レバミゾール
Levamisole
Levamisole hydrochloride / Levamisole phosphate
別名: Levasole · Amtech · Ascaridil · Decaris · Ergamisol · Immunol · Ketrax · Meglum · Prohibit · Solaskil · Vermisol · Vizole · cloridrato de levamizol · ICI-59623 · levamisoli hydrochloridum · NSC-177023 · R-12564 · RP-20605 · l-tetramisole 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
2.2 mg/kg PO every other day, with appropriate antimicrobial therapyPO· q48h
— 🐕
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 |
|---|---|---|---|---|---|
| For recurrent cutaneous infections (immune stimulant) | 2.2 mg/kg PO every other day, with appropriate antimicrobial therapy | PO | q48h | — | 🌎 NA |
| As an immune stimulant | 0.5-2 mg/kg PO 3 times a week | PO | 3 times a week | — | 🌎 NA |
| For adjunctive therapy in dogs with chronic pyoderma | 0.5-1.5 mg/kg PO 2-3 times a week | PO | 2-3 times a week | — | 🌎 NA |
| For adjunctive therapy in dogs with chronic pyoderma | 2.2 mg/kg PO every other day | PO | q48h | — | 🌎 NA |
| As an alternative treatment for SLE | 3-7 mg/kg PO every other day for 4 months; alone or in combination with corticosteroids | PO | q48h | 4 months | 🌎 NA |
| As a microfilaricide | 11 mg/kg PO for 6-12 days. Examine for microfilaria within 7-10 days and at weekly intervals until eliminated or treatment is halted. | PO | q24h | 6-12 days | 🌎 NA |
| For treatment of Angiostrongylus vasorum | 7.5 mg/kg (route not specified) for two consecutive days, followed by 10 mg/kg for 2 days; if the infection is not cleared, the regimen is repeated. | Not specified | q24h | 4 days | 🌎 NA |
| For Crenosoma vulpis (lungworms) | 8 mg/kg once | PO | Once | 1 dose | 🌎 NA |
| For Capillaria (lungworms) | 7-12 mg/kg once daily PO for 3-7 days | PO | q24h | 3-7 days | 🌎 NA |
| For Filaroides osleri (lungworms) | 7-12 mg/kg once daily PO for 20-45 days | PO | q24h | 20-45 days | 🌎 NA |
| For Filaroides osleri (lungworms) | 7.5 mg/kg PO twice daily or 25 mg/kg PO every other day for 10 days | PO | q12h or q48h | 10 days | 🌎 NA |
| For Capillaria aerophilia (lungworms) | 10 mg/kg PO once daily for 5 days; repeat in 9 days | PO | q24h | 5 days | 🌎 NA |
- For adjunctive therapy in dogs with chronic pyoderma: Efficacy not established
- For adjunctive therapy in dogs with chronic pyoderma: May only be efficacious in 10% of cases
- As a microfilaricide: Rarely recommended today. Retching and vomiting are common. Avoid giving on an empty stomach or immediately after drinking water. A 'conditioning' dose of 5 mg/kg PO once a day may be necessary. Stop therapy if abnormal behavior or ataxia develops.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| For the treatment of lungworms | 20-40 mg/kg PO every other day for 5-6 treatments | PO | q48h | 5-6 treatments | 🌎 NA |
| For Aelurostrongylus abstrusus (lungworms) | 100 mg PO daily every other day for 5 treatments; give atropine (0.5 mg SC, 15 minutes before administering); or 15 mg/kg PO every other day for 3 treatments, then 3 days later: 30 mg/kg PO, then 2 days later: 60 mg/kg. | PO | Varies | Varies | 🌎 NA |
| For Capillaria aerophilia (lungworms) | 4.4 mg/kg SC for 2 days, then 8.8 mg/kg once 2 weeks later; or 5 mg/kg PO once daily for 5 days, followed by 9 days of no therapy, repeat two times | SC/PO | Varies | Varies | 🌎 NA |
