카르비마졸
Carbimazole
Thioimidazole-derivative antithyroid drug
다른 이름: Vidalta · Neo-Carbimazole · Carbazole · Basolest · Camazol · Carbistad · Neo Tomizol · NeoMercazole · Neo-Thyreostat · Thyrostat · Tyrazol · Neo-morphazole · Neo-Mercazole · carbimazolum
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 |
|---|---|---|---|---|---|
| Hyperthyroidism | 15 mg/animal (starting dose) or 10 mg/animal if total thyroxine <100 nmol/l. Adjust dose in 5 mg increments. | PO | q24h | Long-term | 🌍 EU |
- Hyperthyroidism: Do not break tablets. Note: There are no data on the use of the sustained-release formulation in dogs.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Hyperthyroidism | 2.5-5 mg (total dose) per cat | PO | twice daily | — | 🌎 NA |
| Hyperthyroidism | 10-15 mg total dose daily per cat in divided doses | PO | divided doses | for 1-3 weeks | 🌎 NA |
| Hyperthyroidism | Initially, give 5 mg (total dose) | PO | q8h | for 2-3 weeks | 🌎 NA |
| Hyperthyroidism (Sustained-release tablets) | 15 mg | PO | once daily | — | 🌎 NA |
| Hyperthyroidism | 15 mg/animal (starting dose) or 10 mg/animal if total thyroxine <100 nmol/l. Adjust dose in 5 mg increments. | PO | q24h | Long-term | 🌍 EU |
- Hyperthyroidism: Will produce a euthyroid state for most patients. Then adjust dosage for the patient to the lowest effective dose. Most cats will need dosing at least once daily.
- Hyperthyroidism: Then adjust. May need to increase dose in approximately 10% of cats. Most cats require 5 mg PO q12h to maintain euthyroidism.
- Hyperthyroidism (Sustained-release tablets): Give at the same time each day. Do not break or crush tabs. Adjust dose upwards or downwards within a range of 10 mg-25 mg per day in 5 mg increments depending on clinical signs and TT4. If cat requires doses less than 10 mg per day, use alternative treatment.
- Hyperthyroidism: Do not break tablets.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
카르비마졸(Carbimazole)은 주로 수의학에서 고양이 갑상선 기능 항진증을 관리하는 데 사용되는 티오이미다졸 유도체 항갑상선제입니다。
- 이 약물은 전구약물(prodrug)로 작용하며 체내에서 메티마졸(methimazole)로 빠르게 변환됩니다。
- 메티마졸 특유의 쓴맛이 없기 때문에 고양이가 더 잘 받아들이며 위장관 부작용 발생률을 줄여줍니다。
- 미국이나 캐나다에서는 시판되지 않지만, 유럽 및 기타 지역에서는 널리 사용됩니다。
- 임상 팁: 분자량의 차이로 인해 동일한 혈청 농도에 도달하려면 메티마졸의 약 2배에 해당하는 밀리그램 용량이 필요합니다。
작용 기전
Carbimazole is a prodrug that is almost entirely converted to methimazole in the body.
- Methimazole actively inhibits the enzyme thyroid peroxidase (TPO).
- Inhibition of TPO → blocks the oxidation of iodide to iodine → prevents iodine incorporation into tyrosyl residues of thyroglobulin.
- It also inhibits the coupling of iodinated tyrosyl residues (monoiodotyrosine and diiodotyrosine) → prevents formation of thyroxine (T4) and triiodothyronine (T3).
- Note: It does not affect the release or activity of pre-formed thyroid hormones already in circulation, which accounts for the 1-3 week lag time before clinical improvement is seen.
