多潘立酮
Domperidone
Domperidone maleate
別名: Motilium · Equidone · Leisguard · Domperidonum · R-33812
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 |
|---|---|---|---|---|---|
| As a prokinetic agent | 0.05-0.1 mg/kg PO once or twice a day | PO | q12-24h | — | 🌎 NA |
| For vomiting due to gastritis | 2-5 mg (total dose) PO two to three times a day | PO | q8-12h | — | 🌎 NA |
| Antiemetic / Prokinetic | 0.1 - 0.5 mg/kg | PO | q8h-q12h | As needed | 🌍 EU |
| Leishmaniasis (Treatment and Prevention) | 0.5 mg/kg | PO | sid | 28 days | 🌍 EU |
- As a prokinetic agent: Scant clinical experience; suggested dose based upon experimental data.
- Antiemetic / Prokinetic: Administer 15-30 minutes before feeding.
- Leishmaniasis (Treatment and Prevention): For prevention, the 28-day course can be repeated every 3-4 months depending on infection risk.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As a prokinetic agent | 0.05-0.1 mg/kg PO once or twice a day | PO | q12-24h | — | 🌎 NA |
| Antiemetic / Prokinetic | 0.1 - 0.5 mg/kg | PO | q8h-q12h | As needed | 🌍 EU |
- As a prokinetic agent: Scant clinical experience; suggested dose based upon experimental data.
- Antiemetic / Prokinetic: Administer 15-30 minutes before feeding.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| For fescue toxicity | 1.1 mg/kg PO once daily starting 10 to 15 days prior to Expected Foaling Date (EFD) | PO | q24h | Up to 5 days after foaling if inadequate milk | 🌎 NA |
- For fescue toxicity: Treatment may be continued for up to 5 days after foaling if mares are not producing adequate milk.
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
多潘立酮是一種周邊作用的多巴胺-2 (D2) 受體拮抗劑，主要用作促進胃腸動力藥、止吐藥以及催乳劑。
主要臨床應用包括：
- 馬：預防和治療圍產期母馬的高狐茅中毒（fescue toxicosis）、刺激泌乳（無乳症），以及作為馬垂體中葉功能障礙（PPID / 馬庫興氏症）的診斷劑。
- 小動物：標示外使用於促進胃腸動力和止吐，特別適用於胃排空延遲的疾病。
臨床要點：與甲氧氯普胺（metoclopramide）不同，多潘立酮不易穿過血腦屏障。這顯著降低了中樞神經系統（CNS）副作用（如錐體外症候群引起的震顫、抽搐）的風險，使其成為對中樞作用促動力藥敏感的病患的理想替代品。
作用機轉
Domperidone exerts its effects through multiple pathways:
- Dopamine-2 (D2) Receptor Antagonism in the GI tract → enhances gastric motility and accelerates gastric emptying (prokinetic effect).
- D2 Receptor Antagonism in the Chemoreceptor Trigger Zone (CRTZ) → blocks emetic signaling (antiemetic effect). Because the CRTZ lacks a complete blood-brain barrier, domperidone can act here without entering the deeper CNS.
- Alpha-2 and Beta-2 Adrenergic Receptor Antagonism → provides additional modulatory effects on stomach motility.
- Pituitary Gland Disinhibition → Dopamine normally inhibits prolactin release. By blocking dopamine receptors, domperidone → increases prolactin secretion → stimulates milk production (galactagogue effect). This directly counteracts the dopamine-mimetic alkaloids found in toxic tall fescue.
安全性與警告
禁忌症
- Known hypersensitivity to domperidone
- Presence or suspicion of gastrointestinal obstruction, perforation, or hemorrhage
- Pregnant mares >15 days prior to expected foaling date (unless specifically managed)
- Horses intended for human consumption
- Gastrointestinal hemorrhage
- Mechanical GI obstruction or perforation
- Prolactin-secreting pituitary tumors (prolactinomas)
- Known hypersensitivity to the drug
不良反應
- Galactorrhea (inappropriate milk production)
- Gynecomastia
- Premature lactation in horses (dripping milk prior to foaling)
- Failure of passive transfer in foals
- Rarely: somnolence or dystonic reactions
- Arrhythmias (associated with withdrawn injectable human products, especially with hypokalemia or heart disease)
- Galactorrhea (milk production in females)
- Mammary gland hyperplasia
- Changes in estrus cycle
- Mild gastrointestinal upset
注意事項
MDR1 Mutation Warning: Domperidone is potentially a neurotoxic substrate of P-glycoprotein. Use with extreme caution in herding breeds (e.g., Collies, Australian Shepherds) that may possess the MDR1 (ABCB1) gene mutation causing a nonfunctional blood-brain barrier efflux pump.
