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二巰基丁二酸 (Succimer)

Succimer

meso-2,3-dimercaptosuccinic acid (DMSA)

解毒劑 / 重金屬螯合劑PO狗貓鳥

別名: Chemet · Succicaptal · meso-2,3 dimercaptosuccinic acid · DMSA · DIM-SA

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

10 mg/kg PO q8hPO· q8h· 10 days
— 🐕

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
Lead poisoning10 mg/kg PO q8hPOq8h10 days🌎 NA
Lead poisoning10 mg/kg PO three times daily for 5 days, followed by 10 mg/kg PO twice daily for 2 weeksPOTID then BID19 days🌎 NA
  • Lead poisoning: Blood lead levels should be rechecked a few days following the last dose; a second round may be necessary.

貓

適應症劑量途徑頻次療程地區
Lead poisoning10 mg/kg PO three times daily for 5 days, followed by 10 mg/kg PO twice daily for 2 weeksPOTID then BID19 days🌎 NA
Lead poisoning10 mg/kg PO q8hPOq8h10 days🌎 NA
  • Lead poisoning: Blood lead levels should be rechecked a few days following the last dose; a second round may be necessary.

鳥

適應症劑量途徑頻次療程地區
Lead poisoning15-35 mg/kg PO twice dailyPOBID5 days🌎 NA
Lead poisoning30 mg/kg PO twice dailyPOBIDminimum of 7 days🌎 NA
  • Lead poisoning: If severe neurologic signs, may supplement with one dose of CaEDTA (<50 mg/kg IM).

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概覽

二巰基丁二酸 (DMSA) 是一種口服重金屬螯合劑，在獸醫學中主要用於治療小動物和鳥類的​鉛中毒​。它是二巰基丙醇 (BAL) 的水溶性類似物，但具有可口服給藥且治療指數更寬的顯著優勢。

  • ​目標毒素：​ 對鉛 (Pb) 高度有效；對砷 (As) 和汞 (Hg) 中毒也具潛在療效。
  • ​安全性：​ 通常安全有效。它不會過度螯合大多數必需微量元素（如鋅、銅和鐵），也不會增加胃腸道對鉛的吸收。

​臨床要點：​ 在小動物鉛中毒的治療中，Succimer 通常比 CaEDTA 更受青睞，因為它可以在家口服、腎毒性較低，且不會劇烈消耗必需礦物質。

作用機轉

Succimer acts as a heavy metal chelator through its sulfhydryl (-SH) groups.

  • ​Binding:​ The sulfhydryl groups physically bind (chelate) heavy metal ions (such as lead, mercury, and arsenic) in the bloodstream and tissues.
  • ​Complex Formation:​ Heavy metal + Succimer → Water-soluble chelate complex.
  • ​Excretion:​ These stable, water-soluble complexes are subsequently filtered by the kidneys and excreted safely in the urine, thereby reducing the heavy metal burden in the body.

安全性與警告

禁忌症

  • Hypersensitivity to succimer
  • Continued exposure to the lead source (source must be removed prior to or concurrently with therapy)

不良反應

  • Gastrointestinal upset (vomiting, diarrhea)
  • Flu-like symptoms (fatigue, body aches)
  • Increased liver enzymes (AST, ALT)
  • Rash
  • Unpleasant sulfurous odor imparted to breath, saliva, urine, and feces

注意事項

Important Precautions

  • ​Source Removal:​ Chelation therapy should only be attempted if the source of lead (e.g., lead paint, sinkers, shot) is removed from the GI tract and environment to prevent further absorption.
  • ​Laboratory Interferences:​
    • Can cause false-positive urine ketones when using nitroprusside reagents (e.g., Ketostix).
    • Can cause falsely low measurements of CPK or serum uric acid.
  • ​Pregnancy & Nursing:​ FDA Category C. Fetotoxic and teratogenic at high doses in mice. Safety in pregnant or nursing animals is unknown; use with extreme caution and discourage nursing.

藥物交互作用

Other chelating agents (CaEDTA, dimercaprol, trientine, penicillamine)

Concomitant use is not recommended in humans due to potential for increased toxicity or altered efficacy.

監測

  • Blood lead levels (recheck a few days after completing therapy)
  • Gastrointestinal adverse effects
  • Liver enzymes (AST, ALT)
  • Hydration status

藥物動力學

吸收

Rapidly but incompletely absorbed after oral ingestion (based on human data).

分佈

No specific veterinary information available.

代謝

No specific veterinary information available.

排除

Absorbed drug is excreted primarily through the kidneys into the urine.

過量

Overdose & Toxicity

  • ​Dogs:​ Succimer has a relatively wide margin of safety. Doses up to 200 mg/kg/day did not cause overt toxicity. However, massive doses (300 mg/day) caused fatalities, primarily presenting with kidney and GI tract lesions.
  • ​Birds:​ Cockatiels are particularly sensitive to high doses. Doses of 80 mg/kg PO q12h caused a significant number of fatalities, whereas 40 mg/kg q12h did not.
  • ​Treatment:​ If an acute overdose occurs, standardized gut evacuation (emesis/lavage) followed by activated charcoal protocols are recommended.

可用產品

劑型

  • Capsules

人用標示

  • Succimer Capsules: 100 mg (Chemet)

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 succimer capsules in tight containers at room temperature. Protect from light.

飼主須知

寵物主人重要須知

  • ​強烈氣味：​ 本藥物含有硫磺，具有非常強烈、難聞的「臭雞蛋」味。​這是完全正常的現象​，並不代表藥物壞掉。
  • ​氣味轉移：​ 在治療期間，這種氣味可能會轉移到寵物的呼吸、唾液、尿液和糞便中。
  • ​餵藥方式：​ 為了方便餵食，您可以打開膠囊，將裡面的藥粉撒在少量適口性佳的軟食上。
  • ​保持水分：​ 請確保您的寵物隨時有乾淨的飲水。藥物會與鉛結合並透過尿液排出體外，因此充足的水分對於安全有效的治療至關重要。

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