이미프라민
Imipramine
Imipramine hydrochloride, Imipramine pamoate
다른 이름: Tofranil-PM · imipramini chloridum · imipramini hydrochloridum · imizine · Antidep · Celamine · Depramina · Depsonil · Elepsin · Ethipramine · Imiprex · Imiprin · Imp-Tab · Impril · Janimine · Melipramine · Mipralin · Novo-Pramine · Praminan · Primonil · Pryleugan · Sermonil · Surplix · Talpramin · Imipraminum
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 |
|---|---|---|---|---|---|
| Urethral incompetence | 5-15 mg (total dose) | PO | q12h | — | 🌎 NA |
| Urinary incontinence when other agents fail | 5-20 mg (total dose) | PO | q12h | — | 🌎 NA |
| Cataplexy | 0.5-1 mg/kg | PO | q8h | — | 🌎 NA |
| Adjunctive treatment of separation anxiety or other tricyclic antidepressant-responsive behavior disorders | 2.2-4.4 mg/kg | PO | once to twice daily | — | 🌎 NA |
| Adjunctive cancer pain treatment | 0.5-1 mg/kg | PO | q8h | — | 🌎 NA |
| Anxiety, inappropriate urination, narcolepsy | 1-2 mg/kg | PO | q12h | — | 🌍 EU |
| Anxiety, inappropriate urination, narcolepsy | 2-4 mg/kg | PO | q24h | — | 🌍 EU |
- Cataplexy: Titrate dose based on clinical effect
- Anxiety, inappropriate urination, narcolepsy: Alternatively, 2-4 mg/kg p.o. q24h
- Anxiety, inappropriate urination, narcolepsy: Alternatively, 1-2 mg/kg p.o. q12h
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Urethral incompetence | 2.5-5 mg (total dose) | PO | q12h | — | 🌎 NA |
| Adjunctive cancer pain treatment | 2.5-5 mg (total dose) | PO | q12h | — | 🌎 NA |
| Anxiety, inappropriate urination | 0.5-1 mg/kg | PO | q12-24h | — | 🌍 EU |
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Pharmacologic induced ejaculation | 2 mg/kg | IV | once | — | 🌎 NA |
| Narcolepsy/cataplexy | 0.55 mg/kg IV or 250-750 mg (total dose) orally | IV, PO | once | — | 🌎 NA |
- Pharmacologic induced ejaculation: If imipramine alone does not induce erection and ejaculation in 10-15 minutes, give xylazine 0.2-0.3 mg/kg IV. (Note: ARCI UCGFS Class 2 Drug)
- Narcolepsy/cataplexy: PO administration produces inconsistent results.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
이미프라민은 수의학에서 허가 외(off-label)로 사용되는 삼환계 항우울제(TCA)입니다. 주로 분리 불안과 같은 행동 문제에 사용되는 것으로 알려져 있지만, 독특한 수용체 프로파일 덕분에 활용도가 매우 높습니다.
- 개와 고양이에서는 요실금과 탈력발작(cataplexy) 치료에 자주 사용됩니다.
- 말에서는 기면증(narcolepsy) 관리 및 약물 유도 사정에 사용됩니다.
임상 팁: 이미프라민은 3급 아민 TCA로, 간에서 활성 2급 아민 대사산물인 데시프라민(desipramine)으로 빠르게 대사됩니다. 이러한 이중 작용은 세로토닌과 노르에피네프린 경로 모두에 영향을 미쳐 약리학적 작용 범위를 넓혀줍니다.
작용 기전
Imipramine and its active metabolite, desipramine, exert their effects through a complex, multi-receptor pharmacologic profile:
- Monoamine Reuptake Inhibition: Blocks the presynaptic amine pump, preventing the reuptake of serotonin (5-HT) and norepinephrine (NE) → increases neurotransmitter concentrations in the synaptic cleft → modulates mood, arousal, and pain pathways.
- Anticholinergic Activity: Antagonizes muscarinic receptors centrally and peripherally. This mechanism is primarily responsible for its efficacy in treating urinary incontinence (facilitating urine storage by relaxing the detrusor muscle) and its common side effects (dry mouth, tachycardia).
- Alpha-Adrenergic Agonism/Antagonism: Exhibits complex interactions at alpha receptors, which may contribute to increasing internal urethral sphincter tone.
- Antihistaminic (H1) Activity: Contributes to its significant sedative properties.
