디클로르페나미드
Dichlorphenamide
다른 이름: Daranide · Antidrasi · Fenamide · Glaucol · Glauconide · Glaumid · Oralcon · Oratrol · Tensodilen · Diclofenamidum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Adjunctive glaucoma treatment (extra-label)
- q8-12h
NA
반드시 함께 고려할 임상 맥락 (2)
- ■ Give this medicine as directed by your veterinarian. If your animal vomits or acts sick after receiving the medicine on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian.
- Store tablets in well-closed containers and at room temperature (20°C-25°C [68°F-77° F]).
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
디클로르페나미드(Dichlorphenamide)는 전신성 탄산탈수효소 억제제(CAI)로, 수의 안과에서 녹내장의 내과적 치료에 전통적으로 사용되었습니다.
- 임상 요점: 대사성 산증 및 저칼륨혈증과 같은 심각한 전신 부작용과 상업적 공급 부족으로 인해, 전신성 CAI는 대부분 도르졸라미드(dorzolamide) 및 브린졸라미드(brinzolamide)와 같은 국소 대체제로 대체되었습니다.
- 현재 처방될 경우, 일반적으로 조제 약국(compounding pharmacy)을 통해 구해야 합니다.
- 가벼운 항경련 및 이뇨 특성이 있지만, 현대 수의학에서는 이러한 적응증으로 거의 사용되지 않습니다.
작용 기전
Dichlorphenamide exerts its effects via noncompetitive, reversible inhibition of the enzyme carbonic anhydrase (CA).
- In the ciliary body: Inhibition of CA-II → decreased formation of bicarbonate (HCO3-) and hydrogen (H+) ions from carbon dioxide and water → reduced active transport of sodium into the posterior chamber → decreased aqueous humor production → lowered intraocular pressure (IOP).
- In the kidneys: Inhibits CA in the proximal convoluted tubule → increased renal tubular secretion of Na+, K+, and HCO3- → alkaline diuresis and potential metabolic acidosis.
- In the CNS: Exhibits mild anticonvulsant activity, likely secondary to localized metabolic acidosis or direct CA inhibition in the brain.
안전성·주의사항
금기사항
- Significant hepatic disease (may precipitate hepatic coma)
- Renal or adrenocortical insufficiency
- Hyponatremia
- Hypokalemia
- Hyperchloremic acidosis
- Electrolyte imbalance
- Severe pulmonary obstruction (unable to increase alveolar ventilation)
- Hypersensitivity to carbonic anhydrase inhibitors
- Chronic, noncongestive, angle-closure glaucoma (long-term use)
부작용
- Panting
- GI disturbances (inappetence, vomiting, diarrhea)
- CNS effects (sedation, depression, excitement)
- Hematologic effects (bone marrow depression)
- Renal effects (crystalluria, dysuria, renal colic, polyuria)
- Metabolic acidosis
- Hypokalemia
- Hyperglycemia
- Hyponatremia
- Hyperuricemia
- Hepatic insufficiency
- Dermatologic effects (rash)
- Hypersensitivity reactions
주의
Warning: Long-term use is contraindicated in patients with chronic, noncongestive, angle-closure glaucoma as it may mask the condition by lowering IOP while angle closure progresses.
- Use with extreme caution in patients with pre-existing electrolyte imbalances (especially hypokalemia or hyponatremia).
- May precipitate hepatic coma in patients with severe liver disease.
- Avoid in patients with severe pulmonary obstruction who cannot increase alveolar ventilation to compensate for metabolic acidosis.
- Pregnancy Category C: Teratogenic effects observed in animal studies; use only if benefits outweigh risks.
- Laboratory Interference: May cause false-positive results for urine protein using certain test methods (e.g., bromphenol blue, sulfosalicylic acid) due to urine alkalinization. May also decrease iodine uptake by the thyroid gland.
약물 상호작용
Alkaline urine caused by dichlorphenamide may decrease excretion of tricyclic antidepressants.
Increased risk of dichlorphenamide accumulation and toxicity; increased risk for metabolic acidosis; dichlorphenamide increases salicylate excretion.
Dichlorphenamide may cause hypokalemia, leading to an increased risk for digoxin toxicity.
Rarely, carbonic anhydrase inhibitors interfere with the hypoglycemic effects of insulin.
Dichlorphenamide may negate the effects of methenamine in the urine due to alkalinization.
Concomitant use may exacerbate potassium depletion.
Increased urinary excretion, which may reduce phenobarbital levels.
Decreased primidone concentrations.
Alkaline urine caused by dichlorphenamide may decrease quinidine excretion.
모니터링
- Intraocular pressure (IOP) / tonometry
- Serum electrolytes (may need to supplement potassium)
- Baseline CBC with differential and periodic retests if using chronically
- Clinical signs of adverse effects (GI upset, panting, CNS changes)
약동학
흡수
Onset of action in small animals is approximately 30 minutes, with maximal effect occurring in 2-4 hours.
분포
Not well studied in domestic animals.
대사
Not well studied in domestic animals.
배설
Duration of action in small animals is 8-12 hours.
과다투여
Information regarding acute toxicity of dichlorphenamide is limited.
- Clinical Signs: Likely extensions of adverse effects, including severe electrolyte derangements (hypokalemia, hyponatremia), profound metabolic acidosis, CNS depression, and dehydration.
- Treatment:
- Monitor serum electrolytes, blood gases, volume status, and CNS status.
- Provide aggressive supportive care, including IV fluid therapy to correct dehydration and acid-base/electrolyte imbalances (e.g., potassium supplementation). Treat symptomatically.
제품
제형
- Tablets (historically)
- Compounded oral formulations
동물용의약품
- None commercially available (requires compounding)
인용의약품
- None commercially available (requires compounding)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store tablets in well-closed containers and at room temperature. An expiration date of 5 years after the date of manufacture is assigned to the commercially available tablets (when available).
보호자 정보
- 투여 방법: 수의사의 지시대로 정확하게 투여하십시오. 반려동물이 위장 장애(구토 또는 식욕 부진)를 겪는 경우, 소량의 식사나 간식과 함께 약을 투여해 보십시오.
- 주의 깊게 관찰할 사항: 다음 증상을 발견하면 즉시 수의사에게 연락하십시오:
- 비정상적인 출혈이나 멍 (골수 억제의 징후일 수 있음).
- 근육 떨림, 쇠약 또는 심한 무기력 (저칼륨혈증의 징후).
- 피부 발진이나 과도한 헐떡임.
- 후속 조치: 반려동물의 안압(녹내장)과 혈액 검사(전해질 및 혈구 수)를 모니터링하기 위해 정기적인 검진이 매우 중요합니다.
참고: 상업용 정제는 거의 구할 수 없기 때문에 이 약은 종종 맞춤형으로 조제됩니다. 약이 떨어지기 전에 미리 리필을 준비하십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.