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賴諾普利

Lisinopril

血管張力素轉化酶 (ACE) 抑制劑PO狗貓

別名: Prinivil · Zestril · L-154826 · lisinoprilum · MK-521

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

0.5 mg/kgPO· q12-24h
— 🐕

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
Adjunctive treatment of heart failure0.5 mg/kgPOq12-24h—🌎 NA
Adjunctive treatment of heart failure0.5 mg/kgPOq24h—🌎 NA
Adjunctive treatment of heart failure0.25-0.5 mg/kgPOq24h—🌎 NA
  • Adjunctive treatment of heart failure: Highest recommended doses should be used unless not tolerated by patient.

貓

適應症劑量途徑頻次療程地區
Adjunctive treatment of heart failure0.25-0.5 mg/kgPOq24h—🌎 NA

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

賴諾普利 (Lisinopril) 是一種​血管張力素轉化酶 (ACE) 抑制劑​，在獸醫學中主要作為血管擴張劑，用於治療​鬱血性心衰竭 (CHF)​ 和​全身性高血壓​。

主要臨床重點：

  • ​直接具備活性​：與依那普利 (Enalapril) 不同，賴諾普利不是前驅藥，不需要經過肝臟生物轉化即可發揮作用，這對於併發嚴重肝功能障礙的病患可能具有優勢。
  • ​每日一次給藥​：與其他某些 ACE 抑制劑相比，它通常具有較長的作用時間，使許多病患能夠方便地每日給藥一次。
  • ​腎臟保護​：常被用於減少慢性腎病 (CKD) 或蛋白質流失性腎病病患的蛋白尿，並幫助維持腎功能。
  • ​血流動力學益處​：降低總周邊阻力、肺血管阻力及肺微血管楔壓，同時增加心輸出量和運動耐受力。

​臨床提示​：雖然依那普利和貝那普利 (Benazepril) 在獸醫學中更常用且研究更廣泛，但賴諾普利是一個可行且通常較便宜的替代方案，特別是在偏好每日一次給藥的情況下。

作用機轉

Lisinopril exerts its effects by interfering with the ​Renin-Angiotensin-Aldosterone System (RAAS)​.

  • Mechanism: It competitively binds to and inhibits ​angiotensin-converting enzyme (ACE)​.
  • Pathway: Angiotensin I → (blocked by ACE inhibition) → Decreased Angiotensin II.
  • Physiological Effects:
    1. Vasodilation: Reduction in Angiotensin II (a potent vasoconstrictor) leads to decreased systemic vascular resistance (afterload) and venous tone (preload).
    2. Decreased Aldosterone: Lower Angiotensin II levels reduce the secretion of aldosterone from the adrenal cortex → decreased sodium and water retention.
    3. Bradykinin Preservation: ACE is also responsible for the breakdown of bradykinin. Inhibition leads to increased bradykinin levels, contributing to vasodilation (but also potentially causing a mild cough).
  • Net Result: Decreased blood pressure, reduced cardiac workload, and decreased proteinuria due to efferent arteriolar vasodilation in the glomerulus.

安全性與警告

禁忌症

  • Known hypersensitivity to ACE inhibitors
  • Pregnancy (especially 2nd and 3rd trimesters)

不良反應

  • Anorexia
  • Vomiting
  • Diarrhea
  • Lethargy or weakness
  • Hypotension
  • Renal dysfunction (azotemia)
  • Hyperkalemia
  • Cough (rare in animals compared to humans)

注意事項

Use with caution and close supervision in patients with renal insufficiency (doses may need to be reduced). Use cautiously in patients with hyponatremia or sodium depletion, coronary or cerebrovascular insufficiency, preexisting hematologic abnormalities, or collagen vascular diseases (e.g., SLE). Patients with severe CHF should be monitored very closely for hypotension upon initiation of therapy. May cause a reversible decrease in localization and excretion of certain renal imaging agents.

藥物交互作用

Antidiabetic Agents (insulin, oral agents)

Possible increased risk for hypoglycemia; enhanced monitoring recommended.

Diuretics (e.g., furosemide, hydrochlorothiazide)

Potential for increased hypotensive effects; reducing furosemide doses (by 25-50%) is often recommended when initiating ACE inhibitors in CHF.

Potassium-Sparing Diuretics (e.g., spironolactone, triamterene)

Increased risk of hyperkalemia; enhanced monitoring of serum potassium recommended.

Other Hypotensive Agents

Potential for additive hypotensive effects.

Lithium

Increased serum lithium levels possible; increased monitoring required.

NSAIDs

May reduce the anti-hypertensive or positive hemodynamic effects of lisinopril; may increase the risk of acute renal failure.

Potassium Supplements

Increased risk for hyperkalemia.

監測

  • Clinical signs of CHF (respiratory rate/effort, exercise tolerance)
  • Blood pressure (especially upon initiation or dose changes)
  • Serum electrolytes (specifically potassium)
  • Renal panel (BUN, Creatinine)
  • Urine protein
  • Periodic CBC with differential

藥物動力學

半衰期

狗Duration of action is ~24 hours, but effects tend to drop off with time.

吸收

In dogs, bioavailability ranges from 25-50% with peak levels occurring about 4 hours after dosing.

分佈

Distributed poorly into the CNS. Crosses the placenta. Unknown if distributed into maternal milk.

代謝

Lisinopril is directly active and does not need to be converted in the liver to an active metabolite.

排除

Half-lives are increased in patients with renal failure or severe CHF.

過量

The primary concern with overdosage is hypotension.

  • Toxicity Thresholds: In dogs, the lowest dosage documented to cause hypotension is 27 mg/kg. Dosages below 20 mg/kg generally cause only mild signs (vomiting, lethargy). In cats, hypotension was noted at 4.9 mg/kg in a single case. In birds, mild somnolence occurred at 41 mg/kg.
  • Clinical Signs: Hypotension, lethargy, vomiting, and tachycardia.
  • Treatment: Recent overdoses should be managed using gut-emptying protocols when warranted. Supportive treatment with volume expansion using normal saline is recommended to correct blood pressure. Due to the drug's long duration of action, prolonged monitoring and treatment may be required.

可用產品

劑型

  • Oral tablets
  • Compounded oral suspension

人用標示

  • Lisinopril Oral Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg & 40 mg (Prinivil®, Zestril®, generic)

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 tablets at room temperature in tight containers. A compounded oral suspension (1 mg/mL in Ora-Plus/Ora-Sweet) retains >95% potency for 91 days when stored at 4°C and protected from light.

飼主須知

  • 請勿在未經獸醫指示下突然停藥或減少劑量。
  • 可與食物一起或空腹餵食。請確保您的寵物隨時有乾淨的飲水。
  • ​注意是否有虛弱或昏厥的現象​，這可能是寵物血壓過低的徵兆。
  • 如果嘔吐或腹瀉持續、變得嚴重，或者寵物的整體狀況惡化，請立即聯繫您的獸醫。
  • 請放置於兒童和其他寵物接觸不到的地方。

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