안전성·주의사항
금기사항
- Prior sensitivity to any tricyclic antidepressant
- Concomitant use with monoamine oxidase inhibitors (MAOIs) within 14 days
- Glaucoma
- History of seizures
- Urinary retention
- Severe liver disease
- Hypersensitivity to tricyclic antidepressants
부작용
- Sedation
- Dry mouth
- Constipation
- Tachycardia
- Hyperexcitability
- Tremors
- Seizures (CNS stimulation)
- Bone marrow suppression
- Diarrhea
- Vomiting
- Diarrhoea
- Arrhythmias
- Hypotension
- Syncope
- Increased appetite
주의
Use with extreme caution in patients with seizure disorders, as imipramine may lower the seizure threshold.
Pregnancy Warning: There are isolated reports of limb reduction abnormalities (teratogenic potential). Restrict use in pregnant animals to situations where benefits clearly outweigh the risks (FDA Category D in humans).
Nursing: Excreted into milk in low concentrations (milk:plasma ratio 0.4 to 1.5).
약물 상호작용
Additive anticholinergic effects; use cautiously
May inhibit tricyclic antidepressant metabolism and increase the risk of toxicity
Additive CNS depressant effects; use cautiously
Imipramine may decrease levodopa oral absorption
May decrease tricyclic levels
Increased risk for QTc interval prolongation and tricyclic adverse effects
May decrease tricyclic blood levels
Increased risk for serotonin syndrome
May increase the risk of cardiac effects (arrhythmias, hypertension, hyperpyrexia)
Concomitant use (within 14 days) is generally contraindicated due to risk of serotonin syndrome
May increase risk for cardiac arrhythmias
Increased risk for prolonged QT interval
Tricyclics may increase blood pressure
High risk of fatal serotonin syndrome
Altered metabolism via cytochrome P450 2D6 competition/inhibition
Increased risk of serotonin syndrome
Increased risk of serotonin syndrome (use only in exceptional cases with careful monitoring)
모니터링
- Clinical efficacy
- Adverse effects
- ECG (Tricyclics can widen QRS complexes, prolong PR intervals, and invert or flatten T-waves)
- Blood Glucose (Tricyclics may increase or decrease blood glucose levels)
- Heart rate and rhythm (ECG) in susceptible patients
- Signs of serotonin syndrome (agitation, tremors, hyperthermia, tachycardia) if used with other serotonergic drugs
- Liver function tests (baseline and periodic)
약동학
흡수
Rapidly absorbed from both the GI tract and parenteral injection sites. Peak levels occur within 1-2 hours after oral dosing.
분포
Enters the CNS and maternal milk in levels equal to that found in maternal serum.
대사
Metabolized in the liver to several metabolites, including the active metabolite desipramine.
과다투여
Overdosage with tricyclics can be life-threatening, leading to severe arrhythmias and cardiorespiratory collapse. Because the toxicities and therapies for treatment are complicated and controversial, it is highly recommended to contact a poison control center for further information in any potential overdose situation.
제품
제형
- Tablets
- Capsules
- Injection (Note: The injectable product is no longer marketed in the USA)
- 10 mg oral tablet
- 25 mg oral tablet
인용의약품
- Imipramine HCl Tablets: 10 mg, 25 mg & 50 mg (Tofranil, generic)
- Imipramine Pamoate Capsules: 75 mg, 100 mg, 125 mg & 150 mg (Tofranil-PM, generic)
- Tofranil 10 mg tablets
- Tofranil 25 mg tablets
- Imipramine 10 mg tablets
- Imipramine 25 mg tablets
규제 현황
POM. Veterinary authorized products (e.g., clomipramine) are preferred under the cascade.
POM. Veterinary authorized products (e.g., clomipramine) are preferred under the cascade.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Imipramine HCl tablets and pamoate capsules should be stored in tight, light-resistant containers, preferably at room temperature. The HCl injection should be stored at < 40°C; avoid freezing. Imipramine HCl will turn yellow to reddish on exposure. Slight discoloration will not affect potency, but marked changes in color are associated with a loss of potency.
보호자 정보
- 인내심 필요: 행동 변화가 나타나기까지 수주가 걸릴 수 있습니다. 처방대로 투약을 계속하고, 수의사와 상의 없이 갑자기 투약을 중단하지 마십시오.
- 안전 제일: 이 약물은 동물과 사람 모두에게 과다 복용 시 매우 독성이 강합니다. 어린이 보호용 포장에 보관하고 반려동물과 어린이의 손이 닿지 않는 곳에 안전하게 보관하십시오.
- 부작용: 반려동물이 졸려하거나, 입이 마르거나, 변비가 생길 수 있습니다. 반려동물이 지나치게 흥분하거나, 떨거나, 발작을 일으키면 즉시 수의사에게 연락하십시오.
- 복용을 잊은 경우: 생각난 즉시 투여하되, 절대 한 번에 두 배의 용량을 투여하지 마십시오.
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