クロミプラミン
Clomipramine
Clomipramine HCl
別名: Clomicalm · Anafranil · clomipramini hydrochloridum · G-34586 · monochlorimipramine hydrochloride · Clofranil · Clopram · Clopress · Equinorm · Hydiphen · Maronil · Novo-Clopamine · Placil · Tranquax · Zoiral · Clomipraminum · Clomipramine hydrochloride
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 |
|---|---|---|---|---|---|
| Label directions (Clomicalm) | 2-4 mg/kg | PO | once daily or divided twice daily | — | 🌎 NA |
| Behavioral disorders | 3 mg/kg | PO | q12h | — | 🌎 NA |
| Male dimorphic behaviors, fearful/fear aggression, noise phobias, obsessive/compulsive behaviors | 1 mg/kg PO every 12 hours for 2 weeks; then 2 mg/kg PO q12h for 2 weeks, then 3 mg/kg PO q12h for 4 weeks and maintain | PO | q12h | Maintain after 8 weeks | 🌎 NA |
| Adjunctive treatment of storm phobia | Clomipramine 2 mg/kg PO q12h for 3 months, then 1 mg/kg PO q12h, then 0.5 mg/kg PO q12h for 2 weeks | PO | q12h | 3.5 months | 🌎 NA |
| Separation-related disorders, anxiety, compulsive behaviors, noise fears, cataplexy | 1-2 mg/kg | PO | q12h | Long-term (e.g., 3 months for cataplexy) | 🌍 EU |
- Behavioral disorders: start at a low dose (e.g., 1 mg/kg for 2 weeks, then 2 mg/kg for 2 weeks, then 3 mg/kg)
- Male dimorphic behaviors, fearful/fear aggression, noise phobias, obsessive/compulsive behaviors: May take 4-6 weeks to see apparent improvement.
- Adjunctive treatment of storm phobia: Used with alprazolam (0.02 mg/kg PO as needed 1 hour before anticipated storms and q4h as needed) and behavior modification
- Separation-related disorders, anxiety, compulsive behaviors, noise fears, cataplexy: Licensed for use in association with a behaviour modification plan for separation-related disorders.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Urine marking/spraying; inter-cat aggression; redirected aggression; compulsive grooming/wool sucking | 0.5 mg/kg | PO | once daily | — | 🌎 NA |
| Behavioral disorders | 0.3-0.5 mg/kg | PO | q24h | — | 🌎 NA |
| Behavioral disorders | 0.5-1 mg/kg | PO | once daily | — | 🌎 NA |
| Urine marking | 0.3-0.5 mg/kg PO q24h (2.5-5 mg per cat q24h) | PO | q24h | — | 🌎 NA |
| Anxiety-related disorders, compulsive behaviours, urine spraying | 0.25-1 mg/kg | PO | q24h | — | 🌍 EU |
- Anxiety-related disorders, compulsive behaviours, urine spraying: Monitor for urinary retention.
鳥
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Adjunctive treatment of feather picking | 0.5-9 mg/kg | PO | q12-24h | — | 🌎 NA |
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
クロミプラミンは、主に獣医行動学で使用される三環系抗うつ薬（TCA）です。
- 犬：強迫性障害（儀式的な常同行動）および分離不安の治療薬としてFDAに承認されています。優位性攻撃行動や音響恐怖症に対しても適応外使用されます。
- 猫：尿スプレー、心因性脱毛、強迫的な毛づくろいなどの行動問題に適応外使用されます。
- 鳥類：毛引き行動の治療に使用されます。
臨床のポイント：他のTCAやSSRIと同様に、最大の臨床効果が観察されるまでに長期間（通常4〜8週間）の治療が必要です。単独の治療ではなく、包括的な行動修正プランの補助として使用することが理想的です。
作用機序
The exact mechanism of action of tricyclic antidepressants involves the blockade of monoamine reuptake in the central nervous system.
