암로디핀
Amlodipine
Amlodipine besylate
다른 이름: Norvasc · Lotrel (combination) · Caduet (combination) · Amodip · Istin · Amlodipini besilas · UK-48340-26 · UK-48340-11 · Amlodipine maleate · Amlodipine besylate · Amlodipino
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
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 |
|---|---|---|---|---|---|
| Adjunctive therapy for refractory heart failure (advanced mitral valve degeneration as an afterload reducer) | 0.2-0.4 mg/kg PO twice daily. Initiate therapy at 0.1 mg/kg PO twice daily and up-titrate weekly while monitoring blood pressure. | PO | q12h | — | 🌎 NA |
| Arterial vasodilator for refractory CHF secondary to mitral regurgitation | 0.1 mg/kg q12-24h initially; titrate up as needed to 0.25 mg/kg PO q12-24h | PO | q12-24h | — | 🌎 NA |
| Systemic hypertension in dogs with chronic renal disease | 0.1-0.5 mg/kg PO once daily (q24h) | PO | q24h | — | 🌎 NA |
| Systemic hypertension (2nd step drug) | 0.1 mg/kg q24h; step up to 0.2 mg/kg q24h if needed | PO | q24h | — | 🌎 NA |
| Systemic hypertension | 0.05-0.1 mg/kg (titrate upwards weekly as required, up to 0.5 mg/kg) | PO | q12-24h | Long-term | 🌍 EU |
- Adjunctive therapy for refractory heart failure (advanced mitral valve degeneration as an afterload reducer): After ACE inhibitor maintenance therapy has been established.
- Arterial vasodilator for refractory CHF secondary to mitral regurgitation: Monitor blood pressure.
- Systemic hypertension in dogs with chronic renal disease: Most often combined with an ACE inhibitor. May require weeks to months to achieve satisfactory control.
- Systemic hypertension (2nd step drug): Used after enalapril/benazepril. Each step added if after 1-2 weeks systolic BP > 160 mmHg.
- Systemic hypertension: Monitor blood pressure regularly. Consider concurrent ACE inhibitor.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Systemic hypertension (1st step drug) | 0.625 mg per cat q24h, if cat greater then 6 kg, 1.25 mg/cat q24h | PO | q24h | — | 🌎 NA |
| Systemic hypertension | 0.625-1.25 mg (total dose) PO once daily | PO | q24h | — | 🌎 NA |
| Systemic hypertension | 0.625-1.25 mg/cat | PO | q24h (may increase slowly or increase frequency to q12h if necessary) | Long-term | 🌍 EU |
- Systemic hypertension (1st step drug): Add ACE inhibitor if proteinuric.
- Systemic hypertension: Drug of choice; often successful as a single agent. Maximum effect seen within 7 days.
- Systemic hypertension: Blood pressure monitoring is essential. Appears safe even with concurrent renal failure.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
암로디핀은 디히드로피리딘계 칼슘 채널 차단제(CCB)로, 수의학에서는 주로 강력한 말초 동맥 혈관 확장제로 사용됩니다.
- 고양이 의학: 만성 신장 질환(CKD), 갑상선 기능 항진증 또는 비대성 심근병증에 속발하는 고양이 전신 고혈압 관리의 표준 치료제이자 1차 선택약입니다. 고양이에서는 단일 약제로도 매우 효과적입니다.
- 개 의학: 개에서는 난치성 울혈성 심부전(CHF)의 후부하 감소 보조제나 2차 항고혈압제로 주로 사용됩니다. 개에서 고용량으로 단독 사용할 경우 레닌-안지오텐신-알도스테론계(RAAS)를 활성화할 수 있으므로, 이를 완화하기 위해 주로 ACE 억제제(예: 에날라프릴)와 병용합니다.
- 임상 요점: 작용 발현이 비교적 느려 급성 저혈압 위기를 예방하는 데 도움이 되지만, 투약을 거르면 급격한 반동성 고혈압이 발생할 수 있습니다.
작용 기전
Amlodipine selectively inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle by blocking L-type voltage-gated calcium channels.
- Vascular Smooth Muscle → Relaxation and vasodilation → Significant reduction in peripheral vascular resistance (afterload) → Decreased systemic blood pressure.
- It has a much higher affinity for vascular smooth muscle than cardiac muscle, meaning it produces profound vasodilation with minimal negative inotropic (contractility) or chronotropic (heart rate) effects at therapeutic doses.
