Piroxicam
Oxicam derivative
También conocido como: Feldene · Brexidol · CP-16171 · piroxicamum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Adjunctive therapy of transitional cell carcinomas, squamous cell carcinomas, and palliative therapy for other neoplastic diseases | 0.3 mg/kg PO once a day | PO | q24h | — | 🌎 NA |
| Adjunctive therapy of neoplastic diseases (for dogs who tolerate NSAIDs poorly) | 0.3 mg/kg PO once a day. Give with food. Consider adding misoprostol at 3 micrograms/kg, PO q8h | PO | q24h | — | 🌎 NA |
| Adjuvant therapy for splenic hemangiosarcoma (stage II) | 0.3 mg/kg PO every day | PO | q24h | Until disease recurrence/progression | 🌎 NA |
| Transitional cell carcinoma after laser ablation of the primary tumor | 0.3 mg/kg PO once daily | PO | q24h | Remaining life of the dog | 🌎 NA |
| Inhibit local recurrence in dogs with incompletely resected soft tissue sarcomas | 0.3 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Antiinflammatory/analgesic | 0.3 mg/kg PO every other day (q48h) | PO | q48h | — | 🌎 NA |
| Cancer pain | 0.3 mg/kg PO q24-48h | PO | q24-48h | — | 🌎 NA |
| Adjunctive treatment of Idiopathic lymphoplasmacytic rhinitis (LPR) | 0.3 mg/kg PO q24h | PO | q24h | Minimum of 6 months, if not indefinitely | 🌎 NA |
| All uses (e.g., transitional cell carcinoma, prostatic carcinoma) | 0.3 mg/kg | PO | q24-72h | Long-term | 🌍 EU |
| Colorectal polyps/neoplasia | 20 mg/dog | PR | q2-3days | Long-term | 🌍 EU |
- Adjunctive therapy of neoplastic diseases (for dogs who tolerate NSAIDs poorly): Discontinue if severe irritation or ulceration occurs.
- Adjuvant therapy for splenic hemangiosarcoma (stage II): Given with Etoposide and Cyclophosphamide protocols.
- Transitional cell carcinoma after laser ablation of the primary tumor: Given with Mitoxantrone.
- Inhibit local recurrence in dogs with incompletely resected soft tissue sarcomas: Given with cyclophosphamide at 10 mg/m2 PO once daily. Decrease to every other day if unacceptable adverse effects develop.
- Adjunctive treatment of Idiopathic lymphoplasmacytic rhinitis (LPR): Combined with doxycycline or azithromycin.
- All uses (e.g., transitional cell carcinoma, prostatic carcinoma): Start at least frequent administration and slowly increase if no side effects observed.
- Colorectal polyps/neoplasia: Dose equivalent to 0.24-0.4 mg/kg/day. Uses human suppositories.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Adjunctive therapy of transitional cell carcinomas | 0.3 mg/kg PO q24-72h | PO | q24-72h | — | 🌎 NA |
| Adjunctive therapy of transitional cell carcinomas/neoplastic diseases | 0.3 mg/kg PO every 24-48 hours | PO | q24-48h | — | 🌎 NA |
| Cancer pain | 0.3 mg/kg PO q24-48h or 1 mg (total dose) per cat PO q24h | PO | q24-48h | Maximum of 7 days | 🌎 NA |
| Antiinflammatory/analgesic | 1 mg per cat (total dose) PO once daily | PO | q24h | Maximum of 7 days | 🌎 NA |
| Idiopathic chronic rhinosinusitis | 0.3 mg/kg PO once daily or every other day | PO | q24-48h | — | 🌎 NA |
| All uses (e.g., various neoplasms) | 0.3 mg/kg | PO | q24-96h | Long-term | 🌍 EU |
- Adjunctive therapy of transitional cell carcinomas: Gastric protectants may be useful. Use with caution in pre-existing renal disease.
- All uses (e.g., various neoplasms): Start at least frequent administration and slowly increase if no side effects observed.
Pequeños mamíferos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Fracture associated limb swelling (Rabbits) | 0.1-0.2 mg/kg PO q8h | PO | q8h | 3 weeks | 🌎 NA |
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Mucocutaneous squamous cell carcinoma | 80 mg (total dose) PO once daily | PO | q24h | — | 🌎 NA |
| Squamous cell carcinoma of the third eyelid after surgical excision | 80 mg (total dose) PO once daily | PO | q24h | — | 🌎 NA |
- Mucocutaneous squamous cell carcinoma: Dose was eventually reduced to every other day or every third day due to colic signs.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El piroxicam es un fármaco antiinflamatorio no esteroideo (AINE) de la clase de los oxicams. Aunque posee las propiedades estándar de los AINE (antiinflamatorio, analgésico y antipirético), su uso principal en medicina veterinaria es como tratamiento adyuvante para el carcinoma de células transicionales (TCC) de la vejiga en perros, así como para otras neoplasias como los carcinomas de células escamosas y los adenocarcinomas mamarios.
Perla clínica: El piroxicam tiene un índice terapéutico muy estrecho en perros y gatos en comparación con los AINE más nuevos y selectivos de la COX-2. Hoy en día rara vez se utiliza únicamente para el dolor por osteoartritis debido al alto riesgo de ulceración gastrointestinal.
Se utiliza cada vez más en protocolos de quimioterapia metronómica (dosis bajas y continuas) junto con fármacos como la ciclofosfamida para prevenir la recurrencia de sarcomas mediante la inhibición de la angiogénesis y la modulación del sistema inmunológico.
