아세프로마진
Acepromazine
Acepromazine maleate
다른 이름: PromAce · Aceproject · Aceprotabs · Plegicil · Notensil · Atravet · Acecare · ACP · Acetylpromazine maleate
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
검토된 비계산 근거검토된 비계산 근거 (1)
근거 표시 전용 — 자동 계산 불가
Tranquilization
a) Tranquilization: 0.25 – 0.75 mg/kg IM or SC 46 ; the lower to mid-range of the dosage is generally adequate.
반드시 함께 고려할 임상 맥락 (4)
- 1. Acepromazine does not provide analgesia; addition of an analgesic agent is required when pain relief is needed.
- All dosages are extra-label.
- Store tablets and injection protected from light at 20°C to 25°C (68°F-77°F), with excursions permitted between 15°C and 30°C (59°F-86°F). Tablets should be stored in tight containers. There is no limit to the number of vial punctures throughout the full expiry period. 1
- 2. Administer IV doses slowly; allow at least 15 minutes for onset of action. 1
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
아세프로마진(Acepromazine)은 수의학에서 고전적이고 널리 사용되는 페노티아진계 신경이완제로, 주로 신뢰할 수 있는 진정 및 신경안정 효과를 위해 사용됩니다.
주요 임상 포인트:
- 진통 효과 없음: 아세프로마진은 진통 효과가 전혀 없습니다. 통증이 동반되는 시술 시 반드시 적절한 진통제(예: 마약성 진통제)와 병용해야 합니다(신경이완진통).
- 심혈관계 영향: 알파-1 아드레날린 수용체 차단 작용으로 인한 강력한 혈관 확장제로, 흔히 저혈압을 유발합니다. 저혈량증, 쇼크 또는 혈역학적으로 불안정한 환자에게는 사용을 피해야 합니다.
- 품종 민감성: 초대형견 및 시각하운드(예: 그레이하운드)는 매우 민감합니다. MDR1(ABCB1) 유전자 돌연변이가 있는 개(예: 콜리, 오스트레일리안 셰퍼드)는 용량을 크게 줄여야 합니다(25-50%).
- 말에 대한 주의사항: 수말에서 지속적인 음경 돌출이나 지속발기증을 유발할 수 있으며, 이는 음경견인근의 영구적인 마비로 이어질 수 있습니다.
과거에는 여행 불안이나 소음 공포증에 자주 사용되었으나, 현대 수의 행동학자들은 근본적인 두려움이나 공포를 줄이지 못한 채 동물만 진정시켜 오히려 소음 민감성을 증가시킬 수 있으므로 이러한 상태에 대한 단독 요법으로 사용하는 것을 권장하지 않습니다.
작용 기전
Acepromazine exerts its effects through multiple receptor antagonisms:
- Dopamine (D2) Receptor Antagonism: Blocks postsynaptic D2 receptors in the CNS (specifically the basal ganglia and limbic system) → depresses the reticular activating system → produces sedation and tranquilization.
- Alpha-1 Adrenergic Antagonism: Blocks peripheral alpha-1 receptors → causes peripheral vasodilation → leads to hypotension and secondary hypothermia.
- Additional Blockade: Possesses varying degrees of anticholinergic (muscarinic), antihistaminic (H1), and antispasmodic effects.
- Antiemetic Effect: Blocks dopamine receptors in the Chemoreceptor Trigger Zone (CRTZ) of the medulla.
Clinical Pearl: Because of its alpha-blocking properties, administering epinephrine to an acepromazine-induced hypotensive patient can cause "epinephrine reversal" (unopposed beta-2 vasodilation), worsening the hypotension. Alpha-agonists like phenylephrine are preferred for treating severe acepromazine-induced hypotension.
안전성·주의사항
금기사항
- Significant cardiac disease
- Hypovolemia, hypotension, or shock
- Tetanus or strychnine intoxication
- Intra-arterial injection in horses (can cause severe CNS excitement, seizures, death)
- Use with extreme caution in very young, geriatric, or debilitated animals
- Avoid in racing animals within 4 days of a race
부작용
- Hypotension and cardiovascular collapse
- Bradycardia (vagally mediated) or reflex tachycardia
- Hypothermia or hyperthermia
- Penile protrusion/prolapse in large animals (especially stallions)
- Prolapse of the membrana nictitans (third eyelid)
- Decreased tear production (especially in cats)
- Paradoxical excitement, restlessness, or aggression
- Transient pain at IM injection sites
- Decreased hematocrit (due to splenic sequestration of RBCs)
주의
Dosage Adjustments: The manufacturer's labeled dose is often considered up to 10 times higher than clinically necessary. Use lower end of dose ranges.
Breed Sensitivities:
- MDR1 Mutation: Dogs with the MDR1 (ABCB1) mutation (Collies, Australian Shepherds, etc.) require a 25% dose reduction if heterozygous, and a 30-50% reduction if homozygous.
- Giant Breeds & Sight Hounds: Extremely sensitive; require lower doses.
