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날록손

Naloxone

Naloxone hydrochloride, N-allylnoroxymorphone

해독제; 오피오이드 길항제IVIMSCSublingualIntratracheal개고양이소형 포유류말

다른 이름: Narcan · N-allylnoroxymorphone · naloxona · EN-15304 · naloxoni · Naloxonum · Naloxone hydrochloride

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

감사 완료 v13 용량 근거

검토된 비계산 근거
검토된 비계산 근거 (2)

근거 표시 전용 — 자동 계산 불가

Green tree monitors/reversal of butorphanol

TABLE 127.5. Agent: Naloxone. Dosage: 4 mg/kg IM95. Species/Comments: Green tree monitors/reversal of butorphanol.

IM
고위험인증된 수의사 확인 필요drug_regimen프로토콜 2019감사 dose-audit-mader-reviewed-v1

근거 표시 전용 — 자동 계산 불가

Corn snakes, bearded dragons, red-eared sliders/µ-opioid agonist reversal

TABLE 127.5. Agent: Naloxone. Dosage: 0.04–2 mg/kg SC304,305,307,309. Species/Comments: Corn snakes, bearded dragons, red-eared sliders/µ-opioid agonist reversal.

SC
고위험인증된 수의사 확인 필요drug_regimen프로토콜 2019감사 dose-audit-mader-reviewed-v1

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개요

​날록손(Naloxone)​은 순수 오피오이드 길항제로, 수의학에서는 주로 오피오이드 작용제의 효과(호흡 억제, 진정, 불쾌감 등)를 역전시키는 데 사용됩니다. 오피오이드 과다 복용 시 생명을 구하는 해독제입니다.

주요 용도 외에도 다양한 형태의 쇼크(패혈성, 저혈량성, 심인성) 치료 및 내인성 엔돌핀을 차단하여 꼬리 쫓기와 같은 자해 행동을 억제하는 데 대한 연구가 진행 중입니다.

​임상 요점:​ 날록손 자체에는 진통 효과가 없습니다. 오피오이드로 인한 호흡 억제를 역전시키는 데 사용될 때 오피오이드의 진통 효과도 동시에 역전시키므로 갑작스러운 통증 재발과 카테콜아민 방출을 유발할 수 있습니다.

작용 기전

Naloxone acts as a competitive antagonist at opioid receptors. It binds primarily to the ​mu (μ)​ receptor, but also has affinity for ​kappa (κ)​ and ​sigma (σ)​ receptors.

By occupying these receptors without activating them, it displaces opioid agonists → rapid reversal of opioid-induced respiratory and CNS depression.

At very high doses, naloxone may exhibit additional pharmacologic activity, including GABA antagonism and the ability to increase dopamine levels.

안전성·주의사항

금기사항

  • Hypersensitivity to naloxone
  • Indiscriminate use in animals that have undergone major surgery or trauma (due to severe pain from analgesia reversal)

부작용

  • Reversal of analgesia (return of pain)
  • Acute withdrawal syndrome in opioid-dependent patients
  • CNS excitement (especially if used in meperidine overdose)
  • Seizures (at very high doses, likely secondary to GABA antagonism)
  • Acute severe discomfort or pain (due to sudden loss of analgesia)
  • Antanalgesic effects in opioid-naïve subjects
  • Transient elevation of unconsciousness (at low doses)

주의

​Important Warning:​ The duration of action of naloxone (45-90 minutes) is often shorter than the opioid it is reversing. Patients may slip back into respiratory depression and require re-dosing or continuous ventilatory support.

  • Use with caution in animals with preexisting cardiac abnormalities.
  • Use cautiously in opioid-dependent animals or those that have received exceedingly large doses of narcotics, as it may precipitate an acute withdrawal syndrome.
  • ​Meperidine Toxicity:​ Naloxone is reportedly not effective for reversing meperidine-induced seizures and may elicit CNS excitement if normeperidine excitotoxicity is present. Avoid unless severe respiratory depression is present without ventilatory support.
  • ​Buprenorphine:​ Naloxone is not a good reversal agent for buprenorphine due to buprenorphine's high receptor affinity; massive doses (100X usual) may be required.