Mecanismo de acción
Like other NSAIDs, piroxicam non-selectively inhibits cyclooxygenase (COX) enzymes, thereby blocking the conversion of arachidonic acid to prostaglandins and thromboxanes. This reduces inflammation and pain.
Its anti-tumor effects are not fully understood but are believed to be indirect. Mechanisms include:
- Inhibition of COX-2 expressed by tumor cells (especially TCC)
- Anti-angiogenesis (preventing new blood vessel formation to the tumor)
- Immune system modulation
- Inhibition of superoxide formation
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to piroxicam, aspirin, or other NSAIDs
- Active or history of gastrointestinal ulcer disease
- Bleeding disorders
- Gastric ulceration
- Renal disease
- Concurrent use of corticosteroids
- Concurrent use of other NSAIDs
- Dehydration (relative contraindication due to renal risk)
Efectos adversos
- Gastrointestinal ulceration and bleeding (melena, hematemesis)
- Vomiting, anorexia, and diarrhea
- Renal papillary necrosis
- Peritonitis (secondary to GI perforation)
- Decreased hematocrit (anecdotal in cats)
- Peripheral edema
- Elevated liver enzymes
- Gastrointestinal toxicity
- Gastric ulceration
- Ulcerative skin lesions (reported in cats)
- Potential precipitation of cardiac failure (known in humans, unknown risk in animals)
Precauciones
Extreme Caution: Use in cats is controversial and must be done with extreme caution due to lack of safety studies and potential for severe GI/renal toxicity. Caution: Use carefully in patients with severely compromised cardiac function due to potential for peripheral edema. The therapeutic window in dogs is very narrow; doses as low as 1 mg/kg daily have caused severe GI ulceration and peritonitis.
Interacciones farmacológicas
Increased risk for nephrotoxicity
Increased risk for bleeding
Decreased piroxicam plasma levels and increased likelihood of GI adverse effects (blood loss); do not use concurrently
May increase risk for GI ulceration
May potentiate the renal toxicity of cisplatin
Significantly increased risk for GI adverse effects and ulceration
May reduce the saluretic and diuretic effects of furosemide
Piroxicam is 99% protein-bound and may displace other drugs, increasing their serum levels and duration of action
Serious toxicity has occurred when used concomitantly; use with extreme caution
Increased risk of severe gastric ulceration and GI toxicity
Increased risk of nephrotoxicity and renal papillary necrosis
Increased risk of nephrotoxicity
Piroxicam is highly protein-bound and may displace other drugs, potentially increasing their free plasma concentrations
Monitorización
- Adverse Effects (particularly GI bleeding: melena, hematemesis, pale mucous membranes)
- Liver function tests (occasionally with chronic use)
- Renal function tests (occasionally with chronic use)
- Renal function (BUN, Creatinine, SDMA, Urinalysis)
- Liver enzymes
- Clinical signs of GI ulceration (vomiting, melena, anorexia)
- Hydration status
- Skin integrity (especially in cats)
Farmacocinética
Vida media
Absorción
Well absorbed from the gut. Food decreases the rate of absorption but not the total amount absorbed. Oral bioavailability is 100% in dogs and ~80% in cats. Peak plasma levels occur around 3 hours post-dosing.
Distribución
Volume of distribution is ~0.3 L/kg in dogs. Highly bound to plasma proteins (99%). Synovial levels are ~40% of plasma levels. Maternal milk concentrations are ~1% of plasma levels.
Metabolismo
Undergoes hepatic biotransformation.
Eliminación
Principally excreted as metabolites in the urine. Total body clearance in dogs is 0.066 L/hour.
Sobredosis
Overdosage can lead to severe gastrointestinal (ulceration, perforation) and renal (papillary necrosis, failure) effects. Dogs may be more sensitive to the ulcerative effects than humans.
Treatment:
- Decontamination with emetics and/or activated charcoal if recent.
- Gastrointestinal protectants (e.g., misoprostol, omeprazole, sucralfate) are strongly warranted.
- Fluid diuresis should be considered to protect renal function.
- Monitor carefully and provide supportive care.
Productos disponibles
Formulaciones
- Oral capsules
- 10 mg capsule
- 20 mg capsule
- 20 mg dissolving tablet
- 20 mg/ml injectable solution
- 20 mg suppository
Etiquetado para humanos
- Piroxicam Oral Capsules: 10 mg & 20 mg; Feldene® (Pfizer); generic
- Brexidol
- Generic Piroxicam capsules, dissolving tablets, suppositories, and injectable solutions
Estado regulador
POM. Human authorized products used off-label under the cascade.
POM. Human authorized products used off-label under the cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Capsules should be stored at temperatures less than 30°C (86°F) in tight, light-resistant containers. Expiration is typically 36 months after manufacture when stored properly.
Información para el cliente
El piroxicam es un medicamento antiinflamatorio potente que se utiliza a menudo para ayudar a tratar ciertos tipos de cáncer en mascotas.
- Administrar con comida: Esto puede ayudar a reducir la posibilidad de malestar estomacal.
- Vigilar la aparición de úlceras estomacales: Suspenda la medicación y contacte a su veterinario inmediatamente si su mascota deja de comer, vomita (especialmente si parece posos de café o contiene sangre) o presenta heces oscuras y alquitranadas.
- No mezclar medicamentos: Nunca administre a su mascota aspirina, otros AINE (como Rimadyl, Metacam) o esteroides (como prednisona) mientras esté tomando piroxicam, a menos que su veterinario lo indique explícitamente.
- Dosificación estricta: No exceda la dosis prescrita, ya que el margen de seguridad de este fármaco es muy estrecho en mascotas.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.