| For the treatment of lungworms | 25 mg/kg every other day for 10-14 days | PO | q48h | 10-14 days | 🌎 NA |
| For Capillaria aerophilia (lungworms) | 10 mg/kg PO once daily for 5 days; repeat in 9 days | PO | q24h | 5 days | 🌎 NA |
| For treatment of Ollulanus tricuspis | 5 mg/kg SC | SC | Once | 1 dose | 🌎 NA |
| As a microfilaricide | 10 mg/kg PO for 7 days | PO | q24h | 7 days | 🌎 NA |
| For adjunctive therapy of feline plasma-cell gingivitis/pharyngitis (immune-stimulant) | 25 mg PO every other day for 3 doses | PO | q48h | 3 doses | 🌎 NA |
小型哺乳類
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| For nematodes in Rabbits | 12.5-20 mg/kg PO (for gastric nematodes) or SC (for extragastric nematodes) | PO/SC | Once | — | 🌎 NA |
鳥
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| For intestinal nematodes | 5-15 mL/gallon of drinking water for 1-3 days; repeat in 10 days. If birds refuse to drink, withhold water prior to treating. | PO | Daily | 1-3 days | 🌎 NA |
| For gavage in Australian Parakeets (or desert species that refuse to drink water) | 15 mg/kg; repeat in 10 days | PO | Once | — | 🌎 NA |
| For parenteral use | 4-8 mg/kg IM or SC; repeat in 10-14 days. | IM/SC | Once | — | 🌎 NA |
| For immunostimulation | 0.3 mL/gallon of water for several weeks | PO | Continuous | Several weeks | 🌎 NA |
| As a parenteral immunostimulant | 2 mg/kg IM or SC. 3 doses at 14 day intervals | IM/SC | q14d | 3 doses | 🌎 NA |
| As a nebulized immunostimulant | 1 mL (of 13.65% levamisole phosphate) in 15 mL saline | Inhalation | — | — | 🌎 NA |
| For Capillaria infections | 15-30 mg/kg orally as a single bolus or through a crop tube; or 2.25 mg/gallon of drinking water for 4-5 days. Repeat treatment in 10-14 days. | PO | Varies | 1 or 4-5 days | 🌎 NA |
| Poultry nematodes | 18-36 mg/kg, PO | PO | Once | — | 🌎 NA |
| For Libyastrongylus douglassi in Ratites | Give 30 mg/kg PO or IM at one month of age, then once a month for 7 treatments, then 4 times yearly | PO/IM | Monthly then quarterly | Ongoing | 🌎 NA |
- For intestinal nematodes: Using 13.65% injectable
- For gavage in Australian Parakeets (or desert species that refuse to drink water): Using 13.65% injectable
- For parenteral use: Using 13.65% injectable. May cause vomiting, ataxia, or death. Do not use in debilitated birds.
- For immunostimulation: Using 13.65% injectable
- As a parenteral immunostimulant: Using 13.65% injectable
爬虫類
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| As an anthelmintic (Nematodes, Acanthocephalans, or Pentastomes) | Nematodes: 5-10 mg/kg PO; repeat in two weeks followed by a fecal exam 14 days after the second dose. If positive, a third dose is given. Acanthocephalans, or Pentastomes: as above, but may also be given SC or ICe. | PO/SC/ICe | q14d | 2-3 doses | 🌎 NA |
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| As an immunostimulant | Dosages have ranged from 2.5 mg/kg injected at 7 day intervals, and 2.2 mg/kg PO every 24 hours for 3 days, then off for 4 days for a period of 4-6 weeks. | Injection/PO | Varies | 4-6 weeks | 🌎 NA |
| As adjunctive therapy for EPM | 1-2 mg/kg per day PO | PO | q24h | — | 🌎 NA |
- As an immunostimulant: Anecdotal reports of beneficial effects in the treatment of nasal viral papillomas, COPD, and EPM have been suggested.
