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S-아데노실메티오닌 (SAMe)

S-Adenosyl-Methionine (SAMe)

Ademetionine

간장 보호제 / 영양 보조제PO개고양이

다른 이름: Zentonil · Denamarin · Donamet · Gumbaral · Isimet · MoodLift · S Amet · Samyr · Transmetil · Tunik · Samylin · Hepatosyl · S-adenosyl-L-methionine · Sadenosylmethionine · SAM-e · Sammy · methioninyl adenylate · SAMe · AdoMet · S-adenosylmethionine

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

18 mg/kg (or based on weight: <5.5 kg: 90 mg; 5.5-11 kg: 180-225 mg; 11-16 kg: 225 mg; 16-29.5 kg: 450 mg; 29.5-41 kg: 675 mg; >41 kg: 900 mg)PO· q24h (may divide q12h if giving >1 tablet)
— 🐕

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
General dosing / Liver support18 mg/kg (or based on weight: <5.5 kg: 90 mg; 5.5-11 kg: 180-225 mg; 11-16 kg: 225 mg; 16-29.5 kg: 450 mg; 29.5-41 kg: 675 mg; >41 kg: 900 mg)POq24h (may divide q12h if giving >1 tablet)—🌎 NA
Liver Disease (necro-inflammatory/cholestatic, vacuolar hepatopathy)20 mg/kgPOq24h—🌎 NA
Liver disease, cognitive dysfunction, adjunctive therapyAt least 100 mg for every 10 kg or 20 mg/kgPOq24hLong-term as needed🌍 EU
  • General dosing / Liver support: Give on an empty stomach, at least one hour before feeding.
  • Liver Disease (necro-inflammatory/cholestatic, vacuolar hepatopathy): Give on an empty stomach; use a proven bioavailable product.
  • Liver disease, cognitive dysfunction, adjunctive therapy: Administer on an empty stomach at least 1 hour before food. Tablets should be given whole.

고양이

적응증용량경로빈도기간지역
General dosing / Liver support18 mg/kg (or based on weight: <5.5 kg: 90 mg; 5.5-11 kg: 180-225 mg)POq24h—🌎 NA
Liver Disease (necro-inflammatory/cholestatic, feline hepatic lipidosis)20 mg/kgPOq24h—🌎 NA
Liver disease, cognitive dysfunction, improve bile flow100 mg/cat or 20 mg/kgPOq24hLong-term as needed🌍 EU
  • General dosing / Liver support: Give on an empty stomach, at least one hour before feeding.
  • Liver Disease (necro-inflammatory/cholestatic, feline hepatic lipidosis): Give on an empty stomach; use a proven bioavailable product.
  • Liver disease, cognitive dysfunction, improve bile flow: Administer on an empty stomach at least 1 hour before food. Tablets should be given whole.

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

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개요

​S-아데노실메티오닌 (SAMe)​은 체내에 자연적으로 존재하는 내인성 분자로, 수의학에서 주로 ​간장 보호제​로 널리 사용되는 영양 보조제입니다.

주요 임상 적용 분야:

  • ​간 질환​: 만성 간염, 지방간, 담관간염 및 고양이 세동반질환의 보조 치료제로 사용됩니다.
  • ​독성 관리​: 고갈된 글루타치온을 보충하여 ​아세트아미노펜​이나 ​자일리톨​ 중독과 같은 급성 간독성 물질에 의한 간 손상 치료에 중요한 역할을 합니다.
  • ​기타 용도​: 골관절염, 연령 관련 인지 기능 장애(개 인지 기능 장애 증후군) 및 간독성 잠재력이 있는 약물(예: 페노바르비탈)을 장기 복용하는 환자에게 유익할 수 있습니다.

​임상 팁​: 순수한 SAMe는 반응성이 높고 불안정하기 때문에 상용화된 제품은 안정성을 높이기 위해 다양한 염(예: 토실산염) 형태를 사용합니다. 제품 간 생체 이용률 차이가 크므로 신뢰할 수 있는 수의학 전용 브랜드를 선택하는 것이 강력히 권장됩니다.

작용 기전

SAMe is synthesized from the amino acid methionine and ATP via the enzyme SAMe synthetase. In liver compromise, this enzyme's activity is a rate-limiting step, leading to systemic SAMe deficiency. Exogenous SAMe bypasses this block and participates in three major biochemical pathways:

  • Transsulfuration → Generates sulfur-containing compounds → Precursor to ​Glutathione (GSH)​. Glutathione is the liver's master antioxidant, essential for ROS scavenging and cellular detoxification. Exogenous SAMe prevents GSH depletion.
  • Transmethylation → Serves as a methyl donor → Essential for phospholipid synthesis (e.g., phosphatidylcholine) → Maintains cell membrane structure, fluidity, and function.
  • Aminopropylation → Donates aminopropyl groups → Source of polyamines → Promotes anti-inflammatory effects, protein/DNA synthesis, and hepatocyte replication/regeneration.

Additionally, SAMe inhibits hepatocyte apoptosis secondary to alcohol or bile acid accumulation.

안전성·주의사항

금기사항

  • Use with caution in pregnant animals (safety not definitively proven)
  • No absolute contraindications documented
  • Use with caution during pregnancy (safety not established)

부작용

  • Immediate post-dose vomiting
  • Anorexia
  • Nausea (reported in humans)
  • Diarrhea (reported in humans)
  • Flatulence (reported in humans)
  • Diarrhoea
  • Paradoxical anxiety
  • Dry mouth (reported in humans)
  • Headache (reported in humans)
  • Sweating (reported in humans)
  • Dizziness (reported in humans)

주의

There are no apparent absolute contraindications to the use of SAMe.

