가바펜틴
Gabapentin
1-(aminomethyl)cyclohexaneacetic acid
다른 이름: Neurontin · Aclonium · Equipax · Gantin · Gabarone · Neurostil · Progresse · CI-945 · GOE-3450 · Gabapentinum
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 |
|---|---|---|---|---|---|
| Ancillary therapy of refractory seizures | 10-20 mg/kg | PO | q6-8h | — | 🌎 NA |
| Ancillary therapy of refractory seizures | 10-30 mg/kg | PO | q8-12h | — | 🌎 NA |
| Ancillary therapy of refractory seizures | 25-60 mg/kg/day divided q6-8h | PO | q6-8h | — | 🌎 NA |
| Ancillary therapy of refractory seizures | 10 mg/kg | PO | q8h | 3 months | 🌎 NA |
| Ancillary therapy of refractory seizures | 10-30 mg/kg | PO | q8h | — | 🌎 NA |
| Adjunctive treatment of chronic or cancer pain | 3 mg/kg | PO | once a day | — | 🌎 NA |
| Analgesic | 1.25-10 mg/kg | PO | q24h | — | 🌎 NA |
| Analgesic | 5-10 mg/kg | PO | 2-3 times a day | — | 🌎 NA |
| Analgesic | 2.5-10 mg/kg (up to 15 mg/kg) | PO | 1-3 times a day | — | 🌎 NA |
| Adjunctive seizure therapy / Chronic pain | 10-20 mg/kg | PO | q6-8h | — | 🌍 EU |
- Ancillary therapy of refractory seizures: Author notes gabapentin is the least effective of the newer antiepileptic drugs, particularly in dogs.
- Ancillary therapy of refractory seizures: Author initially uses 10 mg/kg PO q8h.
- Ancillary therapy of refractory seizures: For uncontrolled seizures when phenobarbital and potassium bromide levels were therapeutic, or sub-therapeutic but had unacceptable side effects.
- Analgesic: Most VIN consultants recommend this dose.
- Adjunctive seizure therapy / Chronic pain: starting dose; incremental dose increases are recommended
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Ancillary therapy of refractory seizures | 5-10 mg/kg | PO | q8-12h | — | 🌎 NA |
| Ancillary therapy of refractory seizures | 5 mg/kg | PO | three times daily | — | 🌎 NA |
| Ancillary therapy of refractory seizures | 10-30 mg/kg | PO | q8-12h | — | 🌎 NA |
| Analgesic | 1.25-10 mg/kg | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of chronic or cancer pain | 3 mg/kg | PO | once a day | — | 🌎 NA |
| Adjunctive analgesia associated with neuropathic pain | 2.5-5 mg/kg | PO | q12h | — | 🌎 NA |
| Analgesic | 5-10 mg/kg | PO | 2-3 times a day | — | 🌎 NA |
| Analgesic | 50 mg (total dose) per cat | PO | 1-3 times a day | — | 🌎 NA |
| Adjunctive seizure therapy / Chronic pain | 5-10 mg/kg | PO | q8-12h | — | 🌍 EU |
- Adjunctive analgesia associated with neuropathic pain: Author starts at 5 mg/kg and increases (up to 10 mg/kg) if no effect seen in two hours. Wean off slowly. Reduce in renal insufficiency.
- Analgesic: Most VIN consultants recommend this dose.
- Adjunctive seizure therapy / Chronic pain: starting dose; incremental dose increases are recommended
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
가바펜틴은 감마아미노뷰티르산(GABA)의 구조적 유사체로, 수의학에서 주로 신경병증성 진통 및 항경련 특성으로 널리 사용됩니다.
- 진통 작용: 만성, 부적응성 및 신경병증성 통증(예: 골관절염, 추간판 질환, 암성 통증)에 매우 효과적입니다. 종종 다중 모드 진통 요법의 일부로 사용됩니다.
- 발작 관리: 난치성 또는 복합 부분 발작을 위한 보조 항경련제(AED)로 사용되지만, 단독 약물로서의 효능은 제한적입니다.
- 행동/항불안: 동물병원 방문이나 스트레스가 많은 사건 전에 두려움, 불안, 스트레스(FAS)를 줄이기 위해 고양이와 개에서 오프라벨로 점점 더 많이 사용되고 있습니다.
작용 기전
Despite its name, gabapentin does not bind to GABA receptors, nor does it affect GABA synthesis or uptake.
- Binds selectively to the α2-δ (alpha-2-delta) subunit of voltage-gated calcium channels (CaV) in the central nervous system.
- Inhibition of Calcium Influx → Decreased presynaptic calcium currents.
- Reduced Neurotransmitter Release → Suppresses the release of excitatory neurotransmitters including glutamate, substance P, and norepinephrine in the dorsal horn of the spinal cord.
- This dampens neuronal excitability, effectively preventing allodynia (pain from non-noxious stimuli) and hyperalgesia (exaggerated pain response).
안전성·주의사항
금기사항
- Hypersensitivity to gabapentin
- Use of xylitol-containing human oral solutions in dogs
- Oral solutions containing xylitol (highly toxic to dogs)
부작용
- Ataxia
- Dizziness (humans)
- Somnolence
- Peripheral edema (humans)
- Withdrawal-precipitated seizures (if abruptly discontinued)
- Increased rate of pancreatic adenocarcinoma (noted in male rats)
- Mild sedation
- False-positive urinary protein tests (reported in humans)
- Hepatic toxicity (rare, reported in humans)
주의
WARNING: Commercially available human oral solutions (e.g., Neurontin) often contain xylitol (up to 300 mg/mL), which is highly toxic to dogs, causing severe hypoglycemia and hepatotoxicity. Avoid use in dogs.