- Primary Action: Clomipramine predominantly inhibits the presynaptic reuptake of serotonin (5-HT) via the serotonin transporter (SERT) → increasing synaptic serotonin concentrations.
- Active Metabolite: Its primary active metabolite, desmethylclomipramine, primarily inhibits the reuptake of norepinephrine (NE) via the norepinephrine transporter (NET).
- Receptor Downregulation: The chronic elevation of these neurotransmitters leads to the gradual down-regulation of post-synaptic receptors, which correlates with the delayed onset of clinical behavioral effects (taking several weeks).
- Off-target Effects: TCAs also exhibit antagonism at muscarinic (cholinergic), histamine (H1), and alpha-1 adrenergic receptors, which are responsible for many of their adverse effects (e.g., dry mouth, sedation, hypotension).
安全性・警告
禁忌
- Prior hypersensitivity to clomipramine or other tricyclic antidepressants
- Concomitant use with monoamine oxidase inhibitors (MAOIs) within 14 days
- Concurrent ingestion of aged cheeses (high tyramine content)
- Known sensitivity to tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs)
- Concurrent use of Monoamine Oxidase Inhibitors (MAOIs) or within 2 weeks of their use
- Male breeding animals (due to risk of testicular hypoplasia)
有害事象
- Emesis
- Diarrhea
- Sedation, lethargy, and depression
- Anticholinergic effects (dry mouth, tachycardia, urinary retention)
- Elevation of liver enzymes
- Pancreatitis (rarely reported in dogs)
- Birds: Ataxia, drowsiness, regurgitation
- Sporadic vomiting
- Changes in appetite
- Urinary retention (especially in cats)
- Testicular hypoplasia (in male breeding animals)
注意事項
Seizure Warning: TCAs may lower the seizure threshold. Use with extreme caution in animals with preexisting seizure disorders.
- Anticholinergic Risks: Use cautiously in patients with decreased GI motility, urinary retention, cardiac rhythm disturbances, or increased intraocular pressure.
- Hepatic Function: May cause hepatic abnormalities. Baseline and annual monitoring of liver enzymes is recommended for long-term use.
- Thyroid Disease: Use cautiously in hyperthyroid patients or those on thyroid supplementation due to increased risk of cardiac arrhythmias.
- Reproductive Safety: Not a known teratogen, but high doses have demonstrated testicular atrophy. The manufacturer warns against use in breeding male dogs. FDA Category C for human pregnancy.
- Species Sensitivity: Cats may be more sensitive to adverse effects (sedation, anticholinergic signs) due to slower elimination of the desmethyl metabolite.
医薬品相互作用
Additive anticholinergic effects; use cautiously
Risk of extrapyramidal side effects (reported in a macaw)
May inhibit tricyclic antidepressant metabolism and increase the risk of toxicity
Increased risk for prolonged QT interval
May cause increased blood pressure
Additive CNS depression; use cautiously
Increased risk for serotonin syndrome
Increased risk for QTc interval prolongation and tricyclic adverse effects
May decrease tricyclic blood levels
Increased risk for serotonin syndrome
May increase the risk of cardiac effects (arrhythmias, hypertension, hyperpyrexia)
Concomitant use is generally contraindicated due to high risk of fatal serotonin syndrome
Risk of fatal serotonin syndrome; do not use concurrently or within 2 weeks of each other
Potentiation of anticholinergic effects (e.g., dry mouth, tachycardia, urinary retention)
Potentiation of CNS depressant effects
Potentiation of CNS depressant effects (though noted as safe to use together with care)
Potentiation of sympathomimetic cardiovascular effects
Potentiation of anticoagulant effects
Increased plasma levels of the antiepileptic drug
Increased plasma levels of the antiepileptic drug
Increased risk of serotonin syndrome; use only in exceptional cases with careful monitoring
High risk of fatal serotonin syndrome. Do not use within 2 weeks of each other.