Pregnancy/Nursing: The safety of exogenous SAMe has not been definitively proven in pregnancy; use with caution. However, limited studies in laboratory animals and pregnant women with liver disease have not demonstrated ill effects. It is unknown if SAMe enters maternal milk.

약물 상호작용

TramadolMajor

Theoretical risk of additive serotonergic effects (serotonin syndrome)

MeperidineMajor

Theoretical risk of additive serotonergic effects

Dextromethorphan

Theoretical risk of additive serotonergic effects

PentazocineMajor

Theoretical risk of additive serotonergic effects

Monoamine oxidase inhibitors (MAOIs) (e.g., selegiline)

Theoretical risk of additive serotonergic effects

Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine)

Theoretical risk of additive serotonergic effects

Tricyclic antidepressants (TCAs) (e.g., amitriptyline, clomipramine)

Theoretical risk of additive serotonergic effects

SelegilineMajor

Additive serotonergic effects; potential for serotonin syndrome

FluoxetineMajor

Additive serotonergic effects; potential for serotonin syndrome

ClomipramineMajor

Additive serotonergic effects; potential for serotonin syndrome

AmitriptylineMajor

Additive serotonergic effects; potential for serotonin syndrome

ParacetamolModerate

SAMe may increase the clearance of drugs undergoing hepatic glucuronidation

DiazepamModerate

SAMe may increase the clearance of drugs undergoing hepatic glucuronidation

MorphineModerate

SAMe may increase the clearance of drugs undergoing hepatic glucuronidation

모니터링

  • Clinical signs (appetite, activity, attitude)
  • Liver enzymes (ALT, AST, ALP, GGT)
  • Liver biopsies (if indicated)
  • Hepatic and erythrocyte glutathione levels (Note: may require 1-4 months before changes in lab values are noted)
  • Liver enzyme panel (ALT, AST, ALP, GGT)
  • Total bilirubin and bile acids
  • Clinical signs of cognitive improvement or behavioral changes
  • Signs of serotonin syndrome (agitation, tremors, hyperthermia) if used concurrently with serotonergic drugs

약동학

반감기

고양이Short (rapidly metabolized)개Short (rapidly metabolized)

흡수

Oral bioavailability is highly dependent on the stabilizing salt (tosylate ~1%, 1,4-butanedisulfonate ~5%). The presence of food in the gut substantially reduces absorption. Peak levels occur 1-6 hours post-dosing with enteric-coated tablets. Chewable formulations yield similar AUC but faster peak levels.

분포

Enters portal circulation after absorption.

대사

Primarily metabolized in the liver.

배설

In humans, 17% of a radiolabeled dose is recovered in urine within 48 hours; 27% in feces.

과다투여

SAMe appears to be quite safe. The LD50 in rodents exceeds 4.65 grams/kg. Toxicity studies in dogs and cats at usual prescribed dosages demonstrated no deleterious effects.

In the event of a massive overdose, mild gastrointestinal effects (nausea, vomiting, diarrhea) may be observed, but it is highly unlikely to require specific medical treatment beyond supportive care.

제품

제형

  • Enteric-coated tablets
  • Chewable tablets
  • Oral tablets: 90 mg, 100 mg, 200 mg, 225 mg, 400 mg, 425 mg
  • Oral capsules: 50 mg, 100 mg, 200 mg
  • Oral powder: 75 mg, 150 mg, 300 mg, 400 mg
  • Nutraceutical mixtures (often combined with silybin/milk thistle)

동물용의약품

  • Denosyl (Nutramax): 90 mg, 225 mg, & 425 mg enteric-coated tablets; 225 mg chewable tablets
  • Zentonil (Vetoquinol): 100 mg, 200 mg, and 400 mg tablets
  • Denamarin (Nutramax): Combination product containing SAMe and silybin (silymarin)
  • Denamarin (SAMe + Silybin)
  • Zentonil Advanced
  • Samylin
  • Hepatosyl

인용의약품

  • Various over-the-counter nutritional supplements (tablets/capsules of varying concentrations)
  • Various OTC SAMe dietary supplements (tablets and capsules)

규제 현황

European Union✓ 승인됨EMA
🐕 Dogs🐈 Cats

Classified as GSL (General Sale List) / nutraceutical.

United Kingdom✓ 승인됨VMD
🐕 Dogs🐈 Cats

Classified as GSL (General Sale List) / nutraceutical.

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

보관·안정성

Store at room temperature. Avoid conditions of high temperature or humidity. SAMe is inherently unstable in acidic or aqueous environments; store in tightly sealed, moisture-resistant containers (keep in original blister packs until use).

보호자 정보

반려동물에게 SAMe 투여 시 주의사항

  • ​투여 시간이 매우 중요합니다​: 알약은 ​공복​ 상태에서, 가급적 식사 최소 1시간 전에 투여하십시오. 음식물은 반려동물의 체내 보조제 흡수율을 크게 떨어뜨립니다.
  • ​부수거나 쪼개지 마십시오​: 씹어먹는(츄어블) 형태를 사용하는 것이 아니라면, 장용성 코팅 알약을 부수거나 쪼개지 마십시오. 특수 코팅이 위산으로부터 유효 성분을 보호하여 장에서 제대로 흡수될 수 있도록 돕습니다.
  • ​보관 방법​: 투여하기 직전까지 알약을 원래의 블리스터 포장(알루미늄 포장)에 그대로 보관하십시오. SAMe는 습기와 공기에 매우 민감하여 포장 밖으로 꺼내두면 빠르게 변질됩니다.
  • ​인내심을 가지세요​: 반려동물의 간 혈액 검사 수치가 개선되는 데는 몇 주에서 몇 달이 걸릴 수 있지만, 활력이나 식욕이 좋아지는 것은 더 일찍 관찰될 수 있습니다.

VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.