デラコキシブ
デラコキシブ（Deracoxib）は、獣医用に特別に処方された**コキシブ系非ステロイド性抗炎症薬（NSAID）**です。犬の**変形性関節症**に伴う疼痛および炎症の管理、ならびに**術後疼痛**の管理に対してFDAの承認を受けています。 * **臨床のポイント**: ピロキシカムと同様に、膀胱の移行上皮癌（TCC）においてCOX-2が過剰発現するため、デラコキシブは補助療法としての可能性を示しています。 * 嗜好性が高い（チュアブル錠）ため、コンプライアンスは向上しますが、誤飲による過剰摂取のリスクが高まるため保管には注意が必要です。
作用機序: Deracoxib is a **selective COX-2 inhibitor** (coxib). * **Arachidonic Acid Cascade**: It inhibits the **cyclooxygenase-2 (COX-2)** enzyme → decreases the synthesis of pro-inflammatory **prostaglandins** (e.g., PGE2) responsible for pain, inflammation, and fever. * At therapeutic doses, it largely spares **COX-1**, the constitutive enzyme responsible for maintaining normal gastrointestinal mucosal integrity, renal blood flow, and platelet function. * *Note*: COX-2 selectivity is dose-dependent. At higher doses, COX-1 inhibition occurs, increasing the risk of gastrointestinal and renal toxicity.
動物種別の用量
- Control of pain and inflammation associated with osteoarthritis · 1-2 mg/kg PO once a day as needed · PO · q24h · Ongoing
- Treatment of post-operative pain · 3-4 mg/kg PO once a day as needed · PO · q24h · Not to exceed 7 days of therapy at this dosage
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Known hypersensitivity to deracoxib
有害事象
- Vomiting
- Anorexia/weight loss
- Diarrhea
- Melena
- Hematemesis
- Hematochezia
- GI ulceration/perforation
- Azotemia
- Polydipsia/polyuria
- Urinary tract infection (UTI)
- Hematuria
- Urinary incontinence
- Renal failure
- Anemia
- Thrombocytopenia
- Elevated hepatic enzymes
- Changes in total protein
薬物相互作用
- ACE Inhibitors (e.g., enalapril, benazepril) · NSAIDs can reduce effects on blood pressure. Concurrent use may increase the risk for renal injury due to reduced renal blood flow.
- Aspirin · May increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea). A multi-day washout period is warranted when switching.
- Corticosteroids (e.g., prednisone) · May significantly increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea).
- Digoxin · NSAIDs may increase serum levels of digoxin.
- Fluconazole · May increase plasma levels of deracoxib (extrapolated from human celecoxib data).
- Furosemide · NSAIDs may reduce saluretic and diuretic effects.
- Methotrexate · Serious toxicity has occurred when NSAIDs are used concomitantly; use with extreme caution.
- Nephrotoxic Drugs (e.g., aminoglycosides, amphotericin B) · May enhance the risk of developing nephrotoxicity.
- Other NSAIDs · May increase the risk of gastrointestinal toxicity (ulceration, bleeding, vomiting, diarrhea).
モニタリング
- Baseline and periodic CBC and serum chemistry (including BUN/serum creatinine, and liver function assessment)
- Baseline history and physical
- Efficacy of therapy
- Adverse effect monitoring via client
過量投与
Acute toxicity data indicates non-linear elimination occurs in dogs at dosages of 10 mg/kg and above. * **10 mg/kg/day**: No clinically observable adverse effects in a 14-day study, though focal tubular necrosis was seen in 3 of 10 dogs in a 6-month safety study. * **25-100 mg/kg/day**: Dogs survived 10-11 days but showed vomiting and melena. * **Clinical Signs of Overdose**: Vomiting, diarrhea, lethargy, and elevated creatinine. > **Treatment**: Decontamination with emetics and/or activated charcoal is appropriate for acute ingestions. The ASPCA APCC recommends **GI protectants** at acute dosages of 15 mg/kg and above, and **IV fluid diuresis** at dosages of 30 mg/kg and above in healthy dogs. Monitor for GI erosion/ulceration and treat symptomatically.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。