클로니딘
Clonidine
Clonidine hydrochloride (imidazoline derivative)
다른 이름: Duraclon · Jenloga · Catapres-TTS · ST-155 · clonidini hydrochloridum · Adesipress-TTS · Arkamin · Aruclonin · Atensina · Barclyd · Cantanidin · Caprysin · Catanidin · Catapresan · Catapressan · Clonistada · Clonnirit · Dispaclonidin · Dixarit · Epiclodina · Glausine · Haemiton · Menograine · Mirfat · Normopresan · Paracefan · Tenso-Timelets · Clonidina · Clonidine hydrochloride · Clonidinum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Adjunctive antidiarrheal therapy for refractory cases of inflammatory bowel disease (extra-label)
인증된 수의사 확인 필요
- q8-12h
NA
반드시 함께 고려할 임상 맥락 (2)
- ■ This medicine may be given with or without food. If your animal vomits or acts sick after receiving this medicine on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian.
- Clonidine tablets should be stored in tight, light-resistant containers at room temperature, 25°C (77°F); excursions from 15°C to 30°C (59°F-86°F) are permitted. The preservative-free injection for epidural use should be stored at controlled room temperature, 20°C to 25°C (68°F-77°F). Because it contains no preservative, unused portions of the injection should be discarded.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
클로니딘은 중추성 알파-2 아드레날린 수용체 작용제로, 수의학에서는 전통적으로 개의 성장 호르몬(GH) 결핍증이나 갈색세포종을 진단하는 약물로 사용됩니다. 또한 난치성 염증성 장질환(IBD)(특히 고양이)의 보조 치료제 및 심한 통증이나 수술 마취를 위한 경막외 보조제로도 사용됩니다.
임상 요점 (약리학적 보충):
- 약물 전문에서는 진단 및 위장관 용도를 강조하지만, 현대 수의 행동 의학에서 클로니딘은 개의 공포 기반 불안, 소음 공포증 및 상황적 패닉을 관리하기 위해 허가 외(off-label)로 점점 더 많이 사용되고 있습니다.
- 교감신경 각성을 억제하여 항불안 및 진정 효과를 제공하며, 다른 진정제에서 흔히 볼 수 있는 심각한 운동 실조를 동반하지 않는 경우가 많습니다.
- 심혈관계에 미치는 영향 때문에 신중한 환자 선택과 용량 조절이 필요합니다.
작용 기전
Clonidine acts centrally at the brain stem, stimulating alpha-2 adrenoreceptors.
- Cardiovascular/Sympathetic: Stimulation of presynaptic alpha-2 receptors (e.g., in the locus coeruleus) → decreases norepinephrine release → reduces sympathetic outflow from the CNS → decreased peripheral resistance, heart rate, and blood pressure.
- Endocrine: Stimulates GHRH (Growth Hormone Releasing Hormone) → transient release of Growth Hormone (GH).
- Analgesia: Stimulates presynaptic and postjunctional alpha-2 adrenoreceptors in the dorsal horn of the spinal cord → blocks pain signal transmission to the brain.
- Gastrointestinal: Alpha-2 stimulation alters enteric nervous system tone, increasing fluid absorption and decreasing motility, aiding in refractory IBD.
안전성·주의사항
금기사항
- Known hypersensitivity to clonidine
- Severe cardiovascular disease (use with extreme caution)
- Renal disease (use with extreme caution)
부작용
- Transient hyperglycemia
- Dry mouth
- Constipation
- Aggressive behavior
- Hypotension
- Collapse
- Bradycardia
- Transient sedation
- Rebound hypertension (if withdrawn abruptly)
주의
Clonidine has a narrow margin of safety. It should be used with caution in patients with severe cardiovascular disease, including conduction disturbances or heart failure. Use very cautiously in patients with renal failure. Abrupt withdrawal, especially when used with beta-blockers, may cause rebound hypertension.
약물 상호작용
Possible additive hypotensive effects
May enhance bradycardia. If discontinuing, beta-blocker should be stopped first, then clonidine tapered to avoid rebound hypertension.
