西沙必利
Cisapride
Substituted piperidinyl benzamide
別名: Propulsid · cisapridum · R-51619
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
經審核的 v13 劑量證據
結構化劑量計算證據Gastrointestinal stasis after obstruction has been excluded
- q8–12h
必須一併考量的臨床脈絡 (2)
- Exclude emergent diagnoses (obstruction, enterotoxemia)
- Prokinetic agent (after excluding the possibility of obstruction)
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
西沙必利 (Cisapride) 是一種強效的胃腸促動力藥物，在獸醫學中主要用於治療貓巨結腸症、胃排空遲緩和反流性食道炎。
臨床要點： 由於在人類中會引起嚴重的心律不整（QT間期延長），西沙必利已從人類藥品市場自願下架。目前僅能透過調劑藥局 (compounding pharmacies) 取得供獸醫病患使用。儘管對人類有心臟風險，但狗和貓通常對其耐受性極佳。
它能有效刺激從食道到結腸的腸胃蠕動，使其成為治療貓慢性便秘的基石療法。
作用機轉
Cisapride acts primarily as a serotonin 5-HT4 receptor agonist in the gastrointestinal tract.
- 5-HT4 activation → stimulates the release of acetylcholine at the myenteric plexus.
- This increases lower esophageal sphincter pressure, enhances esophageal peristalsis, and accelerates gastric emptying and colonic motility.
- Unlike metoclopramide, it has minimal dopamine receptor blockade (no extrapyramidal effects) and does not stimulate gastric acid secretion.
- Acetylcholinesterase activity is not inhibited.
安全性與警告
禁忌症
- Gastrointestinal perforation
- Gastrointestinal obstruction
- Gastrointestinal hemorrhage
- Hypersensitivity to cisapride
不良反應
- Vomiting
- Diarrhea
- Abdominal discomfort
- Prolonged QT intervals or cardiac arrhythmias (very rare in veterinary patients)
注意事項
Use with caution in pregnant or nursing animals; high doses caused embryotoxicity and fetotoxicity in lab animals. Dosage may need to be decreased in patients with severe hepatic impairment. Avoid concurrent use with CYP3A4 inhibitors or QT-prolonging drugs due to the risk of severe cardiac arrhythmias.
藥物交互作用
May diminish the prokinetic effects of cisapride.
Cisapride may enhance the sedative effects of benzodiazepines.
Cisapride may enhance anticoagulant effects; additional monitoring and dosage adjustments may be required.
Cisapride decreases GI transit times, potentially altering the absorption of other oral drugs. Serum levels may need closer monitoring.
Inhibit cisapride metabolism, leading to increased cisapride levels and an increased risk for cisapride cardiotoxicity.
May increase the risk of QT interval prolongation and fatal arrhythmias when used concurrently with cisapride.
監測
- Efficacy (resolution of GI stasis, constipation, regurgitation)
- Adverse effects profile (GI upset, signs of arrhythmias)
藥物動力學
吸收
After oral administration, cisapride is rapidly absorbed with an absolute bioavailability of 35-40% (human data).
分佈
Highly bound to plasma proteins and apparently extensively distributed throughout the body.
代謝
Extensively metabolized via cytochrome P450 (CYP3A4 in humans).
排除
Elimination half-life is about 8-10 hours (human data).
過量
LD50 doses in various lab animals range from 160 - 4000 mg/kg. The reported oral lethal dose in dogs is 640 mg/kg.
Clinical Signs: Most common adverse effects seen in dogs and cats are diarrhea, lethargy, ataxia, hypersalivation, muscle fasciculations, agitation, abnormal behavior, hyperthermia, and possibly seizures (dogs).
Treatment: Significant overdoses should be handled using standard gut emptying protocols when appropriate. Supportive therapy should be initiated when required. Activated charcoal is effective in binding unabsorbed cisapride.
可用產品
劑型
- Compounded oral suspension
- Compounded capsules
- Compounded tablets
獸醫用
- None commercially available (Must be compounded)
人用標示
- None (Removed from US market due to adverse cardiac effects)
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 cisapride tablets in tight, light-resistant containers at room temperature. Compounded oral suspensions (e.g., 1 mg/mL in Ora-Plus/Ora-Sweet) retain >90% potency for 60 days stored at both 5°C and 25°C. Compounded preparations should be protected from light.
飼主須知
- 給藥方式： 請嚴格按照獸醫指示給藥，最好在飯前 15 到 30 分鐘餵食，以達到最佳效果。
- 藥物來源： 此藥物必須由專門的調劑藥局特別配製。
- 副作用： 對寵物通常非常安全。請注意是否有輕微的腸胃不適、嘔吐或腹瀉。若發現異常的嗜睡或行為改變，請立即通知獸醫。
- 藥物交互作用： 請告知獸醫您的寵物正在服用的所有藥物和保健品，因為西沙必利有許多可能具危險性的藥物交互作用。
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。