트라조돈
Trazodone
Trazodone hydrochloride
다른 이름: Desyrel · Oleptro · Molipaxin · AF-1161 · trazodona · sleepeasy · Trazodone hydrochloride · Trazodonum
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 |
|---|---|---|---|---|---|
| Adjunctive treatment of anxiety-related disorders (Daily medication only) | 1.9 mg/kg/day-16.2 mg/kg/day (mean = 7.3 mg/kg/day) | PO | daily | — | 🌎 NA |
| Adjunctive treatment of anxiety-related disorders (As needed only) | 2.2 mg/kg/day- 14 mg/kg/day (mean 7.7 mg/kg/day) | PO | PRN | — | 🌎 NA |
| Adjunctive treatment of anxiety-related disorders (Daily medication and as needed) | 1.7 mg/kg/day-19.5 mg/kg/day (mean 7.25 mg/kg/day) | PO | daily and PRN | — | 🌎 NA |
| Adjunctive treatment of anxiety-related disorders | 1 mg/kg PO q12h for 7 days, then up to 3 mg/kg PO q12h. | PO | q12h | 7 days initially | 🌎 NA |
| Adjunctive treatment of anxiety-related disorders | 1-4.8 mg/kg PO twice daily; (titrate to effect in 1 mg increments every 7 days). | PO | q12h | — | 🌎 NA |
| Adjunctive treatment of anxiety-related disorders (Situational) | typical starting dose between 2-5 mg/kg and adjusting upwards as necessary to get control (maximum dose 14 mg/kg/day). | PO | PRN | — | 🌎 NA |
- Adjunctive treatment of anxiety-related disorders (Daily medication only): Begin at half target dose for 3 days to build tolerance.
- Adjunctive treatment of anxiety-related disorders (Situational): Given about an hour prior to the onset of anxiety.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
트라조돈은 세로토닌 2A 길항제/재흡수 억제제(SARI)로 수의학에서 항불안제 및 가벼운 진정제로 널리 사용됩니다.
- 임상적 유용성: 상황적 불안(예: 뇌우, 불꽃놀이, 동물병원 방문, 여행) 및 수술 후 활동 제한이나 케이지 휴식을 돕는 데 매우 효과적입니다.
- 보조 요법: 난치성 행동 장애를 위해 SSRI(예: 플루옥세틴) 또는 가바펜틴과 자주 병용됩니다.
- 안전성 프로파일: 일반적으로 내약성이 우수하고 안전역이 넓으며, 삼환계 항우울제(TCA)에 비해 항콜린성 부작용이 적고 발작 위험이 낮습니다.
- 인체 용도: 우울증, 공격적 행동, 알코올 또는 코카인 금단 증상, 편두통 예방 및 불면증 치료에 사용됩니다.
작용 기전
Trazodone exerts its anxiolytic and sedative effects through multiple neurochemical pathways:
- Serotonin Reuptake Inhibition: Blocks the serotonin transporter (SERT) → increases extracellular serotonin (5-HT) in the synaptic cleft.
- 5-HT2A Receptor Antagonism: Blocks 5-HT2A receptors → prevents overstimulation by serotonin, contributing to its anxiolytic and antidepressant efficacy. Downregulation of these receptors can augment the efficacy of concurrent SSRIs.
- Active Metabolite: Hepatic metabolism produces m-chlorophenylpiperazine (mCPP), which acts as a direct, non-selective serotonin receptor agonist.
- Alpha-1 Adrenergic Antagonism: Blocks peripheral alpha-1 receptors → can cause mild vasodilation and hypotension.
- Histamine (H1) Antagonism: Weak blockade of H1 receptors contributes to its sedative properties.
안전성·주의사항
금기사항
- Hypersensitivity to trazodone
- Concurrent use of MAO inhibitors (e.g., amitraz, selegiline)
- Glaucoma
- History of seizures
- Urinary retention
- Severe liver disease
부작용
- Sedation
- Lethargy
- Ataxia
- Cardiac conduction disturbances
- Increased anxiety (paradoxical)
- Aggression (paradoxical)
- Vomiting/gagging
- Increased excitement
- Increased appetite
- Colitis
- Serotonin syndrome (rare, usually with concurrent serotonergic drugs)
- Excitability
- Dry mouth
- Third eyelid protrusion (in cats)
주의
Cardiac & Organ Impairment: Use with caution in patients with severe cardiac disease or hepatic or renal impairment. Pregnancy: FDA Category C. Animal studies show adverse effects at very high doses (15-50X). Weigh potential risks versus benefits in pregnant or nursing animals. Serotonin Syndrome: Risk increases significantly when combined with other serotonergic drugs (e.g., SSRIs, MAOIs, TCAs).