- Foal Immunity: In horses, failure of passive transfer of immunoglobulins (IgG) may occur even without visible leakage of colostrum. All foals born to treated mares must be tested for serum IgG concentrations.
- Reproductive Impact: May lead to premature birth, low birth weight, or foal morbidity if administered >15 days prior to the expected foaling date. Accurate breeding dates are essential.
- Laboratory Alterations: May increase serum prolactin, ALT, and AST. Can cause false-positive results on milk calcium tests used to predict foaling.
藥物交互作用
May increase domperidone levels due to metabolic inhibition.
May reduce the gastrointestinal prokinetic efficacy of domperidone.
Domperidone may antagonize their dopamine-agonist effects on prolactin.
May increase domperidone levels.
May reduce the gastrointestinal prokinetic efficacy of domperidone.
Domperidone may alter the absorptive characteristics of these drugs by decreasing GI transit times.
May decrease the oral absorption of domperidone
May decrease the oral absorption of domperidone due to altered gastric pH
Inhibits CYP3A4 metabolism of domperidone, potentially increasing plasma concentrations and risk of QT prolongation
Inhibits CYP3A4 metabolism of domperidone, increasing plasma concentrations.
May antagonize the gastrokinetic effects of domperidone.
Increase gastric pH, which may decrease the oral absorption of domperidone. Administer at least 2 hours apart.
監測
- Clinical efficacy (resolution of vomiting, improved gastric emptying, or adequate milk production)
- Serum IgG concentrations in foals born to treated mares
- Serum prolactin levels (if indicated)
- Resolution of nausea and vomiting
- Improvement in clinical signs of Leishmaniasis (if used for this indication)
- Signs of galactorrhea, mammary enlargement, or false pregnancy in females
藥物動力學
半衰期
吸收
Absorbed from the GI tract, but bioavailability in dogs is low (~20%) due to a high first-pass effect. Peak serum levels occur about 2 hours after oral dosing.
分佈
Highly bound (93%) to serum proteins. Does not readily cross the blood-brain barrier.
代謝
Primarily metabolized in the liver.
排除
Metabolites are excreted in the feces and urine.
過量
There is no specific antidote for a domperidone overdose.
- Employ standard gastrointestinal decontamination procedures if ingestion is recent and the patient is asymptomatic.
- Provide supportive and symptomatic care as needed. Monitor for potential neurological signs (especially in MDR1-mutant dogs) or gastrointestinal upset.
可用產品
劑型
- Oral gel
- Tablets
- Suppositories
- 10 mg tablet
- 1 mg/ml oral suspension
- 5 mg/ml oral suspension (veterinary)
獸醫用
- Domperidone Oral Gel 11% (110 mg/mL) in 25 mL multi-dose oral syringes (Equidone® Gel)
- Leisguard 5 mg/ml oral suspension (EU)
人用標示
- 10 mg oral tablets (Canada/Europe)
- Oral suspension (Europe)
- Suppositories (Europe)
- Motilium 10 mg tablets
- Motilium 1 mg/ml oral suspension
各地核准狀態
Approved for veterinary use in several EU countries specifically for the management of canine leishmaniasis (e.g., Leisguard).
Human formulations (POM) are used under the prescribing cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Domperidone gel should be stored at controlled room temperature 25°C (77°F) with excursions between 15°-30°C (59°-86°F) permitted. Recap after each use. Domperidone tablets should be stored at room temperature and protected from light and moisture.
飼主須知
- 用途：多潘立酮用於改善犬貓的胃排空並減少噁心。在馬匹中，它用於預防食用有毒狐茅草引起的併發症，並刺激哺乳期母馬的乳汁分泌。
- 給藥方式：請嚴格按照獸醫的指示給藥。
- 人類安全警告：懷孕和哺乳期婦女在處理馬用凝膠產品時應格外小心，因為全身性接觸可能會影響人類生殖荷爾蒙。請戴上手套並在處理後徹底洗手。
- 副作用：您可能會注意到寵物出現不正常的乳汁分泌或乳房腫大。在馬匹中，乳汁可能會在小馬出生前滴落。如果您發現寵物有任何異常的嗜睡、抽搐或行為改變，請立即聯繫您的獸醫。
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。