VetSheet

나프록센

Naproxen

비스테로이드성 항염증제 (NSAID)POIV개소형 포유류말

다른 이름: Aleve · Anaprox · EC-Naprosyn · Midol Extended Relief · Naprelan · Equiproxen · naproxeneum · RS-3540 · RS-3650 · naproxen sodium

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

2 mg/kg PO every other day (q48h)PO· q48h
— 🐕

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

적응증용량경로빈도기간지역
Osteoarthritis and musculoskeletal inflammatory diseases (Last resort)2 mg/kg PO every other day (q48h)POq48h—🌎 NA
  • Osteoarthritis and musculoskeletal inflammatory diseases (Last resort): Because of the difficulty in accurately dosing naproxen and its potential for adverse effects, use only when FDA-approved and safer NSAIDs have been ineffective.

소형 포유류

적응증용량경로빈도기간지역
Septic arthritis pain; inflammation (Rabbits)2.4 mg/mL in drinking water for 21 daysPOContinuous21 days🌎 NA
  • Septic arthritis pain; inflammation (Rabbits): Dose specific to rabbits.

말

적응증용량경로빈도기간지역
Myositis and soft tissue diseases of the musculoskeletal system5 mg/kg by slow IV, then 10 mg/kg, PO (top dressed in feed) twice daily for up to 14 days or 10 mg/kg, PO (top dressed in feed) twice daily for up to 14 consecutive days.IV, POq12hUp to 14 days🌎 NA
Systemic therapies for joint disease10 mg/kg PO dailyPOq24h—🌎 NA
  • Myositis and soft tissue diseases of the musculoskeletal system: ARCI UCGFS Class 4 Drug. Veterinary product no longer commercially available.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

나프록센은 프로피온산 계열에 속하는 ​비스테로이드성 항염증제(NSAID)​로, 이부프로펜 및 케토프로펜과 구조적으로 유사합니다.

  • ​수의학적 용도​: 수의학에서의 사용은 더 안전하고 COX-2 선택성이 높은 최신 NSAID로 대부분 대체되었습니다.
  • ​독성 위험​: 개에서는 반감기가 매우 길고(74시간) 광범위한 장간 순환을 거치기 때문에 치료 지수가 매우 좁아 독성이 강한 것으로 알려져 있습니다. 많은 임상 수의사들이 개에게 이 약을 사용하는 것을 강력히 반대합니다.
  • ​말에서의 용도​: 과거에는 말의 근골격계 통증, 근염 및 연조직 질환에 사용되었으나, 수의용 제품(Equiproxen®)은 미국에서 더 이상 판매되지 않습니다.

작용 기전

Naproxen exerts its analgesic, anti-inflammatory, and antipyretic effects by inhibiting the ​cyclooxygenase (COX)​ enzymes.

  • Arachidonic Acid → COX-1 and COX-2 inhibition → Decreased synthesis of prostaglandins and thromboxanes.
  • The reduction in pro-inflammatory prostaglandins mitigates inflammation, pain, and fever.
  • Because naproxen is a non-selective COX inhibitor, it also blocks the constitutive, protective prostaglandins (via COX-1) in the gastric mucosa and kidneys. This mechanism explains its high propensity for causing gastrointestinal ulceration and renal toxicity, particularly in sensitive species like dogs and cats.

안전성·주의사항

금기사항

  • Active GI ulcers
  • History of hypersensitivity to naproxen or other NSAIDs
  • Pre-existing hematologic, renal, or hepatic disease

부작용

  • GI distress (anorexia, vomiting, diarrhea)
  • Gastrointestinal ulcers and perforation
  • Melena and bloody vomitus
  • Renal effects (nephritis, nephrotic syndrome, fluid retention)
  • Hepatic effects (increased liver enzymes)
  • Hematologic effects (hypoproteinemia, decreased hematocrit, anemia)
  • CNS effects (neuropathies, lethargy, depression)

주의

WARNING: Extremely narrow therapeutic index in dogs. Use is generally discouraged unless all FDA-approved, safer NSAIDs have failed.

  • Relatively Contraindicated: Patients with a history of or pre-existing hematologic, renal, or hepatic disease.
  • Caution: Use cautiously in patients with a history of GI ulcers or heart failure (may cause fluid retention).
  • Infection: Animals suffering from inflammation secondary to concomitant infection should receive appropriate antimicrobial therapy alongside NSAID treatment.

