하이드로모르폰

Hydromorphone

Hydromorphone hydrochloride

오피오이드 작용제 / 진통제IVIMSCPORectal개고양이소형 포유류페렛

다른 이름: Dilaudid-HP · Exalgo · Palladone · dihydromorphinone hydrochloride · Dolonovag · Hydal · HydroStat IR · Opidol · Sophidone

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

0.08-0.2 mg/kg IV, IM, or SCIV/IM/SC· Not specified

체중— 🐕

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
As an analgesic	0.1 mg/kg IV or SC q2h or as a CRI at 0.03 mg/kg/hr	IV/SC	q2h or CRI	—	🌎 NA
For cancer pain	0.08-0.2 mg/kg IV, IM, or SC	IV/IM/SC	Not specified	—	🌎 NA
As an analgesic	0.05-0.2 mg/kg IV, IM, SC q2-4h	IV/IM/SC	q2-4h	—	🌎 NA
As an analgesic	0.2-0.6 mg/kg PO q6-8h	PO	q6-8h	—	🌎 NA
For perioperative pain	0.1-0.2 mg/kg IV, IM, SC q2-4h	IV/IM/SC	q2-4h	—	🌎 NA
As a premed prior to moderately painful procedures	0.1 mg/kg	Not specified	Once	—	🌎 NA
As a sedative/restraint agent for fractious or aggressive dogs	0.1-0.2 mg/kg mixed with acepromazine (0.05 mg/kg) IM	IM	Once	—	🌎 NA
As an alternate induction method (especially in critical patients)	0.05-0.2 mg/kg IV, slowly to effect followed by diazepam 0.02 mg/kg IV	IV	Once	—	🌎 NA

As an analgesic: Suggested doses based on pharmacokinetic study
As a premed prior to moderately painful procedures: May be combined with acepromazine (0.02-0.05 mg/kg) in young, healthy patients.
As a sedative/restraint agent for fractious or aggressive dogs: Maximal effect usually reached in about 15 minutes, but an additional wait of another 15 minutes may be necessary in some dogs.
As an alternate induction method (especially in critical patients): Do not mix two drugs together. Positive pressure ventilation likely necessary. Treat bradycardia with glycopyrrolate or atropine if needed.

고양이

적응증	용량	경로	빈도	기간	지역
As an analgesic	0.05-0.1 mg/kg IM, IV or SC q2-6 hours	IM/IV/SC	q2-6h	—	🌎 NA
For cancer pain	0.08-0.2 mg/kg IV, IM, or SC	IV/IM/SC	Not specified	—	🌎 NA
For moderate to severe pain	0.08-0.3+ mg/kg IV, IM or SC q2-6 hours	IV/IM/SC	q2-6h	—	🌎 NA
As a premed prior to moderately painful procedures	0.1 mg/kg	Not specified	Once	—	🌎 NA
As an alternate induction method (especially in critical patients)	0.05-0.2 mg/kg IV, slowly to effect followed by diazepam 0.02 mg/kg IV	IV	Once	—	🌎 NA

As a premed prior to moderately painful procedures: May be combined with acepromazine (0.05-0.2 mg/kg) in young, healthy patients.
As an alternate induction method (especially in critical patients): Do not mix two drugs together. Positive pressure ventilation likely necessary.

소형 포유류

적응증	용량	경로	빈도	기간	지역
As a pre-op (Rabbits)	0.05-0.1 mg/kg IV	IV	Once	—	🌎 NA
As a CRI post-op (Rabbits)	0.05 mg/kg IV loading dose, then 0.05-0.1 mg/kg/hr	IV	CRI	—	🌎 NA

페렛

적응증	용량	경로	빈도	기간	지역
As a pre-op	0.05-0.1 mg/kg IV	IV	Once	—	🌎 NA
As a CRI post-op	0.05 mg/kg IV loading dose, then 0.05-0.1 mg/kg/hr	IV	CRI	—	🌎 NA

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

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개요

하이드로모르폰은 강력한 반합성 순수 뮤-오피오이드 수용체 작용제로, 수의학에서 진정제, 보정제, 진통제 및 마취 전 투약으로 널리 사용됩니다.

