레바미솔
Levamisole
Levamisole hydrochloride / Levamisole phosphate
다른 이름: Levasole · Amtech · Ascaridil · Decaris · Ergamisol · Immunol · Ketrax · Meglum · Prohibit · Solaskil · Vermisol · Vizole · cloridrato de levamizol · ICI-59623 · levamisoli hydrochloridum · NSC-177023 · R-12564 · RP-20605 · l-tetramisole hydrochloride
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
2.2 mg/kg PO every other day, with appropriate antimicrobial therapyPO· q48h
— 🐕
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 |
|---|---|---|---|---|---|
| For recurrent cutaneous infections (immune stimulant) | 2.2 mg/kg PO every other day, with appropriate antimicrobial therapy | PO | q48h | — | 🌎 NA |
| As an immune stimulant | 0.5-2 mg/kg PO 3 times a week | PO | 3 times a week | — | 🌎 NA |
| For adjunctive therapy in dogs with chronic pyoderma | 0.5-1.5 mg/kg PO 2-3 times a week | PO | 2-3 times a week | — | 🌎 NA |
| For adjunctive therapy in dogs with chronic pyoderma | 2.2 mg/kg PO every other day | PO | q48h | — | 🌎 NA |
| As an alternative treatment for SLE | 3-7 mg/kg PO every other day for 4 months; alone or in combination with corticosteroids | PO | q48h | 4 months | 🌎 NA |
| As a microfilaricide | 11 mg/kg PO for 6-12 days. Examine for microfilaria within 7-10 days and at weekly intervals until eliminated or treatment is halted. | PO | q24h | 6-12 days | 🌎 NA |
| For treatment of Angiostrongylus vasorum | 7.5 mg/kg (route not specified) for two consecutive days, followed by 10 mg/kg for 2 days; if the infection is not cleared, the regimen is repeated. | Not specified | q24h | 4 days | 🌎 NA |
| For Crenosoma vulpis (lungworms) | 8 mg/kg once | PO | Once | 1 dose | 🌎 NA |
| For Capillaria (lungworms) | 7-12 mg/kg once daily PO for 3-7 days | PO | q24h | 3-7 days | 🌎 NA |
| For Filaroides osleri (lungworms) | 7-12 mg/kg once daily PO for 20-45 days | PO | q24h | 20-45 days | 🌎 NA |
| For Filaroides osleri (lungworms) | 7.5 mg/kg PO twice daily or 25 mg/kg PO every other day for 10 days | PO | q12h or q48h | 10 days | 🌎 NA |
| For Capillaria aerophilia (lungworms) | 10 mg/kg PO once daily for 5 days; repeat in 9 days | PO | q24h | 5 days | 🌎 NA |
- For adjunctive therapy in dogs with chronic pyoderma: Efficacy not established
- For adjunctive therapy in dogs with chronic pyoderma: May only be efficacious in 10% of cases
- As a microfilaricide: Rarely recommended today. Retching and vomiting are common. Avoid giving on an empty stomach or immediately after drinking water. A 'conditioning' dose of 5 mg/kg PO once a day may be necessary. Stop therapy if abnormal behavior or ataxia develops.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For the treatment of lungworms | 20-40 mg/kg PO every other day for 5-6 treatments | PO | q48h | 5-6 treatments | 🌎 NA |
| For Aelurostrongylus abstrusus (lungworms) | 100 mg PO daily every other day for 5 treatments; give atropine (0.5 mg SC, 15 minutes before administering); or 15 mg/kg PO every other day for 3 treatments, then 3 days later: 30 mg/kg PO, then 2 days later: 60 mg/kg. | PO | Varies | Varies | 🌎 NA |
| For Capillaria aerophilia (lungworms) | 4.4 mg/kg SC for 2 days, then 8.8 mg/kg once 2 weeks later; or 5 mg/kg PO once daily for 5 days, followed by 9 days of no therapy, repeat two times | SC/PO | Varies | Varies | 🌎 NA |
