micrograms/kg PO once daily for 4-5 days; occasional failures can be handled by repeating treatment and extending duration to 8-10 days. · PO · q24h · 4-5 days (up to 8-10 days) · Additional protocols for treatment failures include combining cabergoline with metergoline (500 micrograms/kg PO twice daily), or cabergoline with bromocriptine (10-30 micrograms/kg PO twice daily).
- Adjunctive treatment of mastitis after puppies weaned · 5 micrograms/kg PO daily. · PO · q24h · Not specified
給藥途徑
禁忌症
- Pregnancy (unless abortion is desired)
- Hypersensitivity to ergot derivatives
- Uncontrolled hypertension (in humans)
- Nursing mothers
不良反應
- Vomiting (infrequent, alleviated by food)
- Coat color changes (in dogs treated >14 days)
- Postural hypotension (reported in humans)
- Dizziness (reported in humans)
- Headache (reported in humans)
- Nausea (reported in humans)
藥物相互作用
- Hypotensive Drugs · Concomitant use may cause additive hypotension due to cabergoline's hypotensive effects.
- Metoclopramide · Use with cabergoline may reduce the efficacy of both drugs and should be avoided. · major
- Phenothiazines (e.g., acepromazine, chlorpromazine) · Use of cabergoline with dopamine (D2) antagonists may reduce the efficacy of both drugs and should be avoided.
- Domperidone · Antagonizes the therapeutic effect of cabergoline · major
- Phenothiazines (e.g., Acepromazine) · May antagonize cabergoline effects due to dopamine receptor blockade · moderate
- Hypotensive agents · Additive hypotensive effects · moderate
監測
- Clinical efficacy (resolution of pseudopregnancy, estrus induction, etc.)
- Adverse effects (vomiting, behavioral changes)
過量
Overdose information is not available for dogs or cats, and remains very limited for humans. * **Potential Signs:** It is postulated that cabergoline overdoses could cause severe hypotension, nasal congestion, syncope, or hallucinations. * **Treatment:** Treatment is basically supportive and primarily focuses on supporting cardiovascular function and blood pressure.
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。