VetSheet

스피로노락톤

Spironolactone

알도스테론 길항제 / 칼륨 보존 이뇨제PO개고양이

다른 이름: Aldactone · Aldactazide · Cardalis · Prilactone · espironolactona · SC-9420 · spirolactone · spironolactonum

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

1-2 mg/kg PO q12hPO· q12h
— 🐕

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 a diuretic in CHF (when furosemide and ACE inhibitors alone do not control fluid accumulation)1-2 mg/kg PO q12hPOq12h—🌎 NA
As a diuretic in CHF (with other diuretics when hypokalemia is an issue)2-4 mg/kg PO once dailyPOq24h—🌎 NA
As a diuretic in CHF (to allow further reduction of furosemide dose)0.5 mg/kg PO once daily to 2 mg/kg twice dailyPOq24h to q12h—🌎 NA
For treating ascites (using fixed dose combination with hydrochlorothiazide)0.5-1 mg/kg PO twice dailyPOq12h—🌎 NA
For treating ascites (caused by right-sided heart failure)1-2 mg/kg PO q12hPOq12h—🌎 NA
For adjunctive treatment of hypertension1-2 mg/kg PO q12hPOq12h—🌎 NA
For adjunctive treatment of hypertension (Step 4 drug)1-2 mg/kg twice dailyPOq12h—🌎 NA
Congestive heart failure, ascites, hyperaldosteronism2-4 mg/kgPOq24hContinuous🌍 EU
  • As a diuretic in CHF (when furosemide and ACE inhibitors alone do not control fluid accumulation): Refractory CHF
  • As a diuretic in CHF (to allow further reduction of furosemide dose): 0.5 mg/kg once daily for aldosterone blockage (weak diuretic effect); 2 mg/kg twice daily for stronger diuretic effect.
  • For treating ascites (using fixed dose combination with hydrochlorothiazide): Empirical dosage based on the spironolactone component of Aldactazide.
  • For treating ascites (caused by right-sided heart failure): Added to optimized furosemide and ACE inhibitor therapy.
  • For adjunctive treatment of hypertension (Step 4 drug): For systolic >160 mmHg, diastolic >120 mmHg after enalapril/benazepril and amlodipine.
  • Congestive heart failure, ascites, hyperaldosteronism: Licensed for use in combination with standard therapy for treatment of CHF caused by valvular regurgitation in dogs.

고양이

적응증용량경로빈도기간지역
As a diuretic in CHF (when furosemide and ACE inhibitors alone do not control fluid accumulation)1-2 mg/kg PO q12hPOq12h—🌎 NA
As a diuretic in CHF (when serum potassium is low)1 mg/kg q12h POPOq12h—🌎 NA
For adjunctive treatment of hypertension1-2 mg/kg PO q12hPOq12h—🌎 NA
For adjunctive treatment of hypertension (Step 3 drug)1-2 mg/kg twice dailyPOq12h—🌎 NA
For adjunctive treatment of primary hyperaldosteronism1-2 mg/kg PO twice dailyPOq12h—🌎 NA
Congestive heart failure, ascites, hyperaldosteronism2-4 mg/kgPOq24hContinuous🌍 EU
  • As a diuretic in CHF (when furosemide and ACE inhibitors alone do not control fluid accumulation): Refractory CHF
  • For adjunctive treatment of hypertension (Step 3 drug): When systolic BP >160 mmHg, diastolic >120 mmHg after amlodipine and ACE inhibitor.
  • For adjunctive treatment of primary hyperaldosteronism: If potassium supplementation alone does not control clinical signs.
  • Congestive heart failure, ascites, hyperaldosteronism: Severe ulcerative facial dermatitis has been reported in Maine Coon cats.

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

진료 중이신가요? VetSheet의 AI가 약물, 용량, 투여 기간을 구조화된 진료 기록에 바로 기입합니다.VetSheet 작동 방식 보기

개요

스피로노락톤은 합성 ​알도스테론 길항제​이자 칼륨 보존 이뇨제입니다. 수의학에서는 주로 울혈성 심부전(CHF), 복수, 전신 고혈압 및 원발성 알도스테론증(특히 고양이)의 보조 치료제로 사용됩니다.

