VetSheet

카르바마제핀

Carbamazepine

5H-Dibenz[b,f]azepine-5-carboxamide

항경련제 / 신경병증성 통증 진통제 / 행동 조절제PO개말

다른 이름: Tegretol · Carbatrol · Epitol · Equetro · G-32883 · carbamazepinum · karbamatsepiini · karbamazepinas

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

4-8 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
As a psychotherapeutic agent4-8 mg/kg PO q12hPOq12h—🌎 NA
  • As a psychotherapeutic agent: Not commonly used, but may have some utility in dogs that seem to have amygdalar hyperactivity; sometimes used in conjunction with SSRIs to control explosive aggression.

말

적응증용량경로빈도기간지역
For photic head shaking10 mg/kg PO q6h or 29 mg/kg PO q12hPOq6h or q12h—🌎 NA
  • For photic head shaking: May be helpful in some horses that do not respond to cyproheptadine.

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

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개요

카르바마제핀은 삼환계 항우울제인 이미프라민과 화학적으로 관련된 디벤조아제핀 이미노스틸벤 유도체입니다.

​임상 요점:​ 인의에서는 주요 항경련제 및 기분 안정제로 널리 사용되지만, 수의학(특히 개)에서의 유용성은 빠른 간 자가유도(autoinduction)로 인해 심각하게 제한됩니다. 개는 치료 며칠 후 이 약물을 매우 빠르게 대사하므로 치료 혈청 농도를 유지하는 것이 극히 어렵습니다.

이러한 약동학적 한계 때문에 동물의 발작 조절에 사용되는 경우는 드뭅니다. 대신 수의학에서는 주로 다음과 같은 용도로 사용됩니다:

  • 개의 ​행동 의학​ (예: 편도체 과활성 또는 폭발적 공격성 관리, 종종 SSRI와 병용).
  • 말의 ​신경병증성 통증​ 또는 시프로헵타딘과 같은 다른 치료에 반응하지 않는 ​광과민성 머리 흔들기(photic head shaking)​와 같은 특정 신경 질환.

작용 기전

Carbamazepine primarily acts by blocking voltage-gated sodium channels in neuronal membranes.

  • ​Mechanism:​ Binds preferentially to the inactive state of sodium channels → delays their recovery → inhibits repetitive neuronal firing and stabilizes hyperexcited neural membranes.
  • It also decreases the synaptic transmission of excitatory impulses and may reduce the release of the excitatory neurotransmitter glutamate.
  • Structurally related to tricyclic antidepressants, it also possesses mild anticholinergic, antidiuretic, and muscle relaxant properties.

안전성·주의사항

금기사항

  • Patients receiving MAO Inhibitors (e.g., selegiline) within the past 14 days
  • Patients with a history of bone marrow depression
  • Known hypersensitivity to carbamazepine or tricyclic antidepressants

부작용

  • Sedation and lethargy
  • Ataxia (unsteadiness)
  • Gastrointestinal upset (vomiting, anorexia)
  • Hepatotoxicity (elevated liver enzymes)
  • Blood dyscrasias (rare but possible bone marrow suppression)

주의

Use with extreme caution due to extensive drug interactions (it is a potent inducer of hepatic enzymes). In dogs, it rapidly induces its own metabolism (autoinduction), making long-term therapeutic dosing difficult. May interfere with thyroid function tests (decreased values) and some pregnancy tests, though veterinary significance is unclear.

약물 상호작용

Azole Antifungals (e.g., Ketoconazole, Itraconazole)

May increase plasma levels or effects of carbamazepine

Calcium Channel Blockers (e.g., Diltiazem, Verapamil)

May increase plasma levels or effects of carbamazepine; Carbamazepine may also decrease their effects

Cimetidine

May increase plasma levels or effects of carbamazepine

Danazol

May increase plasma levels or effects of carbamazepine

Grapefruit Juice

May increase plasma levels or effects of carbamazepine

Isoniazid

May increase plasma levels or effects of carbamazepine; Carbamazepine may also increase effects of Isoniazid

Macrolides (e.g., Erythromycin, Clarithromycin)

May increase plasma levels or effects of carbamazepine

MAO Inhibitors (e.g., Selegiline)

Contraindicated; discontinue MAOI at least 14 days prior to carbamazepine

Niacin

May increase plasma levels or effects of carbamazepine

SSRI Antidepressants (e.g., Fluoxetine)

May increase plasma levels or effects of carbamazepine

Tricyclic Antidepressants (e.g., Clomipramine, Amitriptyline)

May increase plasma levels or effects of carbamazepine; Carbamazepine may also decrease their effects, though it can increase Clomipramine levels

Valproic Acid

May increase plasma levels or effects of carbamazepine; Carbamazepine may decrease its effects and increase risk for phenobarbital toxicity

Barbiturates (e.g., Phenobarbital)

