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독세핀

Doxepin

Doxepin hydrochloride

삼환계 항우울제 / 항히스타민제POTopical개고양이새

다른 이름: Sinequan · Anten · Aponal · Deptran · Desidoxepin · Doneurin · Doxal · Doxepia · Gilex · Mareen · Quitaxon · Triadapin · Zonalon · Sinepin · doxepini hydrochloridum · NSC-108160 · P3693A · Doxepinum · Doxepin hydrochloride

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

3-5 mg/kg PO q12h; maximum dose is 150 mg (per dog) q12hPO· q12h
— 🐕

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

적응증용량경로빈도기간지역
Treatment of psychogenic dermatoses3-5 mg/kg PO q12h; maximum dose is 150 mg (per dog) q12hPOq12h—🌎 NA
Treatment of psychogenic dermatoses3-5 mg/kg, PO q8-12h. Begin at 3 mg/kg PO q12h for 2 weeks, then increase by 1 mg/kg PO q12h for 2 weeks up to the maximum dosage as needed; if no clinical response after at least 3-4 weeks of therapy, decrease dosage by 1 mg/kg PO q12h for 2 weeks until at the initial dosagePOq8-12hTitrated over weeks🌎 NA
Antihistaminic effects in treatment of atopy2.2 mg/kg PO three times dailyPOTID—🌎 NA
Antihistaminic effects in treatment of atopy3-5 mg/kg twice dailyPOBID—🌎 NA
Antihistaminic effects in treatment of atopy0.5-2 mg/kg PO q12hPOq12h—🌎 NA
Antihistaminic effects in treatment of atopy1-2 mg/kg PO q12hPOq12h—🌎 NA
Treatment of behavior problems (OCD)0.5-1 mg/kg PO twice dailyPOBID—🌎 NA
Treatment of behavior problems (acral lick granulomas)3-5 mg/kg PO q12h (up to 150 mg per dog)POq12h—🌎 NA
  • Antihistaminic effects in treatment of atopy: Used especially if dog has anxiety or other behavioral condition
  • Antihistaminic effects in treatment of atopy: May be best in nervous or highly strung dogs
  • Treatment of behavior problems (acral lick granulomas): Doses as above for psychogenic dermatoses

고양이

적응증용량경로빈도기간지역
Treatment of psychogenic dermatoses0.5-1 mg/kg PO q12-24h. Up to 25-50 mg (total dose) per cat.POq12-24hAllow 3-4 weeks for initial trial🌎 NA
Excessive grooming0.5-1 mg/kg PO q12h.POq12h—🌎 NA
Treatment of behavior problems (e.g., overgrooming, intercat aggression)0.5-1 mg/kg PO once to twice daily.POSID to BID—🌎 NA

새

적응증용량경로빈도기간지역
Treatment of anxiety, pruritus caused feather plucking in psittacines1-2 mg/kg PO q12hPOq12h—🌎 NA
Treatment of anxiety, pruritus caused feather plucking in psittacines0.5-1 mg/kg PO twice dailyPOBID—🌎 NA

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

독세핀은 디벤조옥사제핀 유도체인 ​삼환계 항우울제(TCA)​로, 수의학에서는 주로 기저에 불안 요소가 있는 심인성 피부 질환의 보조 치료제로 사용됩니다.

항우울제로 분류되지만 매우 강력한 ​H1-항히스타민 특성​을 가지고 있어 가려움증과 행동 문제를 관리하는 이중 목적의 약물입니다. 아토피 피부염에 대한 단독 항히스타민제로서의 효능은 논란의 여지가 있으나, 가려움증이 불안 및 강박 행동(예: 말단 핥기 육아종, 과도한 그루밍)을 악화시키거나 유발할 때 매우 유용합니다.

​임상 요점​: 항불안 및 항히스타민 효과가 결합되어 있기 때문에 알레르기성 피부 질환을 앓고 있는 신경질적이거나 예민한 환자에게 자주 선택됩니다.

작용 기전

Doxepin exerts its effects through multiple receptor pathways:

  • ​Monoamine Reuptake Inhibition:​ In the central nervous system, doxepin blocks the presynaptic reuptake of norepinephrine (moderate inhibition) and ​serotonin (5-HT)​ (weak inhibition) → increasing their synaptic concentrations and prolonging their activity, which contributes to its antidepressant and anxiolytic effects.
  • ​Receptor Antagonism:​ It exhibits potent H1-histamine receptor blockade (providing anti-pruritic and sedative effects), as well as ​anticholinergic (muscarinic)​ and alpha-1 adrenergic blocking activity. These latter receptor affinities are largely responsible for its side effect profile (e.g., dry mouth, urinary retention, hypotension).

