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소듐 스티보글루코네이트

Sodium Stibogluconate

Sodium Antimony Gluconate

항리슈만편모충약IVSCIM개

다른 이름: Pentostam · Sodium antimony gluconate · stiboglucat-natrium · natriumstibogluconat-9-wasser · solusurmin · sodio stibogluconato · natrii stibogluconas · Stibogluconate sodium

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

30-50 mg/kg IV or SC dailyIV/SC· q24h· 3-4 weeks
— 🐕

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
Treatment of cutaneous leishmaniasis30-50 mg/kg IV or SC dailyIV/SCq24h3-4 weeks🌎 NA
Treatment of visceral leishmaniasis30-50 mg/kg IV or SC q24hIV/SCq24hone month🌎 NA
  • Treatment of visceral leishmaniasis: Has severe side effects and may not be obtainable in the USA; allopurinol alone is usually used initially.

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개요

소듐 스티보글루코네이트는 개의 리슈만편모충증 치료에 사용되는 5가 안티몬 화합물입니다. 미국에서는 시판되지 않으며 CDC를 통해 공급됩니다. 심각한 부작용의 위험이 있으므로 주의해서 사용해야 합니다.

작용 기전

The exact mechanism of action of sodium stibogluconate remains incompletely elucidated.

  • ​Prodrug Hypothesis:​ It is widely hypothesized to act as a prodrug, where the pentavalent antimony (SbV) is reduced to the more toxic trivalent antimony (SbIII) within the host macrophage or the parasite itself.
  • ​Bioenergetic Disruption:​ It is believed to interfere with the parasite's bioenergetics by reducing ATP and GTP synthesis in susceptible Leishmania amastigotes, ultimately leading to parasite death.

안전성·주의사항

금기사항

  • Pre-existing cardiac arrhythmias
  • Significantly impaired renal function
  • Previous serious adverse reaction to a dose of stibogluconate
  • Severe renal impairment
  • Severe hepatic impairment

부작용

  • Increased AST levels
  • Pain on injection
  • Musculoskeletal pain
  • Hemolytic anemia
  • Leukopenia
  • Vomiting
  • Diarrhea
  • Pancreatitis
  • Myocardial injury and arrhythmias
  • Renal toxicity
  • Shock
  • Sudden death
  • Thrombophlebitis (with IV administration)
  • Nephrotoxicity
  • Hepatotoxicity
  • Injection site pain
  • Lethargy
  • Anorexia
  • Myalgia/Arthralgia
  • Cardiac arrhythmias (rare)

주의

Contraindicated in patients with pre-existing cardiac arrhythmias or significantly impaired renal function.

  • ​Duration Warning:​ The incidence of adverse effects reportedly increases significantly if the drug is administered for longer than 2 months.
  • ​Pregnancy:​ Has not been shown to cause fetal harm, but should be withheld during pregnancy unless the benefits clearly outweigh the risks.
  • ​Nursing:​ Controversial; the manufacturer states it should not be used in nursing mothers, though some human pediatric guidelines consider it compatible.

약물 상호작용

Amphotericin BMajor

Increased risk of nephrotoxicity

AllopurinolMinor

Synergistic antileishmanial effect (often used together clinically)

모니터링

  • CBC
  • Liver enzymes (especially AST)
  • Renal function tests
  • ECG (for myocardial injury/arrhythmias)
  • Bone marrow cultures for Leishmania
  • Clinical efficacy
  • Renal function (BUN, Creatinine, SDMA, Urinalysis)
  • Hepatic enzymes (ALT, AST, ALP)
  • Pancreatic enzymes (cPLI, Lipase)
  • ECG (for arrhythmias)

약동학

반감기

개0.6-1.5 hours

흡수

Well absorbed following intramuscular or subcutaneous injection.

분포

In dogs, steady-state volume of distribution is 0.25 L/kg.

대사

Pentavalent antimony is partially reduced to the more toxic and active trivalent antimony in vivo.

배설

The main route of excretion is via the kidneys; glomerular filtration rate determines the excretion rate. Clearance in dogs is 1.71 L/kg/hr.

과다투여

In the unlikely event of a parenterally administered overdose, it is suggested to immediately contact an animal poison control center.

  • ​Chelation Therapy:​ Potentially, antimony toxicity can be managed by chelating agents such as ​dimercaptosuccinic acid (DMSA)​ or d-penicillamine to enhance excretion.

제품

제형

  • Injection: 100 mg (of antimony)/mL
  • Injectable: 100 mg/ml solution

인용의약품

  • Sodium Stibogluconate (sodium antimony gluconate) 100 mg (of antimony)/mL for injection in 6 mL and 100 mL (Pentostam)
  • Pentostam 100 mg/ml solution for injection

규제 현황

European Union✓ 승인됨처방전의약품EMA
🐕 Dogs

POM (Prescription Only Medicine)

United Kingdom✓ 승인됨처방전의약품VMD
🐕 Dogs

POM (Prescription Only Medicine)

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

보관·안정성

Store at temperatures below 25°C (76°F) and protect from freezing and exposure to light. After removing the first dose, the vial should not be used after one month.

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