糖質コルチコイド
Glucocorticoids
Corticosteroids
別名: Prednisone · Dexamethasone · Hydrocortisone · Methylprednisolone · Kenalog · Recicort · Glucocorticosteroids · Triamcinolone acetonide
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 |
|---|---|---|---|---|---|
| Anti-inflammatory (Prednisolone equivalent) | 0.5-1.0 mg/kg | PO | q12h to q24h | Taper to lowest effective alternate-day dose | 🌍 EU |
| Immunosuppressive (Prednisolone equivalent) | 2.0-4.0 mg/kg | PO | q24h (divided q12h initially) | Taper slowly over weeks to months | 🌍 EU |
- Anti-inflammatory (Prednisolone equivalent): Doses are highly variable depending on the specific glucocorticoid used.
- Immunosuppressive (Prednisolone equivalent): Monitor closely for severe adverse effects at these doses.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Anti-inflammatory (Prednisolone equivalent) | 1.0-2.0 mg/kg | PO | q12h to q24h | Taper to lowest effective alternate-day dose | 🌍 EU |
| Immunosuppressive (Prednisolone equivalent) | 2.0-4.0 mg/kg | PO | q12h to q24h | Taper slowly over weeks to months | 🌍 EU |
- Anti-inflammatory (Prednisolone equivalent): Cats require higher doses than dogs and should receive prednisolone, not prednisone.
- Immunosuppressive (Prednisolone equivalent): Monitor for signs of diabetes mellitus.
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
糖質コルチコイドは、哺乳類のほぼすべての細胞型およびシステムに深い影響を与えるステロイドホルモンの広範なクラスです。獣医学では、主に以下の4つの幅広い用量範囲と適応症で使用されます：
- 生理的補充療法： 副腎皮質機能低下症（アジソン病など）の患者向け。
- 抗炎症： アレルギー状態、呼吸器疾患（喘息）、皮膚疾患、変形性関節症の管理。
- 免疫抑制： 免疫介在性溶血性貧血（IMHA）、血小板減少症、天疱瘡、全身性エリテマトーデスなどの自己免疫疾患向け。
- 抗腫瘍： 特定の腫瘍（リンパ腫など）における細胞毒性薬として。
臨床のポイント： 猫は通常、犬よりも高い用量を必要としますが、副作用に対する耐性が強い傾向があります。逆に、犬は糖質コルチコイドに非常に敏感であり、長期使用により医原性副腎皮質機能亢進症（クッシング症候群）を容易に発症します。
作用機序
Glucocorticoids exert their effects primarily by binding to cytosolic glucocorticoid receptors (GR). The receptor-ligand complex translocates to the nucleus, where it binds to glucocorticoid response elements (GREs) on DNA, altering gene transcription (transactivation and transrepression).
- Anti-inflammatory Pathway: They induce the production of lipocortin (annexin-1), which inhibits phospholipase A2. This blocks the release of arachidonic acid from cell membranes → dramatically decreasing the synthesis of both prostaglandins and leukotrienes.
- Immune Suppression: They inhibit macrophage function, decrease circulating T-lymphocytes, suppress inflammatory cytokines (IL-1, IL-6, TNF-alpha), and inhibit the complement cascade.
- Metabolic Effects: Stimulate gluconeogenesis, mobilize amino acids, and redistribute adipose tissue, which can lead to insulin resistance.
安全性・警告
禁忌
- Systemic fungal infections (unless used for physiologic replacement)
- Intramuscular administration in patients with idiopathic thrombocytopenia
- Known hypersensitivity to the specific compound
- Chronic use of sustained-release injectables for systemic diseases
- Concurrent use with NSAIDs (relative contraindication due to severe GI ulcer risk)
- Pregnant animals
- Renal disease (systemic use)
- Diabetes mellitus (systemic use)
- Corneal ulcers
- Concurrent use of NSAIDs
- Uncontrolled diabetes mellitus
- Late pregnancy (may induce abortion or parturition)
有害事象
- Polyuria (PU), polydipsia (PD), and polyphagia (PP)
- Weight gain and fat redistribution
- Panting (especially in dogs)
- Dull, dry haircoat and alopecia
- Vomiting and diarrhea
- Gastrointestinal ulceration
- Elevated liver enzymes (ALP > ALT) and vacuolar hepatopathy (dogs)
- Pancreatitis
- Insulin resistance leading to or worsening diabetes mellitus
- Muscle wasting and weakness
- Behavioral changes (depression, lethargy, viciousness)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
- Laminitis (horses)
- Hypothalamic-pituitary axis (HPA) suppression
- Adrenal atrophy
- Weight loss (catabolic effect)
- Cutaneous atrophy
- Diarrhoea
- Increased urine glucose levels
- Decreased serum T3 and T4 values
- Impaired wound healing
- Delayed recovery from infections
- Muscle weakness
- Obesity
- Thromboembolic disease
- Polyuria and polydipsia (PU/PD)
- Muscle atrophy and weakness
- Alopecia and thin skin
- Insulin resistance and secondary diabetes mellitus
- Immunosuppression and increased susceptibility to infections
- Hepatomegaly and elevated liver enzymes (steroid hepatopathy in dogs)
注意事項
Animals receiving systemic glucocorticoids (other than short-term 'burst' therapy) MUST be tapered off the drugs slowly to allow endogenous ACTH and corticosteroid function to return. Abrupt withdrawal can precipitate a life-threatening Addisonian crisis. During periods of stress (e.g., surgery, trauma, severe illness) during the tapering process, additional glucocorticoids should be administered. Use with caution in young, growing animals as it can retard bone growth.