Increased risk of serotonin syndrome. Use with trazodone only in exceptional cases with careful monitoring.
May potentiate anticholinergic effects.
May potentiate CNS depressant effects.
May potentiate sympathomimetic effects.
Plasma levels of the antiepileptic drugs may be increased by co-administration.
監視
- Clinical efficacy (behavioral improvement)
- Baseline and annual liver function tests
- EKG (especially in patients with cardiac risks or hyperthyroidism)
- Clinical efficacy (reduction in anxiety/compulsive behaviors)
- Signs of serotonin syndrome (agitation, tremors, hyperthermia, tachycardia) if used with other serotonergic drugs
- Urinary output and frequency, particularly in cats
- Appetite and gastrointestinal tolerance
薬物動態
半減期
吸収
Dogs: Rapidly converted in the liver to active metabolite desmethylclomipramine. Food decreases AUC for the parent compound by ~25% but not the metabolite. Cats: Oral bioavailability averages 90%. Humans: Well absorbed but substantial first-pass effect reduces systemic bioavailability to ~50%.
分布
Highly lipophilic and widely distributed throughout the body (Vd = 17 L/kg). Highly bound to plasma proteins (96%). Crosses the placenta, maternal milk, and the blood-brain barrier.
代謝
Metabolized principally in the liver to several metabolites, including the active desmethylclomipramine. Cats metabolize clomipramine more slowly than dogs (male cats slower than females).
消失
About two-thirds of metabolites are eliminated in the urine and the rest in the feces.
過剰投与
Clomipramine has a narrow margin of safety. Significant clinical signs can be seen at or slightly above the therapeutic range (2-3 mg/kg).
- Lethal Dose: In dogs, lethal doses are approximately 50-100 mg/kg/day PO (12.5-25X recommended dose).
- Clinical Signs (Dogs): Lethargy, tachycardia, ataxia, depression, vocalization, and vomiting.
- Clinical Signs (Cats): Lethargy, mydriasis, tachypnea, ataxia, depression, and tachycardia.
- Severe Toxicity: Overdosage with TCAs can be life-threatening, leading to severe arrhythmias, seizures, and cardiorespiratory collapse.
Action: Because toxicities and therapies are complicated and controversial, contact an animal poison control center immediately in any potential overdose situation.
製品
製剤
- Oral tablets
- Oral capsules
- 5 mg tablet
- 20 mg tablet
- 80 mg tablet
動物用医薬品
- Clomipramine HCl Oral Tablets: 5 mg, 20 mg, 40 mg, & 80 mg (Clomicalm®)
- Clomicalm 5 mg tablets
- Clomicalm 20 mg tablets
- Clomicalm 80 mg tablets
ヒト用医薬品
- Clomipramine Oral Capsules: 25 mg, 50 mg, & 75 mg (Anafranil®)
- Anafranil 10 mg, 25 mg, 50 mg, 75 mg capsules/tablets
規制ステータス
Licensed for separation-related disorders in dogs.
POM-V classification.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Veterinary tablets should be stored in a dry place at controlled room temperature (15-30°C) in the original closed container. Human capsules should be stored at <30°C in tight containers and protected from moisture.
飼主向け情報
- 忍耐が必要です：ペットの行動に良い効果が見られるまでに数週間（通常4〜8週間）かかる場合があります。
- トレーニングとの併用：獣医師または獣医行動専門医が提供する行動修正プランと組み合わせて使用すると最も効果的です。
- 投与方法：食事と一緒に、または空腹時に与えることができます。薬を飲んだ後に嘔吐する場合は、食事と一緒に与えてみてください。
- 急に中止しないでください：獣医師の指示なしに突然治療を中止しないでください。離脱症状や行動の再発を引き起こす可能性があります。
- 毒性の警告：この薬はペットや子供の手の届かないところに厳重に保管してください。過剰摂取は非常に毒性が高く、生命を脅かす危険があります。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。