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ヒドロモルフォン

Hydromorphone

Hydromorphone hydrochloride

オピオイド作動薬 / 鎮痛薬IVIMSCPORectal犬猫小型哺乳類フェレット

別名: Dilaudid-HP · Exalgo · Palladone · dihydromorphinone hydrochloride · Dolonovag · Hydal · HydroStat IR · Opidol · Sophidone

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

0.08-0.2 mg/kg IV, IM, or SCIV/IM/SC· Not specified
— 🐕

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
As an analgesic0.1 mg/kg IV or SC q2h or as a CRI at 0.03 mg/kg/hrIV/SCq2h or CRI—🌎 NA
For cancer pain0.08-0.2 mg/kg IV, IM, or SCIV/IM/SCNot specified—🌎 NA
As an analgesic0.05-0.2 mg/kg IV, IM, SC q2-4hIV/IM/SCq2-4h—🌎 NA
As an analgesic0.2-0.6 mg/kg PO q6-8hPOq6-8h—🌎 NA
For perioperative pain0.1-0.2 mg/kg IV, IM, SC q2-4hIV/IM/SCq2-4h—🌎 NA
As a premed prior to moderately painful procedures0.1 mg/kgNot specifiedOnce—🌎 NA
As a sedative/restraint agent for fractious or aggressive dogs0.1-0.2 mg/kg mixed with acepromazine (0.05 mg/kg) IMIMOnce—🌎 NA
As an alternate induction method (especially in critical patients)0.05-0.2 mg/kg IV, slowly to effect followed by diazepam 0.02 mg/kg IVIVOnce—🌎 NA
  • As an analgesic: Suggested doses based on pharmacokinetic study
  • As a premed prior to moderately painful procedures: May be combined with acepromazine (0.02-0.05 mg/kg) in young, healthy patients.
  • As a sedative/restraint agent for fractious or aggressive dogs: Maximal effect usually reached in about 15 minutes, but an additional wait of another 15 minutes may be necessary in some dogs.
  • As an alternate induction method (especially in critical patients): Do not mix two drugs together. Positive pressure ventilation likely necessary. Treat bradycardia with glycopyrrolate or atropine if needed.

猫

適応用量経路頻度期間地域
As an analgesic0.05-0.1 mg/kg IM, IV or SC q2-6 hoursIM/IV/SCq2-6h—🌎 NA
For cancer pain0.08-0.2 mg/kg IV, IM, or SCIV/IM/SCNot specified—🌎 NA
For moderate to severe pain0.08-0.3+ mg/kg IV, IM or SC q2-6 hoursIV/IM/SCq2-6h—🌎 NA
As a premed prior to moderately painful procedures0.1 mg/kgNot specifiedOnce—🌎 NA
As an alternate induction method (especially in critical patients)0.05-0.2 mg/kg IV, slowly to effect followed by diazepam 0.02 mg/kg IVIVOnce—🌎 NA
  • As a premed prior to moderately painful procedures: May be combined with acepromazine (0.05-0.2 mg/kg) in young, healthy patients.
  • As an alternate induction method (especially in critical patients): Do not mix two drugs together. Positive pressure ventilation likely necessary.

小型哺乳類

適応用量経路頻度期間地域
As a pre-op (Rabbits)0.05-0.1 mg/kg IVIVOnce—🌎 NA
As a CRI post-op (Rabbits)0.05 mg/kg IV loading dose, then 0.05-0.1 mg/kg/hrIVCRI—🌎 NA

フェレット

適応用量経路頻度期間地域
As a pre-op0.05-0.1 mg/kg IVIVOnce—🌎 NA
As a CRI post-op0.05 mg/kg IV loading dose, then 0.05-0.1 mg/kg/hrIVCRI—🌎 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。

