메틸페니데이트
Methylphenidate
Methylphenidate Hydrochloride
다른 이름: Concerta · Metadate · Methylin · Daytrana · Focalin · Equasym · Attenta · Rilatine · Riphenidate · Ritalina · Ritaline · Ritaphen · Rubifen · Tranquilyn
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 |
|---|---|---|---|---|---|
| Treatment of narcolepsy/cataplexy | 5-10 mg (total dose) | PO | once daily | — | 🌎 NA |
| Treatment of narcolepsy/cataplexy (to supplement imipramine) | 0.25-0.5 mg/kg or 5-10 mg (total dose) | PO | q12-24h | — | 🌎 NA |
| Diagnosis and treatment of hyperkinesis | 5-20 mg (total dose) | PO | q8-12h | 3 days | 🌎 NA |
| Hyperkinesis-hyperactivity | Small dogs: 5+ mg total dose; Large Dogs: 20-40 mg total dose | PO | q12h | — | 🌎 NA |
- Treatment of narcolepsy/cataplexy (to supplement imipramine): Used to supplement imipramine given at 0.5-1 mg/kg PO q8-12h
- Diagnosis and treatment of hyperkinesis: Give for 3 days and assess for improvement of target behaviors (anxiety, overactivity, learning ability)
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
메틸페니데이트는 구조적 및 약리학적으로 암페타민과 유사한 중추신경계(CNS) 흥분제입니다. 수의학에서는 주로 반려견의 기면증/탈력발작 및 운동항진증(과동증)의 진단 및 관리를 위해 허가 외(off-label)로 사용됩니다.
중추신경계 효과 외에도 약한 교감신경 흥분 작용이 있으나, 표준 치료 용량에서는 말초 순환에 미치는 영향이 최소화됩니다.
임상적 주의사항: 메틸페니데이트는 미국에서 2급(C-II) 통제 약물로 분류되어 엄격한 처방 규제가 적용되며, 인체 오남용의 위험이 매우 높습니다. 수의사는 처방 및 조제 시 적절한 법적, 윤리적 예방 조치를 취해야 합니다.
작용 기전
Methylphenidate acts primarily as a norepinephrine-dopamine reuptake inhibitor (NDRI).
- It binds to and blocks the dopamine transporter (DAT) and norepinephrine transporter (NET) on presynaptic neurons.
- Blockade of these transporters → prevents the reuptake of monoamines → increases the concentration of dopamine and norepinephrine in the extraneuronal space (synaptic cleft).
- This amplified monoamine signaling in the brainstem arousal system and cerebral cortex leads to increased alertness, focus, and CNS stimulation.
안전성·주의사항
금기사항
- Seizure disorders
- Cardiac disease or hypertension
- Aggressive animals
부작용
- Tachycardia (increased heart rate)
- Tachypnea (increased respiratory rate)
- Anorexia
- Tremors
- Hyperthermia (particularly exercise-induced)
주의
Use with extreme caution in dogs with pre-existing seizure disorders, cardiac disease, hypertension, or those exhibiting aggressive behavior. Methylphenidate is a Class-II controlled substance with a high potential for human abuse; prescribe and dispense with strict adherence to controlled substance regulations.
약물 상호작용
Methylphenidate may increase serum levels of these anticonvulsants
Rare cases of cardiovascular effects (including death) reported in humans; mechanism unknown
Methylphenidate may reduce the efficacy of hypotensive effects
Concurrent use could lead to a severe hypertensive crisis
Methylphenidate may inhibit SSRI metabolism and increase their serum levels
Methylphenidate may inhibit TCA metabolism and increase their serum levels
Methylphenidate may inhibit warfarin metabolism and increase INR
모니터링
- Clinical efficacy (improvement in target behaviors or narcoleptic episodes)
- Vital signs (heart rate, respiratory rate)
- Body weight (monitor for anorexia/weight loss)
- Periodic CBC with differential and platelet counts (recommended during prolonged therapy based on human guidelines)
약동학
반감기
흡수
Dogs: Immediate-release tablets peak in ~15 minutes. Sustained-release tablets peak in ~30 minutes but with much lower peak concentrations. Humans: Rapidly and well absorbed from the GI tract; food may increase the rate but not the extent of absorption. Peak levels occur ~2 hours post-dose.
분포
Humans: Protein binding is low.
대사
Humans: Extensively metabolized during the first-pass effect.
배설
Humans: Less than 1% is excreted unchanged in the urine. Clearance in dogs is rapid (0.27 L/hr for IR, 0.97 L/hr for SR).
과다투여
Toxicity can occur at relatively low doses in veterinary patients.
- Dogs: Doses of 1 mg/kg (or below) can cause toxic reactions. One fatality was reported at 3.1 mg/kg, though research dogs have survived 20 mg/kg/day for 90 days.
- Cats: A 5 mg tablet caused severe toxicity (tremors, agitation, mydriasis, tachycardia, tachypnea, hypertension) which resolved after 25 hours with supportive care.
Clinical Signs of Overdose: Primarily CNS over-stimulation and excessive sympathomimetic effects: hyperactivity, salivation, diarrhea, head bobbing, agitation, tachycardia, hypertension, tremors, seizures, and hyperthermia.
Treatment:
- Decontamination: Standard gut detoxification (emesis, activated charcoal, cathartic). Avoid emesis if the animal is already symptomatic due to seizure/aspiration risks.
- Supportive Care:
- Phenothiazines (e.g., acepromazine, chlorpromazine) to control agitation.
- Beta-blockers to manage severe tachycardia.
- External cooling for hyperthermia.
- Cyproheptadine may be administered to help prevent or treat serotonin syndrome.
제품
제형
- Oral tablets
- Chewable tablets
- Extended-release tablets
- Extended-release capsules
- Oral solution
- Transdermal patch
인용의약품
- Methylphenidate Oral Tablets: 5 mg, 10 mg & 20 mg
- Chewable Tablets: 2.5 mg, 5 mg & 10 mg
- Extended-Release Tablets: 10 mg, 18 mg, 20 mg, 27 mg, 36 mg & 54 mg
- Extended-Release Capsules: 20 mg, 30 mg, 40 mg, 50 mg & 60 mg
- Methylphenidate Oral Solution: 5 mg/5 mL & 10 mg/5 mL
- Methylphenidate Transdermal Patch: 10 mg/9 h, 15 mg/9 h, 20 mg/9 h & 30 mg/9 h
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Unless otherwise noted on the label, methylphenidate tablets and extended-release tablets/capsules should be stored in tight, light-resistant containers at room temperature.
보호자 정보
- 안전한 보관: 이 약물은 인체 오남용 가능성이 높은 통제 약물입니다. 잠금장치가 있는 캐비닛이나 안전한 장소에 단단히 보관하십시오.
- 투여 방법: 반려동물에게 서방형(효과가 오래 지속되는) 정제나 캡슐이 처방된 경우, 부수거나 씹게 하지 마십시오. 반드시 통째로 삼키게 해야 합니다.
- 모니터링: 심박수 증가, 호흡 가쁨, 안절부절못함, 떨림 또는 식욕 부진과 같은 과도한 흥분 징후가 있는지 반려동물을 주의 깊게 관찰하십시오. 이러한 징후가 나타나면 즉시 수의사에게 알리십시오.
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