牛
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| For removal of mature and immature Dictyocaulus vivapurus | 5.5-11 mg/kg PO, either given in feed or as a drench or oral bolus. May also be administered SC at 3.3-8 mg/kg. | PO/SC | Once | — | 🌎 NA |
| For treatment of susceptible nematodes | 7.5 mg/kg PO | PO | Once | — | 🌎 NA |
豚
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| For removal of mature and immature Metastrongylus | 8 mg/kg PO in feed or water | PO | Once | — | 🌎 NA |
羊
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| For removal of mature and immature Dictyocaulus vivapurus | 8 mg/kg PO | PO | Once | — | 🌎 NA |
| For treatment of susceptible nematodes | 7.5 mg/kg PO | PO | Once | — | 🌎 NA |
ヤギ
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| For removal of mature and immature Dictyocaulus vivapurus | 8 mg/kg PO | PO | Once | — | 🌎 NA |
| For treatment of susceptible nematodes | 7.5 mg/kg PO | PO | Once | — | 🌎 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
レバミゾールはイミダゾチアゾール誘導体であり、主に大動物における抗線虫薬として利用され、歴史的には小動物におけるミクロフィラリア駆除薬および免疫賦活剤として使用されてきました。
臨床上のポイント：
- 小動物での使用減少： 治療域が狭く、より安全で有効な駆虫薬（マクロライド系、ベンズイミダゾール系など）が登場したため、現代の犬猫の臨床ではほとんど使用されません。
- 大動物での有用性： 牛、羊、豚においては依然として価値のある広域スペクトル駆虫薬であり、特に胃腸管および肺の線虫に有効ですが、寄生虫の薬剤耐性が世界的な懸念となっています。
- 免疫調節作用： 細胞性免疫を刺激する独自の能力により、特に免疫不全の患者において、慢性感染症、免疫介在性疾患、特定の腫瘍に対する補助療法として適応外使用されることがあります。
作用機序
Antiparasitic Action: Levamisole acts as a cholinergic agonist at nicotinic acetylcholine receptors on the nematode muscle.
- Receptor activation → continuous depolarization → spastic paralysis of the worm.
- The paralyzed nematodes are subsequently expelled alive from the host's gastrointestinal or respiratory tract.
- At higher concentrations, it interferes with nematode carbohydrate metabolism by blocking fumarate reduction and succinate oxidation.
Immunostimulant Action: The exact mechanism is not fully elucidated. It is believed to:
- Restore cell-mediated immune function in peripheral T-lymphocytes.
- Stimulate phagocytosis and chemotaxis by monocytes and macrophages.
- Effects are generally more pronounced in immunocompromised animals rather than healthy ones.
安全性・警告
禁忌
- Lactating dairy animals (not approved)
- Severely debilitated animals
- Patients with significant renal or hepatic impairment
- Cats with FIV or FIP (and likely ineffective in FeLV)
- Use as a dirofilarial adulticide
- Intravenous (IV) administration (never recommended)
- Intramuscular (IM) administration in birds (avoid if possible)
有害事象
- Cattle: Muzzle foaming, hypersalivation, excitement, trembling, lip-licking, head shaking, injection site swelling
- Sheep/Goats: Transient excitability, depression, hyperesthesia, salivation, stinging upon SC injection
- Swine: Salivation, muzzle foaming, coughing/vomiting (especially if infected with lungworms)
- Dogs: GI disturbances (vomiting, diarrhea), neurotoxicity (panting, shaking, agitation), immune-mediated anemia, agranulocytosis, dyspnea, pulmonary edema, immune-mediated skin eruptions (erythema multiforme, toxic epidermal necrolysis), lethargy
- Cats: Hypersalivation, excitement, mydriasis, vomiting
注意事項
Narrow Margin of Safety: Levamisole has a narrow therapeutic index, especially in small animals and birds. Accurate dosing is critical.
- Stress: Use cautiously or delay use in cattle that are stressed due to vaccination, dehorning, or castration.
