氟米松
Flumethasone
6alpha, 9alpha-difluoro-16alpha methylprednisolone
別名: Flucort · Cerson · Locacortene · Locortene · Lorinden · flumetasone · glumetasoni pivalas · NSC-107680
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 |
|---|---|---|---|---|---|
| Labeled indications (musculoskeletal conditions, dermatoses, allergic states, shock) | 0.0625-0.25 mg daily in divided doses | PO | daily in divided doses | — | 🌎 NA |
| Labeled indications | 0.0625-0.25 mg daily; may repeat | IV, IM, SC | daily | — | 🌎 NA |
| Labeled indications (joint inflammation) | 0.166-1 mg | Intra-articularly | — | — | 🌎 NA |
| Labeled indications (localized lesions) | 0.125-1 mg | Intra-lesionally | — | — | 🌎 NA |
| General anti-inflammatory/immunosuppressive | 0.06-0.25 mg once daily | IV, IM, SC, or PO | once daily | — | 🌎 NA |
- Labeled indications (musculoskeletal conditions, dermatoses, allergic states, shock): Tablets no longer marketed in the USA
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Labeled indications (acute and chronic dermatoses) | 0.03125-0.125 mg daily in divided doses | PO | daily in divided doses | — | 🌎 NA |
| Labeled indications (acute and chronic dermatoses) | 0.03125-0.125 mg. If necessary, may repeat. | IV, IM, or SC | If necessary, may repeat | — | 🌎 NA |
| General anti-inflammatory/immunosuppressive | 0.03-0.125 mg once daily | IV, IM, SC, or PO | once daily | — | 🌎 NA |
- Labeled indications (acute and chronic dermatoses): Tablets no longer marketed in the USA
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Labeled indications (musculoskeletal conditions, allergic states) | 1.25-2.5 mg daily. If necessary, the dose may be repeated. | IV, IM or intra-articular | daily | — | 🌎 NA |
| General anti-inflammatory | 1-2.5 mg/450 kg | IV or IM | — | — | 🌎 NA |
- Labeled indications (musculoskeletal conditions, allergic states): ARCI UCGFS Class 4 Drug
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
氟米松（Flumethasone）是一種在獸醫學中廣泛使用的高效、長效含氟糖皮質激素，具有強大的抗發炎和免疫抑制特性。
主要藥理特徵包括：
- 高效能：其效力約為氫化可的松（hydrocortisone）的15至30倍。
- 缺乏鹽皮質激素活性：它幾乎沒有明顯的鹽皮質激素（滯鈉）作用，與早期類固醇相比，降低了水腫和高血壓的風險。
- 臨床應用：對急性發炎反應（如昆蟲叮咬過敏、疫苗反應、休克）、肌肉骨骼發炎（滑囊炎、肌炎、骨關節炎）以及各種急慢性皮膚病非常有效。
臨床要點：與所有全身性皮質類固醇一樣，氟米松的治療總體目標是在最短的時間內使用最低的有效劑量，以盡量減少醫源性腎上腺皮質機能亢進（庫興氏症候群）和腎上腺軸抑制的風險。
作用機轉
Flumethasone exerts its effects via classic genomic and non-genomic steroid pathways:
- Genomic Pathway: Free flumethasone crosses the cell membrane and binds to cytosolic glucocorticoid receptors (GR).
- The receptor-ligand complex translocates to the nucleus and binds to glucocorticoid response elements (GREs) on DNA.
- Transactivation: Upregulates the expression of anti-inflammatory proteins, notably lipocortin-1 (annexin A1). Lipocortin-1 inhibits phospholipase A2 → blocking the release of arachidonic acid from membrane phospholipids → profoundly decreasing the synthesis of pro-inflammatory prostaglandins and leukotrienes.
- Transrepression: Downregulates the expression of pro-inflammatory cytokines (e.g., IL-1, IL-6, TNF-alpha) by inhibiting transcription factors like NF-κB and AP-1.
- Non-genomic Pathway: Rapid physicochemical interactions with cellular membranes provide immediate effects, which is particularly beneficial in shock or acute hypersensitivity states.