​임상 요점 및 약리학적 배경:​

  • ​알도스테론 회피(Aldosterone Escape):​ 푸로세미드와 같은 루프 이뇨제에 비해 직접적인 이뇨 효과는 약하지만, 레닌-안지오텐신-알도스테론계(RAAS)를 차단하는 데 중요한 역할을 합니다. ACE 억제제를 복용 중인 환자라도 결국 알도스테론 수치가 다시 반등할 수 있는데(알도스테론 회피 현상), 스피로노락톤은 이를 완화합니다.
  • ​심근 보호:​ 인의학에서는 심근의 섬유화를 방지하고 해로운 심장 리모델링을 예방하는 효과로 높이 평가받고 있습니다. 수의학(예: 점액종성 승모판 질환이 있는 개)에서 이 이점의 정도에 대해서는 논란이 있지만, 표준 다제 병용 CHF 프로토콜에 점점 더 많이 포함되고 있습니다.
  • ​생체이용률:​ 음식과 함께 투여할 때 흡수율이 크게 향상됩니다.

작용 기전

Spironolactone acts as a competitive antagonist at the mineralocorticoid receptor.

  • ​Mechanism:​ It competitively inhibits aldosterone binding in the distal renal tubules and collecting ducts.
  • ​Pathway:​ Blockade of the receptor → prevents the synthesis of aldosterone-induced proteins (such as Na+/K+ ATPase and epithelial sodium channels) → decreases sodium and chloride reabsorption while decreasing potassium, ammonium, and phosphate excretion.
  • ​Result:​ Mild diuresis with potassium retention. It does not affect carbonic anhydrase or proximal renal transport mechanisms.

안전성·주의사항

금기사항

  • Hyperkalemia
  • Addison's disease (hypoadrenocorticism)
  • Anuria
  • Acute renal failure
  • Significant renal impairment
  • Hyperkalaemia
  • Hyponatraemia
  • Concurrent use with NSAIDs in animals with renal insufficiency
  • Pregnancy
  • Lactation
  • Animals intended for breeding

부작용

  • Facial dermatitis (notably reported in Maine Coon cats)
  • Hyperkalemia
  • Hyponatremia
  • Dehydration
  • Increased BUN and mild acidosis (in patients with renal impairment)
  • Gastrointestinal distress (vomiting, anorexia)
  • CNS effects (lethargy, ataxia)
  • Endocrine changes (anti-androgenic effects, e.g., gynecomastia in humans, feminization of male fetuses)
  • Hyponatraemia
  • Hyperkalaemia
  • Reversible prostatic atrophy (in entire male dogs)
  • Severe ulcerative facial dermatitis (in Maine Coon cats)
  • Hepatotoxicity (reported in humans)

주의

​Hepatic & Renal Caution:​ Use cautiously in patients with hepatic disease (though often used to treat ascites). Use in patients with renal impairment may lead to hyperkalemia.

​Reproductive Safety:​ FDA Category D for pregnancy. Spironolactone and its active metabolites cross the placenta and can cause feminization of male fetuses. Canrenone (active metabolite) is excreted in breast milk; use with caution in nursing animals.

약물 상호작용

DigoxinModerate

Spironolactone may increase the half-life of digoxin; enhanced monitoring of digoxin serum levels is warranted. May also cause falsely elevated digoxin values if using a radioimmune assay (RIA).

Mitotane

Spironolactone may mute the effects of mitotane if given concurrently; monitor carefully.

Neuromuscular blockers, non-depolarizing

Possible increase in neuromuscular blockade effects.

Potassium-sparing diuretics (e.g., triamterene)

Increased risk of hyperkalemia.

Potassium supplementsMajor

Increased risk of hyperkalemia.

Salicylates (e.g., Aspirin)

Spironolactone's diuretic effects may be decreased if administered concomitantly.

