카르비마졸

항갑상선제

**카르비마졸(Carbimazole)**은 주로 수의학에서 **고양이 갑상선 기능 항진증**을 관리하는 데 사용되는 티오이미다졸 유도체 **항갑상선제**입니다。 * 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.

동물 종별 용량

Dogs

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 · Do not break tablets. Note: There are no data on the use of the sustained-release formulation in dogs.

Cats

Hyperthyroidism · 2.5-5 mg (total dose) per cat · PO · twice daily
Hyperthyroidism · 10-15 mg total dose daily per cat in divided doses · PO · divided doses · for 1-3 weeks · 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 · Initially, give 5 mg (total dose) · PO · q8h · for 2-3 weeks · 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) · 15 mg · PO · once daily · 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 · 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 · Do not break tablets.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

POtransdermal

금기

Hypersensitivity to carbimazole or methimazole
Not recommended in cats intolerant to methimazole
History of or concurrent hematologic abnormalities
Liver disease
Autoimmune disease

이상반응

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)

약물 상호작용

Bupropion · Potential for increased risk for hepatotoxicity; increased monitoring (LFT's) necessary
Digoxin · Carbimazole may decrease digoxin efficacy
Warfarin · Potential for decreased anticoagulant efficacy if carbimazole added
Iodine-131 (Radioiodine) · Carbimazole interferes with the uptake and efficacy of radioiodine therapy. It must be discontinued prior to treatment. · major
Low iodine prescription diets · Concurrent use is not recommended as it may interfere with the dietary management of hyperthyroidism. · major

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

과용량

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.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.