주요 임상적 특징:

역가: 체중 당 기준으로 모르핀보다 약 5배 더 강력하며, 옥시모르폰과 거의 동등한 역가를 가집니다.
모르핀 대비 장점: 일반적으로 진정 작용이 덜하고, 정맥 투여 후 히스타민 방출이 최소화되며, 유의미한 혈관 확장이나 저혈압을 유발하는 경우가 드뭅니다.
임상적 유용성: 진통 효과와 작용 시간이 옥시모르폰과 비슷하지만 비용이 훨씬 저렴하여 수의 임상에서 옥시모르폰을 빠르게 대체하고 있습니다.
규제 상태: 남용 및 신체적 의존성 위험이 높아 스케줄 II (C-II) 향정신성의약품으로 분류됩니다.

작용 기전

Hydromorphone exerts its effects by binding to opioid receptors, primarily the mu (μ) receptors, with some affinity for delta (δ) receptors.

Mechanism pathway: Agonist binding to mu-receptors in the CNS (limbic system, spinal cord, thalamus, midbrain) and peripheral tissues (GI tract, smooth muscle) → activation of G-proteins → inhibition of adenylate cyclase → decreased intracellular cAMP → opening of potassium channels (causing hyperpolarization) and closing of voltage-gated calcium channels → decreased presynaptic release of excitatory neurotransmitters (e.g., Substance P, glutamate) → profound analgesia and altered pain perception.

Secondary effects include respiratory depression (decreased sensitivity of the respiratory center to CO2), antitussive activity, and increased GI sphincter tone leading to decreased motility.

안전성·주의사항

금기사항

Hypersensitivity to narcotic analgesics
Diarrhea caused by toxic ingestion (until toxin is eliminated)
Prior to GI obstructive surgery (due to vomiting risk)
Patients stung by scorpion species Centruroides sculpturatus Ewing and C. gertschi Stahnke (may potentiate venom)

부작용

Dogs: Nausea, vomiting, defecation, panting, vocalization, sedation, CNS depression, respiratory depression, bradycardia, decreased GI motility (constipation with chronic use)
Cats: Nausea, ataxia, hyperesthesia, hyperthermia, behavioral changes (mania/excitement if given without tranquilization)
Mild histamine release (infrequent compared to morphine)

주의

Black Box Warning / Extreme Caution: Use with extreme caution in patients with respiratory disease, acute respiratory dysfunction, head injuries, increased intracranial pressure, and acute abdominal conditions (e.g., colic) as it may obscure diagnosis.

Vomiting Risk: Contraindicated as a preanesthetic in animals with suspected gastric dilation, volvulus, or intestinal obstruction.
Systemic Disease: Use cautiously in hypothyroidism, severe renal insufficiency (acute uremia), adrenocortical insufficiency (Addison's), and severe hepatic disease (prolonged duration of action).
Cardiovascular: Can cause bradycardia; use cautiously in patients with preexisting bradyarrhythmias.
Feline Hyperthermia: Can cause self-limiting hyperthermia in cats. High doses in cats should be combined with a tranquilizer to prevent bizarre behavioral changes.
Vulnerable Populations: Geriatric, debilitated, or neonatal patients may be more susceptible and require lower dosages.

