메틸프레드니솔론
Methylprednisolone
6alpha-methylprednisolone
다른 이름: Depo-Medrol · Solu-Medrol · A-Methapred · Depo-Medrone · Solu-Medrone · 6alpha-methylprednisolone · methylprednisolonum · NSC-19987 · Methylprednisolone acetate · Methylprednisolone sodium succinate
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 |
|---|---|---|---|---|---|
| Labeled uses (Oral) | Dogs weighing 5-15 lbs: 2 mg; Dogs weighing 15-40 lbs: 2-4 mg; Dogs weighing 40-80 lbs: 4-8 mg; these total daily doses should be divided | PO | q6-10h | — | 🌎 NA |
| Labeled uses (Injectable) | 2-120 mg (average 20 mg) | IM | May repeat at weekly intervals | — | 🌎 NA |
| Intralesional (sub-lesional) use | 10-40 mg total dose | intralesional | — | — | 🌎 NA |
- Labeled uses (Oral): Divide total daily dose and give 6-10 hours apart.
- Labeled uses (Injectable): Depending on breed (size), severity of condition, and response.
- Intralesional (sub-lesional) use: A sufficient volume of 20 mg/mL methylprednisolone acetate is used to undermine the lesion.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Labeled uses (Oral) | Cats weighing 5-15 lbs: 2 mg; Cats weighing >15 lbs: 2-4 mg; these total daily doses should be divided | PO | q6-10h | — | 🌎 NA |
| Labeled uses (Injectable) | up to 20 mg (average 10 mg) | IM | May repeat at weekly intervals | — | 🌎 NA |
| Intralesional (sub-lesional) use | 10-40 mg total dose | intralesional | — | — | 🌎 NA |
- Labeled uses (Oral): Divide total daily dose and give 6-10 hours apart.
- Labeled uses (Injectable): Depending on breed (size), severity of condition, and response.
- Intralesional (sub-lesional) use: A sufficient volume of 20 mg/mL methylprednisolone acetate is used to undermine the lesion.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Antiinflammatory (glucocorticoid effects) | 200 mg | IM | repeated as necessary | — | 🌎 NA |
| Intra-articular use | 100 mg | IA | — | — | 🌎 NA |
- Antiinflammatory (glucocorticoid effects): Labeled use.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
메틸프레드니솔론은 히드로코르티손보다 약 4~5배 더 강력하고 무기질코르티코이드 활성이 거의 없는 합성 중간 작용형 글루코코르티코이드입니다. 강력한 항염증 및 면역 억제 특성으로 수의학에서 광범위하게 사용됩니다.
임상 요점 및 제형:
- 메틸프레드니솔론 염기: 유지 또는 점감 요법을 위한 경구용 정제.
- 메틸프레드니솔론 아세테이트 (Depo-Medrol®): 근육내, 병변내 또는 관절내 주사용 미세결정 현탁액. 천천히 흡수되어 장기간의 저장 효과(수주~수개월)를 제공합니다. 주의: 심각하고 장기적인 시상하부-뇌하수체-부신(HPA) 축 억제를 유발할 수 있습니다.
- 메틸프레드니솔론 소듐 숙시네이트 (Solu-Medrol®): 급성 위기(예: 척수 손상, 중증 알레르기 반응, 쇼크) 시 빠른 정맥 투여를 위해 고안된 수용성 에스테르. 단, 쇼크/외상에 대한 고용량 사용은 점점 더 논란이 되고 있습니다.
매우 효과적이지만, 글루코코르티코이드 요법의 목표는 항상 전신 부작용, 특히 의인성 부신피질기능항진증(쿠싱 증후군)을 최소화하기 위해 가능한 한 최단 기간 동안 최소 유효 용량을 사용하는 것입니다.
작용 기전
Glucocorticoids exert their effects by diffusing across cell membranes and binding to specific cytoplasmic glucocorticoid receptors (GR).
- Genomic Pathway: The receptor-ligand complex translocates to the nucleus → binds to glucocorticoid response elements (GREs) on target genes → alters gene transcription.