- Cardiac Muscle → Mildly depresses impulse formation (automaticity) and conduction velocity.
안전성·주의사항
금기사항
- Patients with cardiogenic shock
- Advanced aortic stenosis (relative contraindication)
- Use with caution in patients with heart failure (due to slight negative inotropic effects)
- Use with caution in patients with hepatic dysfunction
부작용
- Cats: Infrequent azotemia, lethargy, hypokalemia, reflex tachycardia, weight loss
- Dogs: Gingival hyperplasia (with long-term use)
- Anorexia and hypotension (early in therapy)
주의
Renal Considerations in Cats: There is concern that using amlodipine alone for treating hypertension in cats with renal disease may expose glomeruli to higher pressures secondary to efferent arteriolar constriction (caused by localized RAAS activation). Using an ACE inhibitor concurrently may help prevent this, though routine use of ACE inhibitors with amlodipine in cats with CKD remains somewhat controversial.
- Cardiac Disease: Use cautiously in patients with heart failure due to slight negative inotropic effects.
- Hepatic Disease: Use cautiously as the drug is extensively metabolized in the liver; half-life may be prolonged.
- Pregnancy: Fetotoxic in laboratory animals at very high doses; prolonged labor in rats. FDA Category C.
약물 상호작용
Concomitant use may cause additive hypotension.
Concomitant use may cause additive hypotension.
Concomitant use may cause additive hypotension.
May cause hypotension if used concurrently.
May alter bioavailability of amlodipine.
May impair hepatic metabolism of amlodipine, increasing circulating levels
May impair hepatic metabolism of amlodipine, increasing circulating levels
May impair hepatic metabolism of amlodipine, increasing circulating levels
May impair hepatic metabolism of amlodipine, increasing circulating levels
CYP3A4 inducer; may reduce circulating amlodipine levels
Increased risk of hypotension when combined
모니터링
- Systemic blood pressure (frequent monitoring during dose titration)
- Ophthalmic exam (to assess for hypertensive retinopathy/retinal detachment)
- Renal values and electrolytes (especially if combined with ACE inhibitors)
- Clinical signs of hypotension (lethargy, weakness)
약동학
반감기
흡수
Slowly but almost completely absorbed after oral administration. Bioavailability is not altered by food.
분포
Very high plasma protein binding characteristics (approximately 93%).
대사
Slowly but extensively metabolized to inactive compounds in the liver.
배설
Hepatic metabolism and subsequent excretion.
과다투여
Overdoses pose a significant risk for profound hypotension and reflex tachycardia (though bradycardia is also possible). Common clinical signs in dogs and cats include lethargy and vomiting.
Treatment:
- When possible, massive overdoses should be managed with gut emptying (emesis/lavage) and activated charcoal.
- Provide aggressive supportive treatment (IV fluids).
- Specific therapies may include beta-agonists, intravenous lipid emulsion (ILE) therapy, and intravenous calcium to counteract the calcium channel blockade.
제품
제형
- Oral tablets
- Oral suspension (compounded)
인용의약품
- Amlodipine Oral Tablets: 2.5 mg, 5 mg, & 10 mg (Norvasc, generic)
- Fixed-dose combination products with benazepril (Lotrel) or atorvastatin (Caduet)
규제 현황
Amodip is approved for cats in the EU.
POM-V, POM.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store tablets at room temperature in tight, light-resistant containers. Compounded oral suspensions (1 mg/mL in Ora-Plus/Ora-Sweet) retain >90% potency for 91 days at 5°C and 25°C, but must be protected from light.
보호자 정보
- 투여 방법: 음식과 함께 또는 빈속에 투여할 수 있습니다.
- 투약을 거르지 마십시오: 고혈압은 "침묵의 살인자"입니다. 투약을 거르면 혈압이 급격히 다시 상승하여 급성 실명, 발작 또는 심각한 신장 손상을 유발할 수 있습니다.
- 모니터링: 반려동물의 혈압을 측정하고 용량이 올바른지 확인하기 위해 정기적인 동물병원 방문이 필요합니다.
- 부작용: 특히 약을 처음 시작할 때 무기력, 쇠약 또는 식욕 부진의 징후가 있는지 관찰하십시오. 개에서는 장기간 사용 시 잇몸이 과도하게 자랄 수 있습니다(치은 증식증).
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