医薬品相互作用
May cause hypokalemia when administered concomitantly
May lead to profound muscle weakness in myasthenia gravis patients; discontinue 24h prior if possible
Glucocorticoids may reduce salicylate blood levels; increased risk of GI ulceration
Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
Increased risk for arrhythmias secondary to glucocorticoid-induced hypokalemia
May cause additive hypokalemia
May increase glucocorticoid metabolism
May potentiate the effects of hydrocortisone and possibly other glucocorticoids
Insulin requirements may increase due to glucocorticoid-induced insulin resistance
May decrease glucocorticoid metabolism
May alter steroid metabolism; higher steroid doses may be necessary to treat mitotane-induced adrenal insufficiency
Significantly increased risk of severe gastrointestinal ulceration
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
Live attenuated vaccines should be avoided due to augmented virus replication; diminished immune response to all vaccines may occur
Hypokalaemia may develop
Decreased metabolism of corticosteroids
Significantly increased risk of severe gastrointestinal ulceration and perforation.
Increased risk of hypokalemia due to additive potassium-wasting effects.
監視
- Weight, appetite, and signs of edema
- Serum and/or urine electrolytes (potassium, calcium, sodium)
- Total plasma proteins and albumin
- Liver enzymes (ALP, ALT, GGT)
- Growth and development in young animals
- ACTH stimulation test (if assessing adrenal recovery or iatrogenic Cushing's)
- Clinical signs of hyperadrenocorticism
- Blood glucose (especially in diabetics)
- Thyroid panel (T3/T4 may decrease)
- Clinical signs of PU/PD and weight gain
- Blood glucose (due to diabetes mellitus risk)
- ACTH stimulation test (to monitor HPA axis suppression)
- Water intake and urine output
- Appetite and body weight
- Blood glucose (especially in cats)
- Liver enzymes (ALP is typically markedly elevated in dogs on steroids)
- Clinical signs of secondary infections (e.g., UTI, pyoderma)
- Gastrointestinal signs (vomiting, melena)
薬物動態
半減期
吸収
Varies significantly by ester formulation. Sodium succinate/phosphate esters are absorbed very rapidly (minutes). Acetate esters are absorbed moderately (days to weeks). Acetonide esters are absorbed poorly (weeks).
分布
Widely distributed. Unbound glucocorticoids can enter milk and cross the placenta.
代謝
Primarily hepatic metabolism.
消失
Metabolites are primarily excreted by the kidneys.
過剰投与
Short-term massive overdoses are unlikely to cause acute harmful effects, though one case of acute CNS effects in a dog has been reported (treat supportively). Chronic overdosage leads to serious adverse effects manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome).
製品
製剤
- Oral tablets and liquids
- Injectable solutions (e.g., sodium succinate/phosphate esters for rapid onset)
- Injectable suspensions (e.g., acetate/acetonide esters for sustained release)
- Topical creams, ointments, and sprays
- Ophthalmic drops and ointments
- Injectable: 40 mg/ml suspension for deep i.m., intra-articular or intralesional use
- Topical: Solution containing 1.77 mg/ml with 17.7 mg/ml salicylic acid
- Systemic (Oral/Injectable)
- Local
- Inhaled
- Oral liquids
- Injectable solutions (e.g., sodium phosphate salts)
- Injectable suspensions (e.g., acetate or acetonide salts)
動物用医薬品
- Kenalog 40 mg/ml injectable suspension
- Recicort 1.77 mg/ml topical solution
- Prednicare (Prednisolone tablets)
- Dexadreson (Dexamethasone injection)
- Moderin (Methylprednisolone tablets)
ヒト用医薬品
- Prednisolone tablets
- Dexamethasone tablets/injection
- Hydrocortisone tablets
規制ステータス
プール期間: cattle meat Varies by specific drug and formulation
Widely approved across member states.
POM-V classification.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store according to specific product labeling, generally at room temperature away from light and moisture.
飼主向け情報
重大な警告： 獣医師の特別な指示がない限り、絶対にこの薬を突然中止しないでください。ペットの体は投薬中に自身のステロイド生成を停止しており、突然の離脱は生命を脅かす危機を引き起こす可能性があります。
- 予想される変化： この薬を服用している間、ペット（特に犬）がより多くの水を飲み、頻繁に排尿し、異常な食欲を示すことは非常に一般的です。常に新鮮な水にアクセスできるようにし、頻繁にトイレに行けるようにしてください。
- パンティング（あえぎ）： 犬は過度にパンティングすることがあります。これは一般的な副作用です。
- 行動の変化： 一部のペットは無気力になったり、落ち込んだり、異常にイライラしたりすることがあります。
- 獣医師に連絡するタイミング： 激しい嘔吐、黒色/タール状の便（胃潰瘍の兆候）、極度の虚弱に気づいた場合、または喉の渇き/排尿の増加が管理できなくなった場合は、獣医師に連絡してください。
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。