二巰丙醇
Dimercaprol
2,3-dimercapto-1-propanol
別名: BAL in Oil · Sulfactin Homburg · British anti-lewisite · dimercaptopropanol · dithioglycerol dimercaprolum · Dicaptol
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 |
|---|---|---|---|---|---|
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days; q8h on 3rd day; BID for next 10 days | Until recovery | 🌎 NA |
| Arsenic toxicity | 4 mg/kg IM | IM | q4-6h | Max 4 continuous days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM loading dose, then 2.5 mg/kg IM | IM | q3-4h for two days, then progressively lengthen to q12h | Until recovery | 🌎 NA |
- Arsenic toxicity: Intensive supportive care required. 5 mg/kg dose only for acute cases and only for the first day. Give with sodium thiosulfate: 40-50 mg/kg IV as a 20% solution 2-3 times daily.
- Arsenic toxicity: Do not give for more than 4 continuous days.
- Arsenic toxicity: Loading dose of 5 mg/kg for acute cases only.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days; q8h on 3rd day; BID for next 10 days | Until recovery | 🌎 NA |
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days, then q12h | Until recovery | 🌎 NA |
| Arsenic toxicity | 4 mg/kg IM | IM | q4-6h | Max 4 continuous days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM loading dose, then 2.5 mg/kg IM | IM | q3-4h for two days, then progressively lengthen to q12h | Until recovery | 🌎 NA |
- Arsenic toxicity: Intensive supportive care required. 5 mg/kg dose only for acute cases and only for the first day. Give with sodium thiosulfate.
- Arsenic toxicity: If ingestion was within 36 hours. Use emetics/gastric lavage if recent. Institute fluid therapy.
- Arsenic toxicity: Do not give for more than 4 continuous days.
- Arsenic toxicity: Loading dose of 5 mg/kg for acute cases only.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Arsenic toxicity | 5 mg/kg IM initially, followed by 3 mg/kg IM q6h for remainder of first day, then 1 mg/kg IM q6h | IM | q6h | 2 or more additional days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM initially, followed by 3 mg/kg IM q6h for remainder of first day, then 1 mg/kg IM q6h | IM | q6h | Next 48 hours | 🌎 NA |
- Arsenic toxicity: Therapy is difficult due to large volumes required and painful IM route. Must be used acutely; delays significantly decrease effectiveness.
- Arsenic toxicity: Effective if administered within hours of ingestion. Wash off topical arsenic, empty digestive tract. Administer sodium thiosulfate PO and IV.
牛
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Arsenic toxicity (no clinical signs) | 3 mg/kg IM | IM | q8h | — | 🌎 NA |
| Arsenic toxicity (clinical signs) | 6 mg/kg IM | IM | q8h | 3-5 days | 🌎 NA |
| Arsenic, lead or mercury poisoning | 2.5-5 mg/kg IM | IM | q4h | 2 days | 🌎 NA |
| Mercury toxicity | 3 mg/kg IM | IM | four times daily for 3 days, then twice daily | 13 days total | 🌎 NA |
- Arsenic, lead or mercury poisoning: Efficacy questionable unless given before signs appear or very early. Withdrawal info not available.
- Mercury toxicity: Treatment is often unsuccessful.
豬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Mercury toxicity | 3 mg/kg IM | IM | four times daily for 3 days, then twice daily | 13 days total | 🌎 NA |
- Mercury toxicity: Treatment is often unsuccessful.
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
二巰丙醇（Dimercaprol，又稱英國抗路易斯毒氣劑或BAL）是一種重金屬螯合劑，在獸醫學中主要用於治療砷中毒。它偶爾也用於鉛、汞和金中毒。
它最初在二戰期間開發，作為路易斯毒氣（一種含砷的化學戰劑）的解毒劑。它含有巰基，能與重金屬結合，防止它們干擾必需的細胞酶。
臨床要點： 二巰丙醇配製於花生油中，必須進行深部肌肉注射，這可能會相當疼痛。它對某些金屬（如硒）相對無效，並且絕對禁忌用於鐵、鎘和硒中毒，因為產生的二巰丙醇-金屬複合物比單獨的金屬毒性更強。
作用機轉
Heavy metals exert their toxic effects by binding to sulfhydryl (-SH) groups on essential cellular enzymes, leading to enzyme inactivation. Dimercaprol contains two sulfhydryl groups that act as "decoys."