안전성·주의사항

금기사항

  • Prior sensitivity to doxepin or other tricyclic antidepressants
  • Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) such as selegiline or amitraz (within 14 days)
  • Urinary retention
  • Glaucoma
  • Severe cardiac disease
  • History of seizures
  • Concurrent use with MAOIs

부작용

  • Hyperexcitability (paradoxical)
  • Gastrointestinal distress
  • Lethargy and sedation
  • Ventricular arrhythmias (particularly in overdose)
  • Anticholinergic effects (dry mouth, urinary retention, constipation)
  • Altered blood glucose levels
  • Dry mouth (xerostomia)
  • Tachycardia

주의

​Pregnancy & Nursing:​ Safety during pregnancy has not been established (FDA Category C). Doxepin and its active metabolite distribute into milk; use with caution in nursing patients as sedation and respiratory depression have been reported in human infants.

​Cardiac Effects:​ Tricyclics can widen QRS complexes, prolong PR intervals, and invert or flatten T-waves on ECG. Use with caution in patients with pre-existing cardiac disease.

​Laboratory Alterations:​ May alter (increase or decrease) blood glucose levels.

약물 상호작용

Anticholinergic AgentsModerate

Additive anticholinergic effects; use cautiously.

CimetidineModerate

May inhibit tricyclic antidepressant metabolism and increase the risk of toxicity.

CNS DepressantsModerate

Additive CNS depression; use cautiously.

Meperidine, Pentazocine, Dextromethorphan

Increased risk for serotonin syndrome.

Monoamine Oxidase Inhibitors (MAOIs, e.g., amitraz, selegiline)

Concomitant use (within 14 days) is generally contraindicated due to high risk of serotonin syndrome.

Quinidine

Increased risk for QTc interval prolongation and tricyclic adverse effects.

SSRIs (e.g., fluoxetine, paroxetine, sertraline)

Increased risk for serotonin syndrome.

Sympathomimetic Agents

May increase the risk of cardiac effects (arrhythmias, hypertension, hyperpyrexia).

Monoamine Oxidase Inhibitors (MAOIs)Major

Risk of fatal serotonin syndrome

Selective Serotonin Reuptake Inhibitors (SSRIs)Major

Increased risk of serotonin syndrome

모니터링

  • Efficacy (reduction in pruritus, anxiety, or compulsive behaviors)
  • Adverse effects (GI distress, lethargy, hyperexcitability)
  • ECG (if arrhythmias are suspected or in cases of overdose)
  • Heart rate and rhythm
  • Resolution of pruritus or behavioral signs
  • Signs of excessive sedation or anticholinergic effects

약동학

반감기

고양이Variable개Variable

흡수

Appears to be well absorbed after oral administration.

분포

Doxepin and its N-demethylated active metabolite are distributed into milk.

대사

Extensively metabolized in the liver to an active N-demethylated metabolite.

배설

Excreted primarily via the kidneys as metabolites.

과다투여

Overdosage with tricyclic antidepressants can be life-threatening.

  • ​Clinical Signs:​ Severe ventricular arrhythmias, cardiorespiratory collapse, profound CNS depression or seizures.
  • ​Action:​ Because the toxicities and therapies for treatment are complicated and controversial, it is highly recommended to contact an animal poison control center immediately for further information in any potential overdose situation.

제품

제형

  • Capsules: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg
  • Oral Concentrate: 10 mg/mL
  • Oral capsule (25 mg, 50 mg)
  • Topical cream

인용의약품

  • Doxepin Capsules: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg & 150 mg (Sinequan, generic)
  • Doxepin Oral Concentrate: 10 mg/mL in 120 mL (generic)
  • Sinepin capsules (25 mg, 50 mg)
  • Sinequan capsules
  • Zonalon cream

규제 현황

European Union✓ 승인됨처방전의약품EMA

POM (Prescription Only Medicine) status.

United Kingdom✓ 승인됨처방전의약품VMD

POM (Prescription Only Medicine) status.

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

보관·안정성

Store protected from direct sunlight in tight, light-resistant containers at room temperature.

보호자 정보

  • ​인내심 필요​：눈에 띄는 행동이나 피부 개선이 나타나기까지 몇 주(일반적으로 3~4주)가 걸릴 수 있습니다. 처방된 대로 정확히 투약을 계속하십시오.
  • ​안전 제일​：모든 삼환계 항우울제는 어린이 보호 포장으로 제공되어야 하며 어린이와 반려동물의 손이 닿지 않는 곳에 보관해야 합니다. 과다 복용은 치명적일 수 있습니다.
  • ​갑작스러운 중단 금지​：잠재적인 금단 증상을 피하기 위해 약물 투약을 중단하기 전에 수의사와 상의하십시오.
  • ​부작용 모니터링​：반려동물이 극심한 무기력증, 예기치 않은 과잉 행동, 구토 또는 빠르거나 불규칙한 심박수 징후를 보이면 수의사에게 연락하십시오.

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