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코데인

Codeine

Codeine phosphate, Codeine sulfate

오피오이드 작용제 / 진통제 / 진해제POIMIVSC개고양이소형 포유류

다른 이름: Tylenol with Codeine · Empirin with Codeine · Pardale-V · Co-codamol (human combination) · Codeine phosphate hemihydrate · Codeini phosphas hemihydricus · Codeinii phosphas · Codeinum · Methylmorphine · Codeine sulfate

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

감사 완료 v13 용량 근거

구조화 용량 계산 근거

Antitussive (extra-label)

1–2 mg/kgPO

인증된 수의사 확인 필요

  • q6-12h

NA

반드시 함께 고려할 임상 맥락 (2)
  • ■ This medicine may be given with food or on an empty stomach.
  • Store codeine sulfate tablets in light-resistant, well-closed containers at room temperature 15°C to 30°C (59°F-86°F).
규제 약물인증된 수의사 확인 필요formulary프로토콜 2023감사 dose-audit-plumb-v13

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개요

​코데인(Codeine)​은 페난트렌 유도체 오피오이드 작용제로, 수의학에서는 주로 ​진해제​(기침 억제제) 및 경미한 ​진통제​로 사용됩니다. 때때로 지사제로도 사용됩니다.

  • ​진통​: 경도에서 중등도의 통증에 사용되며, 주로 NSAID가 효과가 없거나 금기인 경우에 사용됩니다.
  • ​진해​: 가래가 없는 마른 기침(예: 기관 허탈, 만성 기관지염)을 억제하는 데 매우 효과적입니다.
  • ​지사​: 위장관 운동성을 감소시킵니다.

​임상 요점​: 인의학에서는 널리 사용되지만, 개에서의 사용은 논란의 여지가 있습니다. 개는 경구 코데인 흡수율이 매우 낮고, 이를 활성 대사산물(모르핀)로 변환하는 강력한 효소 경로가 부족합니다. 따라서 개에서의 진통 효과는 변동성이 매우 크며, 일반적으로 부프레노르핀이나 메타돈과 같은 다른 오피오이드보다 열등한 것으로 간주됩니다.

작용 기전

Codeine acts as a weak agonist at mu (μ) opioid receptors.

  • Analgesia: Binds to ​μ-receptors​ in the central nervous system → inhibits the release of excitatory neurotransmitters (such as Substance P) in ascending pain pathways → alters the perception of and response to pain.
  • Antitussive: Causes direct depression of the medullary cough center in the brainstem.
  • Antidiarrheal: Binds to enteric μ-receptors → decreases gastrointestinal motility and increases sphincter tone.
  • Metabolism Note: In humans, codeine is a prodrug metabolized by the enzyme CYP2D6 → morphine. Dogs lack significant CYP2D6-equivalent activity, relying mostly on codeine-6-glucuronide for any analgesic effect, which explains its limited efficacy in this species.

안전성·주의사항

금기사항

  • Hypersensitivity to narcotic analgesics
  • Patients receiving monoamine oxidase inhibitors (MAOIs) like amitraz or selegiline
  • Diarrhea caused by toxic ingestion (until toxin is eliminated)
  • Repeated use in severe inflammatory bowel disease
  • Scorpion stings (Centruroides sculpturatus and C. gertschi) as it may potentiate venom
  • Combination products containing acetaminophen are STRICTLY CONTRAINDICATED in cats
  • Hypersensitivity to opioids
  • Severe respiratory depression or asthma
  • Cats (especially if using combination products containing paracetamol)

부작용

  • Sedation (most common)
  • Constipation
  • Anorexia
  • Vomiting
  • Ileus
  • Biliary and pancreatic duct spasms
  • Respiratory depression (at high doses)
  • Cats: CNS stimulation, hyperexcitability, tremors, seizures
  • Nausea

주의

Use with caution in patients with hypothyroidism, severe renal insufficiency, Addison's disease, and in geriatric or severely debilitated patients.

Use with caution in patients with head injuries or increased intracranial pressure, and in those with acute abdominal conditions (e.g., colic) as it may obscure the diagnosis.

Use with extreme caution in patients suffering from respiratory disease or acute respiratory dysfunction (e.g., pulmonary edema secondary to smoke inhalation).

Warning: Opiates can increase plasma amylase and lipase values up to 24 hours following administration due to increased biliary tract pressure.

