플루메타손
Flumethasone
6alpha, 9alpha-difluoro-16alpha methylprednisolone
다른 이름: Flucort · Cerson · Locacortene · Locortene · Lorinden · flumetasone · glumetasoni pivalas · NSC-107680
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 |
|---|---|---|---|---|---|
| Labeled indications (musculoskeletal conditions, dermatoses, allergic states, shock) | 0.0625-0.25 mg daily in divided doses | PO | daily in divided doses | — | 🌎 NA |
| Labeled indications | 0.0625-0.25 mg daily; may repeat | IV, IM, SC | daily | — | 🌎 NA |
| Labeled indications (joint inflammation) | 0.166-1 mg | Intra-articularly | — | — | 🌎 NA |
| Labeled indications (localized lesions) | 0.125-1 mg | Intra-lesionally | — | — | 🌎 NA |
| General anti-inflammatory/immunosuppressive | 0.06-0.25 mg once daily | IV, IM, SC, or PO | once daily | — | 🌎 NA |
- Labeled indications (musculoskeletal conditions, dermatoses, allergic states, shock): Tablets no longer marketed in the USA
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Labeled indications (acute and chronic dermatoses) | 0.03125-0.125 mg daily in divided doses | PO | daily in divided doses | — | 🌎 NA |
| Labeled indications (acute and chronic dermatoses) | 0.03125-0.125 mg. If necessary, may repeat. | IV, IM, or SC | If necessary, may repeat | — | 🌎 NA |
| General anti-inflammatory/immunosuppressive | 0.03-0.125 mg once daily | IV, IM, SC, or PO | once daily | — | 🌎 NA |
- Labeled indications (acute and chronic dermatoses): Tablets no longer marketed in the USA
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Labeled indications (musculoskeletal conditions, allergic states) | 1.25-2.5 mg daily. If necessary, the dose may be repeated. | IV, IM or intra-articular | daily | — | 🌎 NA |
| General anti-inflammatory | 1-2.5 mg/450 kg | IV or IM | — | — | 🌎 NA |
- Labeled indications (musculoskeletal conditions, allergic states): ARCI UCGFS Class 4 Drug
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
플루메타손은 수의학에서 강력한 항염증 및 면역 억제 특성을 위해 사용되는 매우 강력하고 지속 시간이 긴 불소화 글루코코르티코이드입니다.
주요 약리학적 특징은 다음과 같습니다:
- 높은 역가: 히드로코르티손보다 약 15~30배 더 강력합니다.
- 무기질코르티코이드 활성 결여: 무기질코르티코이드(나트륨 저류) 효과가 거의 없어, 이전 세대의 스테로이드에 비해 부종 및 고혈압의 위험이 적습니다.
- 임상적 유용성: 급성 염증 반응(예: 곤충 물림 과민증, 백신 반응, 쇼크), 근골격계 염증(점액낭염, 근육염, 골관절염) 및 다양한 급성 또는 만성 피부 질환에 매우 효과적입니다.
임상 핵심: 모든 전신성 코르티코스테로이드와 마찬가지로 플루메타손 치료의 전반적인 목표는 의인성 부신피질기능항진증(쿠싱 증후군) 및 부신축 억제의 위험을 최소화하기 위해 '필요한 만큼만, 가능한 적게, 가능한 짧은 기간 동안' 사용하는 것입니다.
작용 기전
Flumethasone exerts its effects via classic genomic and non-genomic steroid pathways:
- Genomic Pathway: Free flumethasone crosses the cell membrane and binds to cytosolic glucocorticoid receptors (GR).
- The receptor-ligand complex translocates to the nucleus and binds to glucocorticoid response elements (GREs) on DNA.
- Transactivation: Upregulates the expression of anti-inflammatory proteins, notably lipocortin-1 (annexin A1). Lipocortin-1 inhibits phospholipase A2 → blocking the release of arachidonic acid from membrane phospholipids → profoundly decreasing the synthesis of pro-inflammatory prostaglandins and leukotrienes.
- Transrepression: Downregulates the expression of pro-inflammatory cytokines (e.g., IL-1, IL-6, TNF-alpha) by inhibiting transcription factors like NF-κB and AP-1.
- Non-genomic Pathway: Rapid physicochemical interactions with cellular membranes provide immediate effects, which is particularly beneficial in shock or acute hypersensitivity states.