약물 상호작용

Aminoglycosides (gentamicin, amikacin)

Increased risk for nephrotoxicity

Anticoagulants (heparin, LMWH, warfarin)

Increased risk for bleeding

Aspirin

Decreased plasma levels of naproxen and increased likelihood of GI adverse effects (blood loss). Concomitant use is not recommended.

Bisphosphonates (alendronate)

May increase risk for GI ulceration

Corticosteroids

Concomitant administration significantly increases the risks for GI adverse effects and ulceration

Furosemide

Naproxen may reduce the saluretic and diuretic effects of furosemide

Highly protein bound drugs (phenytoin, valproic acid, sulfonamides)

Potential displacement leading to increased serum levels and duration of action of the displaced drug

Methotrexate

Serious toxicity has occurred; use together with extreme caution

Probenecid

May cause a significant increase in serum levels and half-life of naproxen

모니터링

  • Analgesic/anti-inflammatory efficacy
  • GI signs: appetite, feces (occult blood, diarrhea)
  • PCV (packed cell volume) and hematocrit if indicated or on chronic therapy
  • WBCs if indicated or on chronic therapy
  • Renal and hepatic function panels (especially in dogs)

약동학

반감기

말~4 hours개74 hours

흡수

Horses: 50% bioavailability after oral dosing; absorption is not altered by food. Dogs: Rapid oral absorption with 68-100% bioavailability.

분포

Highly bound to plasma proteins (99% in humans). Crosses the placenta and enters milk at about 1% of serum levels.

대사

Metabolized in the liver.

배설

Detectable in the urine for at least 48 hours in the horse after an oral dose.

과다투여

Toxicity is a major concern, particularly in dogs and cats.

  • Dogs: The reported oral LD50 is >1000 mg/kg, but clinical toxicity occurs at much lower doses.
    • ​>5 mg/kg​: Gastrointestinal signs and GI ulceration.
    • ​>25 mg/kg​ (some dogs as low as 10 mg/kg): Significant renal damage.
    • ​>50 mg/kg​: Neurologic signs.
  • Clinical Signs: Vomiting (often bloody), lethargy, anorexia, diarrhea, melena, anemia, and elevated renal/hepatic values.
  • Treatment:
    • Decontamination: Emesis and/or activated charcoal if recent ingestion.
    • GI Protection: Misoprostol and sucralfate are recommended for 10-14 days post-exposure.
    • Renal Protection: Fluid diuresis should be considered if renal effects are expected.
    • Supportive Care: Monitor electrolyte and fluid balance carefully; manage renal failure using established guidelines.

제품

제형

  • Oral tablets
  • Gelcaps
  • Capsules
  • Delayed/controlled-release tablets
  • Oral suspension
  • Injection (historically available for horses)

동물용의약품

  • None currently marketed in the USA (Equiproxen® is discontinued)

인용의약품

  • Naproxen Oral Tablets/Gelcaps/Capsules: 200 mg, 250 mg, 375 mg, 500 mg
  • Naproxen Delayed/Controlled-release Tablets: 375 mg, 500 mg, 750 mg
  • Naproxen Oral Suspension: 125 mg/5 mL

규제 현황

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

보관·안정성

Store in well-closed, light-resistant containers at room temperature. Avoid temperatures above 40°C (104°F).

보호자 정보

​위험​: 수의사의 명확한 지시 없이 Aleve®와 같은 인체용 일반의약품 진통제를 반려동물에게 절대 투여하지 마십시오. 나프록센은 개와 고양이에게 매우 치명적인 독성을 가집니다.

  • 반려동물에게 나프록센이 처방된 경우, 투약 일정(개의 경우 이틀에 한 번 투여할 수도 있음)을 엄격히 준수하십시오.
  • 다음 증상을 발견하면 ​즉시 투약을 중단하고 수의사에게 연락하십시오​:
    • 식욕 부진 또는 무기력/우울증
    • 구토 (특히 피가 섞여 있거나 커피 찌꺼기처럼 보이는 경우)
    • 설사 또는 검고 끈적이는 흑변
    • 음수량이나 배뇨 습관의 변화

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