- Anti-inflammatory Mechanism: They induce the synthesis of lipocortin-1 (annexin-1) → inhibits phospholipase A2 → blocks the release of arachidonic acid from membrane phospholipids → profoundly decreases the synthesis of pro-inflammatory prostaglandins and leukotrienes.
- Immunosuppressive Mechanism: They suppress the transcription of inflammatory cytokines (e.g., IL-1, IL-2, IL-6, TNF-alpha), inhibit macrophage and neutrophil migration/function, and induce apoptosis in lymphocytes.
- Metabolic Effects: Stimulate hepatic gluconeogenesis, promote protein catabolism, and redistribute lipid stores.
안전성·주의사항
금기사항
- Systemic fungal infections (unless used for Addison's replacement)
- Viral infections
- Arrested tuberculosis
- Peptic or corneal ulcers
- Acute psychoses
- Cushingoid syndrome
- Idiopathic thrombocytopenia (for IM administration)
- Acute local infections (for intrasynovial/intratendinous use)
- Chronic systemic therapy using sustained-release injectable forms
- Pregnant animals
- Renal disease
- Diabetes mellitus
부작용
- Polyuria (PU), polydipsia (PD), polyphagia (PP)
- Iatrogenic hyperadrenocorticism (Cushingoid signs) with sustained use
- Weight gain and lipidemias
- Dull, dry haircoat and alopecia
- Muscle wasting and weakness
- Gastrointestinal ulceration, vomiting, diarrhea, melena, hematochezia
- Elevated liver enzymes (ALP, ALT) and hepatopathy
- Pancreatitis
- Activation or worsening of diabetes mellitus (especially in cats)
- Behavioral changes (depression, lethargy, viciousness, panting)
- Extracellular hyperglycemia leading to volume expansion and potential CHF (cats)
- Hypothalamic-pituitary-adrenal (HPA) axis suppression
- Adrenal atrophy
- Weight loss (catabolic effect)
- Cutaneous atrophy (thinning of skin)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome)
- Diarrhoea
- Increased urine glucose levels
- Decreased serum T3 and T4 levels
- Impaired wound healing
- Delayed recovery from infections
주의
Tapering Required: Animals receiving systemic glucocorticoids (other than short 'burst' therapy) must be tapered off slowly to allow endogenous ACTH and corticosteroid function to recover. Abrupt withdrawal can precipitate an Addisonian crisis.
- Stress Dosing: Additional glucocorticoids may be needed during stressors (surgery, trauma, illness) during the tapering process.
- Use with Caution: In patients with diabetes mellitus, osteoporosis, predisposition to thrombophlebitis, hypertension, congestive heart failure (CHF), and renal insufficiency.
- Pregnancy: FDA Category C. May cause teratogenic effects in early pregnancy. Exogenous steroids can induce parturition in the latter stages of pregnancy in horses and ruminants.
- Nursing Dams: Glucocorticoids enter milk and may inhibit growth or interfere with endogenous corticosteroid production in nursing offspring.
약물 상호작용
May cause hypokalemia; potential for CHF and cardiac enlargement
Combination in epidurals has caused serious CNS injuries and death
May lead to profound muscle weakness in myasthenia gravis patients
Glucocorticoids may reduce salicylate blood levels
May increase the metabolism of glucocorticoids and decrease blood levels
Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
May cause hypokalemia
May reduce methylprednisolone blood levels
May potentiate the effects of methylprednisolone
Insulin requirements may increase due to glucocorticoid-induced insulin resistance
May decrease metabolism of glucocorticoids; ketoconazole may induce adrenal insufficiency upon withdrawal
May decrease metabolism of glucocorticoids and increase blood levels
May alter steroid metabolism; higher steroid doses may be needed
Increased risk of severe gastrointestinal ulceration
May increase metabolism of glucocorticoids and decrease blood levels
May increase metabolism of glucocorticoids and decrease blood levels
Virus replication may be augmented; diminished immune response to vaccines
May affect INR values; requires monitoring
Increased risk of hypokalaemia
Enhanced metabolism of corticosteroids, potentially reducing their efficacy
Decreased metabolism of corticosteroids, potentially increasing their effects and toxicity
모니터링
- Weight, appetite, and signs of edema
- Serum and/or urine electrolytes
- Total plasma proteins, albumin
- Growth and development in young animals
- ACTH stimulation test (if iatrogenic Cushing's or Addison's is suspected)
- Clinical signs of iatrogenic hyperadrenocorticism (PU/PD, polyphagia, weight gain)
- Blood glucose levels (especially in diabetic or pre-diabetic patients)
- Serum electrolytes (specifically potassium)
- Thyroid panel (T3 and T4 may be artificially decreased)
- Signs of gastrointestinal ulceration (melena, vomiting blood)
약동학
반감기
흡수
Orally administered methylprednisolone is relatively well absorbed. The acetate IM injection is slowly absorbed and can have a duration of effect of weeks to months. The sodium succinate IV injection is water soluble and very fast acting.
