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에페드린

Ephedrine

Ephedrine sulfate

교감신경 흥분성 기관지 확장제 / 승압제POIVIMSCIntranasal개고양이

다른 이름: Enurace · Ephedrine sulphate · Ephedrine hydrochloride · Ephedrini hydrochloridum

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

1-2 mg/kg PO q8-12hPO· q8-12h
— 🐕

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 bronchospasm (maintenance therapy)1-2 mg/kg PO q8-12hPOq8-12h—🌎 NA
Treatment of bronchospasm2 mg/kg PO q8-12hPOq8-12h—🌎 NA
Treatment of urinary incontinence5-15 mg (total dose) PO q8hPOq8h—🌎 NA
Treatment of urinary incontinence1.2 mg/kg PO q8h or 5-15 mg (total dose) PO q8hPOq8h—🌎 NA
Treatment of hypotension associated with anesthesia0.03-0.1 mg/kg IV bolusIVOnce, may repeat in 5 minutes—🌎 NA
Treatment of hypotension associated with anesthesia0.1-0.25 mg/kg IV bolusIVOnce—🌎 NA
Treatment of hypotension associated with anesthesia0.1-0.2 mg/kg IV bolusIVOnce15-60 minutes🌎 NA
Treatment of hypotension associated with anesthesia0.15-0.25 mg/kg IV boluses OR CRI at 5-10 micrograms/kg/minuteIVTo effect or CRI—🌎 NA
Hypotension during anaesthesiaDose not specified in monographIV/IMAs needed (effects wane after 2-3 doses)Perioperative🌍 EU
Urinary incontinenceDose not specified in monographPONot specifiedLong-term🌍 EU
  • Treatment of hypotension associated with anesthesia: Dilute 5 mg in 10 mL of saline and give the lower dosage first as sinus tachycardia may accompany the higher dose.
  • Treatment of hypotension associated with anesthesia: For relatively short procedures in ASA I or II patients when hypotension is not responsive to 1 or 2 crystalloid boluses.
  • Treatment of hypotension associated with anesthesia: Dilute into 5 mL of a balanced electrolyte solution or saline and give small increment IV boluses until desirable blood pressure achieved.
  • Hypotension during anaesthesia: Assists in bradycardia. Tachyphylaxis occurs rapidly.
  • Urinary incontinence: Exclude polyuria before treatment. Can be used with phenylpropanolamine.

고양이

적응증용량경로빈도기간지역
Treatment of bronchospasm (emergency treatment)2-5 mg POPOOnce—🌎 NA
Treatment of urinary incontinence2-4 mg (total dose) PO q8hPOq8h—🌎 NA
Treatment of urinary incontinence2-4 mg/kg PO q6-12h or 2-4 mg (total dose) PO q8hPOq6-12h or q8h—🌎 NA
Treatment of urinary incontinence2-4 mg per cat PO q8-12hPOq8-12h—🌎 NA
Treatment of hypotension associated with anesthesia0.15-0.25 mg/kg IV boluses OR CRI at 5-10 micrograms/kg/minuteIVTo effect or CRI—🌎 NA
Hypotension during anaesthesiaDose not specified in monographIV/IMAs neededPerioperative🌍 EU
Nasal congestion (cat 'flu')Dose not specified in monographtopicalNot specifiedShort-term🌍 EU
  • Treatment of hypotension associated with anesthesia: Dilute into 5 mL of a balanced electrolyte solution or saline and give small increment IV boluses until desirable blood pressure achieved.
  • Hypotension during anaesthesia: Use with caution.
  • Nasal congestion (cat 'flu'): Proposed for treatment of nasal congestion; may be of some benefit.

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

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개요

에페드린은 비카테콜아민계 교감신경 흥분성 아민입니다. 수의학에서는 주로 개와 고양이의 ​요도 괄약근 기능 부전(USMI)​ 관리에 사용되지만, 중추신경계 부작용 발생률이 낮은 페닐프로판올아민(PPA)이 더 선호되는 경우가 많습니다.

