설파살라진
Sulfasalazine
Salicylazosulfapyridine
다른 이름: Azulfidine EN-tabs · salazosulfapyridine · salicylazosulfapyridine · sulfasalazinum · sulphasalazine · Aculfin · Azulfin · Colo-Pleon · Pleon RA · Pyralin · SAS · Salazopirina · Salazoprin · Salazopyrina · Salazopyrine · Salisulf Gastroprotetto · Salopyrine · Saridine · Sazo · Sulazine · Ulco
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
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
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Inflammatory large bowel disease | 20-40 mg/kg PO q8h for 3 weeks, followed by 20-40 mg/kg q12h for 3 weeks, and 10-20 mg/kg q12h for 3 weeks. | PO | q8h then q12h | 9 weeks | 🌎 NA |
| Inflammatory large bowel disease | 20-48.4 mg/kg (maximum total dose of one gram in refractory patients) PO q8h. | PO | q8h | Minimum 4 weeks | 🌎 NA |
| Chronic colitis | 20-50 mg/kg (up to a maximum of 1 gram) three times daily. | PO | q8h | Variable | 🌎 NA |
| Inflammatory large bowel disease | 10-25 mg/kg PO three times a day for 4-6 weeks. | PO | q8h | 4-6 weeks | 🌎 NA |
| Adjunctive treatment of vasculitis | 20-40 mg/kg PO q8h | PO | q8h | Unspecified | 🌎 NA |
| Adjunctive treatment of vasculitis | 25 mg/kg PO three times a day. | PO | q8h | Unspecified | 🌎 NA |
| All uses (Management of colitis) | 15-30 mg/kg | PO | q8-12h | — | 🌍 EU |
- Inflammatory large bowel disease: May consider an initial dose of 12.5 mg/kg, q8h. After signs resolve, reduce dosage by 25% at 2 week intervals.
- Chronic colitis: Initial dosage usually 20-30 mg/kg TID. Reduce dose at 2-4 week intervals if stool remains normal.
- Inflammatory large bowel disease: With resolution of clinical signs, reduce dose by 25 percent at 2 week intervals.
- All uses (Management of colitis): maximum 6 g/day
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Inflammatory large bowel disease | 10-20 mg/kg PO once daily. | PO | q24h | Unspecified | 🌎 NA |
| Inflammatory large bowel disease | 10-20 mg/kg PO q24 hours (once daily) tapered to the lowest effective dose | PO | q24h | Unspecified | 🌎 NA |
| Inflammatory large bowel disease | 10-20 mg/kg PO q8-12h (maximum of 10 days) | PO | q8-12h | Maximum 10 days | 🌎 NA |
| Inflammatory large bowel disease | 10-20 mg/kg PO q8-24h; up to a maximum of 10 days treatment | PO | q8-24h | Maximum 10 days | 🌎 NA |
| All uses (Management of colitis) | 10-20 mg/kg | PO | q8-12h | — | 🌍 EU |
- Inflammatory large bowel disease: Use cautiously in cats because of their sensitivity to salicylates.
페렛
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| General | 10-20 mg/kg PO 2-3 times a day | PO | q8-12h | Unspecified | 🌎 NA |
| General | 25 mg (total dose) PO twice daily | PO | q12h | Unspecified | 🌎 NA |
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
설파살라진은 아조 결합을 통해 설파제 항생제(설파피리딘)와 살리실산염 항염증제(메살라민 또는 5-ASA)를 결합한 독특한 국소 작용 전구약물입니다.
- 주요 용도: 개와 고양이의 특발성 염증성 장질환(IBD), 특히 형질세포-림프구성 결장염(대장성 설사) 치료의 핵심 약물입니다. 개의 혈관염 보조 치료제로도 사용됩니다.
- 제한점: 활성화를 위해 결장 세균이 필요하므로 소장 질환에는 효과가 없습니다.
- 임상 요점: 결장염에 매우 효과적이지만, 개에서 건성 각결막염(KCS) 또는 "안구건조증"을 유발할 위험이 있어 수의학적 사용 시 주의 깊은 모니터링이 필요합니다. 조기에 발견하지 못하면 비가역적일 수 있습니다. 고양이는 살리실산염에 본질적으로 민감하므로 투여 시 각별한 주의가 필요합니다.
작용 기전
Sulfasalazine acts as a targeted delivery vehicle to transport anti-inflammatory medication directly to the colon.
- Delivery: The intact drug passes mostly unabsorbed (only 10-33% absorbed) through the stomach and small intestine.
- Activation: In the colon, bacterial azoreductase enzymes cleave the diazo bond.
- Mechanism:
- 5-Aminosalicylic Acid (5-ASA / Mesalamine) → Acts locally on the colonic mucosa to inhibit cyclooxygenase (COX) and lipoxygenase (LOX) pathways → Decreases production of pro-inflammatory prostaglandins and leukotrienes. It also acts as a local free radical scavenger.