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概要

ヒドロモルフォンは強力な半合成の​純粋なμ-オピオイド受容体作動薬​であり、獣医学において鎮静薬、保定薬、鎮痛薬、および麻酔前投薬として広く使用されています。

主な臨床的特徴：

  • ​効力​：重量ベースでモルヒネの約5倍の効力を持ち、オキシモルフォンとほぼ同等です。
  • ​モルヒネに対する利点​：一般的に鎮静作用が少なく、静脈内投与後のヒスタミン遊離が最小限であり、有意な血管拡張や低血圧を引き起こすことは稀です。
  • ​臨床的有用性​：鎮痛効果と作用時間がオキシモルフォンと同等でありながら大幅に安価であるため、獣医療において急速にオキシモルフォンに取って代わりつつあります。
  • ​規制状況​：乱用および身体的依存の高い可能性があるため、​スケジュールII（C-II）​の規制薬物に指定されています。

作用機序

Hydromorphone exerts its effects by binding to opioid receptors, primarily the mu (μ) receptors, with some affinity for delta (δ) receptors.

Mechanism pathway: Agonist binding to mu-receptors in the CNS (limbic system, spinal cord, thalamus, midbrain) and peripheral tissues (GI tract, smooth muscle) → activation of G-proteins → inhibition of adenylate cyclase → decreased intracellular cAMP → opening of potassium channels (causing hyperpolarization) and closing of voltage-gated calcium channels → decreased presynaptic release of excitatory neurotransmitters (e.g., Substance P, glutamate) → profound analgesia and altered pain perception.

Secondary effects include respiratory depression (decreased sensitivity of the respiratory center to CO2), antitussive activity, and increased GI sphincter tone leading to decreased motility.

安全性・警告

禁忌

  • Hypersensitivity to narcotic analgesics
  • Diarrhea caused by toxic ingestion (until toxin is eliminated)
  • Prior to GI obstructive surgery (due to vomiting risk)
  • Patients stung by scorpion species Centruroides sculpturatus Ewing and C. gertschi Stahnke (may potentiate venom)

有害事象

  • Dogs: Nausea, vomiting, defecation, panting, vocalization, sedation, CNS depression, respiratory depression, bradycardia, decreased GI motility (constipation with chronic use)
  • Cats: Nausea, ataxia, hyperesthesia, hyperthermia, behavioral changes (mania/excitement if given without tranquilization)
  • Mild histamine release (infrequent compared to morphine)

注意事項

Black Box Warning / Extreme Caution: Use with extreme caution in patients with respiratory disease, acute respiratory dysfunction, head injuries, increased intracranial pressure, and acute abdominal conditions (e.g., colic) as it may obscure diagnosis.

  • Vomiting Risk: Contraindicated as a preanesthetic in animals with suspected gastric dilation, volvulus, or intestinal obstruction.
  • Systemic Disease: Use cautiously in hypothyroidism, severe renal insufficiency (acute uremia), adrenocortical insufficiency (Addison's), and severe hepatic disease (prolonged duration of action).
  • Cardiovascular: Can cause bradycardia; use cautiously in patients with preexisting bradyarrhythmias.
  • Feline Hyperthermia: Can cause self-limiting hyperthermia in cats. High doses in cats should be combined with a tranquilizer to prevent bizarre behavioral changes.
  • Vulnerable Populations: Geriatric, debilitated, or neonatal patients may be more susceptible and require lower dosages.

医薬品相互作用

Butorphanol, Nalbuphine

Potentially could antagonize opiate effects

CNS Depressants

Additive CNS depression effects possible

Diuretics

Opiates may decrease diuretic efficacy in CHF patients

Monoamine Oxidase Inhibitors (e.g., amitraz, selegiline)

Severe and unpredictable opiate potentiation; not recommended if MAOI used within 14 days

Skeletal Muscle Relaxants

Hydromorphone may enhance muscle relaxant effects

Phenothiazines

May antagonize analgesic effects and increase risk for hypotension

Tricyclic Antidepressants (clomipramine, amitriptyline)