또한 마취로 인한 저혈압을 치료하기 위한 주사용 ​승압제​ 및 호흡기 질환을 위한 ​기관지 확장제​로도 사용됩니다.

​임상 요점:​ 에페드린은 다른 많은 교감신경 흥분제보다 혈액-뇌 장벽을 더 쉽게 통과하기 때문에 경도에서 중등도의 중추신경계 자극을 유발할 수 있으며, 일부 환자에서는 안절부절못하거나 흥분하는 증상으로 나타납니다.

작용 기전

Ephedrine is a mixed-acting sympathomimetic.

  • ​Indirect Action (Primary):​ It enters the sympathetic nerve terminal and promotes the release of stored norepinephrine into the synaptic cleft.
  • ​Direct Action (Secondary):​ It directly stimulates ​α- and β-adrenergic receptors​.

​Key Pathways:​

  • ​α1-receptors​ → Smooth muscle contraction → Increased internal urethral sphincter tone (improving continence) and peripheral vasoconstriction (increasing blood pressure).
  • ​β1-receptors​ → Positive inotropic and chronotropic effects on the heart → Increased cardiac output.
  • ​β2-receptors​ → Smooth muscle relaxation → Bronchodilation.

​Note:​ Because it relies heavily on endogenous norepinephrine stores, repeated frequent dosing can deplete these stores, leading to tachyphylaxis (diminished response over time).

안전성·주의사항

금기사항

  • Severe cardiovascular disease
  • Cardiac arrhythmias
  • Pregnancy
  • Lactation
  • Glaucoma

부작용

  • Irritability
  • Tachycardia
  • Hypertension
  • Anorexia
  • Tachyphylaxis (decreased response to subsequent doses)
  • Panting
  • Mydriasis (dilated pupils)
  • CNS stimulation (restlessness, agitation)
  • Atrial fibrillation
  • Vasoconstriction
  • Reduction of intestinal wall motility and tone

주의

Use with caution in patients with glaucoma, prostatic hypertrophy, hyperthyroidism, diabetes mellitus, cardiovascular disorders, or hypertension.

When administered IV, the administration rate should be carefully controlled (in humans, not to exceed 10 mg/minute; scale appropriately for veterinary patients).

​Pregnancy/Nursing:​ FDA Category C. Excreted in milk and may have deleterious effects on nursing animals. Consider milk replacer if use is absolutely necessary in a nursing dam.

약물 상호작용

Acepromazine (and other phenothiazines)

Phenothiazines block alpha-adrenergic receptors; concomitant use can lead to unopposed beta-activity causing vasodilation and increased cardiac rate.

Alpha-blockers (e.g., phentolamine, prazosin)

May negate the therapeutic effects of ephedrine.

General Anesthetics (cyclopropane, halogenated hydrocarbons)

Increased risk of arrhythmias. Propranolol may be administered should these occur.

Beta-blockers

Concomitant use may diminish the effects of both drugs.

DigoxinMajor

Increased risk of arrhythmias if used concurrently.

Monoamine Oxidase Inhibitors (including amitraz)

Should not be given within two weeks of receiving MAOIs; severe hypertension and hyperpyrexia are possible.

Other Sympathomimetic Agents (e.g., phenylpropanolamine)

Should not be administered together as increased toxicity may result.

Reserpine

May reverse the pressor effects of ephedrine.

TheophyllineModerate

May increase the risk for theophylline toxicity.

Tricyclic Antidepressants

May decrease the pressor effects of ephedrine.

Urinary Alkalinizers (e.g., sodium bicarbonate, citrates, carbonic anhydrase inhibitors)

May reduce urinary excretion of ephedrine and prolong its duration of activity, potentially requiring dosage adjustments.

Other sympathomimeticsModerate

Synergistic effects, increasing the risk of adverse cardiovascular and CNS stimulation.

Volatile anaestheticsMajor

Enhances the sensitivity of the myocardium to the arrhythmogenic effects of ephedrine.

