미르타자핀
Mirtazapine
6-azamianserin, Org-3770, mepirzapine
다른 이름: Remeron SolTab · Zispin · Mirataz · 6-azamianserin · Org-3770 · mepirzapine · Mirtazapinum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Chemotherapy-induced anorexia
- q24-72h
NA
반드시 함께 고려할 임상 맥락 (2)
- Management of weight loss (label dosage; FDA-approved): Using the transdermal formulation, apply 1.5-inch ribbon (≈2 mg/cat) to the inner pinna of the cat’s ear every 24 hours for 14 days. 1 The person applying medication should wear gloves. Alternate application of ointment between the left and right inner pinnae of the ears.
- ■ This medicine may be given with or without food. If your animal vomits after receiving the medication on an empty stomach, give it with food or a small treat. If vomiting continues, contact your veterinarian.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
미르타자핀은 비정형 사환계 항우울제로, 수의학에서는 주로 개와 고양이의 강력한 식욕 촉진제 및 항구토제로 널리 사용됩니다.
- 임상 요점: 만성 신장 질환(CKD), 울혈성 심부전, 위장관 질환, 간 질환 또는 종양 환자에게 특히 유익하며, 구역질과 식욕 부진을 동시에 개선합니다.
- 난치성 구토나 항암 화학요법으로 인한 구역 및 구토(CINV) 치료를 위해 다른 항구토제와 안전하게 병용할 수 있습니다.
- 주요 용량 제한 부작용은 진정 작용이지만, 고양이에서는 역설적인 흥분(발성 증가, 애교 증가)이 자주 관찰됩니다.
중요: 진정 부작용을 최소화하기 위해 항상 최저 유효 용량을 사용하십시오. 개에서는 하루 30mg을 초과하지 마십시오. 고용량에서는 역설적으로 식욕 촉진 효과가 사라집니다.
작용 기전
Mirtazapine has a complex, multi-receptor pharmacological profile (often classified as a NaSSA - Noradrenergic and Specific Serotonergic Antidepressant):
- Central pre-synaptic α2-adrenergic receptors: Antagonism blocks the negative feedback loop → increases Norepinephrine (NE) release → stimulates appetite via other α-receptors.
- 5-HT3 receptors: Potent antagonism in the Chemoreceptor Trigger Zone (CRTZ) and GI tract → provides robust anti-nausea and antiemetic effects.
- 5-HT2 receptors: Antagonism contributes to its anxiolytic profile.
- H1 (Histamine) receptors: Potent antagonism → produces prominent sedative effects.
- Peripheral α1-adrenergic & Muscarinic receptors: Moderate antagonism → may cause occasional orthostatic hypotension and mild anticholinergic effects.
안전성·주의사항
금기사항
- Hypersensitivity to mirtazapine
- Use of monoamine oxidase inhibitors (MAOIs, e.g., selegiline) within the past 14 days
- Pre-existing haematological disease
부작용
- Drowsiness/sedation
- Increased affection (cats)
- Hypotension
- Tachycardia
- Sedation (common and can be profound)
- Increased vocalization (especially in cats)
- Altered behavior and increased interaction with others
- Blood dyscrasias (reported in humans)
주의
Use with caution in patients with known cardiac disease or cerebrovascular disease that could be exacerbated by hypotension.
- Monitor patients with renal impairment, renal failure, or hepatic disease closely, as clearance may be reduced.
- Use with caution in patients with diabetes mellitus, as antidepressants may indirectly affect blood glucose concentrations.
- Due to weak anticholinergic activity, use vigilance in patients susceptible to these effects (e.g., urinary retention, prostatic hypertrophy, acute closed-angle glaucoma, increased intraocular pressure, GI obstruction, or ileus).
- May impair concentration and alertness in active animals.
- Use cautiously in patients with pre-existing hematological disease (leukopenia, neutropenia, thrombocytopenia), as it has been rarely associated with blood dyscrasias in humans.
약물 상호작용
Mirtazapine may cause increases in blood pressure
Minimal effects on mirtazapine blood levels, but may cause additive impairment of motor skills
May cause increased serum concentrations of mirtazapine
Increased risk for serotonin syndrome
Increased risk for serotonin syndrome; MAO inhibitors considered contraindicated with mirtazapine
Increased risk for serotonin syndrome
Increased risk of serotonin syndrome
모니터링
- Increased appetite
- Decreased episodes of vomiting
- Weight gain
- Adverse effects (sedation, vocalization, tachycardia)
- Appetite and body weight
- Behavioral changes (sedation, vocalization)
- Complete blood count (due to human risk of blood dyscrasias)
- Hepatic and renal function parameters
약동학
반감기
흡수
Rapidly and completely absorbed following oral administration. Food has minimal effects on rate and extent of absorption. Oral bioavailability is about 20% for dogs and 50% for humans.
분포
Plasma protein binding is approximately 70-72% for dogs, mice, and rats.
대사
Metabolized via multiple pathways including 8-hydroxylation, N-oxidation, and demethylation followed by conjugation. Cats have a limited capacity for glucuronidation, leading to less rapid clearance and requiring extended dosing intervals.
배설
Elimination occurs primarily via urine (75%) and feces (15%). Renal or hepatic impairment may reduce clearance.
과다투여
Ingestion of upwards of 10-fold to 30-fold the therapeutic dose in humans exhibits minimal toxicity requiring no acute intervention other than observation.
Treatment: Despite the wide safety margin, standard overdose protocols (including the administration of activated charcoal) and monitoring are recommended in acute overdose situations.
제품
제형
- Oral Tablets
- Orally Disintegrating Tablets (ODT)
- 15 mg tablets
- 15 mg/ml oral solution
- Transdermal formulation (named patient basis / authorized veterinary preparations)
동물용의약품
- None
- Mirataz 20 mg/g transdermal ointment
인용의약품
- Mirtazapine Oral Tablets: 7.5 mg, 15 mg, 30 mg & 45 mg (Remeron, generic)
- Mirtazapine Orally Disintegrating Tablets: 15 mg, 30 mg & 45 mg (Remeron SolTab, generic)
- Zispin 15 mg tablets
- Zispin 15 mg/ml oral solution
규제 현황
Mirataz transdermal ointment is authorized for cats.
Mirataz transdermal ointment is authorized for cats.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store coated and orally disintegrating tablets at 25°C (77°F) with excursions permitted to 15-30°C (59-86°F). Protect from light and moisture. Orally disintegrating tablets should be used immediately once removed from the blister pack.
보호자 정보
- 투여 방법: 처방된 대로 정확히 투여하십시오. 식사와 관계없이 투여할 수 있습니다.
- 구강 붕해정(ODT): 녹는 알약을 사용하는 경우, 손이 완전히 건조한 상태인지 확인하십시오. 반려동물의 혀 아래에 알약을 놓고 녹을 때까지 몇 초간 입을 다물게 하십시오. 알약이 녹은 후 즉시 물을 제공하십시오.
- 기대 효과: 식욕이 개선되고 구토가 감소하는 것을 볼 수 있습니다.
- 보고해야 할 부작용: 과도한 졸음, 심한 무기력, 빠른 심박수 또는 이상 행동이 관찰되면 수의사에게 연락하십시오.
고양이 보호자를 위한 참고 사항: 이 약을 복용한 후 고양이가 평소보다 많이 울거나(큰 소리로 야옹거림) 과도하게 애교를 부리는 것은 매우 흔한 일입니다. 이는 일반적으로 무해하지만, 생활에 불편을 준다면 수의사에게 알리십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.