May decrease plasma levels or effects of carbamazepine

Cisplatin

May decrease plasma levels or effects of carbamazepine

Doxorubicin

May decrease plasma levels or effects of carbamazepine

Felbamate

May decrease plasma levels or effects of carbamazepine

Phenytoin

May decrease plasma levels or effects of carbamazepine

Primidone

May decrease plasma levels or effects of carbamazepine

Rifampin

May decrease plasma levels or effects of carbamazepine

Theophylline

May decrease plasma levels or effects of carbamazepine

Acetaminophen

Carbamazepine may decrease its effect by lowering serum concentrations

Benzodiazepines

Carbamazepine may decrease its effect by lowering serum concentrations

Bupropion

Carbamazepine may decrease its effect by lowering serum concentrations

Buspirone

Carbamazepine may decrease its effect by lowering serum concentrations

Cyclosporine

Carbamazepine may decrease its effect by lowering serum concentrations

Doxycycline

Carbamazepine may decrease its effect by lowering serum concentrations

Glucocorticoids

Carbamazepine may decrease its effect by lowering serum concentrations

Lamotrigine

Carbamazepine may decrease its effect by lowering serum concentrations

Levothyroxine

Carbamazepine may decrease its effect by lowering serum concentrations

Methadone

Carbamazepine may decrease its effect by lowering serum concentrations

Mirtazapine

Carbamazepine may decrease its effect by lowering serum concentrations

Non-depolarizing muscle blockers (e.g., Atracurium)

Carbamazepine may decrease its effect by lowering serum concentrations

Praziquantel

Carbamazepine may decrease its effect by lowering serum concentrations

Topiramate

Carbamazepine may decrease its effect by lowering serum concentrations

Tramadol

Carbamazepine may decrease its effect by lowering serum concentrations

Zonisamide

Carbamazepine may decrease its effect by lowering serum concentrations

Trazodone

Carbamazepine may decrease its effect by lowering serum concentrations

Warfarin

Carbamazepine may decrease its effect by lowering serum concentrations

모니터링

  • Complete Blood Count (CBC)
  • Liver function tests
  • Clinical efficacy and behavioral changes

약동학

반감기

개Initially ~15 hours, but drops to 1-2 hours after chronic dosing due to autoinduction.

흡수

Variable and relatively slow oral absorption.

분포

Widely distributed into tissues; highly protein-bound.

대사

Extensively metabolized in the liver. In dogs, it is a potent inducer of hepatic microsomal enzymes and rapidly induces its own metabolism (autoinduction) within days of starting therapy.

배설

Excreted primarily in the urine as metabolites.

과다투여

Overdose can lead to significant CNS depression, severe ataxia, tremors, seizures, respiratory depression, and cardiovascular abnormalities (tachycardia, hypotension). Treatment is primarily supportive and symptomatic, including gastric decontamination if caught early, IV fluids, and respiratory support. Seizures should be treated with standard anticonvulsants (e.g., diazepam, phenobarbital).

제품

제형

  • Oral Tablets
  • Oral Chewable Tablets
  • Extended-Release Tablets/Capsules
  • Oral Suspension

인용의약품

  • Carbamazepine Oral Tablets: 100 mg (regular and chewable), & 200 mg (Tegretol, Epitol, generic)
  • Carbamazepine Oral Tablets or Capsules Extended-Release (12-hour) (Tegretol XR, Carbatrol, Equetro, generic)
  • Carbamazepine Oral Suspension (Tegretol, generic)

규제 현황

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

보관·안정성

Store below 30°C (86°F) in airtight containers, as humid conditions can reduce potency by up to one-third. Protect from light. Compounded oral suspension (40 mg/mL in simple syrup) retains >90% potency for 90 days stored at both 5°C and 25°C, but must be protected from light and shaken vigorously before use.

보호자 정보

수의사가 반려동물에게 카르바마제핀을 처방했습니다. 다음 정보를 주의 깊게 읽어보시기 바랍니다:

  • ​허가 외 사용(Off-Label Use):​ 이 약물은 수의학에서 "허가 외"로 사용됩니다. 자주 사용되는 약물은 아니며, 수의사는 반려동물의 특정 행동적 또는 신경학적 필요에 따라 이 약을 처방했습니다.
  • ​엄격한 투약 일정:​ 처방된 대로 정확하게 약을 투여하는 것이 매우 중요합니다. 동물은 이 약물을 매우 빠르게 처리하기 때문에 한 번이라도 투약을 거르면 효과가 떨어질 수 있습니다. 종종 빈번한 투여가 필요합니다.
  • ​관찰할 사항:​ 반려동물에게 무기력증, 비틀거림(운동실조) 또는 위장 장애(구토, 식욕 부진)의 징후가 있는지 관찰하십시오.

​중요:​ 비정상적인 행동, 심한 구토 또는 눈/잇몸이 노랗게 변하는 증상(황달)을 발견하면 간 스트레스나 부작용의 징후일 수 있으므로 즉시 수의사에게 알리십시오.

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