Cardiac glycosides (e.g., digoxin)Major

Concomitant use can cause severe cardiac arrhythmias.

Tricyclic antidepressants (e.g., amitriptyline)Major

Concomitant use can cause severe cardiac arrhythmias.

MAO inhibitors (e.g., selegiline)Major

May cause severe hypertension when given concurrently.

AmitriptylineMajor

Concomitant use with tricyclic antidepressants can cause arrhythmias.

SelegilineMajor

Concomitant use with MAO inhibitors may cause severe hypertension.

PhenylpropanolamineModerate

Can be used in conjunction for urinary incontinence, but increases sympathetic load.

모니터링

  • Clinical effectiveness (resolution of incontinence, improved blood pressure, or bronchodilation)
  • Behavioral changes (restlessness, irritability)
  • Heart rate and rhythm (ECG during anaesthesia)
  • Resolution of urinary incontinence
  • Signs of CNS stimulation or excessive panting

약동학

흡수

Rapidly absorbed after oral or parenteral administration.

분포

Thought to cross both the blood-brain barrier and the placenta.

대사

Metabolized in the liver.

배설

Excreted unchanged in the urine. Urine pH may significantly alter excretion characteristics.

과다투여

Clinical signs of overdosage may consist of an exacerbation of adverse effects (restlessness, tachycardia).

In a very large overdose, severe cardiovascular signs (hypertension leading to rebound hypotension, bradycardias to tachycardias, and cardiovascular collapse) or CNS effects (ranging from severe stimulation to coma) can be seen.

​Treatment:​

  • If the overdose was recent, empty the stomach using usual precautions.
  • Administer activated charcoal and a cathartic.
  • Treat clinical signs supportively as they occur.

제품

제형

  • Capsules
  • 10 mg tablet
  • 15 mg tablet
  • 30 mg tablet
  • 50 mg tablet
  • 3 mg/ml solution for injection
  • 30 mg/ml solution for injection
  • 0.5% nasal drops
  • 1% nasal drops

동물용의약품

  • Enurace 10 mg, 15 mg, 30 mg, 50 mg tablets

인용의약품

  • Ephedrine Sulfate Capsules: 25 mg
  • Ephedrine Sulfate Injection: 50 mg/mL in 1 mL single-dose vials & preservative free in 1 mL single-dose amps
  • Ephedrine hydrochloride 3 mg/ml, 30 mg/ml solutions for injection
  • Ephedrine 0.5%, 1% nasal drops

규제 현황

European Union✓ 승인됨처방전의약품EMA
🐕 Dogs

POM-V classification in the UK/EU.

United Kingdom✓ 승인됨처방전의약품VMD
🐕 Dogs

POM-V, POM.

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

보관·안정성

Store ephedrine sulfate products in tight, light-resistant containers at room temperature unless otherwise directed. When used parenterally, ephedrine sulfate is usually administered directly and not diluted.

보호자 정보

  • ​규칙적인 투약이 중요합니다:​ 요실금에 이 약이 효과를 발휘하려면 수의사의 지시대로 정확하게 투여해야 합니다. 투약을 거르면 효과가 사라지고 요실금이 재발할 수 있습니다.
  • ​인내심:​ 약의 완전한 효과가 나타나기까지 며칠이 걸릴 수 있습니다.
  • ​부작용:​ 이 약은 흥분제처럼 작용하기 때문에 반려동물이 '초조함'을 느낄 수 있습니다. 반려동물이 지속적인 행동 변화(안절부절못함, 과민함, 서성거림)를 보이거나 요실금이 지속되거나 악화되면 수의사에게 연락하십시오.
  • ​투약 시간:​ 수면 방해를 예방하기 위해, 별도의 지시가 없는 한 하루의 마지막 복용량을 취침 직전에 주지 않도록 하십시오.
  • ​식욕:​ 반려동물의 식욕이 일시적으로 감소하는 것을 관찰할 수 있습니다.

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