케토프로펜
Ketoprofen
2-(3-benzoylphenyl)propanoic acid
다른 이름: Ketofen · Anafen · Comforion Vet · ketoprofenum · RP-19583 · Ketoprofeno
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Anti-inflammatory/analgesic (extra-label)
인증된 수의사 확인 필요
- q12-24h
NA
반드시 함께 고려할 임상 맥락 (1)
- Ketoprofen injection should be stored below 25°C (77°F), with brief excursions permitted between 0°C and 40°C (32°F-104°F) and used within 4 months of first vial puncture. 13
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
케토프로펜은 이부프로펜, 나프록센, 카프로펜과 구조적으로 관련된 강력한 프로피온산 유도체 비스테로이드성 항염증제(NSAID)입니다. 수의학에서는 강력한 진통, 해열 및 항염증 특성으로 인해 널리 사용됩니다.
주요 약리학적 특징:
- 거울상 이성질체 특성: 상업용 케토프로펜은 라세미 혼합물입니다. S(+) 거울상 이성질체는 주로 항프로스타글란딘 활성(및 관련 위장관/신장 독성)을 담당하는 반면, R(-) 거울상 이성질체는 심각한 위장관 부작용 없이 진통 효과를 제공합니다.
- 사용 축종: 말의 근골격계 통증에 널리 사용되며, 일부 임상 수의사들은 고양이의 단기 진통을 위한 최우선 NSAID 중 하나로 간주합니다. 개, 소, 돼지 및 다양한 특수 동물에도 사용됩니다.
- 임상적 주의사항: 매우 효과적이지만 케토프로펜은 비선택적 COX 억제제입니다. 따라서 특히 소동물에서 최신 COX-2 선택적 NSAID(콕시브계)에 비해 위장관 궤양 및 신장 독성의 위험이 더 높습니다. 개와 고양이에서의 사용은 일반적으로 단기(예: 1~5일)로 제한됩니다.
작용 기전
Ketoprofen exerts its effects primarily through the inhibition of the cyclooxygenase (COX) enzymes.
- Arachidonic Acid Cascade: Cell membrane phospholipids → Phospholipase A2 → Arachidonic Acid.
- COX Inhibition: Ketoprofen non-selectively blocks COX-1 and COX-2 enzymes. This prevents the conversion of arachidonic acid into prostaglandin precursors (endoperoxides), thereby halting the synthesis of pro-inflammatory and hyperalgesic prostaglandins (e.g., PGE2) and thromboxanes.
- LOX Inhibition (Theoretical): Ketoprofen purportedly has inhibitory activity on lipoxygenase (LOX), which would theoretically block the formation of leukotrienes. However, in vitro studies have not definitively confirmed this dual-inhibition activity at therapeutic doses in veterinary species.
- Central and Peripheral Action: By reducing peripheral prostaglandins, it decreases nociceptor sensitization. It also acts centrally to reduce fever by inhibiting prostaglandin synthesis in the hypothalamus.
안전성·주의사항
금기사항
- Known hypersensitivity to ketoprofen or other NSAIDs
- Active gastrointestinal ulceration or bleeding
- Significant renal or hepatic impairment
- Late pregnancy (due to risk of premature closure of the patent ductus arteriosus)
- Intra-arterial administration
- Dehydrated, hypovolaemic, or hypotensive patients
- Patients with pre-existing gastrointestinal disease
- Patients with blood clotting problems
- Pregnant animals
- Animals < 6 weeks of age
부작용
- Horses: Gastric mucosal damage, GI ulceration, renal crest necrosis, mild hepatitis, injection site inflammation (IM)
- Dogs and Cats: Vomiting, anorexia, gastrointestinal ulceration, renal toxicity
- General: Masking of infection signs (inflammation, hyperpyrexia)
- Gastrointestinal signs (vomiting, diarrhea, anorexia)
- Gastrointestinal ulceration and bleeding
- Renal toxicity (especially in dehydrated/hypotensive patients)
- Hepatic accumulation (in patients with liver disease)
- Potential precipitation of cardiac failure (rare/unknown risk in animals)
주의
High Protein Binding: Because ketoprofen is highly protein-bound, patients with hypoproteinemia may have increased levels of free (active) drug, significantly increasing the risk of toxicity.
- GI and Renal Risks: Use only when potential benefits outweigh risks in patients with a history of GI ulceration or compromised renal/hepatic function.
- Masking Infection: May mask clinical signs of infection such as fever and inflammation. Use appropriate anti-infective therapy if a primary infectious process is present.
- Breeding Animals: Use with caution in breeding animals; effects on fertility and fetal health are not fully established. Avoid in late pregnancy.
- Administration Warnings: Avoid subcutaneous (SC) injections in horses. Do not administer intra-arterially in any species.
약물 상호작용
Increased risk for nephrotoxicity.
Increased risk for bleeding.
Plasma levels of ketoprofen could decrease; increased likelihood of GI adverse effects (blood loss). Concomitant use is not recommended.
May increase risk for GI ulceration.
Concomitant administration significantly increases the risks for GI adverse effects and ulceration.
May increase risk for nephrotoxicity.
May increase NSAID levels.
Ketoprofen may reduce the saluretic and diuretic effects of furosemide.
Ketoprofen is 99% protein-bound and may displace other drugs, leading to increased serum levels and duration of action.
Serious toxicity has occurred when NSAIDs are used concomitantly; use with extreme caution.
