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費爾巴酯

Felbamate

Dicarbamate

抗癲癇藥PO狗

別名: Felbatol · Taloxa · Felbamyl · AD-03055 · W-554

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

15 mg/kg PO q8h. Dose can be increased in 15 mg/kg increments every 2 weeks until seizures are controlled. Doses as high as 70 mg/kg q8h are required and tolerated in some dogs.PO· q8h
— 🐕

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
Seizures (As either add-on therapy or monotherapy)15 mg/kg PO q8h. Dose can be increased in 15 mg/kg increments every 2 weeks until seizures are controlled. Doses as high as 70 mg/kg q8h are required and tolerated in some dogs.POq8h—🌎 NA
Seizures (As a third choice antiepileptic agent)15-65 mg/kg PO q8hPOq8h—🌎 NA
Seizures (For patients on phenobarb and bromides and seizure activity unchanged or having intolerable side effects)5-20 mg/kg PO three times dailyPOTID—🌎 NA
  • Seizures (As either add-on therapy or monotherapy): Starting dose is 15 mg/kg.
  • Seizures (As a third choice antiepileptic agent): Steady state reached after 4th oral dose. Monitor CBC and liver function tests as you would for phenobarbital. Therapeutic serum concentration reported to be 15-100 micrograms/mL.
  • Seizures (For patients on phenobarb and bromides and seizure activity unchanged or having intolerable side effects): If intolerable side effects, do levels and decrease the dose of the one that is in the high end of the range. Then add felbamate.

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。

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概覽

​費爾巴酯 (Felbamate)​ 是一種獨特的雙氨基甲酸酯類​抗癲癇藥物​，主要作為犬隻的二線或三線抗癲癇藥物。

  • 對於​複雜部分性癲癇​和全身性癲癇特別有用。
  • ​臨床要點​：與許多其他抗癲癇藥物不同，費爾巴酯在與苯巴比妥或溴化鉀合用時，通常​不會​引起額外的鎮靜作用，這使其成為一種理想的附加療法。
  • 由於其半衰期短，需要嚴格執行每日三次 (TID) 的給藥頻率。
  • 成本和取得難易度可能是獸醫臨床上的限制因素。
  • 由於在獸醫學中的使用有限，其完整的副作用概況可能尚不完全清楚。

作用機轉

Felbamate reduces excitatory neurotransmission and enhances inhibitory pathways.

  • Increases activation of voltage-gated sodium channels → decreases sustained high-frequency firing of action potentials.
  • NMDA Receptor Antagonism: Blocks the NR2B subunit of the NMDA receptor → prevents glutamate-mediated excitation.
  • GABA_A Modulation: Acts as a positive allosteric modulator at GABA_A receptors → enhances chloride influx and neuronal hyperpolarization.

安全性與警告

禁忌症

  • Hypersensitivity to felbamate or other carbamates (e.g., meprobamate)

不良反應

  • Keratoconjunctivitis sicca (KCS)
  • Liver enzyme induction
  • Tremor
  • Limb rigidity
  • Salivation
  • Restlessness and agitation (at high doses)
  • Blood dyscrasias (thrombocytopenia, lymphopenia, leukopenia)
  • Sedation (usually when combined with other anticonvulsants)
  • Vomiting/nausea (usually when combined with other anticonvulsants)

注意事項

Warning: May cause liver enzyme induction. Half-life may decrease over time, requiring dose adjustments.

  • Use with caution in patients with pre-existing hepatic dysfunction or a history of blood dyscrasias.
  • Pregnancy Category C: Use only if potential benefits outweigh risks. Excreted in maternal milk, but adverse consequences to nursing puppies appear remote.

藥物交互作用

Phenobarbital

Felbamate may increase phenobarbital levels. Phenobarbital may decrease felbamate levels.

Phenytoin

Felbamate may increase phenytoin levels. Phenytoin may decrease felbamate levels.

Valproate

Felbamate can cause increases in valproic acid levels.

監測

  • Liver function tests (q2-3 months recommended by some clinicians)
  • Complete Blood Count (CBC) (q2-3 months recommended by some clinicians)
  • Therapeutic drug levels (25-100 micrograms/mL range, though usefulness is questionable)
  • Seizure frequency and severity

藥物動力學

半衰期

狗5-14 hours (averages around 6 hours)

吸收

Well absorbed after oral administration in dogs.

分佈

Crosses the blood-brain barrier to exert CNS effects.

代謝

Undergoes hepatic metabolism. Can induce liver enzymes, which may decrease its own half-life over time.

排除

Excreted in the urine (about 50% unchanged and 50% as metabolites).

過量

Limited veterinary information is available.

  • In humans, a massive overdose (12 grams over 12 hours) resulted only in mild gastric distress and a slightly increased heart rate.
  • Treatment should be supportive and symptomatic. Consider gastric decontamination if ingestion is recent and the patient is neurologically stable.

可用產品

劑型

  • Tablets
  • Oral suspension

人用標示

  • Felbamate Tablets: 400 mg & 600 mg (Felbatol®)
  • Felbamate Suspension: 120 mg/mL in 240 & 960 mL (Felbatol®)

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 preparations at room temperature. The oral suspension should be shaken well before use.

飼主須知

  • ​嚴格的給藥時間表​：必須嚴格按照處方給藥，通常為​每8小時一次（每天三次）​。因為藥物很快會排出體外，漏服可能導致癲癇發作。
  • ​副作用​：觀察是否有乾眼症跡象（瞇眼、濃稠眼分泌物）、發抖、焦躁不安或嘔吐。如果發現這些症狀，請聯繫您的獸醫。
  • ​血液檢查​：您的獸醫可能會建議定期進行血液檢查以監測肝功能和血球計數，特別是如果您的狗正在服用其他癲癇藥物。
  • ​請勿突然停藥​：未經獸醫同意，切勿突然停止使用癲癇藥物，因為這可能引發嚴重且危及生命的癲癇發作。

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