메토클로프라마이드
Metoclopramide
Metoclopramide HCl
다른 이름: Reglan · Metozolv · Emeprid · Metomotyl · Vomend · Maxolon · AHR-3070-C · DEL-1267 · metoclopramidi hydrochloridum · MK-745 · Metoclopramide hydrochloride
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Gastrointestinal stasis after obstruction has been excluded
인증된 수의사 확인 필요
- q6–8h
반드시 함께 고려할 임상 맥락 (2)
- Exclude emergent diagnoses (obstruction, enterotoxemia)
- Prokinetic agent (after excluding the possibility of obstruction)
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
메토클로프라마이드는 수의학에서 널리 사용되는 위장관 운동 촉진제 및 항구토제입니다.
- 운동 촉진 효과: 주로 상부 위장관(위 및 소장)에 작용하며 결장에는 거의 영향을 미치지 않습니다. 위 정체, 위식도 역류 및 수술 후 장폐색증에 임상적으로 사용됩니다.
- 항구토 효과: 개는 화학수용체 유발대(CRTZ)에 도파민 수용체가 풍부하여 매우 효과적입니다. 반면 고양이는 D2 수용체가 적어 항구토제로서의 신뢰성이 떨어집니다(마로피탄트와 같은 NK-1 길항제가 종종 선호됨).
임상 요점:
- 파보바이러스 장염이나 급성 췌장염과 같은 심각한 상태에 대해 지속적 정맥 주입(CRI)으로 자주 투여됩니다.
- 혈액뇌장벽을 통과하기 때문에, 특히 고용량이나 말과 같이 민감한 종에서 눈에 띄는 추체외로 부작용(예: 떨림, 안절부절못함, 광란 행동)을 유발할 수 있습니다.
작용 기전
Metoclopramide exerts its effects through both peripheral gastrointestinal and central nervous system mechanisms:
- Peripheral (GI Tract): Sensitizes upper GI smooth muscle to acetylcholine → increases tone and amplitude of gastric contractions, relaxes the pyloric sphincter, and increases duodenal and jejunal peristalsis. It also increases lower esophageal sphincter (LES) pressure, reducing reflux.
- Central (CNS): Antagonizes Dopamine (D2) receptors in the Chemoreceptor Trigger Zone (CRTZ) → blocks emetic signaling to the vomiting center, providing a potent central antiemetic effect.
- Additional Mechanisms: At higher doses, it exhibits weak 5-HT3 (Serotonin) receptor antagonism and 5-HT4 receptor agonism, further contributing to its antiemetic and prokinetic profiles.
안전성·주의사항
금기사항
- GI hemorrhage
- GI obstruction or perforation
- Hypersensitivity to metoclopramide
- Seizure disorders (relatively contraindicated, lowers seizure threshold)
- Head trauma
- Pheochromocytoma (may induce hypertensive crisis)
- Concurrent phenothiazine therapy
- Dogs with pseudopregnancy (stimulates prolactin release)
- Gastrointestinal obstruction
- Gastrointestinal perforation
- Gastrointestinal hemorrhage
- Seizure disorders (epilepsy)
부작용
- Dogs: Changes in mentation and behavior (motor restlessness, involuntary spasms, aggression, hyperactivity to drowsiness/depression), constipation
- Cats: Frenzied behavior, disorientation, constipation
- Horses: Severe CNS effects (IV use), alternating sedation and excitement, behavioral changes, abdominal pain
- Extrapyramidal effects (tremors, rigid posture)
- Nausea and diarrhea
- Transient hypertension
- Elevated prolactin levels
- Extrapyramidal signs (tremors, twitching, hyperactivity, restlessness)
- Constipation or diarrhea
- Changes in mentation or behavior
주의
Absolute Contraindication: Do not use in patients with suspected or confirmed GI obstruction, perforation, or hemorrhage.
- Use with extreme caution in patients with a history of seizures, as metoclopramide can lower the seizure threshold.
- Dosage adjustment (reduce CRI by 25-50%) may be required in patients with renal failure.
- Avoid use in dogs experiencing pseudopregnancy due to its prolactin-stimulating effects.
- Monitor closely for extrapyramidal signs (involuntary muscle spasms, rigidity, tremors), which can be reversed with anticholinergic agents like diphenhydramine.
약물 상호작용
Metoclopramide may enhance the absorption of these agents.
Acute hypotension has been reported if metoclopramide is used concurrently IV.
May antagonize the GI motility effects of metoclopramide.
