雙氯芬胺
Dichlorphenamide
別名: Daranide · Antidrasi · Fenamide · Glaucol · Glauconide · Glaumid · Oralcon · Oratrol · Tensodilen · Diclofenamidum
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Adjunctive glaucoma treatment (extra-label)
- q8-12h
NA
必須一併考量的臨床脈絡 (2)
- ■ Give this medicine as directed by your veterinarian. If your animal vomits or acts sick after receiving the medicine on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian.
- Store tablets in well-closed containers and at room temperature (20°C-25°C [68°F-77° F]).
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
雙氯芬胺 (Dichlorphenamide) 是一種全身性碳酸酐酶抑制劑 (CAI)，傳統上在獸醫眼科中用於青光眼的內科治療。
- 臨床要點：由於顯著的全身性副作用（如代謝性酸中毒和低血鉀）以及市面上普遍缺貨，全身性 CAI 已在很大程度上被局部替代藥物（如多佐胺 (dorzolamide) 和 布林佐胺 (brinzolamide)）所取代。
- 目前若需開立此藥，通常需要透過調劑藥局 (compounding pharmacy) 取得。
- 它具有輕微的抗癲癇和利尿特性，但在現代獸醫學中很少用於這些適應症。
作用機轉
Dichlorphenamide exerts its effects via noncompetitive, reversible inhibition of the enzyme carbonic anhydrase (CA).
- In the ciliary body: Inhibition of CA-II → decreased formation of bicarbonate (HCO3-) and hydrogen (H+) ions from carbon dioxide and water → reduced active transport of sodium into the posterior chamber → decreased aqueous humor production → lowered intraocular pressure (IOP).
- In the kidneys: Inhibits CA in the proximal convoluted tubule → increased renal tubular secretion of Na+, K+, and HCO3- → alkaline diuresis and potential metabolic acidosis.
- In the CNS: Exhibits mild anticonvulsant activity, likely secondary to localized metabolic acidosis or direct CA inhibition in the brain.
安全性與警告
禁忌症
- Significant hepatic disease (may precipitate hepatic coma)
- Renal or adrenocortical insufficiency
- Hyponatremia
- Hypokalemia
- Hyperchloremic acidosis
- Electrolyte imbalance
- Severe pulmonary obstruction (unable to increase alveolar ventilation)
- Hypersensitivity to carbonic anhydrase inhibitors
- Chronic, noncongestive, angle-closure glaucoma (long-term use)
不良反應
- Panting
- GI disturbances (inappetence, vomiting, diarrhea)
- CNS effects (sedation, depression, excitement)
- Hematologic effects (bone marrow depression)
- Renal effects (crystalluria, dysuria, renal colic, polyuria)
- Metabolic acidosis
- Hypokalemia
- Hyperglycemia
- Hyponatremia
- Hyperuricemia
- Hepatic insufficiency
- Dermatologic effects (rash)
- Hypersensitivity reactions
注意事項
Warning: Long-term use is contraindicated in patients with chronic, noncongestive, angle-closure glaucoma as it may mask the condition by lowering IOP while angle closure progresses.
- Use with extreme caution in patients with pre-existing electrolyte imbalances (especially hypokalemia or hyponatremia).
- May precipitate hepatic coma in patients with severe liver disease.
- Avoid in patients with severe pulmonary obstruction who cannot increase alveolar ventilation to compensate for metabolic acidosis.
- Pregnancy Category C: Teratogenic effects observed in animal studies; use only if benefits outweigh risks.
- Laboratory Interference: May cause false-positive results for urine protein using certain test methods (e.g., bromphenol blue, sulfosalicylic acid) due to urine alkalinization. May also decrease iodine uptake by the thyroid gland.
藥物交互作用
Alkaline urine caused by dichlorphenamide may decrease excretion of tricyclic antidepressants.
Increased risk of dichlorphenamide accumulation and toxicity; increased risk for metabolic acidosis; dichlorphenamide increases salicylate excretion.
Dichlorphenamide may cause hypokalemia, leading to an increased risk for digoxin toxicity.
Rarely, carbonic anhydrase inhibitors interfere with the hypoglycemic effects of insulin.
Dichlorphenamide may negate the effects of methenamine in the urine due to alkalinization.
Concomitant use may exacerbate potassium depletion.
Increased urinary excretion, which may reduce phenobarbital levels.
Decreased primidone concentrations.
Alkaline urine caused by dichlorphenamide may decrease quinidine excretion.
監測
- Intraocular pressure (IOP) / tonometry
- Serum electrolytes (may need to supplement potassium)
- Baseline CBC with differential and periodic retests if using chronically
- Clinical signs of adverse effects (GI upset, panting, CNS changes)
藥物動力學
吸收
Onset of action in small animals is approximately 30 minutes, with maximal effect occurring in 2-4 hours.
分佈
Not well studied in domestic animals.
代謝
Not well studied in domestic animals.
排除
Duration of action in small animals is 8-12 hours.
過量
Information regarding acute toxicity of dichlorphenamide is limited.
- Clinical Signs: Likely extensions of adverse effects, including severe electrolyte derangements (hypokalemia, hyponatremia), profound metabolic acidosis, CNS depression, and dehydration.
- Treatment:
- Monitor serum electrolytes, blood gases, volume status, and CNS status.
- Provide aggressive supportive care, including IV fluid therapy to correct dehydration and acid-base/electrolyte imbalances (e.g., potassium supplementation). Treat symptomatically.
可用產品
劑型
- Tablets (historically)
- Compounded oral formulations
獸醫用
- None commercially available (requires compounding)
人用標示
- None commercially available (requires compounding)
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 tablets in well-closed containers and at room temperature. An expiration date of 5 years after the date of manufacture is assigned to the commercially available tablets (when available).
飼主須知
- 給藥方式：請嚴格按照獸醫師的指示給藥。如果您的寵物出現腸胃不適（嘔吐或食慾不振），請嘗試將藥物與少量食物或零食一起餵食。
- 注意事項：如果您發現以下情況，請立即聯繫您的獸醫師：
- 異常出血或瘀傷（可能是骨髓抑制的跡象）。
- 肌肉顫抖、虛弱或嚴重嗜睡（低血鉀的跡象）。
- 皮疹或過度喘氣。
- 回診追蹤：定期回診對於監測寵物的眼壓（青光眼）和血液檢查（電解質和血球計數）至關重要。
注意：由於市面上很少有商業化錠劑，此藥物通常是客製化調劑的。請確保提前準備好處方箋以備不時之需。
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。