안전성·주의사항
금기사항
- Hypersensitivity to carbimazole or methimazole
- Not recommended in cats intolerant to methimazole
- History of or concurrent hematologic abnormalities
- Liver disease
- Autoimmune disease
부작용
- Vomiting
- Anorexia
- Depression
- Eosinophilia (usually transient)
- Leukopenia (usually transient)
- Lymphocytosis (usually transient)
- Self-induced excoriations (rare but serious)
- Bleeding (rare but serious)
- Hepatopathy (rare but serious)
- Thrombocytopenia (rare but serious)
- Agranulocytosis (rare but serious)
- Positive direct antiglobulin test (rare but serious)
- Acquired myasthenia gravis (rare but serious)
- Positive ANA (with chronic use)
주의
Hypersensitivity: Contraindicated in patients hypersensitive to carbimazole or methimazole. Cross-Reactivity: Because carbimazole is a prodrug converted into methimazole, cats who have had prior serious reactions to methimazole should receive carbimazole with great caution. Pregnancy/Nursing: High levels of methimazole cross the placenta and may induce hypothyroidism in kittens. Levels higher than those found in plasma are found in breast milk. Kittens should be placed on a milk replacer after receiving colostrum from mothers on methimazole. FDA categorizes methimazole as category D for use during pregnancy.
약물 상호작용
Potential for increased risk for hepatotoxicity; increased monitoring (LFT's) necessary
Carbimazole may decrease digoxin efficacy
Potential for decreased anticoagulant efficacy if carbimazole added
Carbimazole interferes with the uptake and efficacy of radioiodine therapy. It must be discontinued prior to treatment.
Concurrent use is not recommended as it may interfere with the dietary management of hyperthyroidism.
모니터링
- CBC, platelet counts (baseline and every 2-3 weeks during first 3 months)
- Serum T4 (baseline and every 2-3 weeks during first 3 months)
- Liver function tests (if indicated by clinical signs)
- ANA (if indicated by clinical signs)
- T4 at 3-6 month intervals (after stabilized)
- Other diagnostic tests as dictated by adverse effects
약동학
반감기
흡수
Rapidly absorbed from the GI tract.
분포
In cats, the volume of distribution of methimazole is variable (0.12-0.84 L/kg). Methimazole apparently concentrates in thyroid tissue and biologic effects persist beyond measurable blood levels. Crosses the placenta and enters breast milk.
대사
Rapidly and nearly totally converted to methimazole in vivo.
배설
Plasma elimination half-life of methimazole ranges from 2.3-10.2 hours in cats and 8-9 hours in dogs.
과다투여
Acute toxicity that may be seen with overdosage includes vomiting, anorexia, depression, and more serious effects such as agranulocytosis, hepatopathy, and thrombocytopenias.
Treatment: Consists of following standard protocols in handling an oral ingestion (empty stomach if not contraindicated, administer charcoal, etc.) and treating symptomatically and supportively.
제품
제형
- Oral Tablets
- Oral Sustained-Release Tablets
동물용의약품
- Carbimazole Oral Sustained-Release Tablets: 10 mg & 15 mg (Vidalta, Intervet-UK)
인용의약품
- Carbimazole Oral Tablets: 5 mg & 20 mg (NeoCarbimazole, Carbazole, Neo Mercazole)
규제 현황
Approved for feline hyperthyroidism.
POM-V (Prescription Only Medicine - Veterinarian)
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Unless otherwise labeled, carbimazole tablets should be stored at room temperature in well-closed containers.
보호자 정보
- 목적: 이 약물은 갑상선 호르몬 생성을 줄여 고양이의 갑상선 기능 항진증을 관리합니다. 이는 완치제가 아닌 관리 목적의 약물입니다。
- 효과 발현 시간: 고양이의 증상이 눈에 띄게 개선되려면 보통 1~3주가 소요됩니다。
- 투여 방법: 처방된 대로 정확히 투여하십시오. 서방형 정제(예: Vidalta)를 부수거나 쪼개지 마십시오。
- 주의해야 할 부작용: 고양이가 구토, 식욕 부진, 무기력증을 보이거나 얼굴을 심하게 긁는 경우 수의사에게 연락하십시오。
- 안전 주의사항: 태반을 통과하고 모유로 분비될 수 있으므로 임산부나 수유 중인 여성은 이 약물을 취급할 때 주의해야 합니다(장갑 착용 권장)。
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