May exacerbate the actions of other CNS depressant drugs
Possible additive bradycardia
May decrease the antihypertensive effects of clonidine
May block the antihypertensive effects of clonidine
Increased central nervous system depression and hypotension
Additive sedation, bradycardia, and respiratory depression
Additive hypotensive and bradycardic effects; may exacerbate rebound hypertension upon withdrawal
Additive lowering of blood pressure
모니터링
- Growth Hormone (GH) levels and adverse effects (when used for diagnostics)
- Blood pressure
- Heart rate
- Efficacy and adverse effect profile (when used for ongoing diarrhea treatment)
- Degree of sedation
- Behavioral response
- Plasma IGF-1 or GH levels (when used diagnostically)
약동학
반감기
흡수
Well absorbed after oral administration in humans (peak plasma 3-5 hours). After epidural administration, maximal analgesia occurs within 30-60 minutes.
분포
Widely distributed into body tissues; tissue concentrations are higher than in plasma. Enters the CSF, but brain concentrations are low compared with other tissues. In cats, exhibits a two-compartment open model and penetrates tissues rapidly.
대사
Metabolized in the liver; one active metabolite (p-hydroxyclonidine) has been identified.
배설
Up to 60% of a dose is eliminated unchanged in the urine. Elimination may be prolonged with higher dosages (dose-dependent elimination kinetics) or in renal dysfunction.
과다투여
Clonidine has a narrow margin of safety.
- Clinical Signs: Hypotension, bradycardia, vomiting, weakness, depression, lethargy, tachycardia, ataxia, and hypertension. Rarely, seizures or respiratory depression.
- Toxicity Values: LD50 for oral clonidine in rats is 465 mg/kg; mice 206 mg/kg.
- Treatment: For large overdoses, gut evacuation using standard protocols (use emetics cautiously as consciousness may deteriorate rapidly). Symptomatic and supportive care. Fluids and pressors (e.g., dopamine) for hypotension. IV atropine for bradycardia. Atipamezole or yohimbine may be used to reverse cardiovascular effects, but multiple doses may be required as signs can last up to 48 hours.
제품
제형
- Epidural injection
- Oral tablets
- Oral modified-release tablets
- Transdermal patch
- Injectable: 150 μg/ml solution
- Oral: 25 μg tablets
인용의약품
- Clonidine HCl Injection for epidural use: 100 micrograms/mL & 500 micrograms/mL preservative-free (Duraclon)
- Clonidine HCl Oral Tablets: 0.1 mg, 0.2 mg & 0.3 mg (Catapres, generic)
- Clonidine HCl Oral Modified-release Tablets: 0.1 mg (Jenloga)
- Clonidine HCl Transdermal: 0.1 mg/24hrs, 0.2 mg/24hrs, & 0.3 mg/24hrs (Catapres-TTS-1, 2, or 3)
- Catapres 150 μg/ml injectable solution
- Catapres 25 μg oral tablets
규제 현황
POM (Prescription Only Medicine)
POM-V
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Tablets should be stored in tight, light-resistant containers at room temperature (15-30°C / 59-86°F). Preservative-free injection for epidural use should be stored at controlled room temperature (25°C); unused portions must be discarded.
보호자 정보
목적: 수의사가 심한 설사, 통증 관리 또는 심한 불안 및 공포증에 대한 허가 외 사용을 포함하여 반려동물의 상태를 관리하기 위해 클로니딘을 처방했습니다.
- 엄격한 투약: 클로니딘은 안전역이 좁습니다. 처방된 정확한 용량을 투여하십시오. 지시된 것보다 더 많이 투여하지 마십시오.
- 부작용: 극심한 무기력, 쇠약, 창백한 잇몸 또는 예상치 못한 행동 변화(예: 공격성)의 징후가 있는지 관찰하십시오. 이러한 증상이 나타나면 수의사에게 연락하십시오.
- 갑자기 중단하지 마십시오: 수의사와 상의 없이 이 약을 갑자기 중단하지 마십시오. 혈압이 위험하게 급상승(반동성 고혈압)할 수 있습니다.
- 우발적 섭취: 모든 반려동물과 어린이의 손이 닿지 않는 곳에 보관하십시오. 과다 복용이 발생하면 즉시 응급 수의학적 치료를 받으십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.