약물 상호작용

Opioid partial-agonists (butorphanol, pentazocine, nalbuphine)

Naloxone may antagonize the effects of these agents (respiratory depression, analgesia). It should not be relied upon to treat respiratory depression caused by buprenorphine.

Clonidine

Naloxone may reduce the hypotensive and bradycardic effects of clonidine; potentially useful for clonidine overdoses.

Yohimbine

Naloxone may increase the CNS effects of yohimbine (anxiety, tremors, nausea, palpitations) and increase plasma cortisol levels.

Opioid Agonists (e.g., Morphine, Methadone, Fentanyl)Major

Naloxone reverses the analgesic, sedative, and respiratory depressant effects of opioid agonists.

BuprenorphineModerate

Buprenorphine binds tightly to opioid receptors; naloxone may not fully reverse its effects or may require much higher doses.

모니터링

  • Respiratory rate and depth
  • CNS function (level of sedation/arousal)
  • Pain associated with opiate reversal
  • Respiratory rate and effort
  • Level of consciousness / sedation score
  • Pain score (monitor for acute pain upon reversal)
  • Heart rate and blood pressure

약동학

반감기

고양이Duration of action is short (30-40 min)개Duration of action is short (30-40 min)

흡수

Minimally absorbed orally (rapidly destroyed in the GI tract). Very rapid onset of action when given IV (1-2 minutes). IM onset is generally within 5 minutes. Duration of action usually persists from 45-90 minutes, but may act for up to 3 hours.

분포

Distributed rapidly throughout the body with high levels found in the brain, kidneys, spleen, skeletal muscle, lung, and heart. Readily crosses the placenta.

대사

Metabolized in the liver, principally via glucuronidative conjugation.

배설

Metabolites are excreted into the urine.

과다투여

Naloxone is considered a very safe agent with a very wide margin of safety. However, massive overdoses have initiated seizures in a few patients, which is theorized to be secondary to GABA antagonism.

제품

제형

  • Injection: 0.4 mg/mL
  • Neonatal Injection: 0.02 mg/mL
  • Injectable: 0.02 mg/ml solution
  • Injectable: 0.4 mg/ml solution

동물용의약품

  • Naloxone 0.02 mg/ml injectable solution
  • Naloxone 0.4 mg/ml injectable solution

인용의약품

  • Naloxone HCl Injection: 0.4 mg/mL (400 micrograms/mL) in 1 mL amps, syringes and 1 mL, 2 mL, & 10 mL vials (Narcan)
  • Naloxone HCl Neonatal Injection: 0.02 mg/mL in 2 mL vials
  • Narcan 0.4 mg/ml injectable solution
  • Narcan nasal spray

규제 현황

European Union✓ 승인됨처방전의약품EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ 승인됨처방전의약품VMD
🐕 Dogs🐈 Cats

POM-V

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

Store at room temperature (15-30°C) and protect from light. Sterile water for injection is the recommended diluent. When given as an IV infusion, either D5W or normal saline should be used. Do not mix with solutions containing sulfites, bisulfites, long-chain or high molecular weight anions, or any solutions at alkaline pH.

보호자 정보

  • ​목적​: 날록손은 오피오이드 진통제의 효과를 역전시키거나 과다 복용을 치료하는 데 사용되는 응급 약물입니다.
  • ​예상되는 현상​: 반려동물이 진정 상태에서 빨리 깨어날 수 있습니다. 진통제의 효과를 역전시키기 때문에 갑작스러운 통증을 느낄 수 있습니다.
  • ​모니터링​: 날록손의 효과는 오피오이드보다 먼저 사라질 수 있습니다. 극심한 졸음이나 느린 호흡, 무반응이 다시 나타나지 않는지 반려동물을 주의 깊게 관찰하십시오.
  • ​투여​: 일반적으로 수의학 전문가가 투여하지만, 일부 경우(신생아 강아지/고양이 등) 혀 밑에 한 방울을 떨어뜨리도록 지시받을 수 있습니다.

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