氟氫可的松
Fludrocortisone
Fludrocortisone acetate
別名: Florinef · Fludrocortisone acetate · 9α-fluorocortisol · 9α-fluorohydrocortisone
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 |
|---|---|---|---|---|---|
| Hypoadrenocorticism (Addison's disease) | 0.01 mg/kg (starting dose); most stable patients require <0.05 mg/kg | PO | q12h (some may only require q24h) | Lifelong | 🌍 EU |
- Hypoadrenocorticism (Addison's disease): Monitor absolute Na and K concentrations 4-6 hours post-pill. If on q24h dosing, check pre-pill concentrations as well.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Hypoadrenocorticism (Addison's disease) | 0.01 mg/kg (starting dose); most stable patients require <0.05 mg/kg | PO | q12h | Lifelong | 🌍 EU |
- Hypoadrenocorticism (Addison's disease): Doses as for dogs; very few reports in cats.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
氟氫可的松是一種具有強效鹽皮質激素活性和中度糖皮質激素活性的合成皮質類固醇。主要用於犬貓腎上腺皮質機能減退症（愛迪生氏病）的治療，特別是在無法使用核准的注射產品（特戊酸去氧皮質酮）時。
臨床警告： 氟氫可的松的鹽皮質激素效力約為氫化可的松的125倍，糖皮質激素效力約為12倍（約為潑尼松龍的3倍）。在代謝或身體面臨壓力期間，可能仍需要額外補充潑尼松龍。
作用機轉
Acts as an aldosterone analogue at the mineralocorticoid receptors in the distal convoluted tubule and collecting duct of the kidneys.
- Mineralocorticoid effect: → Increases sodium (Na+) retention and potassium (K+) excretion.
- Glucocorticoid effect: → Possesses roughly 3 times the glucocorticoid potency of prednisolone, contributing to anti-inflammatory and metabolic effects.
安全性與警告
禁忌症
- No specific contraindications listed in the monograph, but use with caution in patients with congestive heart failure, severe hypertension, or renal disease.
- No specific contraindications available in the monograph, but generally contraindicated in patients with systemic fungal infections or known hypersensitivity.
不良反應
- Hypertension
- Oedema (including cerebral oedema)
- Hypokalaemia
- Hypercortisolism / Iatrogenic Cushing's syndrome (with long-term overdose)
- Polyuria/polydipsia (PU/PD)
- Clinical signs of hypercortisolism (with long-term overdose)
注意事項
- Monitor absolute sodium and potassium concentrations (not just the Na:K ratio) 4-6 hours post-pill.
- If dosing q24h, check Na/K concentrations pre-pill.
- Supplemental doses of prednisolone may be required at times of metabolic or physical stress.
- Some formulations require refrigeration.
- Clinical Pearl: Dose requirements often increase over the first 6-18 months of therapy as residual adrenal function ceases.
藥物交互作用
Increased risk of severe hypokalaemia
Increased risk of hypokalaemia due to additive potassium-depleting effects
Increased risk of hypokalaemia due to additive potassium-depleting effects
監測
- Blood pressure
- Clinical signs of hypercortisolism or hypoadrenocorticism crisis
- Body weight and hydration status
- Absolute serum sodium concentrations (4-6 hours post-pill, and pre-pill if q24h)
- Absolute serum potassium concentrations (4-6 hours post-pill, and pre-pill if q24h)
- Clinical signs of hyperadrenocorticism or hypoadrenocorticism
藥物動力學
半衰期
吸收
Rapidly and completely absorbed from the gastrointestinal tract.
分佈
Widely distributed; highly bound to plasma proteins.
代謝
Hepatic metabolism.
排除
Excreted primarily via the kidneys.
過量
Overdosage can lead to hypertension, oedema (including cerebral oedema), and hypokalaemia. Long-term overdosage may result in clinical signs of hypercortisolism (iatrogenic Cushing's syndrome, e.g., PU/PD, polyphagia, alopecia, pot-bellied appearance). Treatment involves dose reduction and supportive care.
可用產品
劑型
- 0.1 mg oral tablets
- 0.25 mg oral tablets (named patient basis)
- 0.5 mg oral tablets (named patient basis)
獸醫用
- No authorized veterinary product in the UK/EU (desoxycortone pivalate is the authorized alternative)
人用標示
- Florinef 0.1 mg tablets
各地核准狀態
Human approved product used off-label in veterinary medicine.
Used under the cascade when authorized veterinary products (e.g., desoxycortone pivalate) are not suitable.
Used under the prescribing cascade. Some strengths available on a named patient basis.
暫無法規資料: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Normal precautions should be observed. Some formulations require refrigeration (check specific product packaging).
飼主須知
- 切勿突然停藥：此為救命藥物，必須嚴格遵照醫囑給藥。漏服可能導致危及生命的愛迪生氏危象。
- 壓力事件：在寵物面臨壓力（如寄宿、手術、生病、旅行）時，可能需要額外補充藥物（如潑尼松龍）。請提前諮詢獸醫師。
- 定期監測：需要定期抽血檢查以確保劑量正確，尤其是在治療的第一年。
- 副作用：請注意寵物是否有過度口渴、排尿增加、體重增加或水腫的情況，並及時向獸醫師報告。
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