| For the treatment of lungworms | 25 mg/kg every other day for 10-14 days | PO | q48h | 10-14 days | 🌎 NA |
| For Capillaria aerophilia (lungworms) | 10 mg/kg PO once daily for 5 days; repeat in 9 days | PO | q24h | 5 days | 🌎 NA |
| For treatment of Ollulanus tricuspis | 5 mg/kg SC | SC | Once | 1 dose | 🌎 NA |
| As a microfilaricide | 10 mg/kg PO for 7 days | PO | q24h | 7 days | 🌎 NA |
| For adjunctive therapy of feline plasma-cell gingivitis/pharyngitis (immune-stimulant) | 25 mg PO every other day for 3 doses | PO | q48h | 3 doses | 🌎 NA |
소형 포유류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For nematodes in Rabbits | 12.5-20 mg/kg PO (for gastric nematodes) or SC (for extragastric nematodes) | PO/SC | Once | — | 🌎 NA |
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For intestinal nematodes | 5-15 mL/gallon of drinking water for 1-3 days; repeat in 10 days. If birds refuse to drink, withhold water prior to treating. | PO | Daily | 1-3 days | 🌎 NA |
| For gavage in Australian Parakeets (or desert species that refuse to drink water) | 15 mg/kg; repeat in 10 days | PO | Once | — | 🌎 NA |
| For parenteral use | 4-8 mg/kg IM or SC; repeat in 10-14 days. | IM/SC | Once | — | 🌎 NA |
| For immunostimulation | 0.3 mL/gallon of water for several weeks | PO | Continuous | Several weeks | 🌎 NA |
| As a parenteral immunostimulant | 2 mg/kg IM or SC. 3 doses at 14 day intervals | IM/SC | q14d | 3 doses | 🌎 NA |
| As a nebulized immunostimulant | 1 mL (of 13.65% levamisole phosphate) in 15 mL saline | Inhalation | — | — | 🌎 NA |
| For Capillaria infections | 15-30 mg/kg orally as a single bolus or through a crop tube; or 2.25 mg/gallon of drinking water for 4-5 days. Repeat treatment in 10-14 days. | PO | Varies | 1 or 4-5 days | 🌎 NA |
| Poultry nematodes | 18-36 mg/kg, PO | PO | Once | — | 🌎 NA |
| For Libyastrongylus douglassi in Ratites | Give 30 mg/kg PO or IM at one month of age, then once a month for 7 treatments, then 4 times yearly | PO/IM | Monthly then quarterly | Ongoing | 🌎 NA |
- For intestinal nematodes: Using 13.65% injectable
- For gavage in Australian Parakeets (or desert species that refuse to drink water): Using 13.65% injectable
- For parenteral use: Using 13.65% injectable. May cause vomiting, ataxia, or death. Do not use in debilitated birds.
- For immunostimulation: Using 13.65% injectable
- As a parenteral immunostimulant: Using 13.65% injectable
파충류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| As an anthelmintic (Nematodes, Acanthocephalans, or Pentastomes) | Nematodes: 5-10 mg/kg PO; repeat in two weeks followed by a fecal exam 14 days after the second dose. If positive, a third dose is given. Acanthocephalans, or Pentastomes: as above, but may also be given SC or ICe. | PO/SC/ICe | q14d | 2-3 doses | 🌎 NA |
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| As an immunostimulant | Dosages have ranged from 2.5 mg/kg injected at 7 day intervals, and 2.2 mg/kg PO every 24 hours for 3 days, then off for 4 days for a period of 4-6 weeks. | Injection/PO | Varies | 4-6 weeks | 🌎 NA |
| As adjunctive therapy for EPM | 1-2 mg/kg per day PO | PO | q24h | — | 🌎 NA |
- As an immunostimulant: Anecdotal reports of beneficial effects in the treatment of nasal viral papillomas, COPD, and EPM have been suggested.