Hydromorphone may exacerbate the effects of tricyclic antidepressants

Warfarin

Opiates may potentiate anticoagulant activity

監視

  • Respiratory rate and depth (pulse oximetry highly recommended)
  • CNS level of depression or excitation
  • Blood pressure (especially with IV use)
  • Cardiac rate (monitor for bradycardia)
  • Analgesic efficacy

薬物動態

半減期

猫Prolonged (due to glucuronidation deficiency)犬35 minutes to 1 hour (route and dose dependent)

吸収

Absorbed when given by IV, IM, SC, and rectal routes. Peak levels occur between 10-30 minutes after SC dosing in dogs.

分布

High volume of distribution in dogs (> 4 L/kg with both IV and SC dosing).

代謝

Metabolized in the liver, primarily by glucuronidation. Cats are deficient in this metabolic pathway, leading to prolonged half-lives.

消失

The glucuronidated metabolite is excreted by the kidney.

過剰投与

Massive overdoses may produce profound respiratory and/or CNS depression in most species.

Other potential effects include:

  • Cardiovascular collapse
  • Hypothermia
  • Skeletal muscle hypotonia
  • Mania (especially in cats)

Treatment:

  • Naloxone is the specific reversal agent of choice for treating respiratory depression.
  • In massive overdoses, naloxone doses may need to be repeated, as naloxone's duration of action may be shorter than that of hydromorphone.
  • Mechanical respiratory support should be considered in cases of severe respiratory depression.
  • Provide supportive care as needed.

製品

製剤

  • Powder for injection (lyophilized)
  • Oral tablets
  • Oral capsules (extended-release)
  • Oral liquid
  • Suppositories

動物用医薬品

  • None

ヒト用医薬品

  • Hydromorphone HCl Injection: 1 mg/mL, 2 mg/mL, 4 mg/mL, 10 mg/mL (Dilaudid, Dilaudid-HP, generic)
  • Hydromorphone HCl Powder for Injection, lyophilized: 250 mg (Dilaudid-HP)
  • Hydromorphone HCl Oral Tablets: 2 mg, 4 mg, 8 mg (Dilaudid, generic)
  • Hydromorphone HCl Oral Capsules (extended-release): 8 mg, 12 mg, 16 mg (Exalgo)
  • Hydromorphone HCL Oral Liquid: 1 mg/1 mL (Dilaudid, generic)
  • Hydromorphone Suppositories: 3 mg (Dilaudid, generic)

規制ステータス

規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

保管・安定性

Injection should be stored at room temperature and protected from light. A slight yellowish tint does not indicate loss of potency. Stable for at least 24 hours when mixed with commonly used IV fluids if protected from light. Tablets should be stored at room temperature in tight, light-resistant containers. Suppositories should be kept in the refrigerator.

飼主向け情報

ヒドロモルフォンは強力なオピオイド鎮痛薬です。

  • ​監督下での使用​：注射で投与される場合、通常は動物病院内で獣医師の直接の監督下で使用されます。
  • ​自宅での経口投与​：飲み薬（錠剤または液体）を処方された場合は、子供や他のペットの手の届かない安全な場所に保管してください。これは厳格に管理されるべき薬です。
  • ​予想される反応​：ペットは鎮静状態になったり眠そうにしたりすることがあります。犬では、パンティング（あえぎ呼吸）や鳴き声を上げることが一般的な副作用ですが、これは必ずしも痛みを感じていることを意味しません。猫では、時折落ち着きがなくなったり、体温がわずかに上昇したりすることがあります。
  • ​注意すべき副作用​：極度の無気力、深刻な呼吸困難、または重度の便秘がないか観察してください。これらの症状が現れた場合は、獣医師に連絡してください。
  • ​共有の禁止​：この薬を他のペットや人間に絶対に与えないでください。誤った使用は致命的になる可能性があります。

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。