Oral metoclopramide increases cephalexin peak plasma concentrations and AUC in dogs.
May enhance metoclopramide's GI effects.
Metoclopramide may enhance CNS depressant effects.
Metoclopramide increases the rate and extent of GI absorption.
May antagonize the GI motility effects and enhance metoclopramide's CNS effects.
Could cause hypertension.
May potentiate the extrapyramidal effects of metoclopramide.
Reduces induction requirements of propofol by 20-25%.
Potential for enhanced extrapyramidal effects.
Metoclopramide increases the rate and extent of GI absorption.
Increased risk of extrapyramidal effects and CNS depression
May antagonize the gastrointestinal prokinetic effects of metoclopramide
Antagonize the prokinetic effects on the gastrointestinal tract
모니터링
- Clinical efficacy (resolution of vomiting, improved GI transit)
- Adverse effects (especially CNS and extrapyramidal signs)
- Clinical response (reduction in vomiting, improved gastric emptying)
- Hydration status and electrolyte balance
- Signs of extrapyramidal adverse effects (twitching, restlessness)
약동학
반감기
흡수
Well absorbed after oral administration, but a significant first-pass effect may reduce systemic bioavailability to ~30% (high interpatient variation). Bioavailability after IM administration is 74-96%. Peak plasma levels generally occur within 2 hours after oral dosing.
분포
Well distributed in the body and enters the CNS. Weakly bound to plasma proteins (13-22%). Crosses the placenta and enters milk in concentrations approximately twice those of plasma.
대사
The majority of the drug is metabolized to glucuronidated or sulfated conjugate forms.
배설
Primarily excreted in the urine (20-25% unchanged, the rest as metabolites). Approximately 5% is excreted in the feces.
과다투여
The oral LD50 doses are very high (465-870 mg/kg in laboratory animals), making death from oral overdose unlikely in veterinary patients.
Clinical Signs of Toxicity:
- Sedation, ataxia, agitation
- Extrapyramidal effects (tremors, rigidity, spasms)
- Nausea, vomiting, constipation
Treatment:
- No specific antidote exists.
- If ingestion was recent, empty the stomach using standard protocols.
- Anticholinergic agents that enter the CNS (e.g., diphenhydramine at 2.2 mg/kg IV, or benztropine) are highly effective in controlling extrapyramidal effects.
- Peritoneal dialysis or hemodialysis is not effective for drug removal.
제품
제형
- Oral Tablets: 5 mg, 10 mg
- Oral Disintegrating Tablets: 5 mg, 10 mg
- Oral Syrup: 1 mg/mL
- Injection Solution: 5 mg/mL
- Injectable: 5 mg/ml solution
- Oral: 1 mg/ml solution
동물용의약품
- None
- Emeprid 5 mg/ml injectable solution
- Emeprid 1 mg/ml oral solution
- Metomotyl
- Vomend
인용의약품
- Metoclopramide HCl Oral Tablets: 5 mg & 10 mg (Reglan, Metozolv, generic)
- Metoclopramide HCl Oral Disintegrating Tablets: 5 mg & 10 mg
- Metoclopramide HCl Oral Syrup: 1 mg/mL
- Metoclopramide HCl Injection Solution: 5 mg/mL (Reglan, generic)
- Maxolon
규제 현황
Classified as POM-V (Prescription Only Medicine - Veterinarian).
Classified as POM-V.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Photosensitive; must be stored in light-resistant containers at room temperature. Tablets should be kept in tight containers. Injection is stable in solutions with a pH of 2-9 and compatible with D5W, 0.9% NaCl, Ringer's, and LRS.
보호자 정보
메토클로프라마이드는 위를 비우고 메스꺼움과 구토를 예방하는 데 사용됩니다.
- 투여 방법: 위장관 운동 촉진 효과를 극대화하려면 반려동물이 식사하기 약 30분 전에 약을 투여하십시오.
- 행동 변화: 이상 행동이 있는지 관찰하십시오. 개에서는 안절부절못함, 서성거림 또는 공격성으로 나타날 수 있습니다. 고양이에서는 광란 행동이나 방향 감각 상실로 나타날 수 있습니다.
-
응급 경고: 반려동물에게 무의식적인 근육 경련, 눈/얼굴/사지의 떨림 또는 뻣뻣한 자세가 나타나면 즉시 수의사에게 연락하십시오. 이는 추체외로 증상으로 알려져 있으며 수의사가 제공하는 특정 약물로 빠르게 회복될 수 있습니다.
- 약물은 실온에 보관하고 빛을 피하십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.