알프라졸람

Alprazolam

다른 이름: Xanax XR · Niravam · Alprazolam Intensol · D65 MT · U 31889 · alprazolamum

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

0.01-0.1 mg/kg PO as needed for panic, not to exceed 4 mg/dog/day. Start with 1-2 mg (total dose) for a medium-sized dog.PO· prn

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
For treatment of canine anxiety disorders	0.01-0.1 mg/kg PO as needed for panic, not to exceed 4 mg/dog/day. Start with 1-2 mg (total dose) for a medium-sized dog.	PO	prn	—	🌎 NA
For separation anxiety	0.25 mg-2 mg (total dose) once daily to three times daily PO.	PO	q8-24h	—	🌎 NA
For storm phobias	0.02-0.4 mg/kg PO q4h as needed	PO	q4h	—	🌎 NA
For storm phobias (adjunct)	0.02 mg/kg PO as needed one hour before anticipated storm and every 4 hours as needed	PO	q4h	—	🌎 NA
For phobias, night waking	0.01-0.1 mg/kg or 0.25-2 mg (total dose) per dog PO q6-12h PO	PO	q6-12h	—	🌎 NA
For acute anxiety	0.05-0.1 mg/kg PO prn or three times a day. Administer 30-60 minutes prior to trigger event.	PO	prn or q8h	—	🌎 NA
Anxiolysis and fear-related disorders	0.01-0.1 mg/kg	PO	prn up to q6h	As needed	🌍 EU

For storm phobias: Helps to minimize impact of experiencing a severe storm
For storm phobias (adjunct): Used as an adjunct after behavior modification and prior clomipramine treatment
Anxiolysis and fear-related disorders: Titrate up or down to the minimum effective dose. Best given ~30 mins before a fear-inducing event.

고양이

적응증	용량	경로	빈도	기간	지역
For treatment of feline anxiety disorders	0.125-0.25 mg/kg PO q12h (Start at 0.125 mg/kg PO)	PO	q12h	—	🌎 NA
For refractory house soiling	0.1 mg/kg or 0.125-0.25 mg (total dose) per cat PO q8-12h	PO	q8-12h	—	🌎 NA
For urine marking	0.05-0.2 mg/kg PO q12-24h	PO	q12-24h	—	🌎 NA
For fears/phobias/anxieties	0.125-0.25 mg (total dose) PO once to three times a day.	PO	q8-24h	—	🌎 NA
For acute anxiety	0.05 mg/kg PO prn or three times a day. Administer 30-60 minutes prior to trigger event.	PO	prn or q8h	—	🌎 NA
Anxiolysis and urine spraying	0.125-0.25 mg/kg	PO	prn up to bid	As needed	🌍 EU

Anxiolysis and urine spraying: Doses as low as 0.25 mg/cat q8-12h and as high as 0.6 mg/kg have been reported. Titrate down to minimum effective dose. High relapse rate for urine spraying upon withdrawal.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

알프라졸람(Alprazolam)은 강력하고 작용 시간이 짧거나 중간 정도인 벤조디아제핀계 약물로, 수의학에서는 주로 항불안제 및 가벼운 진정제로 사용됩니다. 스케줄 IV(C-IV) 향정신성의약품으로 분류됩니다.

주요 임상적 특징은 다음과 같습니다:

행동 교정: 공황 장애, 뇌우 공포증, 분리 불안 및 부적절한 배설(예: 고양이의 소변 마킹)에 대한 보조 요법으로 자주 처방됩니다.
운동 기능: 디아제팜과 비교할 때, 저용량에서 운동 기능에 미치는 부정적인 영향이 적어 보행이 필요한 환자에게 유리합니다.
임상 팁: 지용성이 높아 경구 투여 시 작용 시작이 빠르므로, 유발 사건 30~60분 전에 투여하면 상황적 불안(예: 뇌우, 폭죽)에 매우 이상적입니다.

작용 기전

Alprazolam exerts its effects by binding to specific benzodiazepine receptors located on the GABA-A receptor complex in the central nervous system.

Mechanism: Binding → enhances the affinity of the receptor for gamma-aminobutyric acid (GABA) → increases the frequency of chloride channel opening → cellular hyperpolarization → decreased neuronal excitability.
Target Areas: It primarily depresses subcortical levels of the CNS, specifically the limbic system, thalamus, and hypothalamus.
Net Effect: This enhanced inhibitory neurotransmission produces the characteristic anxiolytic, sedative, skeletal muscle relaxant, and anticonvulsant effects.

안전성·주의사항

금기사항

Known benzodiazepine hypersensitivity
Aggressive animals (controversial; anxiety reduction may disinhibit aggressive tendencies)

부작용

Sedation
Increased appetite (polyphagia)
Transient ataxia
Behavior changes in cats (irritability, increased affection, depression, aberrant demeanor)
Paradoxical CNS excitement/agitation (rare in dogs)
Physical dependence (with chronic use)
Impeded learning and retarded training

주의

Caution: Use with care in patients with hepatic or renal disease, narrow-angle glaucoma, and in debilitated or geriatric patients.

