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아미노필린 / 테오필린

Aminophylline / Theophylline

1,3-dimethyl-7H-purine-2,6-dione (Theophylline); Theophylline ethylenediamine (Aminophylline)

포스포디에스테라제 억제제 / 기관지 확장제POIVIMSC개고양이페렛말

다른 이름: Theochron · Theo-Cap · Theo-24 · Uniphyl · Bronkodyl · Elixophyllin · Theo-Dur · Slo-Bid · aminofilina · aminophyllinum · euphyllinum · metaphyllin · theophylline and ethylenediamine · theophylline ethylenediamine compound · theophyllinum ethylenediaminum · anhydrous theophylline · teofillina

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

10 mg/kg PO every 12 hours initially, if no adverse effects are observed and the desired clinical effect is not achieved, give 15 mg/kg PO q12hPO· q12h
— 🐕

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

적응증용량경로빈도기간지역
Bronchodilation (Extended-Release)10 mg/kg PO every 12 hours initially, if no adverse effects are observed and the desired clinical effect is not achieved, give 15 mg/kg PO q12hPOq12h—🌎 NA
Tracheal collapse (mild clinical signs, <50% collapse)11 mg/kg PO, IM or IV three times daily.PO/IM/IVq8h—🌎 NA
Severe, acute pulmonary edema and bronchoconstrictionAminophylline 4-8 mg/kg IV or IM, or 6-10 mg/kg PO every 8 hours.IV/IM/POq8h—🌎 NA
CoughAminophylline: 10 mg/kg PO, IV three times dailyPO/IVq8h—🌎 NA
Collapsing trachea (bronchodilator)11 mg/kg PO or IV q6-12hPO/IVq6-12h—🌎 NA
  • Bronchodilation (Extended-Release): Using Theochron Extended-Release Tablets or Theo-Cap Extended-Release Capsules
  • Tracheal collapse (mild clinical signs, <50% collapse): Aminophylline
  • Severe, acute pulmonary edema and bronchoconstriction: Long-term use is not recommended.

고양이

적응증용량경로빈도기간지역
Bronchodilation (Extended-Release)20 mg/kg PO once daily in the PM; using Slo-Bid: 25 mg/kg PO once daily in the PMPOq24h—🌎 NA
Bronchodilation6.6. mg/kg PO twice daily; using sustained release tablets (Theo-Dur): 25-50 mg (total dose) per cat PO in the eveningPOq12h or q24h—🌎 NA
Tracheal collapse (mild clinical signs, <50% collapse)aminophylline: 5 mg/kg PO, two times daily.POq12h—🌎 NA
Bronchoconstriction associated with fulminant CHFAminophylline 4-8 mg/kg SC, IM, IV q8-12h.SC/IM/IVq8-12h—🌎 NA
CoughAminophylline: 5 mg/kg PO twice dailyPOq12h—🌎 NA
  • Bronchodilation (Extended-Release): Products Theo-Dur and Slo-Bid are no longer available in the USA. Cautious use of dog dose/products is a reasonable alternative.
  • Bronchodilation: Using aminophylline tablets or sustained release tablets

페렛

적응증용량경로빈도기간지역
Bronchodilation4.25 mg/kg PO 2-3 times a dayPOq8-12h—🌎 NA

말

적응증용량경로빈도기간지역
Pulmonary edemaAminophylline 2-7 mg/kg IV q6-12h; Theophylline 5-15 mg/kg PO q12hIV/POq6-12h—🌎 NA
Pulmonary edema11 mg/kg PO or IV q8-12h.PO/IVq8-12h—🌎 NA
Heaves (RAO)Aminophylline: 5-10 mg/kg PO or IV twice daily.PO/IVq12h—🌎 NA
Heaves (RAO)Aminophylline: 4-6 mg/kg PO three times a day.POq8h—🌎 NA
  • Pulmonary edema: IV aminophylline should be diluted in at least 100 mL of D5W or normal saline and administered slowly (not >25 mg/min).
  • Pulmonary edema: To 'load' may either double the initial dose or give both oral and IV dose at the same time. IV infusion in ~1L fluids over 20-60 mins.