안전성·주의사항
금기사항
- Last trimester of pregnancy (may induce parturition)
- Systemic fungal infections (unless used for Addison's replacement therapy)
- Idiopathic thrombocytopenia (specifically contraindicated for IM administration)
- Known hypersensitivity to the compound
- Chronic corticosteroid therapy of systemic diseases using sustained-release injectable forms
부작용
- Polydipsia (PD), polyuria (PU), and polyphagia (PP)
- Weight gain and lipidemias
- Dull, dry haircoat and dermatological thinning
- Panting
- Gastrointestinal effects: vomiting, diarrhea, GI ulceration
- Hepatopathy: elevated liver enzymes (ALP, ALT)
- Pancreatitis
- Endocrine: activation or worsening of diabetes mellitus, iatrogenic hyperadrenocorticism (Cushingoid effects) with sustained use
- Musculoskeletal: muscle wasting, retarded growth in young animals
- Behavioral changes: depression, lethargy, viciousness
- Immunosuppression: increased susceptibility to infections
주의
Tapering Required: Animals that have received systemic glucocorticoids (other than short 'burst' therapy) must be tapered off slowly to allow endogenous ACTH and corticosteroid function to recover.
Stress Dosing: If an animal undergoes a 'stressor' (e.g., surgery, trauma, illness) during the tapering process or before normal adrenal/pituitary function resumes, additional glucocorticoids should be administered.
Pregnancy Warning: Corticosteroid therapy may induce parturition in large animal species during the latter stages of pregnancy. Categorized as Class C for canine and feline pregnancy (use cautiously as a last resort when benefits clearly outweigh risks).
약물 상호작용
Administered concomitantly with glucocorticoids may cause hypokalemia
In patients with myasthenia gravis, concomitant administration may lead to profound muscle weakness. Discontinue anticholinesterase at least 24 hours prior if possible.
Glucocorticoids may reduce salicylate blood levels
May increase the metabolism of glucocorticoids and decrease flumethasone blood levels
Glucocorticoids may inhibit the hepatic metabolism of cyclophosphamide; dosage adjustments may be required
Concomitant administration may increase the blood levels of each by mutually inhibiting hepatic metabolism
Flumethasone may decrease diazepam levels
Administered concomitantly with glucocorticoids may cause hypokalemia
May reduce flumethasone blood levels
Insulin requirements may increase in patients receiving glucocorticoids
May decrease the metabolism of glucocorticoids and increase flumethasone blood levels; ketoconazole may induce adrenal insufficiency when glucocorticoids are withdrawn
May decrease the metabolism of glucocorticoids and increase flumethasone blood levels
May alter the metabolism of steroids; higher than usual doses of steroids may be necessary to treat mitotane-induced adrenal insufficiency
Administration of ulcerogenic drugs with glucocorticoids may increase the risk of gastrointestinal ulceration
May increase the metabolism of glucocorticoids and decrease flumethasone blood levels
May increase the metabolism of glucocorticoids and decrease flumethasone blood levels
Patients receiving immunosuppressive dosages should not receive live attenuated-virus vaccines (augmented virus replication); diminished immune response may occur with any vaccine
모니터링
- Weight, appetite, and signs of edema
- Serum and/or urine electrolytes
- Total plasma proteins, albumin
- Blood glucose
- Growth and development in young animals
- ACTH stimulation test if necessary (to assess adrenal axis suppression)
과다투여
Short-term administration of massive dosages of glucocorticoids is unlikely to cause harmful effects. There is one reported incidence of a dog developing acute CNS effects after accidental ingestion. If acute clinical signs occur, provide supportive treatment as required.
Chronic overdosage or sustained high-dose usage leads to serious adverse effects, primarily manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome), characterized by severe polyuria/polydipsia, muscle wasting, alopecia, pot-bellied appearance, and immunosuppression.
제품
제형
- Injection: 0.5 mg/mL solution
- Tablets (Note: Oral formulations are generally no longer marketed in the USA)
동물용의약품
- Flumethasone Injection: 0.5 mg/mL in 100 mL vials; Flucort Solution (Pfizer); (Rx)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Flumethasone injection should be stored at room temperature; avoid freezing.
보호자 정보
플루메타손은 염증을 빠르게 줄이고, 심각한 알레르기를 치료하거나 특정 피부 및 관절 질환을 관리하는 데 사용되는 강력한 스테로이드 약물입니다.
- 지시사항을 주의 깊게 따르십시오: 처방된 정확한 용량을 투여하십시오. 수의사와 상의 없이 이 약의 투여를 갑자기 중단하지 마십시오. 갑작스러운 중단은 신체가 일시적으로 자체 천연 스테로이드를 생성하지 못하게 하여 생명을 위협하는 위기를 초래할 수 있습니다.
- 예상되는 부작용: 반려동물이 물을 더 많이 마시고, 소변을 더 자주 보며, 식욕이 증가하는 것을 알 수 있습니다. 개에서는 헐떡임도 흔하게 나타납니다.
- 수의사에게 연락해야 할 때: 부작용이 심해지거나, 반려동물이 구토, 설사, 검고 끈적이는 변(위궤양의 징후), 극심한 무기력증 또는 행동 변화(비정상적인 공격성이나 우울증 등)를 보이면 수의사에게 연락하십시오.
- 면역 체계: 이 약은 면역 체계를 억제하므로 반려동물을 아픈 동물로부터 멀리 떨어뜨려 놓고, 예방 접종을 하기 전에 수의사와 상의하십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.