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地芬諾酯 (複方地芬諾酯)

Diphenoxylate

Diphenoxylate hydrochloride

止瀉藥 - 鴉片類促效劑PO

別名: Co-phenotrope · Lofenoxal · Lomotil · Diphenoxylate hydrochloride

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

各物種劑量

此藥的劑量資料尚未收錄於 VetSheet 藥典，以下其他章節資料完整。開立處方前請參閱最新仿單。

概覽

地芬諾酯是一種合成的​鴉片類促效劑​，主要用作​止瀉​劑。通常與亞治療劑量的​阿托品​（atropine）配製成複方，以防止藥物濫用。

​警告：​ 在感染性腹瀉或產毒性感染中應謹慎使用，因為降低胃腸道蠕動會延遲病原體和毒素的清除。

​臨床提示：​ 雖然歷史上用於急性腹瀉，但現代獸醫學通常傾向於解決根本原因或使用益生菌/益生元，僅在特定的難治性病例中使用腸道蠕動調節劑。

作用機轉

Diphenoxylate acts locally and centrally on mu-opioid receptors in the gastrointestinal tract.

  • Increases intestinal segmental smooth muscle tone.
  • Decreases the propulsive activity (peristalsis) of smooth muscle.
  • Decreases electrolyte and water secretion into the intestinal lumen. → The addition of atropine is at a sub-therapeutic dose to cause unpleasant anticholinergic side effects if overdosed, thereby discouraging abuse.

安全性與警告

禁忌症

  • Toxigenic diarrhea
  • Infectious enteritis (e.g., Salmonella, Parvovirus)
  • Obstructive GI disease
  • Severe liver disease
  • Cats (generally avoided due to CNS excitation/depression)

不良反應

  • Constipation
  • Sedation
  • Bloating
  • Paralytic ileus
  • CNS depression (especially in cats)
  • Anticholinergic effects at high doses (dry mouth, tachycardia)

注意事項

​Caution:​ Do not use in cases of infectious diarrhea where pathogen clearance is necessary. Use with extreme caution in cats due to increased sensitivity to opioids. Monitor for signs of ileus or severe constipation.

藥物交互作用

Monoamine Oxidase Inhibitors (MAOIs)Major

May cause severe hypertensive crisis

CNS Depressants (e.g., sedatives, anesthetics)Moderate

Additive CNS and respiratory depression

AnticholinergicsModerate

Additive anticholinergic effects and increased risk of severe ileus

監測

  • Fecal output and consistency
  • Bowel sounds (auscultation for ileus)
  • CNS status (sedation or excitation)

藥物動力學

半衰期

貓Unknown狗Approximately 1-2 hours

吸收

Well absorbed from the gastrointestinal tract.

分佈

Widely distributed; crosses the blood-brain barrier.

代謝

Rapidly metabolized in the liver to diphenoxylic acid (difenoxine), which is the primary active metabolite.

排除

Excreted primarily in feces via bile, with a smaller amount excreted in urine.

過量

Overdose can lead to severe CNS depression, respiratory depression, and paralytic ileus. Due to the atropine component, anticholinergic signs (tachycardia, dry mucous membranes, mydriasis) may also occur.

​Treatment:​ Naloxone can be used to reverse the opioid effects. Provide supportive care for anticholinergic toxicity and respiratory depression.

可用產品

劑型

  • Oral: 2.5 mg diphenoxylate + 0.025 mg atropine tablet

人用標示

  • Lomotil (2.5 mg diphenoxylate / 0.025 mg atropine tablets)

各地核准狀態

United States✓ 已核准處方藥 · Schedule VFDA
🐕 Dogs

Human approved products used off-label in veterinary medicine.

European Union✓ 已核准處方藥EMA
🐕 Dogs

POM (Prescription Only Medicine)

United Kingdom✓ 已核准處方藥 · Schedule 5 (CD Inv)VMD
🐕 Dogs

POM (Prescription Only Medicine)

暫無法規資料: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Store at room temperature in a tightly closed container, protected from light and moisture.

飼主須知

地芬諾酯透過減緩腸道蠕動來治療嚴重的腹瀉。

  • ​請勿超過處方劑量​，因為過量會導致嚴重的副作用，包括極度嗜睡和便秘。
  • 確保您的寵物有充足的新鮮飲水以防止脫水。
  • 如果腹瀉持續超過48小時、寵物變得昏昏欲睡，或發現糞便中有血，請聯繫您的獸醫。

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