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For removal of mature and immature Dictyocaulus vivapurus | 5.5-11 mg/kg PO, either given in feed or as a drench or oral bolus. May also be administered SC at 3.3-8 mg/kg. | PO/SC | Once | — | 🌎 NA |
| For treatment of susceptible nematodes | 7.5 mg/kg PO | PO | Once | — | 🌎 NA |
돼지
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For removal of mature and immature Metastrongylus | 8 mg/kg PO in feed or water | PO | Once | — | 🌎 NA |
양
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For removal of mature and immature Dictyocaulus vivapurus | 8 mg/kg PO | PO | Once | — | 🌎 NA |
| For treatment of susceptible nematodes | 7.5 mg/kg PO | PO | Once | — | 🌎 NA |
염소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For removal of mature and immature Dictyocaulus vivapurus | 8 mg/kg PO | PO | Once | — | 🌎 NA |
| For treatment of susceptible nematodes | 7.5 mg/kg PO | PO | Once | — | 🌎 NA |
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
레바미솔은 이미다조티아졸 유도체로서 주로 대동물에서 항선충 구충제로 사용되며, 과거에는 소동물에서 미세사상충 구제제 및 면역 자극제로 사용되었습니다.
임상 요점:
- 소동물 사용 감소: 치료 지수가 좁고 더 안전하고 효과적인 구충제(예: 매크로라이드계, 벤즈이미다졸계)가 등장함에 따라 현대 개와 고양이 임상에서는 거의 사용되지 않습니다.
- 대동물에서의 유용성: 소, 양, 돼지에서 여전히 가치 있는 광범위 구충제이며 위장관 및 폐 선충에 특히 효과적이지만, 기생충 내성이 전 세계적으로 증가하는 추세입니다.
- 면역 조절: 세포 매개 면역을 자극하는 독특한 능력으로 인해, 특히 면역이 저하된 환자에서 만성 감염, 면역 매개 질환 및 특정 종양의 보조 요법으로 허가 외(off-label) 사용되기도 합니다.
작용 기전
Antiparasitic Action: Levamisole acts as a cholinergic agonist at nicotinic acetylcholine receptors on the nematode muscle.
- Receptor activation → continuous depolarization → spastic paralysis of the worm.
- The paralyzed nematodes are subsequently expelled alive from the host's gastrointestinal or respiratory tract.
- At higher concentrations, it interferes with nematode carbohydrate metabolism by blocking fumarate reduction and succinate oxidation.
Immunostimulant Action: The exact mechanism is not fully elucidated. It is believed to:
- Restore cell-mediated immune function in peripheral T-lymphocytes.
- Stimulate phagocytosis and chemotaxis by monocytes and macrophages.
- Effects are generally more pronounced in immunocompromised animals rather than healthy ones.
안전성·주의사항
금기사항
- Lactating dairy animals (not approved)
- Severely debilitated animals
- Patients with significant renal or hepatic impairment
- Cats with FIV or FIP (and likely ineffective in FeLV)
- Use as a dirofilarial adulticide
- Intravenous (IV) administration (never recommended)
- Intramuscular (IM) administration in birds (avoid if possible)
부작용
- Cattle: Muzzle foaming, hypersalivation, excitement, trembling, lip-licking, head shaking, injection site swelling
- Sheep/Goats: Transient excitability, depression, hyperesthesia, salivation, stinging upon SC injection
- Swine: Salivation, muzzle foaming, coughing/vomiting (especially if infected with lungworms)
- Dogs: GI disturbances (vomiting, diarrhea), neurotoxicity (panting, shaking, agitation), immune-mediated anemia, agranulocytosis, dyspnea, pulmonary edema, immune-mediated skin eruptions (erythema multiforme, toxic epidermal necrolysis), lethargy
- Cats: Hypersalivation, excitement, mydriasis, vomiting
주의
Narrow Margin of Safety: Levamisole has a narrow therapeutic index, especially in small animals and birds. Accurate dosing is critical.
- Stress: Use cautiously or delay use in cattle that are stressed due to vaccination, dehorning, or castration.
- Pregnancy: FDA Category C / Papich Class C. Has been implicated in causing abortion in goats. Use only if potential benefits outweigh risks.
