泛昔洛韋
**泛昔洛韋 (Famciclovir)** 是一種口服抗病毒藥物，在獸醫學中主要用於治療**貓疱疹病毒-1型 (FHV-1)** 感染。 * 它是一種前驅藥，在體內會轉化為具有抗病毒活性的**噴昔洛韋 (penciclovir)**。 * 由於貓體內的**肝臟醛氧化酶**（負責此轉化的酵素）濃度極低，因此貓通常需要比人類或其他物種高得多的劑量才能達到治療濃度。 * 在貓身上短期使用（2-3週）通常具有良好的耐受性，但長期使用的安全性數據仍然有限。 * **臨床重點**：雖然價格相對較高，但隨著學名藥的普及，對於嚴重或難治性 FHV-1 病例來說，這已成為更容易取得的治療選擇。
作用機制: Famciclovir is a prodrug that undergoes biotransformation to become active: Famciclovir → **hepatic aldehyde oxidase** → Penciclovir Once inside a virus-infected cell: Penciclovir → **viral thymidine kinase** → Penciclovir monophosphate → **cellular kinases** → Penciclovir triphosphate * The triphosphate form competes with deoxyguanosine triphosphate to inhibit **herpes virus DNA polymerase**. * This selectively and effectively halts **herpes viral DNA synthesis** and replication. * Viral resistance can occur via mutation.
各物種劑量
- Feline herpes virus (FHV-1) · 125 mg (total dose) · PO · 2-3 times a day · Author's choice. Wide range of doses used.
- Adjunctive treatment of FHV-1 rhinotracheitis · 31.25 mg (1/4 of one 125 mg tablet) · PO · q12h · 14 days · Has not been evaluated for longterm therapy.
- Chronic, recurrent and/or severe herpes viral infection · Kittens: 1/8th of one 125 mg tablet; adult cats: 1/4 of one 250 mg tablet · PO · once daily (q24h) · Kittens: 2 weeks; adult cats: 3 weeks · Dose range is variable!
- Feline herpes virus (FHV-1) · 1/4 of one 125 mg tablet · PO · twice daily (q12h) · 10-14 days; may continue once daily for up to 30 days
- Adjunctive treatment (with interferon and lysine) of herpes virus-associated ulcerative facial dermatitis & stomatitis · 125 mg · PO · q12h
- Management of feline herpesvirus (FHV-1) infections · 90 mg/kg · PO · q12h · Dose recommendations have varied because of complex and non-linear pharmacokinetics in cats.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Known hypersensitivity to famciclovir or penciclovir
不良反應
- Cats: Anorexia and polydipsia (noted at high doses of 90 mg/kg PO q8h)
- Humans: Nausea, vomiting, diarrhea, headache, neutropenia, renal failure
- Gastrointestinal signs (vomiting, diarrhea, anorexia)
藥物相互作用
- Probenecid · Can reduce the amount of penciclovir excreted by the kidneys, leading to increased penciclovir plasma levels
監測
- Clinical efficacy (resolution of ocular/respiratory signs)
- Adverse effects (most likely GI upset, anorexia, polydipsia)
- Consider occasional CBCs and serum creatinine to monitor for neutropenia or renal dysfunction if using the drug chronically
- Haematology
- Biochemistry
- Urinalysis (especially in cats with concurrent disease or on long-term therapy)
過量
Little information is available regarding acute toxicity. **Supportive treatment** is recommended. Penciclovir can be removed by hemodialysis.
VetSheet 藥物參考供持牌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方最新藥品說明書。