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硫普羅寧 (Tiopronin)

Tiopronin

N-(2-Mercaptopropionyl)-glycine (MPG)

抗尿結石劑（胱氨酸）PO狗

別名: Thiola · Acadione · Captimer · Epatiol · Mucolysin · Mucosyt · Sutilan · Thiosol · Tioglis · SF 522 · N-(2-Mercaptopropionyl)-glycine · 2-MPG · thiopronine

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

30 mg/kg PO q12hPO· q12h
— 🐕

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
Prophylactic treatment of cystine urinary calculi30 mg/kg PO q12hPOq12h—🌎 NA
Dissolution of urolithsApproximately 40 mg/kg PO q12hPOq12h—🌎 NA
In conjunction with an alkalinizing, protein and sodium restricted diet (e.g., u/d)30-40 mg/kg PO divided into two daily dosesPOdivided into two daily doses—🌎 NA
Treatment of cystine urinary calculi20 mg/kg PO twice dailyPOtwice daily1-3 months🌎 NA
Prevention of cystine urinary calculi15 mg/kg PO twice dailyPOtwice daily—🌎 NA
  • Prophylactic treatment of cystine urinary calculi: Increase water intake and urine diuresis. Alkalinize urine (pH 6.5-7.0) using potassium citrate. In cases with low cystine excretion and low urolith recurrence rate, tiopronin dose may be individually decreased (<30 mg/kg) or stopped.
  • Dissolution of uroliths: Reevaluation of uroliths with ultrasound or radiography every 4th week. After urolith dissolution, give prophylactic dose. If urolith dissolution is not achieved after 2-3 months, surgery is recommended.
  • Treatment of cystine urinary calculi: Relatively high incidence of adverse effects

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概覽

​硫普羅寧 (Tiopronin)​ 是一種專門的​抗尿結石劑​，主要用於獸醫學中以管理和預防犬隻的​胱氨酸尿結石​（膀胱結石）。胱氨酸尿症是一種遺傳性代謝缺陷，導致腎小管對某些氨基酸（特別是胱氨酸）的重吸收出現問題，而胱氨酸在酸性尿液中極難溶解，容易形成結石。

當飲食調整（超低蛋白、鹼化飲食）和尿液鹼化無法完全溶解或預防這些結石復發時，通常會使用硫普羅寧。

  • ​主要特點：​
  • 作為​螯合劑​，增加尿液中胱氨酸的溶解度。
  • 通常比青黴胺 (penicillamine) 更受青睞，因為其潛在的不良反應發生率較低，儘管價格相對昂貴。
  • 需要終身治療和飼主的嚴格配合才能達到預防成功。

作用機轉

Tiopronin is an active sulfhydryl (-SH) compound. In the urine, it undergoes a thiol-disulfide exchange with cystine (which is a cysteine-cysteine disulfide).

  • ​Mechanism Pathway:​ Tiopronin + Cystine → Tiopronin-Cysteine Disulfide Complex + Cysteine.
  • This newly formed complex is up to 50 times more water-soluble than cystine alone.
  • By increasing the solubility of cystine in the urine, tiopronin prevents the precipitation of cystine crystals and facilitates the gradual dissolution of existing cystine calculi.

安全性與警告

禁忌症

  • Agranulocytosis
  • Aplastic anemia
  • Thrombocytopenia or other significant hematologic abnormality
  • Impaired renal or hepatic function
  • Sensitivity to either tiopronin or penicillamine

不良反應

  • Coombs'-positive regenerative spherocyte anemia
  • Aggressiveness
  • Proteinuria
  • Thrombocytopenia
  • Elevations in liver enzymes and bile acids
  • Dermatologic effects (small pustules, dry crusty nose, ecchymosis, itching, rashes, mouth ulcers, jaundice)
  • Myopathy (staggering, difficulty chewing)
  • Lethargy
  • Sulfur odor of the urine
  • GI distress
  • Allergic reactions (adenopathy)
  • Arthralgias
  • Dyspnea
  • Fever
  • Edema
  • Nephrotic syndrome

注意事項

​Hematologic Toxicity:​ Can cause severe blood dyscrasias. Use with extreme caution in patients with pre-existing hematologic abnormalities.

​Immune-Mediated Reactions:​ Associated with Coombs'-positive regenerative spherocyte anemia in dogs. If this occurs, discontinue immediately and initiate appropriate treatment (corticosteroids, blood component therapy).

​Organ Impairment:​ Use cautiously in patients with impaired renal or hepatic function.

​Pregnancy/Nursing:​ FDA Category C. Teratogenic effects (skeletal defects, cleft palates) and decreased fetus viability have been noted with related drugs (penicillamine) or at high doses. Not recommended for use in nursing animals as it may be excreted in milk.

藥物交互作用

Nephrotoxic drugs

Potentially additive toxic effects

Hepatotoxic drugs

Potentially additive toxic effects

Bone marrow depressing drugs

Potentially additive toxic effects

監測

  • Physical examination (1, 3, 6, & 12 months after start, then twice a year)
  • Ultrasonography/radiography of the urinary tract
  • Urinalyses (specific gravity, protein, pH, sediment, and cyanide nitroprusside reaction) using AM samples
  • CBC (with platelets)
  • Liver enzymes (alkaline phosphatase, ALT)
  • Quantitative measurements of urinary cystine excretion related to urinary creatinine excretion (AM samples, before start and once a year during treatment)

藥物動力學

吸收

Rapid onset of action.

排除

Primarily via renal routes. In humans, up to 48% of a dose is found in the urine within 4 hours of dosing. Relatively short duration of action (effect in humans disappears in about 10 hours).

過量

There is little information available regarding acute toxicity or overdosage of tiopronin in veterinary species. It is suggested to contact an animal poison control center for further information and guidance in the event of an overdose situation. Treatment would likely be supportive and symptomatic.

可用產品

劑型

  • Tablets

人用標示

  • Tiopronin Tablets: 100 mg (Thiola)

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.

飼主須知

​重要提示：​ 硫普羅寧是一種用於溶解和預防胱氨酸膀胱結石的專門藥物。與特定的處方飲食和充足的飲水結合使用效果最佳。

  • ​堅持是關鍵：​ 請嚴格按照處方給藥。漏服可能會導致結石迅速重新形成。
  • ​飲食與飲水：​ 鼓勵您的狗盡可能多喝水以幫助沖洗膀胱。嚴格遵守獸醫推薦的飲食。
  • ​注意副作用：​ 如果您發現寵物極度疲倦、牙齦蒼白、異常瘀傷或出血、皮疹、鼻子結痂、行為改變（如突然出現攻擊性）或咀嚼困難，請立即聯繫您的獸醫。
  • ​尿液氣味：​ 您可能會注意到狗的尿液有輕微的硫磺（「臭雞蛋」）味；這是該藥物的正常預期反應。

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