- Renal Insufficiency: Eliminated primarily via the kidneys. Use with caution and consider dosage adjustments in patients with renal impairment. Dogs partially metabolize the drug (30-40%), so mild to moderate renal dysfunction may not require adjustment.
- Withdrawal: Abrupt discontinuation can lead to withdrawal-precipitated seizures. Taper the dose gradually when discontinuing, especially in epileptic patients.
- Laboratory Alterations: May cause false-positive urinary protein readings on Ames N-Multistix SG dipstick tests. Use a sulfosalicylic acid precipitation test instead.
약물 상호작용
Oral antacids given concurrently may decrease oral bioavailability of gabapentin by 20%; separate doses by at least 2 hours.
Co-administration may increase gabapentin AUC and efficacy/adverse effects. Gabapentin may reduce hydrocodone AUC, potentially reducing its effectiveness.
May increase gabapentin levels.
Reduced absorption of gabapentin from the GI tract. Administer gabapentin at least 2 hours after antacids.
Reduced renal clearance of gabapentin (not considered clinically important).
모니터링
- Clinical efficacy (reduction in pain scores or seizure frequency)
- Adverse effects (sedation, ataxia)
- Renal function (in patients with pre-existing disease)
- Clinical response (pain scores, seizure frequency)
- Renal and hepatic function in compromised patients
약동학
반감기
흡수
Dogs: Oral bioavailability ~80% at 50 mg/kg. Peak plasma levels at 2 hours. Cats: Bioavailability ~90% (high interpatient variation 50-120%). Peak levels at 100 minutes. Horses: Rapidly absorbed, peak levels within 2 hours.
분포
Cats: Volume of distribution is relatively low (Vdss 0.65 L/kg). Humans: Minimally bound to plasma proteins; CSF levels are ~20% of plasma levels.
대사
Dogs: Partially metabolized (30-40%) to N-methyl-gabapentin. Humans: Not significantly metabolized.
배설
Primarily via renal routes (excreted unchanged in urine in humans). Cats: Clearance ~3 mL/min/kg.
과다투여
In humans, massive overdoses (up to 49 grams) have been reported without fatality.
- Clinical Signs: Ataxia, lethargy, somnolence, vomiting, and diarrhea.
- Xylitol Toxicity Risk: The human oral solution contains 300 mg/mL of xylitol. Doses as low as 0.33 mL/kg of this solution can cause severe hypoglycemia or hepatotoxicity in dogs.
- Treatment: Primarily supportive. General decontamination (emesis, activated charcoal, cathartics) if caught early. The drug can be removed via hemodialysis. If xylitol toxicity is suspected secondary to the human liquid formulation, aggressive treatment for hypoglycemia and liver protection is required; contact an animal poison control center.
제품
제형
- Capsules
- Tablets
- Compounded Oral Suspension
- 100 mg capsule
- 300 mg capsule
- 400 mg capsule
- 600 mg film-coated tablet
- 800 mg film-coated tablet
- 50 mg/ml oral solution
인용의약품
- Gabapentin Oral Capsules & Tablets: 100 mg, 300 mg, 400 mg, 600 mg, 800 mg (Neurontin, generic)
- Gabapentin Oral Solution: 250 mg/5mL (50 mg/mL) (Neurontin) - Contains xylitol! Use with caution in dogs.
- Neurontin 100 mg, 300 mg, 400 mg capsules
- Neurontin 600 mg, 800 mg film-coated tablets
- Neurontin 50 mg/ml oral solution
규제 현황
POM CD Schedule 3
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Capsules and tablets: Store at room temperature (25°C / 77°F); excursions permitted to 15-30°C. Oral liquid: Store in the refrigerator at 2-8°C (36-46°F). Compounded suspensions are most stable at pH 5.5-6.5.
보호자 정보
가바펜틴이란? 가바펜틴은 만성 신경통을 치료하고, 덜 흔하게는 발작을 조절하는 데 사용되는 약물입니다. 또한 동물병원 방문과 같은 스트레스가 많은 사건 전에 두려움과 불안을 줄이기 위해 자주 사용됩니다.
투약 방법
- 음식과 함께 또는 빈속에 투여할 수 있습니다.
- 인체용 액상 제제(뉴론틴)에는 개에게 매우 독성이 강하고 치명적일 수 있는 인공 감미료인 자일리톨이 포함되어 있으므로, 수의 약국에서 특별히 조제하지 않은 한 절대 개에게 투여하지 마십시오.
주의 사항
- 가장 흔한 부작용은 졸음(진정)과 비틀거림(운동 실조)입니다. 이러한 부작용은 보통 경미하며 반려동물이 약에 적응함에 따라 호전되는 경우가 많습니다.
- 반려동물이 지나치게 졸려하거나 심하게 비틀거린다면 수의사에게 연락하십시오.
중요 참고 사항
- 반려동물이 발작 때문에 가바펜틴을 복용 중인 경우, 갑자기 약을 중단하지 마십시오. 심각한 금단 발작을 유발할 수 있습니다. 복용량을 변경하기 전에 항상 수의사와 상담하십시오.
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