Thiazide diureticsModerate

Potentiates diuretic effects

Loop diureticsModerate

Potentiates diuretic effects

ACE inhibitorsModerate

Increased risk of hyperkalaemia (though generally safe to use concurrently in practice; monitor potassium)

NSAIDsMajor

Increased risk of hyperkalaemia and nephrotoxicity

CiclosporinModerate

Increased risk of hyperkalaemia

모니터링

  • Serum electrolytes (especially potassium and sodium)
  • BUN and creatinine
  • Hydration status
  • Blood pressure (if indicated)
  • Clinical signs of edema/ascites
  • Patient weight
  • Serum potassium
  • Serum sodium
  • Renal function (BUN, Creatinine)
  • Digoxin levels (if used concurrently)

약동학

반감기

개Spironolactone: 1-2 hours; Canrenone (active metabolite): ~20 hours

흡수

In fasted dogs, oral bioavailability is approximately 50%, but increases up to 90% when given with food. In humans, it is >90% bioavailable with peak levels reached within 1-2 hours.

분포

Spironolactone and its active metabolite, canrenone, are both about 98% bound to plasma proteins. Both cross the placenta, and canrenone is detected in breast milk.

대사

Rapidly metabolized to several metabolites, including the active metabolite canrenone, which possesses diuretic activity.

배설

About 70% of a dose is found in the feces and 18% in the urine.

과다투여

Information on acute overdosage of spironolactone in veterinary patients is limited.

  • ​Management:​ Should an acute overdose occur, follow general guidelines for diuretic overdose (e.g., furosemide or chlorothiazide).
  • ​Treatment:​ Empty the stomach if ingestion was recent. Provide supportive care, monitor hydration status, and closely evaluate serum electrolytes (especially potassium and sodium).
  • Contact an animal poison control center for further guidance.

제품

제형

  • Oral tablets
  • Oral suspension (compounded)
  • 10 mg tablet
  • 40 mg tablet
  • 50 mg tablet
  • 80 mg tablet
  • 100 mg tablet
  • Compound preparations with benazepril (e.g., 2.5mg/20mg, 5mg/40mg, 10mg/80mg)

동물용의약품

  • Cardalis (compound with benazepril)
  • Prilactone

인용의약품

  • Spironolactone Oral Tablets: 25 mg, 50 mg & 100 mg; Aldactone® (Searle); generic
  • Spironolactone/Hydrochlorothiazide Oral Tablets: 25 mg/25 mg & 50 mg/50 mg; Aldactazide® (Searle); generic
  • Spironolactone generics

규제 현황

European Union✓ 승인됨처방전의약품EMA
🐕 Dogs

POM-V / POM

United Kingdom✓ 승인됨처방전의약품VMD
🐕 Dogs

POM-V / POM

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

보관·안정성

Store tablets at room temperature in tight, light-resistant containers. An extemporaneously prepared oral suspension using pulverized tablets and cherry syrup is reportedly stable for at least one month when refrigerated.

보호자 정보

  • ​투여 방법:​ 약물이 체내에 흡수되는 비율을 크게 높이므로 ​음식과 함께​ 투여하십시오.
  • ​칼륨 주의사항:​ 이 약은 체내 칼륨 보존을 돕기 때문에 수의사의 특별한 지시가 없는 한 ​반려동물에게 칼륨 보충제를 주거나 고칼륨 식단으로 변경하지 마십시오​.
  • ​수의사에게 연락해야 할 때:​ 반려동물에게 심각하거나 지속적인 구토, 설사, 식욕 부진 또는 극심한 무기력/허약이 나타나면 수의사에게 알리십시오.
  • ​고양이 보호자 참고:​ 일부 고양이(특히 메인쿤)는 이 약을 복용하는 동안 심한 안면 가려움증, 딱지 또는 피부염이 발생할 수 있습니다. 고양이가 얼굴을 과도하게 긁는 것을 발견하면 수의사에게 연락하십시오.

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