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프로메타진

Promethazine

Promethazine hydrochloride

페노티아진계 항히스타민제 / 항구토제POIMIVRectal개고양이

다른 이름: Phenergan · Phenadoz · Promethegan · Promethazine HCl · Lilly 01516 · PM 284 · RP 3277 · prometazina · Promethazine hydrochloride · Promethazini hydrochloridum

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

2 mg/kg PO or IM once dailyPO/IM· q24h
— 🐕

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
As an antiemetic2 mg/kg PO or IM once dailyPO/IMq24h—🌎 NA
As an antihistamine0.2-0.4 mg/kg PO three to four times a dayPOq6-8h—🌎 NA
As an antihistamine1-2 mg/kg PO q12hPOq12h—🌎 NA

고양이

적응증용량경로빈도기간지역
As an antiemetic2 mg/kg PO or IM once dailyPO/IMq24h—🌎 NA
As an antihistamine0.2-0.4 mg/kg PO three to four times a dayPOq6-8h—🌎 NA
As an antihistamine1-2 mg/kg PO q12hPOq12h—🌎 NA

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

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개요

프로메타진은 수의학에서 주로 항구토제 및 항히스타민제로 사용되는 페노티아진 유도체입니다.

  • ​주요 용도​: 개와 고양이의 메스꺼움과 구토를 조절하는 데 가끔 사용되며, 아토피성 피부염이 있는 개의 가려움증 치료에 시도된 바 있습니다(후자의 경우 효능은 일반적으로 떨어짐).
  • ​약리학적 특징​: 아세프로마진과 같은 진정제와 구조적으로 유사하지만, 프로메타진은 강력한 항히스타민 특성과 함께 항구토, 항콜린, 진정 및 경미한 국소 마취 효과를 나타내는 것이 특징입니다.

​임상 팁​: 진정 작용 및 추체외로 부작용의 가능성 때문에 마로피탄트나 온단세트론과 같은 최신 표적 항구토제 또는 디펜히드라민과 같은 표준 항히스타민제에 비해 현대 수의학 임상에서는 상대적으로 드물게 처방됩니다.

작용 기전

Promethazine exerts its effects through competitive antagonism at multiple receptor sites centrally and peripherally:

  • H1-Receptor Antagonism: Competitively blocks histamine at H1 receptors → reduces allergic responses and pruritus.
  • D2-Dopaminergic Antagonism: Blocks dopamine receptors in the Chemoreceptor Trigger Zone (CRTZ) of the medulla → provides central antiemetic effects.
  • Muscarinic Antagonism: Blocks acetylcholine at muscarinic receptors → contributes to antiemetic efficacy and causes anticholinergic side effects (e.g., dry mouth).
  • Alpha-1 Adrenergic Antagonism: Blocks peripheral alpha-1 receptors → can lead to vasodilation and subsequent hypotension.

안전성·주의사항

금기사항

  • Hypovolemia or shock (due to hypotensive effects)
  • Tetanus or strychnine intoxication (due to extrapyramidal effects)
  • Human label black box warning: Contraindicated in children < 2 years old (fatal respiratory depression)
  • Known hypersensitivity to phenothiazines
  • Severe central nervous system depression
  • Comatose patients
  • Use with caution in patients with seizure disorders
  • Use with caution in patients with severe hepatic or cardiovascular disease

부작용

  • Sedation or lethargy
  • Anticholinergic effects (dry mouth, urinary retention, decreased GI motility)
  • Hypotension (especially with rapid IV administration or in hypovolemic patients)
  • Extrapyramidal signs (tremors, rigidity, torticollis) - rare but possible
  • Sedation / Lethargy
  • Dry mucous membranes (anticholinergic effect)
  • Tachycardia
  • Paradoxical excitation (especially in cats)
  • Gastrointestinal disturbances

주의

Use cautiously and at smaller doses in animals with hepatic dysfunction, cardiac disease, or general debilitation. Animals may require lower dosages of general anesthetics following phenothiazine administration. Use with extreme caution in very young or severely debilitated animals. Promethazine can cause false-positive results for salicylates in urine and false-positive/negative results for chorionic gonadotropin in urine.

약물 상호작용

Antacids

May cause reduced GI absorption of oral phenothiazines.

Antidiarrheal mixtures (e.g., Kaolin/pectin, bismuth subsalicylate)

May cause reduced GI absorption of oral phenothiazines.

Atropine & other anticholinergics

May have additive anticholinergic effects when used with promethazine.

