アポモルヒネ
Apomorphine
Apomorphine hydrochloride
別名: Apokyn · APO-go · Apofin · Apokinon · Apomine · Britaject · Ixense · Taluvian · Uprima · Apometic · apomorphini hydrochloridum
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Induction of emesis | 0.03 mg/kg IV or 0.04 mg/kg IM (IV route preferred); alternatively a portion of tablet may be crushed in a syringe, dissolved with few drops of water and administered into the conjunctival sac. After sufficient vomiting occurs, rinse conjunctival sac free of unabsorbed apomorphine. | IV/IM/Topical | Once | — | 🌎 NA |
| Induction of emesis | 0.04 mg/kg IV or 0.08 mg/kg IM or SC | IV/IM/SC | Once | — | 🌎 NA |
| Induction of emesis | 0.04 mg/kg IV, 0.07 mg/kg IM, or 0.25 mg/kg into the conjunctival sac | IV/IM/Topical | Once | — | 🌎 NA |
| Induction of emesis | 0.2 mg/kg | SC | single dose | single dose | 🌍 EU |
| Induction of emesis | 20-40 μg/kg | IV | single dose | single dose | 🌍 EU |
- Induction of emesis: IV route preferred.
- Induction of emesis: Authorized dose. Do not repeat if ineffective.
- Induction of emesis: Non-authorized dose and route but some evidence suggests it is at least as effective.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Induction of emesis | 0.04 mg/kg IV or 0.08 mg/kg IM or SC | IV/IM/SC | Once | — | 🌎 NA |
| Induction of emesis | Not recommended | IM | single dose | single dose | 🌍 EU |
- Induction of emesis: Use of apomorphine in cats is controversial and many recommend not using in this species.
- Induction of emesis: Xylazine is a potent emetic in cats and at least as safe.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
アポモルヒネは合成オピオイド誘導体ですが、モルヒネとは異なり顕著な鎮痛作用はありません。獣医療において、誤飲した毒物を迅速に除去するための犬の第一選択の催吐薬として広く認識されています。
- 即効性： 非経口（静脈内/筋肉内）または結膜嚢への点眼により、非常に迅速に嘔吐を誘発します。
- 動物種特異性： 犬に対して非常に有効です。猫への使用は効果が低く、安全性の懸念があるため議論があり、一般的には推奨されません。
- 制限事項： 他の催吐薬と同様に、通常は胃内容物の40〜60％（最大80％）しか除去できません。催吐に成功しても、その後の毒物学的モニタリングや治療（活性炭の投与など）が不要になるわけではありません。
作用機序
Apomorphine acts as a non-selective dopamine agonist.
It directly stimulates D2-dopaminergic receptors in the chemoreceptor trigger zone (CRTZ) located in the area postrema of the medulla oblongata.
Mechanism Pathway: Apomorphine administration → Crosses the blood-brain barrier → Stimulates D2 receptors in the CRTZ → Activates the central vomiting center → Initiates the emetic reflex.
Clinical Pearl: The CRTZ in dogs is highly sensitive to dopamine, making apomorphine highly effective. In contrast, the feline CRTZ is mediated primarily by alpha-2 adrenergic receptors, which is why alpha-2 agonists (like xylazine or dexmedetomidine) are the preferred emetics for cats, while apomorphine is often ineffective.
安全性・警告
禁忌
- Rodents and rabbits (unable to vomit or lack stomach wall strength)
- Hypoxia, dyspnea, or shock
- Lack of normal pharyngeal reflexes (risk of aspiration)
- Seizuring, comatose, or severely CNS-depressed patients
- Patients who have already vomited repeatedly
- Ingestion of strong acids, alkalis, or other caustic agents (risk of esophageal/gastric rupture)
- Ingestion of petroleum distillates (unless toxicity risk outweighs aspiration risk)
- Ingestion of strychnine or other CNS stimulants (may precipitate seizures)
- Oral opiate or other CNS depressant (e.g., barbiturates) toxicity
- Hypersensitivity to morphine
有害事象
- Protracted vomiting
- CNS depression (lethargy, sedation)
- CNS stimulation (excitement, restlessness)
- Respiratory depression
- Corneal ulcers (anecdotal, associated with conjunctival administration)
注意事項
If vomiting does not occur within the expected time after apomorphine administration, repeated doses are unlikely to induce emesis and may cause clinical signs of toxicity. Use with extreme caution, if at all, in cats. When using the conjunctival route, the eye must be thoroughly rinsed with sterile saline after emesis is achieved to prevent protracted vomiting and potential corneal irritation.
医薬品相互作用
May negate the emetic effects of apomorphine by blocking dopamine receptors in the CRTZ.
May cause severe hypotension; concurrent use is contraindicated in humans.
Additive CNS or respiratory depression may occur.
May reduce the emetic effects of apomorphine
Additive CNS or respiratory depression
監視
- CNS status (depression or excitement)
- Respiratory rate and effort
- Heart rate and rhythm
- Vomitus (quantify volume, examine for toxic contents, and save for possible later analysis)
薬物動態
吸収
Slowly absorbed after oral administration with unpredictable efficacy. Rapidly absorbed after IM administration (vomiting generally within 5 minutes). Topical administration to the conjunctival sac is usually effective but less so than IV or IM.
分布
Readily crosses the blood-brain barrier to access the chemoreceptor trigger zone.
代謝
Primarily conjugated in the liver.
消失
Excreted in the urine.
過剰投与
Excessive doses of apomorphine may result in:
- Respiratory and/or cardiac depression
- CNS stimulation (excitement, seizures) or severe CNS depression
- Protracted vomiting
Treatment:
- Naloxone may reverse the CNS and respiratory depressant effects of the drug, but it cannot be expected to halt the vomiting.
- Atropine has been suggested to treat severe bradycardias associated with overdose.
- If protracted vomiting occurs from conjunctival administration, thoroughly flush the eye with sterile saline.
製品
製剤
- Injection
- Soluble tablets (often used for conjunctival administration or compounding)
動物用医薬品
- Pharmaceutical dosage forms of apomorphine have been occasionally difficult to obtain; compounding pharmacies may be required to obtain the drug.
ヒト用医薬品
- Apomorphine HCl Injection: 10 mg/mL in 2 mL amps and 3 mL cartridges (Apokyn)
規制ステータス
POM-V
POM-V
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store soluble tablets in tight containers at room temperature (15-30°C) and protect from light. Upon exposure to light and air, apomorphine gradually darkens in color. Do not use discolored tablets or solutions (green to turquoise). Solutions are more stable in acidic than in alkaline environments. Compounded sterile solutions (with sodium metabisulfite) can retain potency for two months at 25°C if protected from light. Do not autoclave solutions, as this causes a green discoloration.
飼主向け情報
アポモルヒネは、ペットが潜在的に危険な物質を誤飲した後に嘔吐を誘発するため、獣医師の監督下でのみ使用される即効性の薬です。
- 予想されること： 犬は通常、投薬後数分以内に嘔吐します。
- その後のケア： 胃が空になった後、ペットに吐き気、眠気、または無気力感が残ることがあります。
- 重要事項： 嘔吐を誘発することは、中毒治療の最初のステップにすぎません。ペットが誤飲した物質によっては、獣医師が活性炭の投与や静脈内輸液などの追加治療を推奨する場合があります。
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