トルフェナム酸

動物種別の用量

投与経路

禁忌

• Hypersensitivity to tolfenamic acid or other fenamates (e.g., meclofenamic acid)
• Active gastrointestinal bleeding or ulceration
• Pre-surgical administration (due to anti-thromboxane/platelet effects)
• Dehydrated, hypovolemic, or hypotensive patients
• Patients with gastrointestinal disease
• Patients with blood clotting problems
• Pregnant animals
• Animals under 6 weeks of age
• Intramuscular (IM) administration in cats

有害事象

• Vomiting
• Diarrhea
• Gastrointestinal ulceration (at high doses)
• Platelet dysfunction/prolonged bleeding time
• Potential nephrotoxicity (especially in dehydrated patients)
• Gastrointestinal signs (vomiting, diarrhea, anorexia)
• Gastrointestinal ulceration and bleeding
• Renal toxicity (especially during hypotension)
• Potential precipitation of cardiac failure (rare/unknown risk in animals)

薬物相互作用

• Aspirin · May increase the risk of gastrointestinal toxicity (e.g., ulceration, bleeding, vomiting, diarrhea).
• Corticosteroids · Concomitant therapy may increase the occurrence of gastric ulceration; avoid concurrent use.
• Digoxin · NSAIDs may increase serum levels of digoxin.
• Fluconazole · May increase plasma levels of NSAIDs; potentially affects tolfenamic acid levels in dogs.
• Furosemide · NSAIDs may reduce the saluretic and diuretic effects of furosemide.
• Methotrexate · Serious toxicity has occurred with concomitant NSAID use; use together with extreme caution.
• Nephrotoxic Drugs (e.g., aminoglycosides, amphotericin B) · May enhance the risk of nephrotoxicity.
• Other NSAIDs · May increase the risk of gastrointestinal toxicity (e.g., ulceration, bleeding, vomiting, diarrhea). · major
• Warfarin · Tolfenamic acid is 98-99% protein-bound; may displace highly protein-bound drugs like warfarin, increasing bleeding risk. Monitor closely.
• Glucocorticoids · Increased risk of gastrointestinal ulceration and bleeding. Do not administer concurrently or within 24 hours. · major
• Aminoglycosides · Increased risk of nephrotoxicity. · major

モニタリング

• Clinical efficacy (pain scores, resolution of inflammation)
• Adverse effects (vomiting, diarrhea, anorexia)
• Renal function (BUN, Creatinine, SDMA, USG) with prolonged use
• Signs of GI bleeding (melena, pale mucous membranes)
• Clinical signs of gastrointestinal toxicity (vomiting, diarrhea, melena, anorexia)
• Renal parameters (BUN, creatinine, USG), especially in perioperative or hypotensive patients
• Liver enzymes in patients receiving prolonged therapy

過量投与

Acute toxicity data is limited. Experimental studies in dogs and cats did not demonstrate significant renal or GI toxicity until doses exceeded 10 times the labeled dose. **Treatment Protocol:** * **Decontamination:** Empty the gut following recent oral ingestion (emesis induction, activated charcoal). * **Supportive Care:** Institute IV fluid therapy to maintain hydration and support renal perfusion. * **Seizure Control:** Use IV **diazepam** if seizures occur. * **Monitoring:** Closely monitor for signs of gastrointestinal bleeding (melena, hematemesis). Monitor electrolyte and fluid balance carefully, and manage any acute renal failure using established veterinary guidelines.