- Sulfapyridine → Provides local antibacterial effects, though it is rapidly absorbed systemically and is responsible for the majority of the drug's adverse effects (e.g., KCS, hepatotoxicity).
안전성·주의사항
금기사항
- Hypersensitivity to sulfasalazine, sulfonamides, or salicylates
- Intestinal or urinary obstructions
- Doberman pinschers (highly susceptible to sulfonamide-induced polysystemic immune complex disease)
- Dobermanns (appear to be highly sensitive to adverse effects associated with sulfapyridine)
- Patients with known hypersensitivity to sulfonamides or salicylates
부작용
- Keratoconjunctivitis sicca (KCS) in dogs
- Anorexia
- Vomiting
- Cholestatic jaundice
- Hemolytic anemia
- Leukopenia
- Decreased sperm counts
- Allergic dermatitis
주의
Use with caution in animals with preexisting liver, renal, or hematologic diseases.
Feline Warning: Because cats have a deficient glucuronidation pathway, they are highly sensitive to salicylates. Use extreme caution and strict dosing when using this drug in cats.
Use with caution in nursing patients, as sulfonamides are excreted in milk and may cause kernicterus in newborns.
약물 상호작용
Hypoglycemic effects could be potentiated
Sulfasalazine may reduce absorption of digoxin
May decrease the blood levels of sulfasalazine if administered concurrently
Oral absorption of folic acid may be inhibited
Potentially sulfasalazine could potentiate warfarin
Measurement of serum folate concentration may be affected
May cause a reduction in serum thyroxine concentrations
모니터링
- Clinical efficacy (resolution of diarrhea/colitis signs)
- Schirmer tear tests (STT) prior to therapy and on rechecks (especially in middle-aged to older dogs) to monitor for KCS
- Complete Blood Count (CBC) occasionally with chronic therapy
- Liver function tests occasionally with chronic therapy
- Schirmer tear test (STT) periodically
- Clinical signs of KCS (ocular discharge, blepharospasm)
- Liver enzymes (due to risk of cholestatic jaundice)
- Thyroid panel (if on long-term therapy)
약동학
흡수
Only about 10-33% of an orally administered dose is absorbed. The unabsorbed drug is cleaved in the colon. The sulfapyridine component is rapidly absorbed from the colon, but only a small percentage of the 5-ASA is absorbed.
분포
Sulfonamides are excreted in milk and can cross the placenta.
대사
Unabsorbed and biliary excreted drug is cleaved into 5-ASA and sulfapyridine in the colon by bacterial flora. Absorbed sulfapyridine and 5-ASA are hepatically metabolized.
배설
Renally excreted. Some of the initially absorbed intact drug is excreted unchanged in the bile.
과다투여
Massive overdoses could cause significant salicylate and/or sulfonamide toxicity.
- Treatment: Standard protocols for decontamination (empty stomach, cathartics, etc.) should be considered.
- Supportive Care: Urine alkalinization and forced diuresis may be beneficial in selected cases to enhance elimination.
제품
제형
- Delayed-Release Tablets (enteric coated)
- 500 mg tablet
- 250 mg/5 ml oral suspension
인용의약품
- Sulfasalazine Tablets: 500 mg (Azulfidine, generic)
- Sulfasalazine Delayed-Release Tablets: 500 mg (enteric coated) (Azulfidine EN-tabs, generic)
- Salazopyrin 500 mg tablet
- Salazopyrin 250 mg/5 ml oral suspension
규제 현황
Used under the cascade. POM (Prescription Only Medicine).
Used under the prescribing cascade. POM-V.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Tablets (plain or enteric-coated) should be stored at temperatures less than 40°C, preferably at room temperature (15-30°C) in well-closed containers. Oral suspension should be stored at room temperature; avoid freezing.
보호자 정보
중요 경고: 이 약물은 반려견에게 "안구건조증"(건성 각결막염)을 유발할 수 있으며, 방치할 경우 영구적인 실명으로 이어질 수 있습니다.
- 반려동물의 눈을 주의 깊게 관찰하십시오. 눈을 가늘게 뜨거나, 충혈, 끈적한 노란색/녹색 눈곱이 생기거나, 눈이 탁하고 건조해 보이면 즉시 수의사에게 연락하십시오.
- 투여 방법: 위장 장애를 줄이기 위해 음식과 함께 투여하십시오. 장용 코팅 정제를 사용하는 경우 부수거나 쪼개지 마십시오.
- 고양이 주의사항: 고양이는 이 약물에 매우 민감합니다. 수의사의 정확한 복용량 지침을 따르고 처방된 기간을 초과하지 마십시오.
- 부작용: 식욕 부진, 구토 또는 잇몸/눈의 황변(황달)이 나타나는지 관찰하십시오.
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