- Nursing: Excreted in cows' milk; use with caution in nursing dams.
약물 상호작용
Aspirin
Levamisole may increase salicylate levels
Chloramphenicol
Fatalities have been reported after concomitant administration; avoid using these agents together
Cholinesterase-inhibiting drugs (e.g., organophosphates, neostigmine)
Could theoretically enhance the toxic effects of levamisole; use together with caution
Nicotine-like compounds (e.g., pyrantel, morantel, diethylcarbamazine)
Could theoretically enhance the toxic effects of levamisole; use together with caution
Warfarin
Increased risk for bleeding
모니터링
- Clinical efficacy (fecal exams, resolution of clinical signs)
- Adverse effects/toxicity observation
약동학
반감기
개1.8-4 hours
흡수
Absorbed from the gut after oral dosing and through the skin after dermal application, although bioavailabilities are variable.
분포
Reportedly distributed throughout the body.
대사
Primarily metabolized in the liver.
배설
Metabolites are excreted primarily in the urine (with less than 6% excreted unchanged) and in feces.
과다투여
Signs of levamisole toxicity often mimic those of organophosphate toxicity due to its cholinergic effects.
- Clinical Signs: Hypersalivation, hyperesthesias, irritability, clonic seizures, CNS depression, dyspnea, defecation, urination, and collapse. Acute overdosage can result in death due to respiratory failure. Cardiac arrhythmias may also be seen.
- Avian Toxicity: In pet birds, 40 mg/kg SC is reported as a toxic dose. IM injections may cause more severe toxicity. Signs include depression, ataxia, leg/wing paralysis, mydriasis, regurgitation, and death.
- Treatment: Primarily supportive, as animals generally recover within hours of dosing. If respiratory failure occurs, institute artificial ventilation with oxygen until recovery. For recent oral ingestion, emptying the gut and/or administering activated charcoal with cathartics may be indicated.
- Warning: Intravenous (IV) administration is particularly hazardous and is never recommended.
제품
제형
- Injection (13.65% levamisole phosphate)
- Water Medication/Soluble Powder (18.15g, 46.8g)
- Oral Tablets/Boluses (184 mg, 2.19 g)
동물용의약품
- Levamisole Phosphate Injection: 136.5 mg/mL (13.65%)
- Levamisole Hydrochloride Water Medication: 18.15 grams
- Levamisole Hydrochloride Soluble Drench Powder: 46.8 grams/packet
- Levamisole HCl Oral Tablets/Boluses: 184 mg, 2.19 gram
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Levamisole hydrochloride products should be stored at room temperature (15-30°C); avoid temperatures greater than 40°C. Levamisole phosphate injection should be stored at or below 21°C (70°F); refrigeration is recommended and freezing should be avoided. Compounded oral solution (25 mg/mL) retains >97% potency for 90 days when stored at 4°C and 25°C and protected from light.
보호자 정보
- 엄격한 투약: 수의사의 지시에 따라 정확하게 투약하십시오. 레바미솔은 안전역이 좁아 유효 용량과 독성 용량의 차이가 작습니다.
- 부작용: 과도한 침 흘림, 떨림, 헐떡임, 구토, 설사 또는 이상 행동과 같은 독성 징후가 있는지 반려동물을 주의 깊게 관찰하십시오. 이러한 증상이 나타나면 즉시 수의사에게 연락하십시오.
- 투여 방법: 특정 질환에 대해 경구로 사용할 경우, 공복 상태나 반려동물이 물을 마신 직후에 투여하지 마십시오(수의사의 구체적인 지시를 따르십시오).
- 산업동물: 레바미솔은 번식기 젖소에 대한 사용이 FDA의 승인을 받지 않았습니다. 도축 휴약 기간(예: 소 48시간, 양/돼지 72시간)을 엄격히 준수하십시오.
- 재치료: 기생충 감염이 심한 환경에 있는 동물은 초기 치료 후 2-4주 후에 재치료가 필요할 수 있습니다.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.