디히드로타키스테롤
Dihydrotachysterol
다른 이름: DHT · Hytakerol · AT 10 · Atiten · Dihydral · Dygratyl · Tachyrol · Tachystin · dichysterol · dihydrotachysterol2
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 |
|---|---|---|---|---|---|
| Hypocalcemia secondary to hypoparathyroidism | Initially give 0.03 mg/kg PO for several days or until effect is demonstrated, then give 0.02 mg/kg for 2 days, then 0.01 mg/kg per day. | PO | q24h | — | 🌎 NA |
- Hypocalcemia secondary to hypoparathyroidism: Pet should remain hospitalized until serum calcium concentration remains stable between 8-9.5 mg/dL. Recheck serum calcium on a weekly basis during early stages of treatment; recheck every 2-3 months long-term. Some dogs and cats that appear to be resistant to treatment on tablets or capsules may respond to the liquid form.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Hypocalcemia secondary to hypoparathyroidism | Initially give 0.03 mg/kg PO for several days or until effect is demonstrated, then give 0.02 mg/kg for 2 days, then 0.01 mg/kg per day. | PO | q24h | — | 🌎 NA |
| Chronic hypocalcemia with oral calcium tx | Initially: 0.02-0.03 mg/kg/day PO. Maintenance: 0.01-0.02 mg/kg PO q24-48h. | PO | q24-48h | — | 🌎 NA |
- Hypocalcemia secondary to hypoparathyroidism: Pet should remain hospitalized until serum calcium concentration remains stable between 8-9.5 mg/dL. Recheck serum calcium on a weekly basis during early stages of treatment; recheck every 2-3 months long-term. Some dogs and cats that appear to be resistant to treatment on tablets or capsules may respond to the liquid form.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
디히드로타키스테롤(DHT)은 합성 지용성 비타민 D 유사체로, 수의학에서는 주로 부갑상선 기능 저하증이나 중증 신장 질환에 속발하는 고칼슘혈증을 관리하는 데 사용됩니다.
역사적으로 중요한 약물이지만, 상업적 공급 문제와 칼시트리올의 더 유리한 약동학적 특성(작용 시작이 빠르고 작용 시간이 짧아 우발적인 고칼슘혈증 관리가 더 용이함)으로 인해 임상적 사용은 대부분 칼시트리올로 대체되었습니다.
주요 임상 포인트:
- 작용 시작: 에르고칼시페롤(비타민 D2)보다 빠르지만 칼시트리올보다는 느립니다.
- 신장 활성화 우회: 콜레칼시페롤과 달리 DHT는 활성화되기 위해 신장의 1-알파-수산화효소를 필요로 하지 않으므로 중증 신부전 환자에게 효과적입니다.
- 독성 위험: 약효가 사라지는 데 1~3주가 걸릴 수 있으므로 의인성 고칼슘혈증의 위험이 크며 철저한 모니터링이 필요합니다.
작용 기전
Dihydrotachysterol acts as a synthetic analog of 1,25-dihydroxyvitamin D. Its mechanism of action involves several key steps:
- Hepatic Activation: DHT is absorbed from the GI tract and transported to the liver, where it undergoes hydroxylation by hepatic 25-hydroxylase → 25-hydroxydihydrotachysterol (the active metabolite).
- Receptor Binding: The active metabolite binds to Vitamin D Receptors (VDR) in target tissues (primarily intestine, bone, and kidneys).
- Calcium Homeostasis:
- Intestine: Stimulates the synthesis of calcium-binding proteins (e.g., calbindin) → significantly enhances dietary calcium and phosphorus absorption.
- Bone: Works synergistically with parathyroid hormone (PTH) to promote the accretion and resorption of minerals, mobilizing calcium into the extracellular fluid.
- Kidneys: Promotes the reabsorption of calcium by the renal tubules.
Clinical Pearl: Because the active form of DHT is structurally similar to 1,25-dihydroxyvitamin D, it effectively bypasses the need for renal 1-alpha-hydroxylase, an enzyme often deficient in chronic kidney disease.
안전성·주의사항
금기사항
- Pre-existing hypercalcemia
- Vitamin D toxicity
- Malabsorption syndromes
- Abnormal sensitivity to the effects of vitamin D
부작용
- Hypercalcemia (manifesting as polydipsia, polyuria, anorexia, vomiting, lethargy)
- Nephrocalcinosis (soft tissue mineralization)
- Hyperphosphatemia
주의
Important Warnings
- Hyperphosphatemia: Use with extreme caution. Many clinicians consider hyperphosphatemia or a combined calcium/phosphorus product of >70 mg/dL to be an absolute contraindication due to the risk of metastatic soft tissue mineralization (nephrocalcinosis).
- Renal Dysfunction: Use with extreme caution when receiving the drug for non-renal indications.
- Pregnancy: FDA Category C. Hypervitaminosis D has caused fetal abnormalities in various species. Weigh risks vs. benefits.