분포
Extensively distributed throughout the body.
대사
The liver is the primary site for metabolism (oxidation).
배설
Most of the drug is excreted renally as metabolites.
과다투여
Short-term administration of massive doses is unlikely to cause harmful effects, though one case of acute CNS effects in a dog after accidental ingestion has been reported. If acute overdose occurs, provide supportive treatment as required.
Chronic Overdosage: Chronic usage leads to serious adverse effects, primarily iatrogenic hyperadrenocorticism (Cushing's syndrome), characterized by profound metabolic, dermatologic, and immunosuppressive changes.
제품
제형
- Injectable suspension (Acetate)
- Powder for injection (Sodium Succinate)
- Injectable depot suspension: 40 mg/ml
- Injectable powder for reconstitution: 125 mg, 500 mg
- Oral tablets: 2 mg, 4 mg
동물용의약품
- Methylprednisolone Tablets: 4 mg (Medrol®)
- Methylprednisolone Acetate Injection: 20 mg/mL, 40 mg/mL (Depo-Medrol®)
- Depo-Medrone 40 mg/ml depot suspension
- Solu-Medrone 125 mg powder for reconstitution
- Solu-Medrone 500 mg powder for reconstitution
- Medrone 2 mg tablets
- Medrone 4 mg tablets
인용의약품
- Methylprednisolone Oral Tablets: 2 mg, 4 mg, 8 mg, 16 mg, 24 mg, 32 mg (Medrol®)
- Methylprednisolone Acetate Injection: 20 mg/mL, 40 mg/mL, 80 mg/mL (Depo-Medrol®)
- Methylprednisolone Sodium Succinate Powder for Injection: 40 mg, 125 mg, 500 mg, 1 gram, 2 grams per vial (Solu-Medrol®, A-Methapred®)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store commercially available products at room temperature (15-30°C). Avoid freezing the acetate injection. After reconstituting the sodium succinate injection, store at room temperature and use within 48 hours; only use solutions that are clear.
보호자 정보
반려동물 보호자를 위한 중요 안내:
- 갑자기 중단하지 마십시오: 수의사와 상의 없이 이 약의 투여를 갑자기 중단해서는 안 됩니다. 이 약을 복용하는 동안 신체의 자연적인 스테로이드 생성은 휴면 상태가 되며, 갑자기 중단하면 생명을 위협하는 위기를 초래할 수 있습니다. 수의사가 점진적인 감량 일정을 제공할 것입니다.
- 예상되는 부작용: 이 약을 복용하는 동안 반려동물이 물을 더 많이 마시고, 소변을 더 자주 보며, 식욕이 증가하는 것은 매우 흔한 일입니다. 항상 신선한 물을 마실 수 있게 하고 배변 활동을 자주 할 수 있도록 해주세요.
- 심각한 증상 주의: 구토, 검고 끈적이는 변, 혈변, 극심한 무기력, 헐떡임 또는 심각한 행동 변화와 같은 심각한 부작용을 발견하면 즉시 수의사에게 연락하십시오.
- 지시사항 준수: 처방된 대로 정확하게 약을 투여하십시오. 격일 투여 일정을 사용하는 경우, 약을 거르지 않도록 달력에 표시해 두는 것이 도움이 될 수 있습니다.
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