약물 상호작용
May increase reductions in blood pressure and cause hypotension
Increase risk for GI bleeding; monitor
May increase trazodone blood levels
Use with trazodone may cause additive CNS depressant effects
Trazodone may increase digoxin levels
May increase trazodone blood levels
Increased risk for serotonin syndrome
Increased risk for GI bleeding; monitor
May increase trazodone blood levels; cause additive CNS effects
Increased risk for serotonin syndrome. Commonly used together, but monitor closely.
Contraindicated; high risk of serotonin syndrome
Metabolized by CYP450 2D6; potential for altered metabolism and toxicity
Metabolized by CYP450 2D6; potential for altered metabolism and toxicity
Increased risk of serotonin syndrome, though adjunctive therapy is sometimes used cautiously
Inhibits the breakdown of trazodone, leading to increased blood levels
Increases the breakdown of trazodone, leading to decreased blood levels
May inhibit the breakdown of trazodone (theoretical risk based on ketoconazole similarity)
모니터링
- Clinical efficacy (behavioral calming)
- Adverse effects (sedation, GI upset, paradoxical excitement)
- Signs of serotonin syndrome (vomiting, diarrhea, seizures, hyperthermia, hyperesthesia, mydriasis)
- Renal function (in patients with pre-existing renal disease)
- Signs of serotonin syndrome (tremors, agitation, hyperthermia)
- Efficacy of anxiety reduction
약동학
흡수
In humans, oral bioavailability of immediate-release tablets is about 65%. Presence of food increases absorption (AUC), decreases Cmax, and delays Tmax.
분포
Approximately 90-95% bound to plasma proteins. Volume of distribution ranges from 0.47-0.84 L/kg (in humans).
대사
Extensive hepatic metabolism. Oxidative cleavage via CYP3A4 forms the active metabolite m-chlorophenylpiperazine (mCCP), which is further metabolized to inactive compounds via CYP2D6.
배설
Mostly (70-75%) excreted via renal mechanisms (only 0.13% unchanged in urine). About 21% is excreted in feces.
과다투여
No specific information is available regarding trazodone overdoses in veterinary patients. In humans, the incidence of serious toxicity from trazodone overdose alone is low compared with tricyclic antidepressant overdoses. In the event of a substantial overdose, contact an animal poison control center for guidance. Monitor for profound sedation, ataxia, hypotension, and signs of serotonin syndrome.
제품
제형
- Oral tablets (immediate-release)
- Oral tablets (extended-release)
- 100 mg tablets
- 150 mg tablets
- 100 mg capsules
- 150 mg capsules
- 10 mg/ml oral liquid
인용의약품
- Trazodone Oral Tablets: 50 mg, 100 mg, 150 mg, & 300 mg; generic; (Rx)
- Trazodone Extended-Release (24-hour) Oral Tablets: 150 mg & 300 mg; Oleptro® (Labopharm); (Rx)
- Desyrel
- Molipaxin
규제 현황
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store between 20-25°C (68-77°F); excursions are permitted to 15-30°C (59-86°F). Keep in an airtight container and protect from light.
보호자 정보
- 투여 방법: 위장 장애(구토 또는 헛구역질 등)를 최소화하기 위해 가급적 음식과 함께 투여하십시오.
- 타이밍: 상황적 불안(예: 동물병원 방문, 불꽃놀이)의 경우, 예상되는 스트레스 상황 1~2시간 전에 투여하십시오.
- 관찰: 반려동물에게 과도한 진정, 무기력 또는 비틀거림(운동 실조)이 나타나는지 관찰하십시오.
- 역설적 반응: 드물게 흥분 증가, 불안 또는 식욕 변화를 보일 수 있습니다.
- 중요 경고: 수의사와 상담 없이 다른 약물이나 보조제(특히 아미트라즈가 포함된 진드기 목걸이)와 병용하지 마십시오. 드물지만 심각한 세로토닌 증후군을 유발할 수 있습니다.
- 의사소통: 개에 대한 트라조돈의 광범위한 사용은 아직 연구 중이므로, 예상치 못한 부작용이 발생하면 수의사에게 보고하십시오.
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