CNS Depressant Agents (barbiturates, narcotics, anesthetics)

May cause additive CNS depression if used with phenothiazines.

EpinephrineMajor

Phenothiazines block alpha-adrenergic receptors; concomitant epinephrine can lead to unopposed beta-activity causing vasodilation and increased cardiac rate (epinephrine reversal).

Metoclopramide

Phenothiazines may potentiate the extrapyramidal effects of metoclopramide.

Monoamine Oxidase Inhibitors (MAOIs)

May potentiate extrapyramidal effects.

Opiates

May enhance the hypotensive effects of phenothiazines; dosages may need to be reduced.

Organophosphate Agents

Phenothiazines should not be given within one month of worming with these agents as their toxic effects may be potentiated.

CNS Depressants (e.g., opioids, barbiturates, anesthetics)Major

Additive central nervous system depression and sedation.

Anticholinergic agents (e.g., atropine, glycopyrrolate)Moderate

Additive anticholinergic effects (tachycardia, dry mouth, ileus).

모니터링

  • Clinical efficacy (resolution of vomiting or pruritus)
  • Degree of sedation
  • Hydration status (if vomiting persists)
  • Heart rate and rhythm
  • Blood pressure (especially with IV use)
  • Level of consciousness / CNS status
  • Respiratory rate

약동학

반감기

고양이Unknown개Unknown

흡수

Little veterinary data available. In humans, well absorbed following oral, rectal, or IM administration.

분포

Presumed to follow general phenothiazine patterns (widely distributed, crosses blood-brain barrier).

대사

Metabolized in the liver.

배설

Metabolites are eliminated primarily in the urine.

과다투여

Overdose may result in profound sedation, severe hypotension, or acute extrapyramidal clinical signs (e.g., torticollis, tremors, excessive salivation, rigidity).

  • Treatment: Supportive care is primary. Acute extrapyramidal signs have been successfully treated with injectable diphenhydramine in humans. Hypotension should be treated with IV fluids; avoid epinephrine due to the risk of epinephrine reversal (use alpha-agonists like phenylephrine if pressors are required).

제품

제형

  • Oral tablets
  • Oral syrup
  • Injection (IV/IM)
  • Rectal suppositories
  • 10 mg tablet
  • 25 mg tablet
  • 1 mg/ml syrup
  • 25 mg/ml injectable solution

인용의약품

  • Promethazine HCl for Injection: 25 mg/mL & 50 mg/mL in 1 mL ampules
  • Promethazine HCl Oral syrup: 1.25 mg/mL
  • Promethazine HCl Oral Tablets: 12.5 mg, 25 mg & 50 mg
  • Promethazine HCl Rectal Suppositories: 12.5 mg, 25 mg, & 50 mg
  • Phenergan 10 mg tablets
  • Phenergan 25 mg tablets
  • Phenergan 1 mg/ml syrup
  • Phenergan 25 mg/ml injectable solution

규제 현황

European Union✓ 승인됨처방전의약품 · POMEMA

Available as a human prescription product (POM).

United Kingdom✓ 승인됨처방전의약품 · POMVMD

Phenergan is a POM (Prescription Only Medicine) in the UK.

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

보관·안정성

Store tablets at room temperature (20-25°C) in tight, light-resistant containers. Syrup should be stored at 15-25°C and protected from light. Injection should be stored at room temperature (20-25°C) and protected from light; do not use if precipitate forms or solution is discolored. Suppositories should be stored in the refrigerator (2-8°C). Promethazine can adsorb to plastic IV bags and tubing.

보호자 정보

프로메타진은 메스꺼움과 구토를 조절하거나 때로는 알레르기 반응을 치료하는 데 사용됩니다.

  • ​구강 건조​: 이 약은 입마름을 유발할 수 있습니다. 반려동물의 혀에 소량의 물을 10~15분 동안 적셔주면 이를 완화할 수 있습니다.
  • ​진정 작용​: 졸음, 진정 또는 가벼운 행동 변화를 유발할 수 있습니다. 이러한 효과가 심하거나 우려되는 경우 수의사에게 문의하십시오.
  • ​수의사에게 연락해야 할 때​: 지속적인 구토나 설사는 심각할 수 있습니다. 반려동물의 증상이 호전되지 않으면 수의사에게 연락하십시오.
  • ​위험 신호​: 동물이 비정상적으로 씰룩거리는 움직임, 떨림을 보이거나 몸이 뻣뻣해지면 즉시 수의사에게 연락하십시오.

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