약물 상호작용

Anticholinergic drugs

May increase the chances of constipation developing

Antidepressants (TCAs/MAOIs)

May potentiate CNS depressant effects

CNS Depressants (anesthetics, antihistamines, phenothiazines, barbiturates, tranquilizers)

May cause increased CNS or respiratory depression

Quinidine

May inhibit the transformation of codeine to morphine in the liver, decreasing its efficacy

CNS Depressants (e.g., phenobarbital, diazepam)Moderate

Additive CNS and respiratory depression

SSRIs / MAOIsMajor

Increased risk of serotonin syndrome

CNS Depressants (e.g., sedatives, anesthetics, antihistamines)Major

Additive CNS and respiratory depression

Monoamine Oxidase Inhibitors (MAOIs)Major

May cause severe, unpredictable reactions (serotonin syndrome or severe respiratory depression)

모니터링

  • Efficacy (pain relief, reduction in coughing, or resolution of diarrhea)
  • Adverse effects (sedation, respiratory rate, GI signs)
  • Respiratory rate and depth
  • Level of sedation
  • Pain score or coughing frequency
  • Bowel movements (monitor for constipation)

약동학

반감기

고양이Unknown개1 - 2 hours

흡수

Very limited evidence of oral absorption in dogs. In humans, codeine salts are rapidly absorbed orally, with oral administration being about 2/3 as effective as parenteral. Onset of action is usually within 30 minutes.

분포

Crosses the placenta and enters maternal milk.

대사

Metabolized in the liver.

배설

Excreted into the urine.

과다투여

Opiate overdosage may produce profound respiratory and/or CNS depression. Other effects can include cardiovascular collapse, hypothermia, and skeletal muscle hypotonia.

  • Decontamination: Oral ingestions should be removed using standard gut removal protocols. Inducing vomiting should be attempted with caution due to rapid changes in CNS status.
  • Antidote: Naloxone is the agent of choice for treating respiratory depression. In massive overdoses, naloxone doses may need to be repeated, as its effects may diminish before subtoxic levels of codeine are attained.
  • Supportive Care: Mechanical respiratory support should be considered in cases of severe respiratory depression. Contact an animal poison control center for further guidance.

제품

제형

  • Tablets
  • Oral solution/elixir
  • Parenteral injection
  • Combination products (with acetaminophen, aspirin, or guaifenesin)
  • 3 mg/5 ml paediatric linctus
  • 3 mg/ml linctus
  • 5 mg/ml syrup
  • 15 mg tablet
  • 30 mg tablet
  • 60 mg tablet

동물용의약품

  • Pardale-V tablets (Combination: Paracetamol 400 mg + Codeine phosphate 9 mg)

인용의약품

  • Codeine Phosphate Solution: 15 mg/5 mL
  • Codeine Sulfate Tablets: 15 mg, 30 mg & 60 mg
  • Codeine Phosphate Parenteral Injection: 15 mg/mL & 30 mg/mL
  • Codeine Phosphate Antitussives with expectorants (e.g., with guaifenesin)
  • Codeine Phosphate with Acetaminophen tablets (Tylenol® with Codeine #1, #2, #3, #4)
  • Codeine Phosphate with Aspirin tablets (Empirin® with Codeine #2, #3, #4)
  • Codeine linctus (3 mg/ml, 3 mg/5 ml)
  • Codeine syrup (5 mg/ml)
  • Codeine tablets (15 mg, 30 mg, 60 mg)

규제 현황

European Union✓ 승인됨처방전의약품 · Controlled DrugEMA
🐕 Dogs

Availability of veterinary specific products varies by member state.

United Kingdom✓ 승인됨처방전의약품 · Schedule 2 (pure codeine) or Schedule 5 (low dose combinations/linctus)VMD
🐕 Dogs

Classified as POM-V or POM depending on the specific product (e.g., Pardale-V is POM-V).

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

보관·안정성

Codeine phosphate and sulfate tablets should be stored in light-resistant, well-closed containers at room temperature. Codeine phosphate injection should be stored at room temperature (avoid freezing) and protected from light. Do not use the injection if discolored or if it contains a precipitate.

보호자 정보

  • ​어린이와 반려동물의 손이 닿지 않는 곳에 보관하십시오​: 이 약물은 규제 약물입니다.
  • ​고양이에게 독성​: 아세트아미노펜이 포함된 제품(예: Tylenol® with Codeine)은 ​절대​ 고양이에게 투여해서는 안 됩니다. 급사할 수 있습니다.
  • ​부작용​: 극심한 졸음, 변비, 식욕 부진 또는 구토가 있는지 관찰하십시오. 고양이는 때때로 비정상적으로 과잉 행동을 하거나, 불안해하거나, 떨림을 보일 수 있습니다.
  • ​수의사에게 연락해야 할 때​: 행동이나 활동 수준에 중대한 변화가 있거나 심각한 위장관 증상이 나타나면 즉시 수의사에게 알리십시오.

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