Working Animals: Benzodiazepines may impair the abilities of working or service animals.
Aggression: Use in aggressive dogs remains controversial as it may remove anxiety-based bite inhibition.
Pregnancy: FDA Category D in humans. May cause congenital abnormalities if administered during the first trimester. Use only when benefits clearly outweigh risks.
Hepatic Function: Monitor hepatic enzymes, particularly in cats receiving chronic therapy, due to the risk of idiosyncratic hepatotoxicity associated with some oral benzodiazepines.

약물 상호작용

Antacids

May slow the rate, but not the extent of oral absorption of alprazolam; administer 2 hours apart.

CNS Depressant Agents (barbiturates, narcotics, anesthetics)

Additive CNS depression effects may occur.

Digoxin

Serum levels of digoxin may be increased; monitor for toxicity.

Fluoxetine, Fluvoxamine

Increased alprazolam levels.

Hepatically Metabolized Drugs (Cimetidine, erythromycin, isoniazid, ketoconazole, itraconazole)

Metabolism of alprazolam may be decreased, leading to excessive sedation.

Rifampin

May induce hepatic microsomal enzymes and decrease the pharmacologic effects of benzodiazepines.

Tricyclic Antidepressants (Amitriptyline, Clomipramine, Imipramine)

Alprazolam may increase levels of these drugs; concurrent use with clomipramine may improve efficacy for phobias.

ItraconazoleMajor

Inhibits alprazolam metabolism, potentially increasing sedation and toxicity

KetoconazoleMajor

Inhibits alprazolam metabolism

ClomipramineMinor

Used concurrently as an adjunct, but may have additive CNS depressant effects

모니터링

Clinical efficacy (reduction in anxiety/panic)
Adverse effects (excessive sedation, paradoxical excitation)
Hepatic enzymes (particularly when treating cats chronically)

약동학

흡수

Well absorbed orally with an intermediate onset of action. Peak plasma levels occur in 1-2 hours (in humans).

분포

Highly lipid soluble and widely distributed throughout the body. Readily crosses the blood-brain barrier. Approximately 80% bound to plasma proteins.

대사

Metabolized in the liver to at least two metabolites, including alpha-hydroxy-alprazolam which is pharmacologically active.

배설

Elimination half-lives range from 6-27 hours in humans.

과다투여

Overdoses are generally limited to CNS signs, primarily dose-dependent CNS depression.

Clinical Signs: Ataxia, lethargy, disorientation, and vomiting. Some animals may present with a paradoxical reaction (hyperactivity, vocalization, agitation) which may be followed by CNS depression. Severe signs like hypotension, respiratory depression, and cardiac arrest are quite rare in small animals.
Toxicity: The reported LD50 in rats is >330 mg/kg, but cardiac arrest has occurred at doses as low as 195 mg/kg.
Treatment: Consists of standard protocols for decontamination. The decision to give activated charcoal should be weighed carefully against the risk of aspiration if the patient is sedated. Flumazenil can be used to reverse the sedative effects, but is generally reserved for cases with significant CNS and respiratory depression.

제품

제형

Extended-release oral tablets
Orally disintegrating tablets
Oral solution

인용의약품

Alprazolam Oral Tablets: 0.25 mg, 0.5 mg, 1 mg & 2 mg (Xanax, generic)
Alprazolam Extended-release Oral Tablets: 0.5 mg, 1 mg, 2 mg, & 3 mg (Xanax XR, generic)
Alprazolam Orally Disintegrating Tablets: 0.25 mg, 0.5 mg, 1 mg, & 2 mg (Niravam)
Alprazolam Oral Solution: 1 mg/mL in 30 mL (Alprazolam Intensol)

규제 현황

European Union✗ 미승인처방전의약품 · Controlled DrugEMA

POM (Prescription Only Medicine). Subject to controlled drug regulations depending on member state.

United Kingdom✗ 미승인처방전의약품 · Schedule 4VMD

POM. Controlled drug.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Store tablets at room temperature in tight, light-resistant containers. Orally disintegrating tablets must be protected from moisture. Compounded oral suspensions (1 mg/mL in Ora-Plus/Ora-Sweet) retain >90% potency for 60 days at 5°C and 25°C, but should be protected from light.

보호자 정보

투약 타이밍이 중요합니다: 상황적 불안(뇌우나 폭죽 등)의 경우, 반려동물이 공황 상태에 빠지기 전에 약효가 나타날 수 있도록 예상되는 사건 약 30~60분 전에 약을 투여하십시오.
투약 방법: 알약을 먹이기 어려운 경우 구강 붕해정을 고려할 수 있습니다. 약을 만지기 전에 손이 완전히 건조한지 확인하십시오.
주의 사항: 과도한 졸음, 심한 비틀거림, 또는 눈의 흰자위나 잇몸이 노랗게 변하는 증상(황달)이 나타나면(특히 고양이의 경우) 수의사에게 연락하십시오.
행동 변화: 일부 반려동물은 평소보다 유난히 애교가 많아지거나, 예민해지거나, 오히려 더 활동적으로 변할 수 있습니다(역설적 반응). 이러한 증상이 나타나면 수의사에게 알려주십시오.
훈련: 이 약물은 훈련 중 새로운 명령을 학습하는 능력을 일시적으로 저하시킬 수 있습니다.

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