安全性與警告
禁忌症
- Last trimester of pregnancy (may induce parturition)
- Systemic fungal infections (unless used for Addison's replacement therapy)
- Idiopathic thrombocytopenia (specifically contraindicated for IM administration)
- Known hypersensitivity to the compound
- Chronic corticosteroid therapy of systemic diseases using sustained-release injectable forms
不良反應
- Polydipsia (PD), polyuria (PU), and polyphagia (PP)
- Weight gain and lipidemias
- Dull, dry haircoat and dermatological thinning
- Panting
- Gastrointestinal effects: vomiting, diarrhea, GI ulceration
- Hepatopathy: elevated liver enzymes (ALP, ALT)
- Pancreatitis
- Endocrine: activation or worsening of diabetes mellitus, iatrogenic hyperadrenocorticism (Cushingoid effects) with sustained use
- Musculoskeletal: muscle wasting, retarded growth in young animals
- Behavioral changes: depression, lethargy, viciousness
- Immunosuppression: increased susceptibility to infections
注意事項
Tapering Required: Animals that have received systemic glucocorticoids (other than short 'burst' therapy) must be tapered off slowly to allow endogenous ACTH and corticosteroid function to recover.
Stress Dosing: If an animal undergoes a 'stressor' (e.g., surgery, trauma, illness) during the tapering process or before normal adrenal/pituitary function resumes, additional glucocorticoids should be administered.
Pregnancy Warning: Corticosteroid therapy may induce parturition in large animal species during the latter stages of pregnancy. Categorized as Class C for canine and feline pregnancy (use cautiously as a last resort when benefits clearly outweigh risks).
藥物交互作用
Administered concomitantly with glucocorticoids may cause hypokalemia
In patients with myasthenia gravis, concomitant administration may lead to profound muscle weakness. Discontinue anticholinesterase at least 24 hours prior if possible.
Glucocorticoids may reduce salicylate blood levels
May increase the metabolism of glucocorticoids and decrease flumethasone blood levels
Glucocorticoids may inhibit the hepatic metabolism of cyclophosphamide; dosage adjustments may be required
Concomitant administration may increase the blood levels of each by mutually inhibiting hepatic metabolism
Flumethasone may decrease diazepam levels
Administered concomitantly with glucocorticoids may cause hypokalemia
May reduce flumethasone blood levels
Insulin requirements may increase in patients receiving glucocorticoids
May decrease the metabolism of glucocorticoids and increase flumethasone blood levels; ketoconazole may induce adrenal insufficiency when glucocorticoids are withdrawn
May decrease the metabolism of glucocorticoids and increase flumethasone blood levels
May alter the metabolism of steroids; higher than usual doses of steroids may be necessary to treat mitotane-induced adrenal insufficiency
Administration of ulcerogenic drugs with glucocorticoids may increase the risk of gastrointestinal ulceration
May increase the metabolism of glucocorticoids and decrease flumethasone blood levels
May increase the metabolism of glucocorticoids and decrease flumethasone blood levels
Patients receiving immunosuppressive dosages should not receive live attenuated-virus vaccines (augmented virus replication); diminished immune response may occur with any vaccine
監測
- Weight, appetite, and signs of edema
- Serum and/or urine electrolytes
- Total plasma proteins, albumin
- Blood glucose
- Growth and development in young animals
- ACTH stimulation test if necessary (to assess adrenal axis suppression)
過量
Short-term administration of massive dosages of glucocorticoids is unlikely to cause harmful effects. There is one reported incidence of a dog developing acute CNS effects after accidental ingestion. If acute clinical signs occur, provide supportive treatment as required.
Chronic overdosage or sustained high-dose usage leads to serious adverse effects, primarily manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome), characterized by severe polyuria/polydipsia, muscle wasting, alopecia, pot-bellied appearance, and immunosuppression.
可用產品
劑型
- Injection: 0.5 mg/mL solution
- Tablets (Note: Oral formulations are generally no longer marketed in the USA)
獸醫用
- Flumethasone Injection: 0.5 mg/mL in 100 mL vials; Flucort Solution (Pfizer); (Rx)
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
Flumethasone injection should be stored at room temperature; avoid freezing.
飼主須知
氟米松是一種強效類固醇藥物，用於快速減輕發炎、治療嚴重過敏或控制某些皮膚和關節疾病。
- 請仔細遵循指示：請給予獸醫處方的準確劑量。未經獸醫同意，請勿突然停藥，因為突然停藥可能會導致身體暫時無法產生自身的天然類固醇，從而引發危及生命的危機。
- 預期的副作用：您可能會注意到寵物喝水量增加、排尿更頻繁且食慾增加。狗也常出現喘氣的現象。
- 何時應聯繫獸醫：如果副作用變得嚴重，或者您的寵物出現嘔吐、腹瀉、排出黑色/柏油狀糞便（胃潰瘍的徵兆）、極度嗜睡或行為改變（如異常的攻擊性或抑鬱），請立即聯繫您的獸醫。
- 免疫系統：因為這種藥物會抑制免疫系統，請讓您的寵物遠離生病的動物，並在進行任何疫苗接種前諮詢您的獸醫。
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