- Nursing: Vitamin D is excreted in breast milk in limited amounts; use with caution.
- Laboratory Interference: Serum cholesterol levels may be falsely elevated by vitamin D analogs when using the Zlatkis-Zak reaction.
약물 상호작용
Use with vitamin D analogs may induce severe hypercalcemia.
Can nullify the calcium-elevating effects of vitamin D analogs.
Patients are highly sensitive to the arrhythmogenic effects of hypercalcemia; intensified monitoring is required.
Patients are sensitive to the effects of hypercalcemia; intensified monitoring is required.
May reduce the amount of DHT absorbed from the GI tract.
May reduce the amount of DHT absorbed from the GI tract.
May reduce the amount of DHT absorbed from the GI tract.
May induce hepatic enzyme systems and increase the metabolism of Vitamin D analogs, thus decreasing their activity.
May induce hepatic enzyme systems and increase the metabolism of Vitamin D analogs, thus decreasing their activity.
May induce hepatic enzyme systems and increase the metabolism of Vitamin D analogs, thus decreasing their activity.
May cause hypercalcemia when given in conjunction with Vitamin D analogs.
모니터링
- Serum calcium levels (closely/twice daily during initial treatment; at least 2-4 times yearly during maintenance)
- Serum phosphorus levels (particularly in renal failure patients)
- Calcium-phosphorus product (Ca x P)
약동학
흡수
Readily absorbed from the small intestine if fat absorption is normal. Bile is required for adequate absorption; patients with steatorrhea, liver, or biliary disease will have diminished absorption. Liquid dosage forms may have better bioavailability than tablets/capsules in some animals.
분포
Widely distributed and highly protein-bound in plasma.
대사
Hydroxylated in the liver to 25-hydroxy-dihydrotachysterol, the active form of the drug. Does not require parathormone activation in the kidneys.
배설
Excreted primarily via bile and feces. Offloads relatively rapidly compared to some other forms of vitamin D, with effects dissipating in 1-3 weeks.
과다투여
Acute Toxicity
Acute ingestions should be managed using established protocols for GI decontamination. Orally administered mineral oil may reduce absorption and enhance fecal elimination.
Chronic Toxicity (Hypercalcemia)
Hypercalcemia secondary to chronic dosing is a serious complication.
- Discontinue Therapy: Immediately stop DHT and any exogenous calcium supplementation.
- Severe Hypercalcemia Management: Administer furosemide, calcium-free IV fluids (e.g., 0.9% normal saline) to promote diuresis, urine acidification, and corticosteroids (which decrease intestinal calcium absorption and increase renal excretion).
- Monitoring: Because of the long duration of action of DHT (usually one week and potentially up to 3 weeks), hypercalcemia may persist for an extended period.
- Re-initiation: Restart DHT/calcium therapy at a reduced dosage with diligent monitoring only when serum calcium levels return to the normal range.
제품
제형
- Tablets (compounded)
- Capsules (compounded)
- Oral liquid/concentrate (compounded)
동물용의약품
- None commercially available (must be compounded)
인용의약품
- None commercially available (must be compounded)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store at room temperature (15-30°C). Capsules or tablets should be stored in well-closed, light-resistant containers. Oral concentrate should be stored in tight, light-resistant containers.
보호자 정보
반려동물 보호자를 위한 중요 정보
디히드로타키스테롤(DHT)은 일반적으로 부갑상선이나 신장이 제대로 기능하지 않아 반려동물의 신체가 칼슘을 흡수하고 정상적인 수치를 유지하도록 돕는 데 사용되는 약물입니다.
- 엄격한 투약: 처방된 대로 정확하게 이 약을 투여하십시오. 수의사의 명확한 지시 없이 복용량을 변경하거나 추가 칼슘 보충제를 투여해서는 절대 안 됩니다. 작은 변화라도 혈중 칼슘 수치에 위험한 변동을 일으킬 수 있습니다.
- 고칼슘혈증의 징후: 갈증 증가(물 많이 마심), 배뇨 증가, 식욕 부진, 구토 또는 심한 무기력증이 있는지 주의 깊게 관찰하십시오. 이러한 징후가 보이면 즉시 수의사에게 연락하십시오.
- 저칼슘혈증의 징후: 복용량이 너무 낮으면 반려동물에게 근육 떨림, 안면 경련, 뻣뻣함, 쇠약, 비틀거림(운동 실조), 행동 변화 또는 발작과 같은 저칼슘 징후가 나타날 수 있습니다.
- 빈번한 혈액 검사: 반려동물의 칼슘 수치가 안전한지 확인하기 위해, 특히 약물 복용을 시작할 때 빈번한 혈액 검사가 필요합니다. 이는 반려동물의 안전을 위해 필수적입니다.
- 투여 방법: 반려동물이 알약에 잘 반응하지 않는 경우, 수의사가 액체 형태로 변경할 수 있으며, 때로는 액체가 더 잘 흡수되기도 합니다.
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