약물 상호작용

Butorphanol, Nalbuphine

Potentially could antagonize opiate effects

CNS Depressants

Additive CNS depression effects possible

Diuretics

Opiates may decrease diuretic efficacy in CHF patients

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

Severe and unpredictable opiate potentiation; not recommended if MAOI used within 14 days

Skeletal Muscle Relaxants

Hydromorphone may enhance muscle relaxant effects

Phenothiazines

May antagonize analgesic effects and increase risk for hypotension

Tricyclic Antidepressants (clomipramine, amitriptyline)

Hydromorphone may exacerbate the effects of tricyclic antidepressants

Warfarin

Opiates may potentiate anticoagulant activity

모니터링

Respiratory rate and depth (pulse oximetry highly recommended)
CNS level of depression or excitation
Blood pressure (especially with IV use)
Cardiac rate (monitor for bradycardia)
Analgesic efficacy

약동학

반감기

고양이Prolonged (due to glucuronidation deficiency)개35 minutes to 1 hour (route and dose dependent)

흡수

Absorbed when given by IV, IM, SC, and rectal routes. Peak levels occur between 10-30 minutes after SC dosing in dogs.

분포

High volume of distribution in dogs (> 4 L/kg with both IV and SC dosing).

대사

Metabolized in the liver, primarily by glucuronidation. Cats are deficient in this metabolic pathway, leading to prolonged half-lives.

배설

The glucuronidated metabolite is excreted by the kidney.

과다투여

Massive overdoses may produce profound respiratory and/or CNS depression in most species.

Other potential effects include:

Cardiovascular collapse
Hypothermia
Skeletal muscle hypotonia
Mania (especially in cats)

Treatment:

Naloxone is the specific reversal agent of choice for treating respiratory depression.
In massive overdoses, naloxone doses may need to be repeated, as naloxone's duration of action may be shorter than that of hydromorphone.
Mechanical respiratory support should be considered in cases of severe respiratory depression.
Provide supportive care as needed.

제품

제형

Powder for injection (lyophilized)
Oral tablets
Oral capsules (extended-release)
Oral liquid
Suppositories

동물용의약품

None

인용의약품

Hydromorphone HCl Injection: 1 mg/mL, 2 mg/mL, 4 mg/mL, 10 mg/mL (Dilaudid, Dilaudid-HP, generic)
Hydromorphone HCl Powder for Injection, lyophilized: 250 mg (Dilaudid-HP)
Hydromorphone HCl Oral Tablets: 2 mg, 4 mg, 8 mg (Dilaudid, generic)
Hydromorphone HCl Oral Capsules (extended-release): 8 mg, 12 mg, 16 mg (Exalgo)
Hydromorphone HCL Oral Liquid: 1 mg/1 mL (Dilaudid, generic)
Hydromorphone Suppositories: 3 mg (Dilaudid, generic)

규제 현황

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

보관·안정성

Injection should be stored at room temperature and protected from light. A slight yellowish tint does not indicate loss of potency. Stable for at least 24 hours when mixed with commonly used IV fluids if protected from light. Tablets should be stored at room temperature in tight, light-resistant containers. Suppositories should be kept in the refrigerator.

보호자 정보

하이드로모르폰은 강력한 오피오이드 진통제입니다.

감독 하의 사용: 주사로 투여할 경우, 일반적으로 동물병원 내에서 수의사의 직접적인 감독 하에 사용됩니다.
가정 내 경구 투여: 먹는 약(알약 또는 액상)을 처방받은 경우, 어린이와 다른 반려동물의 손이 닿지 않는 안전한 곳에 보관하십시오. 이는 엄격히 관리되는 약물입니다.
예상되는 반응: 반려동물이 진정되거나 졸려 보일 수 있습니다. 개에서는 헐떡임과 낑낑거림이 흔한 부작용이며, 이것이 반드시 통증을 의미하는 것은 아닙니다. 고양이는 간혹 안절부절못하거나 체온이 약간 상승할 수 있습니다.
주의해야 할 부작용: 심한 무기력증, 극심한 호흡 곤란 또는 심한 변비가 나타나는지 관찰하십시오. 이러한 증상이 발생하면 수의사에게 연락하십시오.
공유 금지: 이 약을 다른 반려동물이나 사람에게 절대 주지 마십시오. 잘못 사용할 경우 치명적일 수 있습니다.

VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.