トリメプラジン・プレドニゾロン配合剤
Trimeprazine with Prednisolone
Trimeprazine tartrate and prednisolone
別名: Temaril-P · Vanectyl-P · Alimemazine tartrate · Chemists Own Peetalix · Nedeltran · Panectyl · Repeltin · Theralene · Vallergan · Variargil
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 |
|---|---|---|---|---|---|
| Antipruritic and antitussive therapy | Weight up to 10 lb = 1/2 tab PO twice daily; 11-20 lb = 1 tablet twice daily; 21-40 lb = 2 tablets twice daily; over 40 lb = 3 tablets twice daily. After 4 days reduce dose to 1/2 of initial dose or to an amount just sufficient to maintain remission of symptoms; adjust as necessary. | PO | twice daily | After 4 days reduce dose | 🌎 NA |
| Treatment of pruritus | 1 tablet per 10 kg of body weight once daily for 3-5 days, then every other day. | PO | once daily then every other day | 3-5 days then every other day | 🌎 NA |
| Atopic dermatitis | 1 tablet of Temaril-P per 5 kg body weight q12h for one week, then once daily for one week, then q48h (every other day). | PO | q12h then once daily then q48h | 1 week q12h, 1 week once daily, then q48h | 🌎 NA |
- Treatment of pruritus: Giving with an EFA (essential fatty acid) may reduce the dose and frequency, if not the need for, glucocorticoids.
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
トリメプラジンとプレドニゾロンの配合剤（一般的な商品名：Temaril-P®）は、主に犬の掻痒（かゆみ）や咳を管理するために獣医療で広く使用される配合薬です。
- トリメプラジン（別名：アリメマジン）はフェノチアジン誘導体であり、強力な抗ヒスタミン作用、軽度の鎮静作用、および鎮咳作用を示します。
- プレドニゾロンは中時間作用型のグルココルチコイドであり、強力な抗炎症作用および免疫抑制作用を提供します。
臨床のポイント： 抗ヒスタミン薬とコルチコステロイドを組み合わせる相乗効果により、より低用量のプレドニゾロンで同等の止痒効果を得ることができます。この「ステロイド節減」アプローチにより、臨床症状を効果的にコントロールしつつ、長期的なグルココルチコイド誘発性の副作用リスクを最小限に抑えることができます。
作用機序
The drug exerts its effects through two distinct mechanisms:
- Trimeprazine: Acts primarily as a competitive antagonist at H1-histamine receptors, preventing histamine-induced capillary permeability, vasodilation, and pruritus. It also exhibits central antitussive and sedative properties by antagonizing central dopamine (D2) and muscarinic (M1) receptors in the brainstem and reticular activating system.
- Prednisolone: Diffuses across cell membranes and binds to cytosolic glucocorticoid receptors. The receptor-ligand complex translocates to the nucleus → alters gene transcription → induces production of lipocortin-1 (annexin-1) → inhibits phospholipase A2. This blocks the release of arachidonic acid, thereby suppressing the synthesis of key inflammatory mediators, including prostaglandins and leukotrienes.
安全性・警告
禁忌
- Systemic fungal infections
- Hypovolemia or shock
- Tetanus or strychnine intoxication
- Late pregnancy (last trimester) due to risk of inducing parturition
有害事象
- Sedation
- Depression
- Hypotension
- Extrapyramidal reactions (rigidity, tremors, weakness, restlessness)
- Polyuria (increased urination)
- Polydipsia (increased thirst)
- Polyphagia (increased appetite)
- Elevated liver enzymes
- Weight loss or weight gain
- Vomiting
- Diarrhea
- Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
- Delayed wound healing
- Osteoporosis
- Increased susceptibility to infections
注意事項
Use with caution in patients with hepatic dysfunction, cardiac disease, active bacterial or viral infections, peptic ulcers, acute psychoses, corneal ulcers, Cushingoid syndrome, diabetes, osteoporosis, predisposition to thrombophlebitis, hypertension, congestive heart failure (CHF), renal insufficiency, general debilitation, and in very young animals. If used chronically, therapy must be withdrawn gradually to prevent Addisonian crisis. May alter thyroid testing and skin allergy testing.
医薬品相互作用
Phenothiazines may increase hypotensive effects
Concomitant use with glucocorticoids may cause severe hypokalemia
May cause reduced GI absorption of oral phenothiazines
May cause reduced GI absorption of oral phenothiazines
In myasthenia gravis patients, concomitant use may lead to profound muscle weakness
Glucocorticoids may reduce salicylate blood levels
Increased risk for cardiac arrhythmias when used with phenothiazines
May cause additive CNS depression
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
Concomitant use with glucocorticoids may cause hypokalemia
May increase metabolism of glucocorticoids
May potentiate the effects of glucocorticoids
Insulin requirements may increase due to glucocorticoid-induced hyperglycemia
May decrease metabolism of glucocorticoids
May alter steroid metabolism; higher steroid doses may be needed
Increased risk of gastrointestinal ulceration
Virus replication may be augmented; diminished immune response may occur
May increase phenothiazine plasma levels
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
監視
- Efficacy (reduction in pruritus or coughing)
- Degree of sedation
- Anticholinergic effects
- Adverse effects associated with corticosteroids (e.g., PU/PD, weight changes, liver enzyme elevations)
過剰投与
Acute overdosage should be handled similarly to phenothiazine (e.g., acepromazine) toxicity. Overdose may cause profound sedation, depression, hypotension, and extrapyramidal signs (tremors, rigidity). Treatment is largely supportive and symptomatic. Do not use epinephrine for hypotension as it may cause further vasodilation (epinephrine reversal); use norepinephrine or phenylephrine if pressors are required.
製品
製剤
- Tablets
動物用医薬品
- Trimeprazine Tartrate 5 mg / Prednisolone 2 mg Tablets (Temaril-P®, Vanectyl-P®)
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
Store trimeprazine products at room temperature (15-30°C); protect tablets from light.
飼主向け情報
- 飲水量と尿量の増加：犬は通常より多くの水を飲み、頻繁に排尿するようになります。常に新鮮な水を用意し、トイレの回数を増やしてあげてください。
- 食欲の増加：この薬は犬の食欲を非常に亢進させることがあります。不要な体重増加を防ぐため、通常の給餌スケジュールを守ってください。
- 鎮静作用：特に治療開始からの数日間は、軽度の眠気や無気力が見られることがあります。これは正常ですが、ひどい場合は獣医師に相談してください。
- 急に服用を中止しない：数週間以上この薬を服用している場合、獣医師の指導のもとでゆっくりと用量を減らす必要があります。急に中止すると、生命を脅かすホルモンバランスの崩れを引き起こす可能性があります。
- 感染症の観察：この薬は免疫系を抑制するため、感染の兆候、皮膚病変の悪化、または重度の無気力に気づいた場合は、獣医師に連絡してください。
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