- Dimercaprol + Heavy Metal → Heterocyclic Ring Complex
- This complex is more stable than the metal-enzyme bond, allowing the metal to be pulled away from the tissues and excreted via the kidneys and feces.
Mechanistic Note: The chelation is not irreversible. The complex can dissociate as dimercaprol concentrations decrease, if oxidized, or in an acidic environment. Therefore, alkalinizing the urine is crucial to prevent the complex from dissociating in the kidneys and causing nephrotoxicity.
安全性與警告
禁忌症
- Impaired hepatic function (unless secondary to acute arsenic toxicity)
- Iron poisoning
- Cadmium poisoning
- Selenium poisoning
不良反應
- Pain at injection site
- Vomiting
- Seizures (at higher dosages)
- Transient increases in blood pressure
- Tachycardia
- Nephrotoxicity
注意事項
Dimercaprol is potentially nephrotoxic; use cautiously in patients with impaired renal function. To protect the kidneys, the urine should be alkalinized to prevent the chelated drug from dissociating in the urine. Animals with diminished renal function or who develop renal dysfunction while on therapy should have the dosage adjusted or therapy discontinued. IM injections must be administered deeply to minimize pain. May decrease Iodine I 131 thyroidal uptake values.
藥物交互作用
Forms a highly toxic complex. Do not administer with iron salts; wait at least 24 hours after the last dimercaprol dose before starting iron therapy.
Forms a highly toxic complex. Do not administer with selenium salts; wait at least 24 hours after the last dimercaprol dose before starting selenium therapy.
Forms a highly toxic complex.
Forms a highly toxic complex.
Forms highly toxic complexes
監測
- Liver function
- Renal function
- Hemogram
- Hydration and perfusion status
- Electrolytes and acid/base status
- Urinary pH (maintain alkaline pH)
藥物動力學
吸收
Peak blood levels occur in 30-60 minutes after IM injection. Slowly absorbed through the skin after topical administration.
分佈
Distributed throughout the body, including the brain. Highest tissue levels are found in the liver and kidneys.
代謝
Non-metal bound drug is rapidly metabolized to inactive compounds.
排除
Excreted in the urine, bile, and feces. In humans, completely eliminated within 6-24 hours.
過量
Clinical signs of dimercaprol overdosage in animals include vomiting, seizures, tremors, coma, and death. No specific doses were located to correspond with these clinical signs. Treatment should be supportive and symptomatic.
可用產品
劑型
- Injection: 100 mg/mL (10%) in peanut oil and benzyl benzoate
人用標示
- Dimercaprol Injection: 100 mg/mL (10%) (for IM use only) in 3 mL ampules (BAL in Oil)
各地核准狀態
POM status.
POM (Prescription Only Medicine).
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store below 40°C; preferably at room temperature (15-30°C). Unstable in aqueous solutions. The commercially available injection is a peanut oil and benzyl benzoate solution. Turbidity or small amounts of flocculent material/sediment do not indicate deterioration.
飼主須知
- 嚴格監控：由於此藥物具有潛在毒性，且重金屬中毒通常危及生命，因此必須在專業獸醫的密切監督下使用（通常在住院環境中）。
- 特殊氣味：二巰丙醇可能會讓您寵物的呼吸中帶有強烈、難聞的硫醇味（類似大蒜或臭鼬味）。這是藥物的正常反應。
- 注射疼痛：此藥物需進行深部肌肉注射，可能會讓您的寵物感到相當疼痛。
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