ヒドロコルチゾンアセポン酸エステル
**ヒドロコルチゾンアセポン酸エステル**は、獣医療において主に炎症性およびそう痒性皮膚疾患、ならびに急性または再発性外耳炎の管理に使用される強力な外用**コルチコステロイド**です。 > **臨床のポイント:** ジエステルプロドラッグとして製剤化されているため、皮膚において高い局所抗炎症効果を発揮する一方で、全身への吸収およびグルココルチコイドに関連する典型的な全身性副作用(副腎抑制や肝酵素上昇など)を大幅に最小限に抑えます。
作用機序: Hydrocortisone aceponate is a highly lipophilic **pro-drug**. Upon application, it penetrates the stratum corneum and is biotransformed by local esterases in the epidermis → **hydrocortisone 17-propionate** (the active form). It binds to local glucocorticoid receptors to inhibit inflammatory pathways, reducing erythema, pruritus, and swelling, while its rapid local metabolism minimizes systemic distribution.
動物種別の用量
- Pruritic inflammatory skin disease · 2 pumps of spray per 10 cm x 10 cm square of skin (delivers 1.52 μg/cm2) · topical · q24h · 7 days · Cortavance spray
- Otitis externa · 1 pump (1 ml) per ear · topical · q24h · 5 days · Easotic (combination product)
- General · Dose not established · topical · unknown · unknown · Safety and efficacy not fully established in cats.
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Ulcerated skin
- Perforated tympanic membrane (ear drum)
- Cutaneous ulcers
- Known hypersensitivity to corticosteroids
- Concurrent systemic viral or fungal infections
- Use on large surface areas for prolonged periods without veterinary supervision
有害事象
- Epidermal atrophy (with protracted use)
- Aural erythema (otic preparation)
- Transient hearing loss in geriatric dogs (rare, otic preparation)
- Transient local erythema
- Skin thinning or atrophy (rare, usually only with prolonged use)
- Delayed wound healing
- Systemic glucocorticoid effects (extremely rare due to rapid metabolism)
薬物相互作用
- Other topical corticosteroids · Increased risk of local skin atrophy and potential systemic absorption · moderate
モニタリング
- Resolution of pruritus and inflammation
- Signs of epidermal atrophy (skin thinning) with prolonged use
- Liver enzyme activities (during long-term use)
- Cortisol response to ACTH stimulation (during long-term use)
- Resolution of pruritus and erythema
- Signs of local skin thinning or atrophy with prolonged use
過量投与
Massive over-application or protracted use can result in **epidermal atrophy** (thinning of the skin). While systemic effects (such as increases in liver enzyme activities or depression of cortisol response to ACTH stimulation) are minimized by the pro-drug formulation, they may theoretically occur with significant overdosage or ingestion.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。