- Pregnancy: FDA Category C / Papich Class C. Has been implicated in causing abortion in goats. Use only if potential benefits outweigh risks.
- Nursing: Excreted in cows' milk; use with caution in nursing dams.
医薬品相互作用
Aspirin
Levamisole may increase salicylate levels
Chloramphenicol
Fatalities have been reported after concomitant administration; avoid using these agents together
Cholinesterase-inhibiting drugs (e.g., organophosphates, neostigmine)
Could theoretically enhance the toxic effects of levamisole; use together with caution
Nicotine-like compounds (e.g., pyrantel, morantel, diethylcarbamazine)
Could theoretically enhance the toxic effects of levamisole; use together with caution
Warfarin
Increased risk for bleeding
監視
- Clinical efficacy (fecal exams, resolution of clinical signs)
- Adverse effects/toxicity observation
薬物動態
半減期
犬1.8-4 hours
吸収
Absorbed from the gut after oral dosing and through the skin after dermal application, although bioavailabilities are variable.
分布
Reportedly distributed throughout the body.
代謝
Primarily metabolized in the liver.
消失
Metabolites are excreted primarily in the urine (with less than 6% excreted unchanged) and in feces.
過剰投与
Signs of levamisole toxicity often mimic those of organophosphate toxicity due to its cholinergic effects.
- Clinical Signs: Hypersalivation, hyperesthesias, irritability, clonic seizures, CNS depression, dyspnea, defecation, urination, and collapse. Acute overdosage can result in death due to respiratory failure. Cardiac arrhythmias may also be seen.
- Avian Toxicity: In pet birds, 40 mg/kg SC is reported as a toxic dose. IM injections may cause more severe toxicity. Signs include depression, ataxia, leg/wing paralysis, mydriasis, regurgitation, and death.
- Treatment: Primarily supportive, as animals generally recover within hours of dosing. If respiratory failure occurs, institute artificial ventilation with oxygen until recovery. For recent oral ingestion, emptying the gut and/or administering activated charcoal with cathartics may be indicated.
- Warning: Intravenous (IV) administration is particularly hazardous and is never recommended.
製品
製剤
- Injection (13.65% levamisole phosphate)
- Water Medication/Soluble Powder (18.15g, 46.8g)
- Oral Tablets/Boluses (184 mg, 2.19 g)
動物用医薬品
- Levamisole Phosphate Injection: 136.5 mg/mL (13.65%)
- Levamisole Hydrochloride Water Medication: 18.15 grams
- Levamisole Hydrochloride Soluble Drench Powder: 46.8 grams/packet
- Levamisole HCl Oral Tablets/Boluses: 184 mg, 2.19 gram
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
Levamisole hydrochloride products should be stored at room temperature (15-30°C); avoid temperatures greater than 40°C. Levamisole phosphate injection should be stored at or below 21°C (70°F); refrigeration is recommended and freezing should be avoided. Compounded oral solution (25 mg/mL) retains >97% potency for 90 days when stored at 4°C and 25°C and protected from light.
飼主向け情報
- 厳密な投薬： 獣医師の指示通りに正確に投薬してください。レバミゾールは安全域が狭く、有効量と中毒量の差が小さい薬です。
- 副作用： 過度なよだれ、震え、パンティング（あえぎ呼吸）、嘔吐、下痢、異常な行動などの中毒症状がないか、ペットを注意深く観察してください。これらの症状が現れた場合は、直ちに獣医師に連絡してください。
- 投与方法： 特定の条件で経口投与する場合、空腹時やペットが水を飲んだ直後には与えないでください（獣医師の具体的な指示に従ってください）。
- 産業動物： レバミゾールは繁殖期の乳用動物への使用はFDAに承認されていません。休薬期間（例：牛は48時間、羊/豚は72時間）を厳守してください。
- 再治療： 寄生虫の多い環境にいる動物は、初回治療の2〜4週間後に再治療が必要になる場合があります。
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。