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개요

아미노필린과 테오필린은 수의학에서 주로 강력한 기관지 확장 효과를 위해 사용되는 ​메틸잔틴 유도체​입니다. 고양이 천식, 말의 재발성 기도 폐쇄(RAO), 개의 기관지염과 같은 하부 호흡기 질환, 기관 허탈의 관리 및 심인성 폐부종의 보조 요법으로 자주 사용됩니다.

​임상 요점:​ 아미노필린은 본질적으로 에틸렌디아민을 첨가하여 만든 테오필린의 수용성 염입니다. ​100mg의 함수 아미노필린에는 약 79mg의 무수 테오필린이 포함되어 있습니다.​ 두 형태 사이를 변경할 때는 용량 변환을 주의 깊게 계산해야 합니다.

이 약물들은 매우 효과적이지만 ​치료 지수가 좁습니다​. 독성은 용량에 비례하지만, 개와 고양이는 일반적으로 사람보다 높은 혈청 농도를 잘 견디는 편입니다. 대사에 있어 환자 간 변동성이 크기 때문에, 특히 간 질환이나 심장 질환이 동반된 환자의 경우 치료 약물 모니터링(TDM)이 강력히 권장됩니다.

작용 기전

The primary mechanism of action involves the competitive inhibition of ​phosphodiesterase (PDE)​ enzymes.

  • PDE Inhibition → Decreased breakdown of ​cyclic AMP (cAMP)​ → Elevated intracellular cAMP levels.
  • Increased cAMP → Enhanced release of endogenous epinephrine → Relaxation of bronchial and pulmonary vascular smooth muscle.
  • Elevated cAMP also inhibits the release of inflammatory mediators like histamine and slow-reacting substance of anaphylaxis (SRS-A) from mast cells.
  • ​Intracellular Calcium Translocation:​ Methylxanthines alter intracellular ionized calcium dynamics, contributing to increased diaphragmatic contractility (reducing respiratory fatigue) and weak positive inotropic/chronotropic effects on the heart.
  • ​Additional Effects:​ Induces mild diuresis, stimulates the central nervous system (CNS) and respiratory centers, and increases gastric acid secretion.

안전성·주의사항

금기사항

  • Hypersensitivity to any xanthines (including theobromine or caffeine)
  • Hypersensitivity to ethylenediamine (specific to aminophylline)

부작용

  • Nausea and vomiting
  • Diarrhea
  • Insomnia / Restlessness
  • Polyphagia (increased appetite)
  • Polydipsia and polyuria (increased thirst and urination)
  • Tachycardia (rapid heart rate)
  • Nervousness, excitability, and tremors (especially in horses)
  • Diaphoresis (sweating in horses)
  • Ataxia
  • Seizures (in severe toxicity)
  • Cardiac dysrhythmias (in severe toxicity)

주의

Use with extreme caution in patients with severe cardiac disease, seizure disorders, gastric ulcers, hyperthyroidism, renal or hepatic disease, severe hypoxia, or severe hypertension.

  • ​Arrhythmias:​ May cause or worsen preexisting cardiac arrhythmias; enhanced monitoring is required.
  • ​Clearance Issues:​ Neonatal, geriatric, and congestive heart failure (CHF) patients may have decreased clearance and prolonged half-lives, making them more susceptible to toxicity.
  • ​Dosing Weight:​ Because of low lipid solubility and low volume of distribution, obese patients should be dosed based on lean body weight.
  • ​IM Injection:​ Aminophylline causes intense local pain when administered IM and is rarely recommended via this route.

약물 상호작용

Phenobarbital

May decrease theophylline levels via hepatic enzyme induction.

Fluoroquinolones (e.g., enrofloxacin, ciprofloxacin)

Can significantly increase theophylline levels. Consider reducing theophylline dose by 30% and monitor for toxicity.

Macrolides (e.g., erythromycin, clindamycin, lincomycin)

Can increase theophylline levels.

Cimetidine

Can increase theophylline levels by inhibiting hepatic metabolism.

Ketamine

Concurrent use can cause an increased incidence of seizures.

Halothane

Concurrent use may cause an increased incidence of cardiac dysrhythmias.

Sympathomimetics (e.g., ephedrine, isoproterenol)

Toxic synergism; can lead to severe cardiac arrhythmias.

Beta-blockers (non-selective, e.g., propranolol)

Can increase theophylline levels and antagonize bronchodilatory effects.