- Terriers: May be somewhat resistant to effects.
Administration: Give IV injections slowly. Allow at least 15 minutes for onset of action. Never inject intra-arterially in horses.
Behavioral: Use cautiously as a restraining agent in aggressive dogs; it may make the animal more prone to startle and react to noises.
Other: May cause regurgitation of ruminal contents in cattle during general anesthesia induction.
약물 상호작용
Possible increased risk for hypothermia
May cause reduced GI absorption of oral phenothiazines
May cause reduced GI absorption of oral phenothiazines
May cause additive CNS depression if used with acepromazine
Acepromazine may impair the vasopressive action of dopamine
Acepromazine may reduce the effectiveness of emetics
Concomitant use can lead to unopposed beta-activity causing vasodilation and increased cardiac rate (epinephrine reversal)
May increase risks for extrapyramidal adverse effects
May enhance hypotensive effects; dosages of acepromazine are generally reduced when used with an opiate
Effects may be potentiated; do not give within one month of worming with these agents
Metabolism may be decreased if given concurrently
Activity may be enhanced by phenothiazines
Increased blood levels of both drugs may result
May cause additive cardiac depression
Additive CNS depression; doses of other anaesthetic drugs should be reduced when ACP is used for premedication
Unopposed beta activity causing severe vasodilation and tachycardia (due to ACP's alpha-adrenergic blockade)
Reduced GI absorption of oral phenothiazines
모니터링
- Cardiac rate, rhythm, and blood pressure (especially in compromised patients)
- Degree of tranquilization and sedation
- Male horses: Monitor to ensure the penis retracts and is not injured
- Body temperature (especially if ambient temperature is very hot or cold)
약동학
반감기
흡수
Onset of action is fairly slow, requiring up to 15 minutes following IV administration, with peak effects seen in 30-60 minutes.
분포
Fairly high volume of distribution (6.6 L/kg in horses), and is more than 99% protein bound.
대사
Metabolized in the liver.
배설
Both conjugated and unconjugated metabolites are eliminated in the urine. Metabolites may be found in equine urine up to 96 hours after dosing.
과다투여
The LD50 in mice is 61 mg/kg IV and 257 mg/kg PO. Dogs have survived oral dosages up to 220 mg/kg, but overdoses can cause serious hypotension, CNS depression, pulmonary edema, and hyperemia.
Clinical Signs of Toxicity:
- Dogs: Ataxia, sedation, lethargy, depression, protrusion of the third eyelid, somnolence, bradycardia, and recumbency.
- Cats: Sedation, ataxia, lethargy, protrusion of the third eyelid, and depression.
Treatment:
- Because of relatively low toxicity, most overdoses are handled by monitoring and symptomatic treatment.
- Massive oral overdoses should be treated by emptying the gut if possible.
- Hypotension: Should not be treated initially with fluids. If fluids fail to maintain BP, use alpha-adrenergic pressor agents (e.g., phenylephrine). Note: Avoid epinephrine due to the risk of "epinephrine reversal" causing further vasodilation.
- Seizures: May be controlled with barbiturates or diazepam.
- CNS Depression: Doxapram has been suggested as an antagonist to the CNS depressant effects.
제품
제형
- Injection: 10 mg/mL
- Tablets: 5 mg, 10 mg, 25 mg
동물용의약품
- Acepromazine Maleate for Injection: 10 mg/mL in 50 mL vials (PromAce, generic)
- Acepromazine Maleate Tablets: 5 mg, 10 mg & 25 mg (PromAce, generic)
규제 현황
Classified as POM-V (Prescription Only Medicine - Veterinarian)
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store protected from light. Tablets should be stored in tight containers. Acepromazine injection should be kept from freezing. Stable and efficacious for at least 180 days after mixing with ketamine and xylazine if stored at room temperature in the dark.
보호자 정보
- 소변 변색: 이 약물은 일시적으로 반려동물의 소변을 분홍색이나 적갈색으로 변하게 할 수 있습니다. 이는 정상적인 부작용이므로 놀라지 않으셔도 됩니다.
- 진통제가 아님: 아세프로마진은 진정 효과를 제공하지만 통증을 완화하지는 않습니다. 반려동물이 통증을 유발하는 시술을 받는 경우 다른 약물이 필요합니다.
- 조용한 환경 유지: 반려동물이 졸려 보이더라도 큰 소리나 갑작스러운 움직임에 놀랄 수 있으며 예측할 수 없는 반응을 보일 수 있습니다. 약효가 떨어질 때까지 조용하고 차분한 환경을 유지해 주세요.
- 제3안검: 반려동물의 "제3안검"(눈 안쪽 꼬리의 막)이 눈의 일부를 덮는 것을 볼 수 있습니다. 이는 정상적인 현상이며 약효가 사라지면 원래대로 돌아옵니다.
- 규제: 식용 목적이 아닌 개, 고양이, 말에 사용하도록 FDA의 승인을 받았습니다.
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