May cause a significant increase in serum levels and half-life of ketoprofen.
Increased risk of severe gastrointestinal ulceration and renal toxicity. Do not administer concurrently or within 24 hours.
Increased risk of severe gastrointestinal ulceration and bleeding. Do not administer concurrently or within 24 hours.
Increased risk of nephrotoxicity.
모니터링
- Clinical efficacy (reduction in pain, lameness, or fever)
- Adverse effects (monitor for vomiting, diarrhea, melena, or anorexia)
- Baseline and periodic liver and renal function tests (BUN, Creatinine, ALT, AST) are recommended with long-term therapy
- Clinical signs of gastrointestinal ulceration (vomiting, melena, anorexia)
- Renal parameters (BUN, Creatinine, USG) especially in older or compromised patients
- Hepatic enzymes
- Hydration status and blood pressure
약동학
반감기
흡수
Rapidly and nearly completely absorbed after oral administration in rats, dogs, and humans. Presence of food or milk decreases oral absorption. Oral absorption is poor in horses. IV and IM areas under the curve are relatively equivalent in horses.
분포
Volume of distribution is low in adult horses, but higher in foals (doses may need to be 1.5X higher in neonates). Enters synovial fluid. Highly bound to plasma proteins (99% in humans, ~93% in horses).
대사
Metabolized to a conjugated metabolite (primarily glucuronidation in dogs and horses). In cats, thioesterification is proposed as a major elimination mechanism.
배설
Eliminated via the kidneys both as a conjugated metabolite and unchanged drug.
과다투여
As with any NSAID, overdosage can lead to severe gastrointestinal and renal toxicity.
- Dogs: The LD50 after oral ingestion is reported to be 2000 mg/kg, but exposures as low as 0.44 mg/kg have caused GI ulcers. Common clinical signs of toxic exposure include vomiting.
- Cats: Highly sensitive; have developed renal toxicity at doses as low as 0.7 mg/kg.
- Horses: Generally tolerate higher doses. Doses up to 11 mg/kg IV once daily for 15 days showed no toxicity. However, severe laminitis occurred at 33 mg/kg/day (15X label dose) for 5 days. At 55 mg/kg/day (25X label dose), horses developed anorexia, depression, icterus, abdominal swelling, gastritis, nephritis, and hepatitis.
Treatment:
- Decontamination: Emetics and/or activated charcoal are appropriate for recent oral exposures.
- GI Protection: Use of gastrointestinal protectants (e.g., omeprazole, sucralfate, misoprostol) is strongly warranted if GI effects are expected.
- Renal Protection: Aggressive IV fluid diuresis is warranted to support renal perfusion if renal effects are expected.
제품
제형
- Veterinary Injection: 100 mg/mL, 10 mg/mL
- Veterinary Tablets: 5 mg, 10 mg, 20 mg
- Human Capsules: 50 mg, 75 mg
- Human Extended-Release Capsules: 100 mg, 150 mg, 200 mg
- Injectable: 1% solution
- Oral: 5 mg tablets
- Oral: 20 mg tablets
동물용의약품
- Ketoprofen Injection: 100 mg/mL (Ketofen, generic)
- Ketoprofen Injection: 10 mg/mL (Anafen, Ketofen - Canada/UK)
- Ketoprofen Tablets: 5 mg, 10 mg, 20 mg (Anafen, Ketofen - Canada/UK)
- Ketofen 1% injection
- Ketofen 5 mg tablets
- Ketofen 20 mg tablets
인용의약품
- Ketoprofen Capsules: 50 mg, 75 mg
- Ketoprofen Extended-Release Capsules: 100 mg, 150 mg, 200 mg
- Oruvail
- Orudis
규제 현황
투여 중단 기간: pig meat 4 days · cattle meat 4 days · cattle milk 0 hours · horse meat 28 days
POM-V classification.
POM-V classification.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Oral capsules should be stored at room temperature in tight, light-resistant containers. Veterinary injection should be stored at room temperature.
보호자 정보
케토프로펜은 반려동물의 통증, 염증 및 발열을 줄이는 데 사용되는 약물입니다.
중요 안전 지침:
- 음식과 함께 투여: 케토프로펜을 경구로 투여하는 경우, 위장 장애의 가능성을 줄이기 위해 식사와 함께 주는 것이 가장 좋습니다.
- 위장 문제 주의: 가장 흔한 부작용은 구토, 식욕 부진 및 설사입니다. 반려동물이 구토하거나, 먹는 것을 중단하거나, 검고 끈적이는 변을 보거나 구토물이나 대변에 피가 섞여 있는 것을 발견하면 즉시 약 투여를 중단하고 수의사에게 연락하십시오. 이는 위궤양의 징후일 수 있습니다.
- 약물 혼합 금지: 수의사가 특별히 지시하지 않는 한, 케토프로펜을 복용하는 동안 아스피린, 이부프로펜 또는 기타 진통제(예: 리마딜, 메타캄 또는 데라막스)를 절대 주지 마십시오. 이를 혼합하면 치명적인 위출혈이나 신부전을 일으킬 수 있습니다.
- 지시사항 엄수: 처방된 것보다 복용량을 늘리거나 더 자주 투여하지 마십시오. 개와 고양이는 NSAID 과다 복용에 매우 민감합니다.
- 수분 공급 필수: 신장을 보호하기 위해 반려동물이 항상 신선한 식수를 마실 수 있도록 해주세요.
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