Corticosteroids

Can increase theophylline levels.

모니터링

  • Therapeutic efficacy (improvement in breathing/cough)
  • Clinical signs of toxicity (GI upset, CNS stimulation, tachycardia)
  • Serum trough levels at steady state (Target: >8-10 mcg/mL in small animals; do not exceed 15 mcg/mL in horses. Human therapeutic range is 10-20 mcg/mL)

약동학

반감기

고양이≈ 7.8 hours말≈ 11.9 to 17 hours개≈ 5.7 hours

흡수

Nearly 100% bioavailable after oral administration of non-sustained release products. Sustained-release products have variable bioavailability ranging from 30-76%.

분포

Distributes throughout extracellular fluids and body tissues. Crosses the placenta and distributes into milk (70% of serum levels). Low plasma protein binding (7-14% in dogs). Volume of distribution: dogs 0.82 L/kg, cats 0.46 L/kg, horses 0.85-1.02 L/kg.

대사

Metabolized primarily in the liver to 3-methylxanthine, which possesses weak bronchodilatory activity.

배설

Renal clearance contributes only about 10% to overall plasma clearance.

과다투여

Clinical signs of toxicity are usually associated with serum levels greater than 20 mcg/mL in humans, though dogs appear to tolerate higher levels.

​Life-threatening signs:​

  • Tachycardia and severe cardiac arrhythmias
  • CNS effects including seizures and hyperthermia

​Treatment is supportive:​

  • ​Decontamination:​ Empty the gut, administer activated charcoal and a cathartic if oral ingestion was recent.
  • ​Seizures:​ Maintain an adequate airway and treat with IV diazepam.
  • ​Monitoring:​ Continuous ECG monitoring for arrhythmias. Monitor and correct fluid/electrolyte imbalances.
  • ​Symptomatic Care:​ Hyperthermia may be treated with phenothiazines; severe tachycardia may be treated with propranolol if life-threatening.

제품

제형

  • Tablets (immediate and extended-release)
  • Capsules (extended-release)
  • Injection (solution)
  • Oral elixir/solution
  • Compounded oral suspension

인용의약품

  • Aminophylline Tablets: 100 mg & 200 mg
  • Aminophylline Injection: 250 mg/10 mL (25 mg/mL)
  • Theophylline Extended-Release Capsules and Tablets: 100 mg, 125 mg, 200 mg, 300 mg, 400 mg, 450 mg, & 600 mg
  • Theophylline Tablets and Capsules: 100 mg, 200 mg, & 300 mg
  • Theophylline Elixir: 80 mg/15 mL
  • Theophylline & Dextrose Injection: Various concentrations (0.4 mg/mL to 4 mg/mL)

규제 현황

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

보관·안정성

Store oral products in tight, light-resistant containers at room temperature. Aminophylline injection should be stored below 30°C, protected from freezing and light. Do not inject solutions that contain a precipitate or visible crystals. Compounded oral suspensions should be protected from light and kept at room temperature (refrigeration causes precipitation).

보호자 정보

이 약물은 반려동물의 기도를 열어주어 숨쉬기를 편안하게 해주는 데 사용됩니다.

  • ​투여 방법:​ 수의사가 처방한 대로 정확히 투여하십시오. 투여를 건너뛰지 마십시오. 서방형(효과가 오래 지속되는) 정제나 캡슐을 사용하는 경우, 수의사의 특별한 지시가 없는 한 ​부수거나 반려동물이 씹어 먹게 하지 마십시오​.
  • ​부작용:​ 약물 복용 초기에는 가벼운 위장 장애, 음수량 및 배뇨량 증가, 또는 약간의 불안감이 나타날 수 있으나 대개 자연스럽게 호전됩니다.
  • ​수의사에게 연락해야 할 때:​ 심한 구토, 극도의 불안감, 근육 떨림, 빠른 호흡 또는 발작이 관찰되면 과다 복용의 징후일 수 있으므로 즉시 수의사에게 연락하십시오.
  • ​식이 주의사항:​ 초콜릿이나 카페인이 함유된 음식은 이 약물과 유사한 성분을 포함하고 있어 독성 위험을 높일 수 있으므로 절대 주지 마십시오.

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