溴化鉀
Potassium bromide
別名: Bromilep · Epilease · Libromide · KBr
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 |
|---|---|---|---|---|---|
| Control of seizures (Maintenance) | 20-40 mg/kg | PO | q24h | Long-term | 🌍 EU |
| Control of seizures (5-day Loading Dose) | 200 mg/kg/day divided into 4-6 hour doses | PO | Divided q4-6h | 5 days | 🌍 EU |
| Control of seizures (Single Loading Dose) | 600-1000 mg/kg | PO | Single dose | Once | 🌍 EU |
| Control of seizures (Intrarectal Loading) | 100 mg/kg | PR | q4h | 6 doses (over 24 hours) | 🌍 EU |
- Control of seizures (Maintenance): Initial daily maintenance dose. More frequent dosing is not detrimental but not necessary.
- Control of seizures (5-day Loading Dose): After 5 days, decrease to maintenance dose (20-40 mg/kg p.o. q24h). If seizures resolve sooner, decrease to maintenance earlier to reduce adverse effects.
- Control of seizures (Single Loading Dose): Likely to result in excessive sedation, ataxia, and potentially vomiting.
- Control of seizures (Intrarectal Loading): Total 600 mg/kg over 24 hours. Use liquid bromide (250 mg/ml). Useful if animal is not conscious enough for oral medication.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Contraindicated | Do not use | PO | N/A | N/A | 🌍 EU |
- Contraindicated: Causes severe coughing due to eosinophilic bronchitis, which may be fatal.
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
溴化鉀 (KBr) 是一種抗癲癇藥物，主要作為輔助或替代療法，用於控制犬隻的難治性癲癇，特別是在單獨使用苯巴比妥 (phenobarbital) 效果不佳或有禁忌症時。其半衰期極長，這意味著除非使用負荷劑量 (loading dose)，否則需要數個月才能達到穩定的治療血藥濃度。
嚴重警告：溴化鉀嚴禁使用於貓，因為有引發嚴重且可能致命的嗜酸性支氣管炎的高風險。
臨床提示： 由於標準實驗室分析儀器會將溴離子測量為氯離子，服用 KBr 的病患會出現假性高氯血症 (血清氯離子濃度假性升高)。
作用機轉
Within the central nervous system, bromide competes with transmembrane chloride transport and inhibits sodium transport → resulting in membrane hyperpolarization and elevation of the seizure threshold.
Bromide also competes with chloride in post-synaptic anion channels following activation by inhibitory neurotransmitters → potentiates the effect of GABA. It acts synergistically with other GABA-ergic therapeutic agents (such as phenobarbital).
安全性與警告
禁忌症
- Cats (causes severe, potentially fatal eosinophilic bronchitis)
- Dogs with a history of, or predisposition to, pancreatitis
不良反應
- Ataxia
- Sedation
- Somnolence
- Vomiting (especially with high concentration solutions >250 mg/ml)
- Polyphagia
- Polydipsia
- Pancreatitis
- Skin reactions (in animals with pre-existing skin diseases)
- Behavioural changes (irritability, restlessness)
- Transient diarrhoea (with intrarectal loading)
注意事項
Dietary Consistency: High levels of dietary salt increase renal elimination of bromide. It is critical that the patient's diet (including treats) be kept strictly constant once bromide therapy has started.
Laboratory Artifact: Bromide is measured in assays for chloride and will produce falsely high 'chloride' results.
Renal Impairment: Use with caution in dogs with renal disease, as bromide is eliminated by the kidneys.
Loading Dose Risks: Loading doses are associated with an increased incidence of adverse effects (sedation, ataxia) and should only be used in dogs with poorly controlled severe seizures.
藥物交互作用
Increased dietary salt increases renal elimination of bromide, decreasing serum bromide concentrations.
Increases bromide excretion and lowers serum bromide levels.
Increases bromide excretion and decreases serum bromide concentrations.
Synergistic GABA-ergic anticonvulsant effects.
監測
- Serum KBr concentrations (Therapeutic range: 0.8-1.5 mg/ml)
- Serum chloride (Note: KBr causes falsely elevated chloride readings on standard chemistry panels)
- Renal function (BUN, Creatinine, USG)
- Signs of excessive sedation, ataxia, or vomiting
- Pancreatic enzymes if clinical signs of pancreatitis develop
藥物動力學
半衰期
吸收
Well absorbed from the gastrointestinal tract.
分佈
Slow rise of plasma bromide levels after enteral administration limits its usefulness in status epilepticus. Steady state plasma concentrations may not be achieved for 3-4 months.
代謝
Not metabolized by the liver.
排除
Eliminated slowly by the kidney in competition with chloride.
過量
Acute bromide toxicity (bromism) presents with profound sedation, ataxia, somnolence, and potentially vomiting.
Treatment of choice: Intravenous administration of 0.9% NaCl (normal saline). The chloride in the saline competes with bromide for renal reabsorption, rapidly accelerating the renal excretion of bromide.
可用產品
劑型
- 325 mg tablets
- 100 mg capsules
- 250 mg capsules
- 1000 mg capsules
- 250 mg/ml oral solution
獸醫用
- Bromilep
- Epilease
- Libromide
- Potassium bromide solution
各地核准狀態
POM-V, AVM-GSL
POM-V, AVM-GSL
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Normal precautions should be observed. Store in a cool, dry place away from direct sunlight.
飼主須知
寵物主人重要須知：
- 飲食一致性至關重要： 狗狗飲食中的鹽分含量會直接影響此藥物的作用。請勿隨意更換狗糧，並謹慎餵食零食或人類食物。鹽分突然增加會導致藥物從體內快速排出，可能引發癲癇發作。
- 需要耐心： 除非獸醫初期使用高劑量的「負荷劑量」，否則此藥物需要很長時間（長達 3-4 個月）才能在體內達到完全且穩定的效果。
- 副作用： 常見副作用包括口渴增加、食慾增加和排尿增加。在治療的前幾週，或使用負荷劑量時，您的狗狗可能會顯得非常嗜睡、走路搖晃或不協調。如果情況嚴重，請聯繫您的獸醫。
- 絕對不可給貓咪服用： 此藥物對貓咪具有高度毒性，會引起致命的肺部疾病。
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